Countdown until we turn the corner on COVID-19.

[Scooter]

I just have a BSCE, MBA.

If I need to know how to build a bridge, you'll be my first call.

But for epidemiological projections I'll rely on someone who isn't talking out of his ass.

[Lord Jim]

We already know the models aren't reliable.

I'll tell you what has proven to be absolutely "unreliable"...

All the misleading, dishonest, talking-out-the ass happy talk "it's all under control" clams about this that came from Il Boobce and his lackeys and sycophants for nearly two months while the POS-In-Chief dithered and blundered...

The most outrageous and disgusting assertion during yesterday's My Pillow infomercial was Fearful Leader comparing the appalling 100k-200k possible death toll to the 1.6 million to 2.2 million that would have died if absolutely nothing had been done, (apparently he likes that model) and claiming this somehow means his "actions" have resulted in "saving over a million lives"...

Sorry Don Boy, it don't work that way...

The proper bar to use will be to compare the ultimate death toll to what the death toll would have been had you taken swift and timely action, going back to January, rather than wallowing in lies and denials and refusing to face reality...

The difference between those two numbers will constitute the amount of blood you have on your hands...

[Darren]

I just have a BSCE, MBA.

If I need to know how to build a bridge, you'll be my first call.

But for epidemiological projections I'll rely on someone who isn't talking out of his ass.

You get an "Atta boy!" for not mistaking the BSCE for computer engineering. You get an "Aw shit." for not understanding immuniopathology.

[Scooter]

I'll call a vet when I need someone to tend my sick goat. Otherwise...

[Darren]

I'll call a vet when I need someone to tend my sick goat. Otherwise...

Vet school, in the past, was tougher to get into than med school. Doc, my girl friend, thought about going for an MD after her PhD. Texas A&M in that era wasn't about to let a woman get three terminal degrees.

Even the nursing school about shit themselves over the prospect of accepting a PhD into the program. They figured she knew more than the instructors in many areas and would be a disruption. She never was.

The class found out she had a PhD when they saw her tassel and gown at graduation. That's when they realized why the grading curve was blown out.

Based on her description of performing splenectomies on cattle, especially the knot tying, she's an excellent surgeon.

[Scooter]

Very laudable.

Now, care to link to all the numerous papers she has published on epidemiological modelling of coronaviruses in humans?




















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Then perhaps the two of you should stay in your lane, and leave the critique of matters beyond your knowledge and experience to the experts.

[Scooter]

Another fearmonger and naysayer?

Coronavirus could travel 27 feet, stay in air for hours: MIT researcher

Social-distancing guidelines to stay 6 feet from others may be woefully inadequate, one scientist warns — saying the coronavirus can travel 27 feet and linger for hours.

MIT associate professor Lydia Bourouiba, who has researched the dynamics of coughs and sneezes for years, warns in newly published research that the current guidelines are based on outdated models from the 1930s.

Rather than the assumed safety of 6 feet, Bourouiba warns that “pathogen-bearing droplets of all sizes can travel 23 to 27 feet.”

Her research, published in the Journal of the American Medical Association, also warns that “droplets that settle along the trajectory can contaminate surfaces” — and “residues or droplet nuclei” may “stay suspended in the air for hours.”

She notes a 2020 report from China that showed that “virus particles could be found in the ventilation systems in hospital rooms of patients with COVID-19.”

Bourouiba fears that the current guidelines are “overly simplified” and “may limit the effectiveness of the proposed interventions” against the deadly pandemic.

She says it is particularly urgent for health care workers who, she argues in her report, face an “underappreciated potential exposure range” while treating the sick and dying.

“There’s an urgency in revising the guidelines currently being given by the [World Health Organization] and the [Centers for Disease Control and Prevention] on the needs for protective equipment, particularly for the frontline health care workers,” Bourouiba told USA Today.

The World Health Organization — which suggests 3 feet is enough to remain safe — told USA Today it “welcomed” studies.

“WHO carefully monitors emerging evidence about this critical topic and will update this scientific brief as more information becomes available,” WHO said in a statement to the paper.

[BoSoxGal]

I saw that article a couple of days ago and it left me pretty unsettled. And I had just been lambasted on our community Facebook page for suggesting that folks should actually be following the distancing guidelines rather than chucking them for meetups with other families in the neighborhood (oh it’s okay we’re outside) and shouldn’t be walking 3 feet behind strangers on the nature footpaths and thus breathing in all the spores they’ve just exhaled during rigorous exercise.


