COVID-19: Vaccine/antidote and testing procedures Megathread [Mod Warning - Post #1]

Martina1991 · 25-10-2020 10:49PM

DaSilva wrote: »

False dilemma, I don't think anybody is suggesting using rapid tests at nursing homes instead of RT-PCR. You've been on here before downplaying the usefulness of these tests, however I can't see any logical argument against using rapid antigen tests where the alternative is no testing at all.

My position is these tests haven't been proven to be accurate enough or suitable for the settings people want them to be used.
And I give references to back up my opinion.

DaSilva · 25-10-2020 10:57PM

Martina1991 wrote: »

My position is these tests haven't been proven to be accurate enough or suitable for the settings people want them to be used.
And I give references to back up my opinion.

I get it, you'd rather wait for there to be conclusive evidence that these tests are useful in the specific scenario of nursing homes. What I am saying is that I think their use in addition to the current procedures is unlikely to cause any harm and only likely to help or at worst have no effect.

I think you know there is literature around the idea that rapid less sensitive tests still have a lot of use. The paper you quote also doesn't even say they should not be used, but that other methods are preferable. If we have the capacity to perform PCR on nursing home workers every day and give them same day results, then why not, but if we don't I think use of rapid tests in addition to the current PCR testing is better than the biweekly PCR testing alone.

https://www.nejm.org/doi/full/10.1056/NEJMp2025631

Hmmzis · 25-10-2020 11:05PM

Bentley Bald Tube wrote: »

Researchers Warn of Heightened Risk of HIV With Certain COVID-19 Vaccines (adenovirus type-5 vectored vaccines).

https://www.ajmc.com/view/researchers-warn-of-heightened-risk-of-hiv-with-certain-covid-19-vaccines

Lancet:
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32156-5/fulltext

Just to clarify, that risk is increased for any male who is seropositive for Ad5, regardless if that came from a regular common cold or a viral vector.

mandrake04 · 25-10-2020 11:20PM

Antigen tests do have their place and were really recommended for developing countries who don’t have the resources, although most governments and the regulatory bodies are looking at them as they would have some applications but they are not the silver bullet everyone thinks they are only good if you have an advanced level of virus in your body. Although there needs to be virus present on the swab with PCR at least it has 3-4 day advantage because it’s far more sensitive.

Pre-Covid PCR was used mainly used in the naughty Viral/Bacterial infections, CT/GC, HPV, HSV, Syphilis and other seasonal respiratory infections. It was not designed for time sensitive pandemics but it’s still holding up pretty well despite criticism from retards who know piss all about it ...kinda good entertainment at times tho.

Biggest downside to any covid test is that depending on timeline of infection and the particular patient infection can be missed, leading to a false sense of security.

Some of the IVD companies are looking into developing stuff for the next pandemic, SARS2 has them thinking outside the box now.

Martina1991 · 25-10-2020 11:21PM

DaSilva wrote: »

I get it, you'd rather wait for there to be conclusive evidence that these tests are useful in the specific scenario of nursing homes. What I am saying is that I think their use in addition to the current procedures is unlikely to cause any harm and only likely to help or at worst have no effect.

Rapid tests are poor at detecting the virus in asymptomatic people. So I think they are unsuitable in the scenarios where people think they will be available like airports, restaurants, pubs, festivals etc

If and when a rapid platform is used in Ireland it will be in a point of care setting, preformed by healthcare professionals. They won't be done at home or by teachers in schools.

This is where I think people get carried away when they hear these rapid tests are on the horizon. They won't be used they way people think they will.

WoollyRedHat · 25-10-2020 11:31PM

Martina1991 wrote: »

Rapid tests are poor at detecting the virus in asymptomatic people. So I think they are unsuitable in the scenarios where people think they will be available like airports, restaurants, pubs, festivals etc

If and when a rapid platform is used in Ireland it will be in a point of care setting, preformed by healthcare professionals. They won't be done at home or by teachers in schools.

This is where I think people get carried away when they hear these rapid tests are on the horizon. They won't be used they way people think they will.

Is it not important to detect level of infectiousness though and isolate potential superspreader individuals using these metrics? I read a Nature article that said they could be considered more effective as a test at day 1 and day 7. Countries like Japan have utilized these tests to good effect. Maybe not a silver bullet but perhaps could be used more effectively this way as pool testing and then PCR being used in tandem (use of antigen tests being used only when cases are at a manageable level).

Agree about point about them not being used the way most people think they will though.

