COVID-19: Vaccine/antidote and testing procedures Megathread [Mod Warning - Post #1]

Miike

mandrake04 wrote: »

It’s probably more reliable type of antigen test as it can detect small reactions that might not be visible to the eye, most rapid antigen tests rely on the paper changing colour and some use phone camera/app to detect the change. The POC device is more sensitive to that.

antigen tests are not a complete folly as they are detecting virus ...other rapid tests were testing for enzymes that the body produces when it sick or stressed.

I think like someone above mentions antigen and PCR combination can probably work together and can improve testing somewhat better than it has been, unfortunately due to the nature of the virus this still won’t be enough to return life to somewhat normality unless you take the whole process seriously. You need to corner the virus and test and isolate it to elimination .... and then maintain a low level through surveillance.

Agree with everything you've said but I'm just thinking as things currently stand our clinics and OPD r/v's are 'blind' bar a screening asking about symptoms. If we could introduce something like the aforementioned BD system on the morning of the appointment it would be an additional layer of protection for staff and other patients. Obviously not bullet proof though

Martina1991

WoollyRedHat wrote: »

By using antigen testing against a groupset ,isolate /PCR test the rest.

If you deploy antigen testing against clusters in first instance and get positives after day 1 you isolate them immediately as they are deemed to have high viral load and then you deploy wholesale PCR testing against those who produced negative results who may have been infected by highly infectious cohort. The other approach is using antigen tests day 1 and 7 then isolate the whole cluster.

What do you mean by groupset, what clusters?
Sports teams maybe in preparation for games, classrooms,certain workplaces.
These tests still require to be carried out by a healthcare professional who would need to be deployed to these settings.
These tests also have a turnaround time of at least 15min. Thats a throughput of 4 tests an hour. You would need a number of devices and people to carry out mass testing for a large group.

Miike wrote: »

Been meaning to ask both of you for some weeks now, I just forgot to PM you . What do you two make of the BD Veritor+ SARS-CoV-2 platform? IF it comes to fruition POC testing would be a nice stop gap between rRT-PCR testing, obviously baring in the mind the pitfalls of the system. My fear is that within the acute system it would be used inappropriately (as we've seen now even with not detected results being taken as true negative and removing people from isolation - massive case in the media recently) but I think it might have a place in primary care or OPD.

I feel like BD are making big claims with this system. I would love to see them replicated though!

I haven't heard of this platform. Looks like another POC device to me. There have been so many produced its hard to know who's legit or looking to make a quick buck, particularly in the States. I don't know if its one HIQA reviewed.


These rapid tests will likely be used in EDs, GP surgeries, maybe pharmacies. These tests should be deployed where they will be useful to patient care.

If a patient recently becomes symptomatic, an antigen test more likely to be clinically useful. No need for PCR test referral, or waiting for result.
-Test positive, treat, isolate, inform close contacts, refer to public health system if necessary
-Test negative, treat patient with antibiotics, steroids, inhaler whatever, based on GP assessment. Restrict movements until symptoms resolve.

Once the virus is suppressed in the community from public health measures, restrictions, and most importantly a vaccine, there should be no need for rapid tests purely for social settings.

mandrake04

Miike wrote: »

Agree with everything you've said but I'm just thinking as things currently stand our clinics and OPD r/v's are 'blind' bar a screening asking about symptoms. If we could introduce something like the aforementioned BD system on the morning of the appointment it would be an additional layer of protection for staff and other patients. Obviously not bullet proof though

Definitely, any POC testing is better than no testing in a clinical setting it’s never going be absolute 100% but good enough.

WoollyRedHat

Martina1991 wrote: »

What do you mean by groupset, what clusters?
Sports teams maybe in preparation for games, classrooms,certain workplaces.
These tests still require to be carried out by a healthcare professional who would need to be deployed to these settings.
These tests also have a turnaround time of at least 15min. Thats a throughput of 4 tests an hour. You would need a number of devices and people to carry out mass testing for a large group.

Sorry I may have been thinking of something else when I said groupsets.

My point was that following contract tracing that identified a cluster, people could then be pool tested. If we could find someone that had a high viral load using antigen testing with quick response and deploy PCR testing for those who tested negative and isolate to control potential clusters spreading. This could be particularly useful at airport's, areas you have mentioned and other point of care settings. This strategy has been used elsewhere and can work

I agree that trained Personnel would have to carry out testing, I'm not advocating for untrained people to be involved in testing it clearly would not work for myriad of reasons. In terms of resources needed, this is why I am emphasizing it can only work with cases at a controllable level , not now.

mandrake04

WoollyRedHat wrote: »

Sorry I may have been thinking of something else when I said groupsets.