I don’t pretend to be an expert, I’m just someone who completed most of a zoology degree before changing tracks and still recalls microbiology and immunology from then and basic common sense of health hygiene taught to me by my mum from the time I could walk. I’m really flabbergasted how much seemingly intelligent people are struggling with this.

[Scooter]

The proper bar to use will be to compare the ultimate death toll to what the death toll would have been had you taken swift and timely action, going back to January, rather than wallowing in lies and denials and refusing to face reality...

[Lord Jim]

Man there sure was a lot of fearmongering and naysaying being presented at the White House briefing today...

Who would have guessed that the White House Coronavirus Task Force would be working so hard to support the unjustified fears being created by the press, just to hurt Donald Trump...

Don't they know that if they weren't reporting all these horrendously negative facts (811 deaths nationwide today) we'd be ready to reopen the country by now?

Remember, it's not all the lack of preparation and the failure to act quickly in an organized way with a national response, and the misinformation that came from the highest levels that is responsible for these nightmare death rates...

It's reporting about these failures that are killing people...

Damn that murderous press!

[Joe Guy]

I thought it was very informative when Trump mentioned today that he thinks his impeachment was illegal. It made me worry a little bit less about that pesky virus that's killing people all over the world.

[BoSoxGal]

wow here's some reputable potentially great news!

Scientists around the world have been racing to develop treatments, cures and a vaccine for Covid-19, and are getting closer by the day.

Jacob Glanville - one of the stars of Netflix documentary Pandemic - runs Distributed Bio, which has been working to find an antibody therapy.

On Monday he tweeted that a development was imminent.

"I'm happy to report that my team has successfully taken five antibodies that back in 2002 were determined to bind and neutralise, block and stop the SARS virus," Dr Glanville told Checkpoint.

"We've evolved them in our laboratory, so now they very vigorously block and stop the SARS-CoV-2 [Covid-19] virus as well.

"This makes them suitable medicines that one could use once they've gone through human testing to treat the virus," Dr Glanville said.

"The new virus is a cousin of the old SARS. So what we've done is we've created hundreds of millions of versions of those antibodies, we've mutated them a bit, and in that pool of mutated versions, we found versions that cross them over.

"So now we know they bind on the same spot as the new virus, Covid-19.

"It binds the spot that the virus uses to gain entry into your cells. It blocks that.

"At this point we know it binds the same spot extremely tightly with high affinity. The next step is we send the antibodies to the military, and they will directly put those on the virus and show that it blocks its ability to infect cells."

Dr Glanville told Checkpoint the military deals with the virus itself as he does not want Covid-19 or SARS in his laboratory.

"The other nice thing about it is you want the stamp of approval of a government military to independently test your work. This is one of the foundations of good science.

"Antibodies are attractive because you can give them to a patient right when they're in the hospital like an antiviral. You can also give them to doctors, you could give them to the elderly people to prevent them from getting sick."

There are a couple of groups around the world who have been working on developing antibodies, he said.

"Part of the reason we think we're moving pretty fast is that instead of starting from scratch discovering an antibody, we went to these existing antibodies that were already extremely well characterised against SARS. And we've adapted them. So we're piggybacking on two years of research.

"It's sort of like a short-term vaccine, except it works immediately.

"A vaccine could take six to eight weeks to take effect, where this will take effect within 20 minutes. You could give it to a patient who's sick, experiencing Covid-19, then within 20 minutes of receiving the shot, their body is flooded with those antibodies.

"Those antibodies will surround and stick all over a virus and make it so it's no longer infectious."

The disadvantage compared to a vaccine is that a vaccine might give you a year or multiple years of protection, Dr Glanville said. Antibodies will only give protection for eight to 10 weeks.

The military will test the antibodies against Covid-19, and another laboratory will start tests to make sure the medicine is safe for humans.

If those are successful, production of the antibodies have to be scaled up.

"We use very exacting manufacturing standards called GMP for making a medicine, and that can take multiple months," Dr Glanville said.

"Once that material is ready we go into a human trial. That's a ... trial where you give it to a series of 400 to 600 people who are in hospitals experiencing symptoms, and then you watch over the next five to 10 days to see whether it helped or not."

He said he and his colleagues are doing everything they can to speed up the process, but it does take time.

"We have saved potentially years of research by piggybacking on the SARS antibodies and our technology is very good at engineering these things to cross and we've succeeded in doing that.