Article in Nature here:

https://www.nature.com/articles/d41586-020-02661-2

Martina1991 · 26-10-2020 12:07AM

WoollyRedHat wrote: »

Is it not important to detect level of infectiousness though and isolate potential superspreader individuals using these metrics? I read a Nature article that said they could be considered more effective as a test at day 1 and day 7. Countries like Japan have utilized these tests to good effect. Maybe not a silver bullet but perhaps could be used more effectively this way as pool testing and then PCR being used in tandem (use of antigen tests being used only when cases are at a manageable level).

How do you determine infectiousness in people who are asymptomatic, have a low viral load or from swabs that were taken poorly.

How do you know when day 1 or day 7 is in an asymptomatic person.

How do you find asymptomatic super spreaders when they are significantly likely to produce a negative result with an antigen test

WoollyRedHat · 26-10-2020 12:20AM

Martina1991 wrote: »

How do you determine infectiousness in people who are asymptomatic, have a low viral load or from swabs that were taken poorly.

How do you know when day 1 or day 7 is in an asymptomatic person.

How do you find asymptomatic super spreaders when they are significantly likely to produce a negative result with an antigen test

By using antigen testing against a groupset ,isolate them /PCR test.

Studies have been undertaken that indicate the rate of truly asymptomatic people is actually only at 20 percent. That statistic is key to success of such an approach with effective isolation. If you deploy antigen testing against clusters in first instance and get positives after day 1 you isolate them immediately because of high viral load detectuon and then you deploy wholesale PCR testing against those who produced negative results who may have been infected by highly infectious cohort. The other approach is using antigen tests day 1 and 7, then isolate the remainder if necessary.

Antigen testing on its own won't work granted, and it won't work when community transmission is everywhere but if used on a localized basis it can be effective and have an affect on supressing overdispersion transmission which can cause clusters to form and effectively spread the virus.

Miike · 26-10-2020 12:29AM

Martina1991 wrote: »

My position is these tests haven't been proven to be accurate enough or suitable for the settings people want them to be used.
And I give references to back up my opinion.

mandrake04 wrote: »

Antigen tests do have their place and were really recommended for developing countries who don’t have the resources, although most governments and the regulatory bodies are looking at them as they would have some applications but they are not the silver bullet everyone thinks they are only good if you have an advanced level of virus in your body. Although there needs to be virus present on the swab with PCR at least it has 3-4 day advantage because it’s far more sensitive.

Pre-Covid PCR was used mainly used in the naughty Viral/Bacterial infections, CT/GC, HPV, HSV, Syphilis and other seasonal respiratory infections. It was not designed for time sensitive pandemics but it’s still holding up pretty well despite criticism from retards who know piss all about it ...kinda good entertainment at times tho.

Biggest downside to any covid test is that depending on timeline of infection and the particular patient infection can be missed, leading to a false sense of security.

Some of the IVD companies are looking into developing stuff for the next pandemic, SARS2 has them thinking outside the box now.

Been meaning to ask both of you for some weeks now, I just forgot to PM you

. What do you two make of the BD Veritor+ SARS-CoV-2 platform? IF it comes to fruition POC testing would be a nice stop gap between rRT-PCR testing, obviously baring in the mind the pitfalls of the system. My fear is that within the acute system it would be used inappropriately (as we've seen now even with not detected results being taken as true negative and removing people from isolation - massive case in the media recently) but I think it might have a place in primary care or OPD.

I feel like BD are making big claims with this system. I would love to see them replicated though!

mandrake04 · 26-10-2020 12:49AM

Miike wrote: »

Been meaning to ask both of you for some weeks now, I just forgot to PM you . What do you two make of the BD Veritor+ SARS-CoV-2 platform? IF it comes to fruition POC testing would be a nice stop gap between rRT-PCR testing, obviously baring in the mind the pitfalls of the system.

It’s probably more reliable type of antigen test as it can detect small reactions that might not be visible to the eye, most rapid antigen tests rely on the paper changing colour and some use phone camera/app to detect the change. The POC device is more sensitive to that.

antigen tests are not a complete folly as they are detecting virus ...other rapid tests were testing for enzymes that the body produces when it sick or stressed.

I think like someone above mentions antigen and PCR combination can probably work together and can improve testing somewhat better than it has been, unfortunately due to the nature of the virus this still won’t be enough to return life to somewhat normality unless you take the whole process seriously. You need to corner the virus and test and isolate it to elimination .... and then maintain a low level through surveillance.

Miike · 26-10-2020 12:59AM

mandrake04 wrote: »

It’s probably more reliable type of antigen test as it can detect small reactions that might not be visible to the eye, most rapid antigen tests rely on the paper changing colour and some use phone camera/app to detect the change. The POC device is more sensitive to that.

antigen tests are not a complete folly as they are detecting virus ...other rapid tests were testing for enzymes that the body produces when it sick or stressed.

