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Germany is relatively well-equipped.
Very much higher testing rates, and 2 to 3 times the acute beds compared to much of the rest of Europe, including the UK.
I doubt if their medics are short of PPE.
Sweden is a test case of fairly relaxed restrictions, that may or may not prove wise. If they included a strong recommendation for the public to wear a mask in any situation of social proximity, I think they might do OK.
https://www.cnbc.com/2020/03/30/sweden-coronavirus-approach-is-very-different-from-the-rest-of-europe.html
In the UK, if you develop mild symptoms indicative of infection, you are supposed to self-isolate, not go to your doctor, not go to hospital, and not even contact the the NHS helpline, unless your symptoms worsen. Your household is supposed to self-quarantine, but you won't be issued a mask, and nobody in your household will be issued a mask.
You won't be tested, and you won't be part of the statistics.
Unless and until you become seriously ill.
Hard to believe really.
NB. On just checking, you are now advised to contact the NHS helpline. This must have changed in the last day or two.
As to what advice or assistance you get, I have no idea.
Testing numbers are slowly ratcheting up in the US and UK, but it is rather late in the day now.
Pretty much yes.
Very regrettably, the US and UK refuse to learn lessons from Asian countries, particularly S Korea, where there is no lockdown but everyone wears a mask, testing is widespread and available to anyone, re-purposed drugs are used and deaths have dropped to a relatively small trickle.
https://www.bloomberg.com/news/articles/2020-03-31/hospitals-tell-doctors-they-ll-be-fired-if-they-talk-to-press
I've not heard much about the potential of tonic water, though it has synergistic properties with gin, but clinical trials are lacking in that regard...
But yes, enough to suggest daily C, D, and Zinc just might put you in a better position generally, and specifically if you contract the virus, but then you might be at risk of a cytokine storm and need a quick shot of Tocilizumab to damp down IL6!
G+T with two lemon slices 3 times a day definitely has therapeutic potential.
The Life Sciences Division Malik is the NWBO Malik, right?
That's what I've always thought.
Same London office address as Advent have (or had).
There is always the possibility that some of the Sawston untapped capacity could be used for manufacture of a prophylactic vaccine, as opposed to a therapeutic vaccine, if UK authorities want to expedite things.
Not a prediction, just a horizon possibility.
Maybe he wasn't impressed with the Ford Pinto he was given as company car.
Actually. Thinking about it; maybe NWBO should carry out a full stock inventory of the secret sauce cupboard..
Well, JR. This can be read in several ways.
Some will suggest that he joined NWBO on a research mission, made his findings and then returned to his former employer.
That could be a plus or a minus for NWBO, depending on whether they were in on the idea or not.
Or he could have decided he made a wrong career move.
Or another reason altogether.
Kind of unusual to leave a BP, go to a small bio and then go back to the same BP in a relatively short time period, I would suggest.
Unlike you, I won't make any conclusion in any direction, other than acknowledge it as interesting!
Good spot though!
LC.
The next 5 mins of this addresses the questions you ask:-
Then he has probably been given the best chance.
Sorry to hear that.
I won't attempt to offer uninformed advice, beyond asking the question about whether he has been offered the chance to receive chloroquine for its anti-viral qualities, and / or azithromycin (which may decrease the chance of death from corona-related pneumonia).
That is what I would be asking the medics, though things appear late in the day from what you indicate.
Right on GGB.
Sounds like Mr Yost knows how to handle an intransigent FDA, who, as you say, are bent on protecting corporate profits.
And even Trump, whose off the cuff rhetoric generally belongs in the baloney category, had a lucky hit with his comments on chloroquine (once in twenty p = 0.05), though he was incorrect to describe it as approved for Coronavirus when he spoke.
Though now it is!
Just my opinion (though it might be shared by at least a few others).
Oh, gawd...
I'm experiencing TSF.
Depends somewhat on how you define 'sick'.
Do you start the clock from the date of infection (which is rarely accurately known)?
Or the day of first symptoms?
Or the day of positive test?
Or the day when symptoms become acute?