"The next step, the big-time consuming part, is the GMP manufacturer. Traditionally, that takes nine to 12 months, obviously, we can't wait that long. So we've worked with two different partners to try to accelerate that to take a few months but that does take time and there's really no way around."

"Assuming that we're able to complete our study, at the end of summer… and it looks good, then we would use something called compassionate use.

"This is was used in the Ebola crisis. And it's been used in other cases where if you have something that's effective, and there's no other good medicine, you can begin releasing it to the world for use prior to going through all the approval process.

"That could be as early as September. Unfortunately, that's also as far away as September.

"So that's as fast as we can conceive of having this medicine widely available."

He told Checkpoint it is essential for his laboratory that everyone gains access to the medicine.

He said they are talking to the European Commission and there is interest in Asia.

"My feeling is that we should also in anticipation that that study looks good… we should start scaling up a lot more doses, hundreds of thousands to millions for the next step."

https://www.rnz.co.nz/national/programm ... id-19-cure

[ex-khobar Andy]

GMP (Good Manufacturing Practice) is a set of criteria which drug (and other) manufacturers are supposed to follow in order to ensure that there is a consistent high quality of dosage, safety (lack of adulterants) and efficacy in the product which goes out to consumers. Different countries have different standards which makes it a little tougher when you are trying to sell a product internationally but there is a lot of overlap and these days of ISO a lot of it is second nature to responsible manufacturers anyway.

I don't think that GMP per se should really be a time sink. The need for a quick resolution should drive this bus and some standards of accuracy are pointless. For example. Aspirin for general heart health is often in 81 mg tabs. That number 81 makes it sound as if there has been a huge effort to find the best dose and they decided on 81 as better than 80 or 82. Not really. The standard full strength aspirin on the market is 325 mg and 81 is just a quarter dose. 325 / 4 = 81.25 . So it's almost arbitrary. There are manufacturers of this stuff who are obliged to jump through hoops to ensure that the dose in their final product is 81.00 mg and not 81.05 (or some similar acceptability range) when (a) the original number is arbitrary anyway and (b) the weight of the patients varies hugely (no pun intended) so the blood concentration could differ by a factor of 2 or more depending whether it's me or my wife who gets the dose. So if someone forgot to check the seventh decimal place on a balance when the criterion being measured is not good even to one significant figure, it should not be grounds for rejecting the manufacturing process. That's my GMP rant which I have expressed often.

40 years ago, I worked for a major US drug manufacturing company in London. For one drug we made there was something like a nine stage procedure from raw material to final product. We sold the drug worldwide so FDA came over every six months (IIRC) to verify that we were doing it properly. So at stage six of the process Intermediate Compound V was processed into Intermediate VI. FDA rules were that VI had to contain less than 0.5% V before it went to the stage 7 reactors. My job in the lab was to test VI to see what the V content was using whatever tools we had (normally HPLC for those taking notes). FDA wanted to see my notes: how was the balance calibrated? How did we test the raw materials? When did we last do a wavelength check on the IR? Had I read (and documented that I had read) the relevant SOP? Had the boss signed off on my training? Minute detail checks, and if a signature was missing the batch was not acceptable. This misses the point that the 0.5% was somewhat arbitrary; and if the production guys had done a good job there was less than 0.01% V in VI and if they had screwed up (got the temperature wrong) there was 5% V in VI.

[This was a 24/7 operation so sometimes I was in the uncomfortable position of phoning the shift manager at 330 AM on a Sunday to tell him that I was going to fail his batch. Depending who the SM was, his (it was always a he) reaction varied from "OK thanks" to "You're out of your fucking mind pal I've been doing this for 20 years and I've never had a batch fail" so it was a learning experience.]

[Second divergence. I once asked one of the more tractable shift managers: what happens to the batches that fail? His response: "Don't ask!" Essentially if it was close it could be reworked: some procedure to get it down to < 0.5%. Recrystallization or whatever. If it was obviously unsalvageable it might be trashed. If it was 5%, ship the final product anywhere but America. FDA guys didn't give a shit about a batch of drug going to Somalia while the Somalis assume that FDA is giving the process their seal of approval.]

[Burning Petard]

Another nay-sayer checks in. I am not so quick to agree that sending stuff to a military lab is the proper way to get satisfactory results. My son was banned for life from participating in blood donation programs because he was given an anthrax vaccine while in the Navy. At the time there were suspicions about this particular vaccine, but the military used it anyway. I worked for 39 years in a research/mfg facility that was regulated under the GMP. The rules seemed to me to be just a minimal level of common sense.

snailgate.