My point was that following contract tracing that identified a cluster, people could then be pool tested. If we could find someone that had a high viral load using antigen testing with quick response and deploy PCR testing for those who tested negative and isolate to control potential clusters spreading. This could be particularly useful at airport's, areas you have mentioned and other point of care settings. This strategy has been used elsewhere and can work

I agree that trained Personnel would have to carry out testing, I'm not advocating for untrained people to be involved in testing it clearly would not work for myriad of reasons. In terms of resources needed included, this is why I am emphasizing it can only work with cases at a controllable level.

Germany and Austria were using this at their Airports and I wouldn’t say it worked looking at their daily cases.

WoollyRedHat

mandrake04 wrote: »

Germany and Austria were using this at their Airports and I wouldn’t say it worked looking at their daily cases.

Did they use it in way described and were they using it just at airports and when their cases were low as a suppression tool?.

ETA: Germany requires proof of a negative test before flight rather than testing on entry to county I would argue that on its own is not enough. If you're going to demand a negative PCR test you need to carry out testing on boarding with isolation until results are available.

mandrake04

WoollyRedHat wrote: »

Did they use it in way described and were they using it just at airports and when their cases were low as a suppression tool?.

ETA: Germany requires proof of a negative test and then that's it, I would argue that on its own is not enough.

I think I read some about Germany using it in Airports, but their case numbers are shyte so it would be hard to know if it worked or not in that scenario.

You said it worked elsewhere can you give examples?

Mark1916

http://reut.rs/35FcUvo

The Oxford-AstraZeneca vaccine has promoted a strong robust immune response in elderly people according to early data seen by the Financial Times.

mandrake04

Mark1916 wrote: »

http://reut.rs/35FcUvo

The Oxford-AstraZeneca vaccine has promoted a strong robust immune response in elderly people according to early data seen by the Financial Times.

Sounds good.

I think this be a better candidate than Pfizer.

manniot2

mandrake04 wrote: »

Sounds good.

I think this be a better candidate than Pfizer.

Staff in the uk told they will start getting it on week commencing 02 nov? That’s next week...horse it out to fook

Gael23

https://www.rte.ie/news/coronavirus/2020/1026/1173930-covid-incidence/

manniot2

Gael23 wrote: »

https://www.rte.ie/news/coronavirus/2020/1026/1173930-covid-incidence/

There is no way the young health care people will take it.

Gael23

manniot2 wrote: »

There is no way the young health care people will take it.

If they know restrictions on their lives will end if they take it maybe?
I won’t be taking it until I see a framework for unwinding of restrictions

Hector Savage

manniot2 wrote: »

There is no way the young health care people will take it.

They won't need to (for most), so long as most of vulnerable take it things will improve, at the end of the day lockdowns are all about preventing health service collapsing once that is prevented, they won't give a f*ck about case numbers anymore.

Well if they have sense they won't.

jackboy

manniot2 wrote: »

There is no way the young health care people will take it.

It will be given to the vulnerable first. A large proportion of these people are in extremely poor health so if there are any serious safety issues with a new vaccine we will know very fast.

manniot2

Gael23 wrote: »

If they know restrictions on their lives will end if they take it maybe?
I won’t be taking it until I see a framework for unwinding of restrictions

I agree they will use bribery to get compliance in taking it. But those working in health care may be less affected by this than others (can still work etc) so they mightn’t be as easy to bribe

manniot2

jackboy wrote: »

It will be given to the vulnerable first. A large proportion of these people are in extremely poor health so if there are any serious safety issues with a new vaccine we will know very fast.

I thought it went to health care front liners first? That’s what is happening in the UK anyway

jackboy

manniot2 wrote: »

I thought it went to health care front liners first? That’s what is happening in the UK anyway

Surely there won’t be a large gap between HCW’s and the vulnerable been given it. Especially if there is large scale resistance to the vaccine from nurses (which is highly likely).

Gael23

jackboy wrote: »

Surely there won’t be a large gap between HCW’s and the vulnerable been given it. Especially if there is large scale resistance to the vaccine from nurses (which is highly likely).