Or when and if the patient develops pneumonia and / or ARD?
Or the day when the patient is deemed critically ill?
Plus, of course, most patients who become 'sick' don't die or even become acutely ill.
(Especially, it increasingly appears, if they are offered treatment with hydroxychloroquine and arithromycin early in the symptom cycle, which is likely to prevent the pneumonia and ARD developing in the first place.)
I'm no medic but from what I've read, time from first noted symptoms to disease resolution (which only rarely means death), is normally 2-4 weeks.
Hi brother, guess big news will be announced by 18 April, after "interesting ", the SP may be two digits
"Italy Finally Starts Mass Treatment with Hydroxychloroquine"
Doctors in Italy have finally began widely prescribing hydroxychloroquine in certain combinations in Rome and the wider region of Lazio with a population of around six million.
According to Corriere della Sera, a well known Italian daily newspaper, Dr. Pier Luigi Bartoletti, Deputy National Secretary of the Italian Federation of General Practitioners, explains that every single person with Covid-19 that has early signs, like a cough or a fever for example, is now being treated with the anti-malaria drug.
The drug “is already giving good results,” Bartoletti says while Malaysia reveals they have been using it since the very beginning. Bartoletti further adds that the drug:
“Must be used with all the necessary precautions, it must be evaluated patient by patient. It can have side effects. But those that take it are responding really well.
We have just understood that the virus has an evolution in two phases and that it is during the second phase, after a few days (about a week), that the situation can suddenly, in 24 or 48 hours, worsen and leads to respiratory failure requiring intensive care.
The results that we are starting to accumulate suggest that hydroxychloroquine administered early, gives the possibility of avoiding this evolution in a majority of patients and is also helping us to prevent hospitals from filling up.”
Incredible. What is more incredible are the statements of Professor Christian Perronne, Head of the Infectious Diseases Department at the Garches University Hospital, made in an interview with a French weekly magazine.
Referring to the European Discovery trial in which UK is taking part with only 800 patients, Perronne says:
“I refused to participate because this study provides for a group of severely ill patients who will only be treated symptomatically and will serve as control witnesses against four other groups who will receive antivirals. It is not ethically acceptable to me.
We could perfectly well, in the situation we are in, evaluate these treatments by applying a different protocol. In addition, the hydroxychloroquine group (which was added to this study at the last minute), should be replaced by a hydroxychloroquine group plus azithromycin, the current reference treatment according to the most recent data.
Finally, the protocol model chosen will not provide results for several weeks. Meanwhile, the epidemic is galloping. We are in a hurry, we are at war, we need quick assessments.”
America is to start yet another study which is to take one month even while one thousand people or more are dying worldwide today. In Italy however doctors are finally not waiting anymore with Perronne saying:
“Even though the overwhelming evidence from large randomized studies is still lacking, I am in favor of a broad prescription for the following reasons:
1. We have a large body of evidence showing that in vitro hydroxychloroquine blocks the virus. We also have several clinical results indicating that this product is beneficial if administered early and we have no mention that it harms or is dangerous in this infection (only one study, poorly detailed, Chinese, on 30 patients with control group, did not observe any benefits but also no harmful effects). What is the risk of administering chloroquine straight away: nothing!
2. This drug is very inexpensive 3. It is well tolerated in long-term treatment. Personally, I have successfully used it clinically in the chronic form of Lyme disease for 30 years at a dose of 200 mg or even 400 mg/day.
I and hundreds of other doctors are able to judge its excellent tolerance in humans. The main contraindications are severe retinal and unbalanced heart disease.
Cardiovascular events remain exceptional if care is taken: to proscribe self-medication – to check with the elderly taking a lot of drugs that there are no drug interactions (with long-term diuretics in particular) and that the rate of blood potassium is within the norm.
Apart from these precautions, the undesirable effects are minor. They are even more so as the treatment is short, which is the case against Covid-19.