I think like someone above mentions antigen and PCR combination can probably work together and can improve testing somewhat better than it has been, unfortunately due to the nature of the virus this still won’t be enough to return life to somewhat normality unless you take the whole process seriously. You need to corner the virus and test and isolate it to elimination .... and then maintain a low level through surveillance.

Agree with everything you've said but I'm just thinking as things currently stand our clinics and OPD r/v's are 'blind' bar a screening asking about symptoms. If we could introduce something like the aforementioned BD system on the morning of the appointment it would be an additional layer of protection for staff and other patients. Obviously not bullet proof though

Martina1991 · 26-10-2020 01:14AM

WoollyRedHat wrote: »

By using antigen testing against a groupset ,isolate /PCR test the rest.

If you deploy antigen testing against clusters in first instance and get positives after day 1 you isolate them immediately as they are deemed to have high viral load and then you deploy wholesale PCR testing against those who produced negative results who may have been infected by highly infectious cohort. The other approach is using antigen tests day 1 and 7 then isolate the whole cluster.

What do you mean by groupset, what clusters?
Sports teams maybe in preparation for games, classrooms,certain workplaces.
These tests still require to be carried out by a healthcare professional who would need to be deployed to these settings.
These tests also have a turnaround time of at least 15min. Thats a throughput of 4 tests an hour. You would need a number of devices and people to carry out mass testing for a large group.

Miike wrote: »

Been meaning to ask both of you for some weeks now, I just forgot to PM you . What do you two make of the BD Veritor+ SARS-CoV-2 platform? IF it comes to fruition POC testing would be a nice stop gap between rRT-PCR testing, obviously baring in the mind the pitfalls of the system. My fear is that within the acute system it would be used inappropriately (as we've seen now even with not detected results being taken as true negative and removing people from isolation - massive case in the media recently) but I think it might have a place in primary care or OPD.

I feel like BD are making big claims with this system. I would love to see them replicated though!

I haven't heard of this platform. Looks like another POC device to me. There have been so many produced its hard to know who's legit or looking to make a quick buck, particularly in the States. I don't know if its one HIQA reviewed.

These rapid tests will likely be used in EDs, GP surgeries, maybe pharmacies. These tests should be deployed where they will be useful to patient care.

If a patient recently becomes symptomatic, an antigen test more likely to be clinically useful. No need for PCR test referral, or waiting for result.
-Test positive, treat, isolate, inform close contacts, refer to public health system if necessary
-Test negative, treat patient with antibiotics, steroids, inhaler whatever, based on GP assessment. Restrict movements until symptoms resolve.

Once the virus is suppressed in the community from public health measures, restrictions, and most importantly a vaccine, there should be no need for rapid tests purely for social settings.

mandrake04 · 26-10-2020 01:17AM

Miike wrote: »

Agree with everything you've said but I'm just thinking as things currently stand our clinics and OPD r/v's are 'blind' bar a screening asking about symptoms. If we could introduce something like the aforementioned BD system on the morning of the appointment it would be an additional layer of protection for staff and other patients. Obviously not bullet proof though

Definitely, any POC testing is better than no testing in a clinical setting it’s never going be absolute 100% but good enough.

WoollyRedHat · 26-10-2020 01:27AM

Martina1991 wrote: »

What do you mean by groupset, what clusters?
Sports teams maybe in preparation for games, classrooms,certain workplaces.
These tests still require to be carried out by a healthcare professional who would need to be deployed to these settings.
These tests also have a turnaround time of at least 15min. Thats a throughput of 4 tests an hour. You would need a number of devices and people to carry out mass testing for a large group.

Sorry I may have been thinking of something else when I said groupsets.

My point was that following contract tracing that identified a cluster, people could then be pool tested. If we could find someone that had a high viral load using antigen testing with quick response and deploy PCR testing for those who tested negative and isolate to control potential clusters spreading. This could be particularly useful at airport's, areas you have mentioned and other point of care settings. This strategy has been used elsewhere and can work

I agree that trained Personnel would have to carry out testing, I'm not advocating for untrained people to be involved in testing it clearly would not work for myriad of reasons. In terms of resources needed, this is why I am emphasizing it can only work with cases at a controllable level , not now.

mandrake04 · 26-10-2020 01:56AM

WoollyRedHat wrote: »

Sorry I may have been thinking of something else when I said groupsets.

My point was that following contract tracing that identified a cluster, people could then be pool tested. If we could find someone that had a high viral load using antigen testing with quick response and deploy PCR testing for those who tested negative and isolate to control potential clusters spreading. This could be particularly useful at airport's, areas you have mentioned and other point of care settings. This strategy has been used elsewhere and can work

I agree that trained Personnel would have to carry out testing, I'm not advocating for untrained people to be involved in testing it clearly would not work for myriad of reasons. In terms of resources needed included, this is why I am emphasizing it can only work with cases at a controllable level.