Will all depend on what supply is available I suppose

manniot2

jackboy wrote: »

Surely there won’t be a large gap between HCW’s and the vulnerable been given it. Especially if there is large scale resistance to the vaccine from nurses (which is highly likely).

I think we will get a far clearer of picture of what the medical community really think about this virus when this vaccine comes out and none of them think it’s worth the risk in taking it

Hector Savage

manniot2 wrote: »

I think we will get a far clearer of picture of what the medical community really think about this virus when this vaccine comes out and none of them think it’s worth the risk in taking it

Very very good point !!

Miike

manniot2 wrote: »

I think we will get a far clearer of picture of what the medical community really think about this virus when this vaccine comes out and none of them think it’s worth the risk in taking it

I've yet yet to meet someone working in health care who has said they won't take it. You seem to forget most of these people are well educated and have families they want to protect.

Saying things like "there is no way young health care people will take it" is tripe but its perfectly on brand for your rhetoric. Some day you'll say something helpful or positive. You try undermine everyone and everything in any way you can but make sweeping generalised statements with no substance. Another one for the ignore list I think.

Miike

jackboy wrote: »

Surely there won’t be a large gap between HCW’s and the vulnerable been given it. Especially if there is large scale resistance to the vaccine from nurses (which is highly likely).

You think the nurses who are the most impacted professional group by the virus will "resist" it?

jackboy

Miike wrote: »

You think the nurses who are the most impacted professional group by the virus will "resist" it?

Yes, just like they resist the annual flu vaccine. Time will tell, maybe they can be convinced to take this one. Trying to force them or emotionally blackmailing them won’t work.

mandrake04

I work in heath care and I would take if it passes CT, just prefer to get something with decent bang for buck.

Miike

jackboy wrote: »

Yes, just like they resist the annual flu vaccine. Time will tell, maybe they can be convinced to take this one. Trying to force them or emotionally blackmailing them won’t work.

This is nothing like flu, though. I've worked on the flu vaccine steering committee for a flu cycle and quite frankly its mind blowing why most HCWs don't avail of flu vaccine but it is it what it is. I'm delighted to say this year (as far as I see it) has been phenomenal for uptake in the people i work with directly.

Echoing what mandrake said, what will largely decide uptake is efficacy in whatever comes to pass. At this stage though I'd let someone shoot me up the hole with a shotgun to just go back to normality for a day.

paw patrol

manniot2 wrote: »

I agree they will use bribery to get compliance in taking it. But those working in health care may be less affected by this than others (can still work etc) so they mightn’t be as easy to bribe

manniot2 wrote: »

I think we will get a far clearer of picture of what the medical community really think about this virus when this vaccine comes out and none of them think it’s worth the risk in taking it

Miike wrote: »

I've yet yet to meet someone working in health care who has said they won't take it. You seem to forget most of these people are well educated and have families they want to protect.

they don't take the flu vaccine in large numbers as it stands much to Leo's dismay given his previous comments.


I know a senior nurse in a hospital and they are bribed to take the flu vaccine . If a certain percentage take it there are rewards such as a night on the town. Seems odd to me.


although this is the flu vaccine we will see with covid.

XsApollo

Well we obviously need to see what happens when/if a vaccine comes out.
Of course it will be a free choice wether to take it or not but I would say there will be ramifications for not taking it.
Countries could have travel restrictions in place for people that haven’t taken it.
Jobs in healthcare, nursing homes might be off limits for a while.... just a few off the top of my head , I see stuff like that coming into effect.

But who knows.

scooby77

Gael23 wrote: »

https://www.rte.ie/news/coronavirus/2020/1026/1173930-covid-incidence/

https://www.thejournal.ie/covid19-vaccine-survey-5245230-Oct2020/

I think that survey result is good news, in that only 12% say no way! So 33% are unsure, need to be convinced. That's fair enough. What will be required is good communication and transparency.
A recent poll from USA (by Associated Press research group) puts is less positive, less than half say yes, around 20% say no.

https://apnews.com/article/dacdc8bc428dd4df6511bfa259cfec44

jackboy

Miike wrote: »

Echoing what mandrake said, what will largely decide uptake is efficacy in whatever comes to pass. At this stage though I'd let someone shoot me up the hole with a shotgun to just go back to normality for a day.

The efficacy will only be truly determined when the vaccine is being used in the real world for a significant period of time. The criteria for efficacy in a clinical trial will be very different than what the public consider efficacy. Most people expect a successful vaccine to eliminate masks and restrictions.