It would therefore be wise to produce hydroxychloroquine in very large quantities without further delay, to make it easily accessible to infected people…
I note that Italy has just authorized the wide distribution of hydroxychloroquine on medical prescription from the start of the infection and that other countries are preparing to do the same. What are we waiting for? To have more dead?”
Incredibly the doctor says in regards to this European study for which we have to wait six weeks (and as a note all these quotes are from a rough translation):
“There will be nothing to hope from this study concerning hydroxychloroquine is administered too late. The protocol indicates that the product can be given only if the oxygen saturation of patients is less than 95%, that is to say patients with a massive oxygen supply or who must be put on artificial ventilation. This is not the right indication.”
As the doctor said above, treatment needs to be given early to stop the second phase from kicking in as that is what is causing hospitalization and in some cases even death.
Quite interestingly, now that they have began treatment, Corriere della Sera has just tweeted: “Contagions in decline in Lombardy.”
So hopefully UK, US and other countries will now learn from Italy and get this early treatment out there before deaths reach Italy levels or even more for USA as they will if people are not treated, but with early treatment this should be contained as in South Korea and many other countries where they have been giving early treatment from nearly the very beginning.
We understand these are challenging times, and patients may be worried, but we are doing everything we can to continue to ensure patient safety.
Chloroquine and hydroxychloroquine are not licensed to treat COVID-19 related symptoms or prevent infection.
Clinical trials are ongoing to test chloroquine and hydroxychloroquine as an agent in the treatment of COVID-19 or to prevent COVID-19 infection. These clinical trials are still not completed, so no conclusions have been reached on the safety and effectiveness of this medicine to treat or prevent COVID-19.
Until we have clear, definitive evidence these treatments are safe and effective for the treatment of COVID-19, they should only be used for this purpose within a clinical trial.
If I was in Spain or Italy, I'd like to know if chloroquine is being used, and if not why not.
Their death rate is scarily high compared to other countries.
All sympathy to you, Captain.
Yes indeed, abc.
I don't know if you watched the YT video of the Professor from S Korea, but it appears from the intro shots of that video that ordinary citizens are still able to walk the streets, and even queue for testing, but (or maybe because) they are all wearing masks.
Hi abc.
Hope I didn't sound like I was shooting the messenger previously!
Yes, I see the Beeb are repeating this.
If they had said 'up to a possible maximum of 406', it would have been more reasonable, I guess.
The time of quickest transmission in Europe would have been at the end of Jan, when most countries began reporting their first cases, and when little or no real personal precautions were being taken. And we are now 2 months in. 406 x 406 is 164,836. And a further month would take it to nearly 67m. About the entire population of the UK.
So I maintain that it's an inflated figure.
But having said that, the social distancing / self isolation requirements are definitely required.
So perhaps the figures should be taken as 'worst case scenario' to highlight what we are up against. Which is your 'sharp shock' point.
And they do highlight the difference that restrictions can potentially make, even if the social distancing figures really are a pretty rough estimate, given that different countries have introduced different levels of restriction.
On lockdown in the UK, people still go to food shops, they still go out for exercise. Essential workers still come and go each day, so transmission will still occur, and so will incubation periods.
On recreation; it's a difficult one. In densely populated areas, where do people go? They have to use the pavement, and small parks bring a lot of people together. I still maintain that driving in your car to a spacious area of recreation, where you can easily keep your distance, is not in itself irresponsible, but it's not really in line with current guidance, and not everybody has that option anyway.
One difference in the Far East is that it is widely accepted that you should always wear a face mask when out, and it's very much the norm.
In Europe, we were told that a face mask basically wasn't a good idea, wasn't necessary, and didn't offer much protection.
Not really true at all.
It may have been the case that the authorities wanted at all costs to reserve available masks for essential workers; medics and those providing personal care to seniors.
And that is perfectly understandable and acceptable.
But the value of face masks is still being downplayed outside of Asia. Obviously scarves and home-made affairs don't offer the same level of two-way protection, but if they protect against airborn droplets entering the mouth and noise, then they basically work.
I think in the UK if they had a spare 50m facemasks in a warehouse somewhere that they could make available, the UK govt would recommend their widespread use. But they haven't.
