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Dr. Angela Rasmussen proslijedio/la je Tweet
‘An ounce of prevention is worth a pound of cure.’ We need more research funding to understand, treat, and prevent pandemic threats like coronavirus. Call your House and Senate representatives. (202)224-3121https://www.nytimes.com/2020/02/03/business/economy/SARS-coronavirus-economic-impact-china.html …
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Dr. Angela Rasmussen proslijedio/la je Tweet
Made this
of confirmed cases(CC) of #2019_nCoV#2019nCoV in mainland China vs the rest of the world for 5-day interval:29Jan-3Feb (BHL: SIN-SYD-SIN-EWR). China’s cases more than doubled (>17,205), CFR remains consistently at 2%. Global breakdown sans China also given. 1/n
pic.twitter.com/K7FDvnLFIx
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Dr. Angela Rasmussen proslijedio/la je Tweet
If you really want to get into the nuts and bolts of the mathematical equations examining disease transmission, this is the thread for you!https://twitter.com/NeuroOscillator/status/1223821590485446656 …
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What a mess this has becomehttps://www.nytimes.com/2020/02/01/world/asia/china-coronavirus.html …
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Dr. Angela Rasmussen proslijedio/la je Tweet
Do government-enforced lock-downs actually slow down outbreaks? What are the economic costs? Are human rights being violated? I hope these questions are being asked.https://twitter.com/amyyqin/status/1223618309326688256 …
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And the last thing anyone anywhere needs is a bunch of people overwhelming providers with demands for tests that are either unproven technology not yet evaluated in patients or some primers that haven’t been adequately validated for clinical use
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The problem with getting information from an “expert” who evidently knows approximately zero about molecular assays is that these both are presented like
#nCoV2019 tests coming soon to a clinic near you! Nope. Neither test is ready for use as the diagnostic.Prikaži ovu nitHvala. Twitter će to iskoristiti za poboljšanje vaše vremenske crte. PoništiPoništi -
And 100% specificity? The second test was only validated in a tiny cohort (pos n=2, neg n=31), no wonder there weren’t false positives. That’s not even remotely in the realm of statistical power you’d need to validate something for clinical use.
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The second test had “perfect” sensitivity. Perfect is not a quantifiable metric. What does that even mean? That it’s very sensitive? Because the paper measures that by diluting the template, and it’s consistent with what you’d expect for RT-PCR. It’s fine, not “perfect”
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Not negating that RT-PCR team’s efforts but designing primers and a PCR assay is...not new.
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The first test is a new technology using CRISPR. The second RT-PCR test uses the existing standard method for doing molecular diagnostics. It’s not some groundbreaking new thing
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Another rant about why it’s dangerous to trust
#nCoV2019 “experts” with no credibility in epi or virology, and obviously a minimal understanding of fundamental molecular biology or ID diagnosticspic.twitter.com/drRn9GOqHJ
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I'm not sure that lit stick of dynamite emojis are the right look for presenting epidemiological data in a non-inflammatory context...https://twitter.com/MackayIM/status/1223579573314441219 …
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The bottom line is that these in vitro studies are critical to establish mechanism of entry, but more detailed studies need to be done with authentic nCoV2019 in vitro and in vivo before we can conclude anything about the significance for disease, treatment, or diagnostics
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However, I wanted to illustrate that critical mechanistic entry work like this is distinct from determining mechanisms of pathogenesis. It is one piece of a larger puzzle. To understand how nCoV2019 causes disease, we need data from animal models & clinical samples from patients.
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To their credit, the authors acknowledge the limitations of using serum from a single patient. They don't make wild assertions about the implications on tropism or what it might mean in terms of pathogenesis. I am impressed that the authors did a well-designed study so rapidly
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In fact, the most interesting part of the study (to me) is their last experiment, showing that serum from a SARS patient can block entry. This suggests that maybe people with preexisting immunity to SARS might be more resistant or SARS antibodies could be used to treat nCoV2019.
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To be clear the authors aren't suggesting that. They only state that a TMPRSS2 inhibitor approved for human use in Japan should be considered. They also interpret the data well in the context of the study and do not overstate their results.
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If the virus can use another protein as a receptor or another protease for S priming, then this doesn't matter. That doesn't mean it's a dumb idea, but we can't interpret studies done in vitro with tools for studying entry mechanism as promising preclinical data
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4. ACE2 and TMPRSS2 can function for nCoV2019 cell entry but that doesn't mean they are the only proteins that can. The idea of using ACE inhibitors or TMPRSS2 inhibitors as antivirals is intriguing, but that doesn't mean they are guaranteed to be effective in patients
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red line, total cases, numbers on left side