CIARAN_BOYLE

scooby77 wrote: »

https://www.thejournal.ie/covid19-vaccine-survey-5245230-Oct2020/

I think that survey result is good news, in that only 12% say no way! So 33% are unsure, need to be convinced. That's fair enough. What will be required is good communication and transparency.
A recent poll from USA (by Associated Press research group) puts is less positive, less than half say yes, around 20% say no.

https://apnews.com/article/dacdc8bc428dd4df6511bfa259cfec44

To be honest I suspect any vaccination program to be

Stage 1 health care workers
Stage 2 vulnerable
Stage 3 mass vaccination

By the time it gets to stage 3. I'll probably be saying why take that vaccine. There's a better one in late stage trials. As I'm lucky enough to not be a vulnerable person or a health care worker ill probably have that luxury.

Miike

jackboy wrote: »

The efficacy will only be truly determined when the vaccine is being used in the real world for a significant period of time. The criteria for efficacy in a clinical trial will be very different than what the public consider efficacy. Most people expect a successful vaccine to eliminate masks and restrictions.

I honestly don't know what the general public will consider efficacy Jack, i don't know who does but this is going to come down to a game of optics I think. The flu vaccine failed the optics challenge because of anecdotes and people BELIVING things like "sure i don't get the flu" - lets hope a COVID vaccine doesn't have the same fate

mandrake04

fwiw I take flu shot every year, I had it through work back in 2009 and then when I was in NY for NYE my wife caught swine flu...she was near decked from it and I had little more than a cough. After that I have had it every year.

stephenjmcd

Mark1916 wrote: »

http://reut.rs/35FcUvo

The Oxford-AstraZeneca vaccine has promoted a strong robust immune response in elderly people according to early data seen by the Financial Times.

Excellent news, showing a strong response across the age groups.

Full results to be published shortly so that should give more of insight again but very promising

stephenjmcd

jackboy wrote: »

The efficacy will only be truly determined when the vaccine is being used in the real world for a significant period of time. The criteria for efficacy in a clinical trial will be very different than what the public consider efficacy. Most people expect a successful vaccine to eliminate masks and restrictions.

Except it will overtime eliminate both of them.

When frontline and vulnerable groups begin rollout we can very slowly ease up on restrictions.

We don't need everyone vaccinated to ease up and get rid of restrictions to go back to how things were but its not overnight. It'll be over a number of months I think

johnire

That's the sort of attitude that really makes me mad.
So life for you and ones like you will get back to normal on the shirttails of the people who will get the vaccine. Is that it? I've news for you and the like of you.... by life returning to normal because of the vaccine all the measures that are currently in place to protect the population- social distancing, rolling lockdowns etc will be gone. That means the people who decide in their wisdom not to get the vaccine will be left very vulnerable to getting Covid. Remember the same number of people can potentially pass it on and with the restrictions removed in society the chances of contracting it are going to increase massively. Also I'd imagine there are going to be implications for travel and definitely travel insurance. So good luck with that.

CIARAN_BOYLE wrote: »

To be honest I suspect any vaccination program to be

Stage 1 health care workers
Stage 2 vulnerable
Stage 3 mass vaccination

By the time it gets to stage 3. I'll probably be saying why take that vaccine. There's a better one in late stage trials. As I'm lucky enough to not be a vulnerable person or a health care worker ill probably have that luxury.

gctest50

Testing with swabs might be cr@p it seems



https://thorax.bmj.com/content/early/2020/10/23/thoraxjnl-2020-215705


( especially if it's carried out by some one-course-wonder of a volunteer instead of a doctor )

amadangomor

gctest50 wrote: »

Testing with swabs might be cr@p it seems



https://thorax.bmj.com/content/early/2020/10/23/thoraxjnl-2020-215705


( especially if it's carried out by some one-course-wonder of a volunteer instead of a doctor )

Did you link the wrong study there. That is about: Use of exhaled breath condensate (EBC) in the diagnosis of SARS-COV-2 (COVID-19)

Gael23

stephenjmcd wrote: »

Except it will overtime eliminate both of them.

When frontline and vulnerable groups begin rollout we can very slowly ease up on restrictions.

We don't need everyone vaccinated to ease up and get rid of restrictions to go back to how things were but its not overnight. It'll be over a number of months I think

The restrictions were imposed overnight.
Months is too long, would like to see rolling back in maybe 3-4 week intervals over a few stages

stephenjmcd

Gael23 wrote: »

The restrictions were imposed overnight.
Months is too long, would like to see rolling back in maybe 3-4 week intervals over a few stages

They were imposed overnight because its easy to do.