And frontline medics must have guaranteed availability of masks.
I really do recommend this video, which is an interview with a S Korean Professor of Infectious diseases, who has to be one of the most eminent experts in the field right now. He has 30 yrs experience in the field leading his countries response to a series of viral epidemics.
And as much as any country can, S Korea has got it taped.
He goes into a lot of detail about how the virus is transmitted, testing protocols, mortality rates, vulnerability by age, and how S Korea has responded, and his view about possible pandemic outcomes.
Regards.
Sorry ABC, but, imo, this amounts to misinformation.
No sources quoted.
Seems to completely disregard incubation period.
There is no consensus on whether an individual is contagious during the incubation period. There is no full consensus on the incubation period itself.
The '1 person infects 2.5' is an estimate based on very imperfect data.
And the social distancing model of 1.25 is just a complete shot in the dark.
How is the 'social distancing' defined?
Answer; it isn't.
I simply do not believe that with sensible hygiene behaviour, but without mass social distancing, that 1 infected individual will lead to 406 infected individuals a month later.
In fact, I think it can be demonstrated to be mathematically almost impossible.
That is simply misinformation, imo.
And my hackles rise when I see emotive words used such as 'slashed' used, when nobody can accurately quantify how all the varying degrees of social distancing actually limit viral transmission.
And I'm always suspicious of little stickmen comparative diagrams, which seem to me to be aimed at promulgating things that are not factually accurate to a gullible audience.
In fact it reminds me of a certain stick diagram on the Optune site (which was a load of baloney).
I would love to know who put this out.
He's got him off to a tee!
Hi JJ. Sincerely hope you are finding adequate ways to cope with the confinement.
It's not my intention to downplay the scale of the pandemic, and I'm certainly not complacent about the true level of threat that the virus represents.
But when countries are looking to enter a recovery phase (and most countries are far from there yet), it should only be done from as fully an informed position as possible. And this requires an estimation of population virus penetration, based on active fact-finding, which requires much wider testing, imo.
If indeed the death rate was a constant, you would expect to see a similar rate across countries.
Which we are just not seeing. There are lots of apparent anomalies in the country by country reporting, of course, which will have multiple possible explanations. Under-reporting, inaccurate reporting, different levels of acute beds / ICU, different drugs being used, different availability of medical professionals, possibly different strains of the virus.
But how can you have anything approaching a uniform death rate, when Germany has 53,000 confirmed cases and 400 deaths, giving a mortality rate of less than 1%, when the corresponding rate for Italy and Spain is between 9 and 11%. Part of the explanation may be that Germany is also testing those with very mild symptoms whereas Italy and Spain may only be able to currently test those with acute symptoms.
There simply isn't a uniform mortality rate, imo.
And any quoted figure (even by the WHO) is really no more than estimate, which is based on inadequate data.
I don't think contact tracing in itself, while laudable just because of the work involved, actually tells you much about the underlying rate of infection in the wider population, especially when the virus is widely abroad, as it were. Because by that time you would be contact tracing much of the population anyway, which would become logistically impossible. If there is a population of largely asymptomatic untested individuals who can pass the virus around while they are infectious, to others who may also be asymptomatic, or indeed may be in a vulnerable category, then it would be as well to know that.
'Given that the asymptomatic % has been measured in the 20-30% range that's very unlikely to be the case.'
The asymptomatic 'infectees' go very largely untested (unless in a country with damn good contact tracing), so how is a 20-30% rate arrived at?
My point is that once a country starts a nationwide restriction on contact and movement, such as is current in the UK (and an even stricter one in Italy and, I imagine, Spain), it is a drastic step with profound consequences, some more obvious than others. The imperative, therefore, is to relax restrictions as soon as possible. But you should only relax the restrictions, if that time of greatest restriction has been used to provide as much information about underlying rates of infection, rates of asymptomatic infection, transmission rates, geographical spread, and so on. And for that, I believe much wider testing, beyond just those who are acutely ill, is necessary. As a minimum that would include those with mild symptoms suggesting possible infection, and those who request testing even if they are without symptoms. That might include those caring for a vulnerable relative, who have obvious reason to want to know.