[Scooter]

Contrary to the naysayers and fearmongers the USNS Comfort is in New York City.

"March 30 (UPI) -- The Navy hospital ship USNS Comfort arrived in New York City on Monday to relieve the strain on city hospitals overwhelmed by the COVID-19 pandemic.

Thus far the endeavour has been a colossal joke, like any other Trumpian move, all show and no substance.

The 1,000-Bed Comfort Was Supposed to Aid New York. It Has 20 Patients.

Such were the expectations for the Navy hospital ship U.S.N.S. Comfort that when it chugged into New York Harbor this week, throngs of people, momentarily forgetting the strictures of social distancing, crammed together along Manhattan’s west side to catch a glimpse.

On Thursday, though, the huge white vessel, which officials had promised would bring succor to a city on the brink, sat mostly empty, infuriating executives at local hospitals. The ship’s 1,000 beds are largely unused, its 1,200-member crew mostly idle.

Only 20 patients had been transferred to the ship, officials said, even as New York hospitals struggled to find space for the thousands infected with the coronavirus. Another Navy hospital ship, the U.S.N.S. Mercy, docked in Los Angeles, has had a total of 15 patients, officials said.

“If I’m blunt about it, it’s a joke,” said Michael Dowling, the head of Northwell Health, New York’s largest hospital system. “Everyone can say, ‘Thank you for putting up these wonderful places and opening up these cavernous halls.’ But we’re in a crisis here, we’re in a battlefield.”

The Comfort was sent to New York to relieve pressure on city hospitals by treating people with ailments other than Covid-19, the illness caused by the coronavirus.

President Trump left a nine-day sequester in the White House last week to travel to Norfolk, Va., to personally see off the ship as it set sail for New York, saying it would play a “critical role.” The ship’s arrival on Monday was cheered as one of the few bright moments in a grim time for the city.

But the reality has been different. A tangle of military protocols and bureaucratic hurdles has prevented the Comfort from accepting many patients at all.

On top of its strict rules preventing people infected with the virus from coming on board, the Navy is also refusing to treat a host of other conditions. Guidelines disseminated to hospitals included a list of 49 medical conditions that would exclude a patient from admittance to the ship.

Ambulances cannot take patients directly to the Comfort; they must first deliver patients to a city hospital for a lengthy evaluation — including a test for the virus — and then pick them up again for transport to the ship.

At a morning briefing on Thursday, officials said three patients had been moved to the Comfort. After The New York Times published an article with that number, Elizabeth Baker, a spokeswoman for the Navy, said the number had increased to 20 by late in the day. “We’re bringing them on as fast as we can bring them on,” she said.

The next day, on Friday, Ms. Baker said the Comfort would begin screening patients for the coronavirus on site by taking their temperature and giving them a short questionnaire, to relieve the burden on hospitals.

Hospital leaders said they had been exasperated by the delays.

Mr. Dowling said he has had to tear his hospitals apart, retrofitting any unused space, including lobbies and conference rooms, into hospital wards. His facilities now house 2,800 so-called Covid patients, up from 100 on March 20, he said. About 25 percent of those are in serious conditions in intensive care units.

Across the city, hospitals are overrun. Patients have died in hallways before they could even be hooked up to one of the few available ventilators in New York. Doctors and nurses, who have had to use the same protective gear again and again, are getting sick. So many people are dying that the city is running low on body bags.

At the same time, there is not a high volume of noncoronavirus patients. Because most New Yorkers have isolated themselves in their homes, there are fewer injuries from car accidents, gun shots and construction accidents that would require an emergency room visit.

Ultimately, Mr. Dowling and others said, if the Comfort refuses to take Covid patients, there are few patients to send. And given the pernicious spread of the disease in New York City, where nearly 50,000 were infected as of Thursday, dividing patients into those who have it and those who do not is pointless, he said.

The solution, he and others said, was to open the Comfort to patients with Covid-19.

“It’s pretty ridiculous,” he said. “If you’re not going to help us with the people we need help with, what’s the purpose?”

Asked about Mr. Dowling’s criticisms, the Defense Department referred to Mr. Trump’s statements about the Comfort at his daily briefing. The president said only that the ship was not accepting patients with the coronavirus.

Late Thursday, Governor Andrew M. Cuomo of New York reached an agreement with Mr. Trump to bring Covid patients to the Javits Convention Center in Manhattan, another alternative site operated by the military, with 2,500 hospital beds.

