Covid19

[thollandpe]

People that have mild symptoms (like my bother and how daughter right now in Paris) are not tested because they do not have enough testing capacity and therefore is not counted. Sad state of affairs.

Lionel, is this your brother and his daughter or your daughter? Sorry to hear.

And have you been in personal contact with either of them in the past two weeks?

[Will Neide]

If one gets tested, how accurate are the results? Anyone work in this field able to comment?

Info on the CDC's assay. Many facilites are using this. Some did their own thing, but similar. Either way, very sensitive provided the RNA yield is adequate. Scroll down to page 33 for limitations and page 35 for performance characteristics. It's a bit too much to copy and paste here.

https://www.fda.gov/media/134922/download

[rwsaunders]

From the newsroom of UPMC (University of Pittsburgh Medical Center), our local 800 pound healthcare gorilla...

PITTSBURGH – UPMC has developed a test for the novel coronavirus SARS-CoV-2 — the virus that causes COVID-19 — UPMC will use this test to diagnose select, symptomatic cases. The health system plans to rapidly increase capacity at its central laboratory and, if there is a need, could test hundreds of patients per week in the near future, filling a critical gap before other commercial tests come online.

“Developing this test for a never-before-seen virus in the midst of a pandemic was a tremendous challenge, even for our academic medical center with its long history of such developments,” said Alan Wells, M.D., D.M.Sc., medical director of the UPMC Clinical Laboratories and Thomas Gill III Professor of Pathology at the University of Pittsburgh School of Medicine. “But testing capabilities are absolutely essential to managing a pandemic. If the communities we serve see a surge in severe illnesses, we must be able to diagnose people quickly to give them the appropriate care while protecting our staff and the broader community. Testing capabilities for COVID-19 in the U.S. have been delayed and limited, creating anxiety for the people we serve and impairing our ability to optimally guide the public health response,” said Donald Yealy, M.D., chair of emergency medicine for UPMC and Pitt. “By creating our own test and collection centers, we can both help our patients and the overall community. We seek getting a diagnosis in hours, not days.”

The U.S. lagged behind other countries in testing capacity, which was centered around public health authorities. The tests created by commercial laboratories are either not serving the Pittsburgh region or can take longer for results, according to Wells. Trained UPMC providers will collect specimens, doing so safely while wearing personal protective equipment, including gowns, gloves and N95 masks or respirators. Collection will occur in negative pressure rooms, which assure that air does not leave the room until it flows through a high-efficiency particulate air (HEPA) filter that removes pathogens. The process involves a “nasopharyngeal” swab, a thin device inserted through a patient’s nose into the nasal cavity.

The specimens will be safely transported for testing to the UPMC Clinical Laboratories, the largest academic clinical lab in the U.S. In most cases, results will be returned within 24 hours. UPMC may continue to send specimens to the Pennsylvania Department of Health’s laboratory in eastern Pennsylvania or health department laboratories in New York and Maryland as needed and for confirmation. UPMC will work with commercial laboratories to send specimens to them as soon as they have capacity, which will maximize the health system’s ability to test all who need it.

As others have noted, here is another case of organizations taking matters into their own hands and bypassing in some sense, the roadblocks that the Feds have established, in not having a central and uniform response, to such a tragic series of events.

[dgaddis]

My wife saw (maybe is currently seeing) her first suspected COVID-19 patient today. Fun times. We don't have any confirmed cases here yet, but any reasonable person knows it's already here, there's confirmed cases in the larger cities in either direction from here.

[Will Neide]

From the newsroom of UPMC (University of Pittsburgh Medical Center), our local 800 pound healthcare gorilla...

......

As others have noted, here is another case of organizations taking matters into their own hands and bypassing in some sense, the roadblocks that the Feds have established, in not having a central and uniform response, to such a tragic series of events.

UPMC is fantastic at marketing.

It's not a case of "taking matters into their own hands." It's a scientific community. Director's and Dr's (clinical pathologists) are salivating at the chance to contribute (in a good way).

The CDC and FDA do not operate in isolation. The community as a whole has always relied on each other, and the roadblocks were removed by the FDA with an emergency use validation protocol awhile ago.

Plus UPMC will be able to charge for this test at some point.

[Bobonli]

UPMC is fantastic at marketing.

It's not a case of "taking matters into their own hands." It's a scientific community. Director's and Dr's (clinical pathologists) are salivating at the chance to contribute (in a good way).

The CDC and FDA do not operate in isolation. The community as a whole has always relied on each other, and the roadblocks were removed by the FDA with an emergency use validation protocol awhile ago.

Plus UPMC will be able to charge for this test at some point.

I challenge you to a marketing duel!! My organization is in much the same position. We literally have more resources than the state govt. When Ebola was a thing, the state and CDC came to us for advice on how to quarantine people in the NY-area. Our CEO has been quietly standing behind the governor at every news conference the past few days. I don't write this to brag but to point out that in many ways local organizations easily outstrip the government for things like this. Hell, we provide medical training for SF soldiers because they cannot get (some of the special content) it from the armed services schools. It's a shame, on the one hand, that our tax dollars don't really go to protecting us from significant domestic threats; on the other hand, it's reassuring to know that UPMC and others are willing to pitch in when needed.

[Lionel]

Lionel, is this your brother and his daughter or your daughter? Sorry to hear.

And have you been in personal contact with either of them in the past two weeks?