Drive-through testing stations are surely possible by this stage.
If this information (which is basically about collection of factual data to enable accurate modelling), is not gathered, then restrictions may remain in place longer than is necessary, or be relaxed prematurely.
No. CDC has it all backwards.
the best way of measuring the infection rate is indirectly through the death rate as it's quite hard to miss.
So in Spain we easily have at least half a million already infected even if the official number is what 72,000. You can infer that from the deaths and number of serious/critical active cases multiplied by (1/0.02). They're only testing you here if you have all the symptoms and are in a bad shape.
Well, as the economy quietly melts week by week, and the Coronavirus crisis is gradually replaced by a mental health crisis, due to the imposition of prolonged isolation (or being stuck indoors with 3 young kids), and the recreational parks introduce one way systems, so that the citizens can take their daily exercise by marching round like automatons, exactly 2 metres apart, with Orwellian thought police looking on, the question will eventually be asked as to whether the 'cure' is worse than the disease!
What is your cost average?
You don't have to answer.
I have to say, that in the UK at least, the infection rate is a complete unknown.
The official advice, if you are experiencing mild symptoms that could be indicative of a Coronavirus infection, is that you stay at home, self-isolate, don't go to your GP, don't go to the hospital, and don't call NHS 111.
Therefore you will not be tested, unless your symptoms become more serious, and you call 111.
Even then, are all such callers tested?
I doubt it very much.
And if you are infected but asymptomatic, you won't know your infected, you won't seek medical advice or attention, and you won't know if you are likely to pass the infection on.
Under-18's are widely reported to generally show no outward symptoms, but that does not mean that none are infected or infectious.
So how can the infection rate be monitored?
Under current policy, it can't.
Thus there is no way of knowing what is the relationship between confirmed active cases, and the underlying infection rate in the wider population. The underlying infection rate could be 5x known cases, it could be 10x, it could be 100x...
Ad if you don't know the wider infection rate, then you cannot possibly know the mortality rate of the virus.
Thus any government decrees about how the public should behave (staying at home basically) are predicated on ignorance of the infection rate and the mortality rate and the transmission rate.
Why was Boris tested if he had only minor symptoms, when ordinary members of the public won't be?
Wider testing is a must, including mass sample testing of different regions and locations, if the authorities are to get a better handle on this situation.
Not too many hopefully, else unadjudicated PFS is buggered.
I have if JR hasn't..
The process is the product and cannot be accurately replicated without access to the IP.
Any competitor with an autologous 'bio-similar' would have to trudge a decade-long road, and would then probably still fail.
Umibe. Just by way of chewing the cud while I'm domestically confined, I thought I'd make a comment or two.
NWBO has a legitimate concern on P-value particularly as it pertains to separation between the cross-over/placebo and Tx arms OS.
This is particularly noteworthy and when coupled with the extremely flexible FDA guidelines might permit approval for recurrent GBM as well which is a large market in and of itself.
It should be noted that the FDA did NOT require NWBO to have a cross-over arm.
There have been extensive discussions with the FDA on all this. The FDA did provide comments with respect to NWBO's SAP.
NWBO deals with these foregoing issues rather extensively in its SAP upon which the FDA has provided its comments.
The FDA guidelines and, indeed, relatively recent approvals demonstrate a paradigm shift in the way that regulatory agencies view novel therapies and should go about evaluating and approving them. NWBO's trial will be a treasure trove of data and the most extensive of any GBM trial.
Look for more dilution so Linda can get paid.
Good grief. You don’t shut down the worlds greatest economy because of your feelings. You quarantine the vulnerable and get them the vaccine/ treatments first.
Sharpie.
Plenty of worse posts today..
No comment.
I wish he got better holiday entitlement.
'Twas actually a reference to their line of work.
NWBO is somewhere half way between a lottery ticket and a Premium Bond.
Stick it in a drawer and forget about it.