Innovation Pharmaceuticals Inc (IPIX)

[KMBJN]

Thanks for sharing the talk. Speaking of false positives and Yeardon, I guess there was a controversial court decision in Portugal which challenged state enforced quarantine based on travelers who tested positive by PCR.

https://www.theportugalnews.com/news/2020-11-27/covid-pcr-test-reliability-doubtful-portugal-judges/56962

“The proportion of samples that were no longer able to infect cells maintained in culture in the laboratory increased with the increase in the number of cycles required to obtain a positive signal. This is because after our body controls the infection there are fragments of the virus's genetic material that persist and decrease over days, when the individual no longer poses a danger to others, ”explains Vasco Barreto. Conclusions like these have helped health authorities in different countries to reduce mandatory quarantine periods for those infected and to dispense with a negative test to “discharge” a patient.

The controversial ruling claimed that the PCR test was unreliable with a Ct of 35, with only 3% true positive at that high cycle threshold of PCR amplification. It cited this study:

https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa1491/5912603

It can be observed that at Ct = 25, up to 70% of patients remain positive in culture and that at Ct = 30 this value drops to 20%. At Ct = 35, the value we used to report a positive result for PCR, <3% of cultures are positive.

There is a lot to be learned about the quality of PCR testing if high Cts are used, especially whether or not someone is infectious if they have a low viral load (high Ct), or is the positive "false" in the sense of no active disease, just dead viral fragments that are harmless to the infected and those they come into contact with.

Some of the ID doctors I've talked to feel that if one can't culture a virus it likely isn't infectious. (Except that some viruses are known to be very hard to culture, and this general rule doesn't apply).

In general, I think officials are bringing down the duration of required quarantine from 14 days. It's really amazing how many different "rules" people have for quarantine, travel, what is a low risk versus high risk exposure, and how all the rules have changed over time, including at my health care facility.

Kids seem to get mild versions of Covid (if any symptoms) and I hear they don't seem to spread it as much as others, either.

In any event, it's good to be careful as long as people aren't being harmed by it. Can't wait for that brilacidin trial to start. Hopefully it will enroll quickly. Once again it will be hard to maintain the blind (as before for ABSSSI) since IV-brilacidin causes temporary tingling in the extremities.