It's my brother and his daughter. They will probably be fine. They live in Paris, I have not seen them in quite a while.

[j44ke]

What does it mean when the President tells the Governors to go buy respirators and other medical devices on their own and not wait for the Federal government?

I don’t understand this at all.

[crumpton]

What does it mean when the President tells the Governors to go buy respirators and other medical devices on their own and not wait for the Federal government?

I don’t understand this at all.

what does it mean when he tells America to "calm down go have a nice meal"?

[j44ke]

What I meant is - by what mechanism do governors do this and for which hospitals? Public v. Private? And with what money? Does this mean states will be bidding against each other? This must be something he just made up in the moment, right? Not being political. I don’t care who explains it, Democrat or Republican. Maybe some of the health care people here know how this works.

[davids]

UPMC is fantastic at marketing.

It's not a case of "taking matters into their own hands." It's a scientific community. Director's and Dr's (clinical pathologists) are salivating at the chance to contribute (in a good way).

The CDC and FDA do not operate in isolation. The community as a whole has always relied on each other, and the roadblocks were removed by the FDA with an emergency use validation protocol awhile ago.

Plus UPMC will be able to charge for this test at some point.

Boston hospitals are doing the same thing.

Because where are the tests?

[summilux]

My university has cancelled classes effective today and we are moving them all online. But libraries and food services operating normally. And the residences are open. WTF?

[Saab2000]

My university has cancelled classes effective today and we are moving them all online. But libraries and food services operating normally. And the residences are open. WTF?

The public library in my Chicago suburb has closed. It’s quite a nice place and I think a sanctuary for many locals, some of whom ha fewer options. It will be open tomorrow as a polling place. I plan to vote.

[colker]

what does it mean when he tells America to "calm down go have a nice meal"?

It means americans are all 6yr old children. Right?

[Bobonli]

What does it mean when the President tells the Governors to go buy respirators and other medical devices on their own and not wait for the Federal government?

I don’t understand this at all.

It means either:
1. He doesn't know that there's a stockpile of critical supplies reserved for disaster
2. Someone told him it's insufficient
2a. Someone told him we'll need lots of ventilators (that's the proper term for a machine that breathes for you ) and that same someone knows the federal govt can't respond quicker that the locals.
3. He has no idea what is coming out of his mouth

The word from the hospitals is that the people who get really sick need to be mechanically ventilated. For awhile. So, assuming the number of really sick people increases, we'll eventually run out of gear. What is not being addressed is that not every Tom and Jane in the hospital (this goes for physicians and nurses) is properly trained to maintain a ventilated patient. These patients usually go to an ICU. Some hospitals in NY are already talking about clearing out OR and recovery rooms to take these patients. It's great they're making space but your average nurse or doc is not competent to care for a ventilator patient....though I imagine that's on the "To Do List" to get more people trained.

Knowing this guy, he probably has Jr and the other kid buying up stock in the medical device industry. Oops. that belongs in the other thread!

[Will Neide]

I challenge you to a marketing duel!! My organization is in much the same position. We literally have more resources than the state govt. When Ebola was a thing, the state and CDC came to us for advice on how to quarantine people in the NY-area. Our CEO has been quietly standing behind the governor at every news conference the past few days. I don't write this to brag but to point out that in many ways local organizations easily outstrip the government for things like this. Hell, we provide medical training for SF soldiers because they cannot get (some of the special content) it from the armed services schools. It's a shame, on the one hand, that our tax dollars don't really go to protecting us from significant domestic threats; on the other hand, it's reassuring to know that UPMC and others are willing to pitch in when needed.

I really can’t fault UPMC for the marketing. I do expect all academic facilities to either be testing or on the cusp of of testing.

Quietly, Ebola is still a thing. We are, and I’m sure you are as well, still prepared and do drills.

[jclay]

For those of you who can read Italian, the dashboard from the Italian Civil Defense: Operations Dashboard for ArcGIS

[Will Neide]

Boston hospitals are doing the same thing.

Because where are the tests?

I can’t speak for Boston, but are you assuming that those labs would have purchased CDC “kits” instead of developing their own? I mean, it’s PCR. The sequence for primers has been available. If you’re a facility who has the personnel and capabilities, then you don’t need the CDC kit. The CDC has put the info out for what is needed for some time. They’ve basically supplied the recipe, and it’s up to the labs to cook it up and validate it.

See up a couple posts if you want some info on the CDC’s “kit.”

[Too Tall]

My nephew came back to the US a couple days ago from Europe and has cold symptoms. He got tested yesterday and awaits the results.

If one gets tested, how accurate are the results? Anyone work in this field able to comment?

Also, I was reading about the possibility of re-infection and it sounds as if the early rumors of that are largely unfounded though it is not impossible depending upon one's immune system health. The early cases of re-infection were sometimes chalked up to testing errors or cases where symptoms had subsided but flared up again. Again, anyone with knowledge able to comment?

Jim I've heard NO credible report of re-infection. Talking to my Doc. pals who are close to this it is their considered professional opinion that re-infection is very unlikely.

[Saab2000]

Jim I've heard NO credible report of re-infection. Talking to my Doc. pals who are close to this it is their considered professional opinion that re-infection is very unlikely.

That is certainly encouraging. Often the facts get lost in the fear when we read early reports.

It seems we are becoming more knowledgeable by the day. That’s a good thing.