Various interviewees estimated the that the coronavirus tests they are familiar with are 75%, 85% or 100% accurate: Demetre Daskalakis, deputy commissioner for the division of disease control of the New York City Department of Health and Mental Hygiene, said he recently told a patient with mild symptoms who sought a test and received a negative result…

Janet Woodcock has spent most of the last 20 years as the head of FDA’s Center for Drugs.  Most of that time, while China and India took over the manufacturing of most of the world’s drugs, her head has been buried in the sand.  From FiercePharma: “As the spread of COVID-19 threatens to disrupt pharma…

This WaPo piece provides further evidence that the government is well aware this virus transmits via the airborne route.  As a result, indoor air that is shared with those infected (who may be asymptomatic or presymptomatic) carries risk of infection.  You don’t need to have someone cough on you.  Breathing infected air is enough to…

Unbelievable.  4 years ago, the FDA gave contractor Battelle half a million dollars to study the use of commercial decontamination equipment, using hydrogen peroxide gas, on N95 masks.  Battelle said the method worked in 2016.  But we are only just hearing about it, as thousands of healthcare workers get infected due, in part, to lack…

Here, the WaPo goes into the tawdry story of how DHHS’ Preparedness group and BARDA got prototypes for a machine to produce reusable N95 masks, then dropped the ball despite their $1.5B yearly funding for ‘preparedness.’ From  the NY Times: Few in the protective equipment industry are surprised by the shortages, because they’ve been predicted for…

Nature Medicine ran a 3 page article that claimed to explain why the novel coronavirus is not a lab construct.  USA Today wrote a summary piece explaining it: “If someone were seeking to engineer a new coronavirus as a pathogen, they would have constructed it from the backbone of a virus known to cause illness,”…

There is a huge disconnect between the personal protective equipment (PPE) healthcare workers (HCWs) should be wearing to protect themselves from coronavirus, and what actually exists right now for them to use.  The White House has told the governors to find their own supplies.  The equipment market is in chaos.  CDC is now telling HCWs to make their own…

From STAT, a report of an online meeting between Johns Hopkins infectious disease doctors and doctors from Zhejiang, one of China’s top medical schools, who had responded to the COVID-19 epidemic:  …We want to work together with you to help fight Covid-19, Wang told the Americans as the hourlong meeting began. Their first question: If…

FiercePharma on other drugs being considered for Covid-19: Other than remdesivir and chloroquine, researchers and physicians are also looking at other existing drugs to treat COVID-19. These include AbbVie’s HIV combo therapy Kaletra (Aluvia), which just failed a clinical study in China in critically ill patients. Chinese authorities, which have been dealing with the virus longer, are…

A view of gloves and boots used by medical staff, drying in the sun, at a center for victims of the Ebola virus in Guekedou.   Nitrile or latex gloves can be rewashed and reused.  Soap and water.  Hang to dry.   Face shields and goggles can be rewashed and reused–avoid bleach solutions which cloud…

This is a preliminary report from a Scottish doctor, and may turn out to be wrong later.  He has analyzed data from Italy on deaths, and concluded that those patients on ACE inhibitors or ARBs (which target ACE receptors, which are also used by coronavirus) had significantly higher death rates. Because coronavirus disease is currently…

Newest on a chloroquine drug trial, to start 3/24:  New York State is about to begin testing drugs for treatment of coronavirus, Gov. Cuomo said Sunday.  The feds have given the state 70,000 doses of hydroxychloroquine, 10,000 doses of zithromax and 750,000 doses of chloroquine. Testing will kick off Tuesday, Cuomo said.  “The president is…

Here’s the story. Oddly, the WHO was initially going to omit studying the cheapest drugs, chloroquine and hydroxychloroquine, despite support for them by Chinese doctors here and here and French doctors.  But now both have been added to WHO’s mega COVID-19 trial.

Handbook of COVID-19 Prevention and Treatment–a 68 page guide Zhejiang University School of Medicine Thanks to Jack Ma/ Alibaba for the web creation and English translation of the Chinese guidelines found to be most useful in clinical care of COVID-19!