“I asked President Trump this morning to consider the request and the urgency of the matter, and the President has just informed me that he granted New York’s request,” Mr. Cuomo said in a statement.

There was no word about doing the same with the U.S.N.S. Comfort.

Capt. Patrick Amersbach, the commanding officer of the medical personnel aboard the Comfort, said at a news conference that, for now, his orders were to accept only patients who had tested negative for the virus. If ordered to accept coronavirus patients, he said, the ship could be reconfigured to make that happen.

“If our mission shifts, we do what we can to meet that mission,” he said.

From the outset, readying the hospital ship for use in a pandemic proved a challenge. The Comfort was built to operate in battlefield conditions, and its physicians accustomed to treating young, otherwise healthy soldiers suffering from injuries related to gunshots and bomb blasts. Most people who are hospitalized with Covid-19 are older and infected with a novel pathogen that even the world’s top medical researchers do not fully understand.

Any outbreak on board could quickly spread and disable the ship’s operations. As a precaution, the ship’s crew isolated for two weeks before embarking on their mission to New York. They must remain onboard for the duration of their mission in New York.

The ship has struggled to fulfill civilian missions in the past. After Hurricane Maria pummeled Puerto Rico in 2017, the Comfort was sent to relieve overextended hospitals, but ended up treating only a handful of patients each day.

A military physician who had previously served on the Navy’s hospital ships said in an interview that conditions on board were suitable for soldiers, but, with its narrow bunked cots instead of modern hospital beds, it was not ideal for treating civilians.

Though military physicians are accustomed to battlefield situations, they are well-trained, and should be able to handle strains of the pandemic if ordered to treat patients with the coronavirus, he said.

“As military doctors,” he said, “they would absolutely do their best.”

[BoSoxGal]

I'd like to know what are those 49 conditions? Google isn't finding the list.

I'm sure a major issue is that the bunk beds are designed and sized for fit, regular sized patients - think cots in a M.A.S.H. unit. Healthy but battle wounded looks very different from overweight, obese, morbidly obese, chronically ill, limited mobility, etc. which is, sadly, a very great many Americans including, I'm sure, New Yorker Americans.

[Darren]

I'd like to know what are those 49 conditions? Google isn't finding the list.

I'm sure a major issue is that the bunk beds are designed and sized for fit, regular sized patients - think cots in a M.A.S.H. unit. Healthy but battle wounded looks very different from overweight, obese, morbidly obese, chronically ill, limited mobility, etc. which is, sadly, a very great many Americans including, I'm sure, New Yorker Americans.

My guess would be any condition that excludes a patient that may infect the ship. I doubt the ship is set up to quarantine patients except in very small numbers if at all.

I was at a VA in the L shaped ER in the aisle that ran around the inner area for the physicians' and nurses' work area. I wasn't thrilled to see and hear several doctors questioning a patient in the adjacent room about where he had been recently.

[Scooter]

My guess would be any condition that excludes a patient that may infect the ship. I doubt the ship is set up to quarantine patients except in very small numbers if at all.

Then what is left for them to do, remove splinters?

It would have been a much better use of resources to assign all of the medical personnel from the ship to relieve civilian hospitals and staff whatever satellite sites they might establish, rather than displaying abject uselessness by wasting 1200 staff to care for 20 patients.

[Bicycle Bill]

Trump's next press conference:  "See that big white ship with the red crosses on it in the harbor?  I – me, your m⃥e⃥r⃥c⃥i⃥f⃥u⃥l⃥ ⃥a⃥n⃥d⃥ ⃥b⃥e⃥n⃥e⃥v⃥o⃥l⃥e⃥n⃥t⃥ ⃥k⃥i⃥n⃥g⃥  president — sent that!!  Dammitall, don't try to say that I'm not doing something!"

-"BB"-

[Darren]

My guess would be any condition that excludes a patient that may infect the ship. I doubt the ship is set up to quarantine patients except in very small numbers if at all.

Then what is left for them to do, remove splinters?

It would have been a much better use of resources to assign all of the medical personnel from the ship to relieve civilian hospitals and staff whatever satellite sites they might establish, rather than displaying abject uselessness by wasting 1200 staff to care for 20 patients.

They should be able to handle anything not virus related such as strokes, heart attacks, accident victims, births, etc. and perform tests including cat scans, MRIs, X-rays, blood panels, etc.