Germany and Austria were using this at their Airports and I wouldn’t say it worked looking at their daily cases.

WoollyRedHat · 26-10-2020 02:02AM

mandrake04 wrote: »

Germany and Austria were using this at their Airports and I wouldn’t say it worked looking at their daily cases.

Did they use it in way described and were they using it just at airports and when their cases were low as a suppression tool?.

ETA: Germany requires proof of a negative test before flight rather than testing on entry to county I would argue that on its own is not enough. If you're going to demand a negative PCR test you need to carry out testing on boarding with isolation until results are available.

mandrake04 · 26-10-2020 02:17AM

WoollyRedHat wrote: »

Did they use it in way described and were they using it just at airports and when their cases were low as a suppression tool?.

ETA: Germany requires proof of a negative test and then that's it, I would argue that on its own is not enough.

I think I read some about Germany using it in Airports, but their case numbers are shyte so it would be hard to know if it worked or not in that scenario.

You said it worked elsewhere can you give examples?

Mark1916 · 26-10-2020 08:49AM

http://reut.rs/35FcUvo

The Oxford-AstraZeneca vaccine has promoted a strong robust immune response in elderly people according to early data seen by the Financial Times.

mandrake04 · 26-10-2020 09:27AM

Mark1916 wrote: »

http://reut.rs/35FcUvo

The Oxford-AstraZeneca vaccine has promoted a strong robust immune response in elderly people according to early data seen by the Financial Times.

Sounds good.

I think this be a better candidate than Pfizer.

manniot2 · 26-10-2020 09:33AM

mandrake04 wrote: »

Sounds good.

I think this be a better candidate than Pfizer.

Staff in the uk told they will start getting it on week commencing 02 nov? That’s next week...horse it out to fook

Gael23 · 26-10-2020 09:34AM

https://www.rte.ie/news/coronavirus/2020/1026/1173930-covid-incidence/

manniot2 · 26-10-2020 09:35AM

Gael23 wrote: »

https://www.rte.ie/news/coronavirus/2020/1026/1173930-covid-incidence/

There is no way the young health care people will take it.

Gael23 · 26-10-2020 09:41AM

manniot2 wrote: »

There is no way the young health care people will take it.

If they know restrictions on their lives will end if they take it maybe?
I won’t be taking it until I see a framework for unwinding of restrictions

Hector Savage · 26-10-2020 09:42AM

manniot2 wrote: »

There is no way the young health care people will take it.

They won't need to (for most), so long as most of vulnerable take it things will improve, at the end of the day lockdowns are all about preventing health service collapsing once that is prevented, they won't give a f*ck about case numbers anymore.

Well if they have sense they won't.

jackboy · 26-10-2020 09:42AM

manniot2 wrote: »

There is no way the young health care people will take it.

It will be given to the vulnerable first. A large proportion of these people are in extremely poor health so if there are any serious safety issues with a new vaccine we will know very fast.

manniot2 · 26-10-2020 09:45AM

Gael23 wrote: »

If they know restrictions on their lives will end if they take it maybe?
I won’t be taking it until I see a framework for unwinding of restrictions

I agree they will use bribery to get compliance in taking it. But those working in health care may be less affected by this than others (can still work etc) so they mightn’t be as easy to bribe

manniot2 · 26-10-2020 09:46AM

jackboy wrote: »

It will be given to the vulnerable first. A large proportion of these people are in extremely poor health so if there are any serious safety issues with a new vaccine we will know very fast.

I thought it went to health care front liners first? That’s what is happening in the UK anyway

jackboy · 26-10-2020 09:50AM

manniot2 wrote: »

I thought it went to health care front liners first? That’s what is happening in the UK anyway

Surely there won’t be a large gap between HCW’s and the vulnerable been given it. Especially if there is large scale resistance to the vaccine from nurses (which is highly likely).

Gael23 · 26-10-2020 09:51AM

jackboy wrote: »

Surely there won’t be a large gap between HCW’s and the vulnerable been given it. Especially if there is large scale resistance to the vaccine from nurses (which is highly likely).

Will all depend on what supply is available I suppose

manniot2 · 26-10-2020 09:55AM

jackboy wrote: »

Surely there won’t be a large gap between HCW’s and the vulnerable been given it. Especially if there is large scale resistance to the vaccine from nurses (which is highly likely).

I think we will get a far clearer of picture of what the medical community really think about this virus when this vaccine comes out and none of them think it’s worth the risk in taking it

COVID-19: Vaccine/antidote and testing procedures Megathread [Mod Warning - Post #1]

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