“The Food and Drug Administration late Friday approved the first coronavirus test that can be conducted entirely at the point of care for a patient — and deliver results in 45 minutes. The FDA granted “emergency use authorization” to Cepheid, a California company that makes a rapid molecular test for the coronavirus. The turnaround time for Cepheid’s…

A Medscape Commentary by John Medrola, MD “I have to remind the American doctor that life is changing.… It’s not a normal life. It’s a #COVID19 life. It’s a pandemic life.” With these words, spoken March 18, during a joint webinar of the Chinese Cardiac Society and the American College of Cardiology, Professor Bin Cao, MD, from China, jolted…

Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open label non-randomized clinical trial 20 patients were treated, 16 patients (unmatched, nonrandomized) were controls, 6 treated patients lost to followup, in some cases due to worsening Update:  on March 25, India banned the export of hydroxychloroquine.  And has approved its use prophylactically: “The…

This paper is designed to help readers understand the new corona virus and why it has inevitably led to the quarantine measures currently imposed.  I will refer to the virus as the COVID-19 virus, as does the W.H.O., instead of using the official, but confusing, name SARS-CoV-2. The official name of the disease is COVID-19. Historical…

From STAT: “NIAID virologist Vincent Munster and his colleagues used a nebulizer — a device that creates an aerosol from liquids — to release samples into the air of both the new coronavirus and the one that caused the SARS outbreak in the early 2000s. They reported detecting viable virus 
in aerosols for up to three hours….

Eric Feigl-Ding@DrEricDing Europe and US are mostly all on the same path. Note log Y-axis (linear=exponential; steeper line is more exponential). Japan also has limited testing. Only SK, Singapore and HK have it under control or improving. #COVID19 Twitter Ads info and privacy

https://www.statnews.com/2020/03/10/simple-math-alarming-answers-covid-19/ Medical staff wait outside rooms at the Red Cross hospital in Wuhan, China.AFP VIA GETTY IMAGES Much of the current discourse on — and dismissal of — the Covid-19 outbreak focuses on comparisons of the total case load and total deaths with those caused by seasonal influenza. But these comparisons can be deceiving, especially in the…

https://www.ad.nl/dossier-coronavirus/40-a-50-nederlandse-coronapatienten-op-intensive-cares-meer-dan-de-helft-is-onder-de-vijftig~a058aad2/?utm_source=twitter&utm_medium=social&utm_campaign=socialsharing_web Today there are between forty and fifty corona patients in critical condition on Dutch intensive care units. “More than half of those patients are under fifty years old. There are also young people. “” That says chairman of the Dutch Association for Intensive Care (NVIC) Diederik Gommers, in an interview with this site.  Marcia Nieuwenhuis 03/14/20, 9:23…

http://www.cidrap.umn.edu/news-perspective/2020/03/study-highlights-ease-spread-covid-19-viruses?fbclid=IwAR1hJyLkXMqXzrRlmjgshJI0Qyc8jUjT6S7EJB2Eqk-u9BCeBkTnI5MSSOU COVID-19 can be spread before it causes symptoms, when it produces symptoms like those of the common cold, and as many as 12 days after recovery, according to a virologic analysis of nine infected patients published today on the preprint server medRxiv. Also, in a study published in today’s Annals of Internal Medicine, researchers at Johns Hopkins found a median…

https://www.journalofhospitalinfection.com/article/S0195-6701(20)30046-3/pdf–a great compilation of the world literature on decontaminating coronavirus in the environment. What has worked well to kill other coronaviruses on surfaces? Bleach (sodium hypochlorite) 0.21% dilution on a surface for one minute.  Different bottles of bleach have different concentrations, so calculate your dilution accordingly. Hydrogen peroxide 0.5% dilution for one minute Alcohol 70%…

https://www.seattletimes.com/seattle-news/health/short-staffed-and-undersupplied-coronavirus-crisis-strains-seattle-areas-capacity-to-deliver-care/

Number of specimens tested for SARS-CoV-2 by CDC labs (N=3,995) and U.S. public health laboratories* (N=15,749)†

The scope of this epidemic does not fit all the data we have been given. The Rzero number has to be greater than 2.2, much greater, to get so many cases so quickly in Wuhan and Lombardy, if the earliest case occurred in November-December, and the doubling time of the epidemic is 6 days.  The…

https://www.forbes.com/sites/alexknapp/2020/03/13/coronavirus-drug-update-the-latest-info-on-pharmaceutical-treatments-and-vaccines/#49181a7e21db Expect to see ASO3 or related adjuvant from GSK in experimental Coronavirus vaccines: GSK has previously developed a pandemic vaccine adjuvant platform, a system that helps to improve vaccines by strengthening the immune response in patients who receive it. In February, the company announced it was partnering with the Coalition for Epidemic Preparedness Innovations to use that platform…

https://thehill.com/policy/healthcare/487329-ohio-health-official-estimates-100000-people-in-state-have-coronavirus A top health official in Ohio estimated on Thursday that more than 100,000 people in the state have coronavirus, a shockingly high number that underscores the limited testing so far. Ohio Department of Health Director Amy Acton said at a press conference alongside Gov. Mike DeWine (R) that given that the virus is spreading in the community in Ohio, she…

https://www.reuters.com/article/us-health-coronavirus-vaccines-insight/as-pressure-for-coronavirus-vaccine-mounts-scientists-debate-risks-of-accelerated-testing-idUSKBN20Y1GZ?               CHICAGO (Reuters) – Drugmakers are working as quickly as possible to develop a vaccine to combat the rapidly spreading coronavirus that has infected more than 100,000 people worldwide.  Behind the scenes, scientists and medical experts are concerned that rushing a vaccine could end up worsening the infection in some…

https://assets.documentcloud.org/documents/6796908/Seattle-Times-Coronavirus-Fact-Sheet.pdf

https://www.statnews.com/2020/03/11/flattening-curve-coronavirus/ While this idea at first seems geeky or counter-intuitive, the intent is to reduce the speed of transmission so the healthcare system does not get overwhelmed, and more time is gained to develop drugs, herbs, traditional Chinese medicines, vaccines for Coronavirus.  While the epidemic will last longer if the “curve is flattened”, we might…

The new coronavirus spreads readily, like flu or cold viruses, but is much more likely to affect family members of someone already infected than others.  We Americans are not very good at protecting ourselves from cold and flu viruses.  Maybe we can learn some strategies that will help us avoid Covid-19, as well as helping…

The chart above is from ZeroHedge

Johns Hopkins is keeping track of COVID-19 cases internationally, in real time, here. There have been 51,171 recovered cases and 3,254 deceased, for a 6% mortality rate.  This number should drop, I hope considerably, as we begin to identify more asymptomatic or mildly symptomatic cases. Update 3/16/20:  Chinese mortality estimate is around 5.8%. One hopeful…

1.  Diagnostic information.  Describe the specific features of the disease in the US (symptoms and signs) so doctors will be able to clinically distinguish most COVID-19 cases from other respiratory infections like colds, influenza, pneumonias, allowing them to isolate, quarantine, treat respiratory infections more sensibly.  CDC and NIH say they will publish articles on this…

The most recent summary on the D/P/T vaccine was published by CDC in the MMWR of April 2018: https://www.cdc.gov/mmwr/volumes/67/rr/pdfs/rr6702a1-H.pdf There are graphs in the MMWR article showing how cases of all three diseases covered by the vaccine have changed over time. These graphs show that there are almost no tetanus or diphtheria cases in the…

At this time, it appears that COVID-19 can spread by droplet, aerosol, fomites (objects) and through intestinal secretions. The incubation period, it seems, may be up to 14 days.  Or much longer.  People who recover may still be able to spread virus–this is unclear (it depends on their viral load) but adds another problem to…