It isn't like they can be rolled back overnight.

Like it or not that's they way I see it going. Its going to take a few months. Cant just be a big bang.

funnydoggy

Good point stephenjmcd

I do hope though that the govt. does a good job in communicating with businesses once restrictions start lifting. The likes of retail could open within a few days notice, but if they're given advance notice they can be up and running ASAP.

This is an interesting piece on the early days of the Oxford vaccine, and how they sought out a manufacturing partner that would ensure supply to poorer countries

https://www.wsj.com/articles/oxford-developed-covid-vaccine-then-scholars-clashed-over-money-11603300412

stephenjmcd

Posted this in the main thread also

Quotes from Prof Adrian Hill leading the Oxford vaccine at the Jenner institute starting to come out now on the back of the news relating to the strong immune response. They to me seem to be slightly ahead of Pfizer.

Keep in mind when he references this country its the UK he's discussing.

"I'd be very surprised if this thing [the pandemic] isn't very clearly on the way down by late spring, at least in this country"

"Billions of doses' are already being produced at ten factories across the globe by a consortium led by British drugs firms AstraZeneca, he said"

"The priorities in the country are "pretty clear" said Prof Hill and added that "we're going to vaccinate high-risk individuals before we vaccinate the young, the fit and healthy who are at a lower risk. I think most countries will do that." This year the researchers are looking for an 'emergency use' authorization which will "allow us to go and vaccinate those most at risk as a priority, then early next year everybody else."

Speaking online to members and alumni of Oxford's Magdalen College, Professor Hill said: 'Much of the reason why drug trials normally take so long is that academics had to spend months writing reports and seeking funding between their stages. In this case, money has been no object.'

funnydoggy

Very reassuring words from Professor Hill. It's starting to gain a lot of momentum now given that more and more media outlets are talking about it.

CIARAN_BOYLE

johnire wrote: »

That's the sort of attitude that really makes me mad.
So life for you and ones like you will get back to normal on the shirttails of the people who will get the vaccine. Is that it? I've news for you and the like of you.... by life returning to normal because of the vaccine all the measures that are currently in place to protect the population- social distancing, rolling lockdowns etc will be gone. That means the people who decide in their wisdom not to get the vaccine will be left very vulnerable to getting Covid. Remember the same number of people can potentially pass it on and with the restrictions removed in society the chances of contracting it are going to increase massively. Also I'd imagine there are going to be implications for travel and definitely travel insurance. So good luck with that.

I won't get an option to get a vaccine for many months after a vaccine is released.

It makes you mad that I realise that and acknowledge that better vaccines will be released or almost released before I get an option an take a vaccine.

I think you get mad very easily.

Gael23

stephenjmcd wrote: »

They were imposed overnight because its easy to do.

It isn't like they can be rolled back overnight.

Like it or not that's they way I see it going. Its going to take a few months. Cant just be a big bang.

What’s so hard about undoing them? I expect compliance will fall significantly anyway once a vaccine is rolled out

CruelSummer

https://edition.cnn.com/2020/10/26/health/covid-vaccine-pfizer-trial-kids/index.html

Children as young as 12 being used as guinea pigs in the States to trial the new Pfizer Covid vaccine - how is this ethical? This vaccine isn’t in development nearly long enough to be used on children in my view.

Dressoutlet

CruelSummer wrote: »

https://edition.cnn.com/2020/10/26/health/covid-vaccine-pfizer-trial-kids/index.html

Children as young as 12 being used as guinea pigs in the States to trial the new Pfizer Covid vaccine - how is this ethical? This vaccine isn’t in development nearly long enough to be used on children in my view.

You know they weren't kidnapped and injected. Parents and children make this decision together. And if they didn't we wouldn't have the vaccines we have now for babies.

NH2013

CruelSummer wrote: »

https://edition.cnn.com/2020/10/26/health/covid-vaccine-pfizer-trial-kids/index.html

Children as young as 12 being used as guinea pigs in the States to trial the new Pfizer Covid vaccine - how is this ethical? This vaccine isn’t in development nearly long enough to be used on children in my view.

If we didn't have children in the trials, how would we know it was safe enough then to roll out the vaccine among children to then protect them from the disease?

Though I do believe initial safety data had to come back first on the adult trials before they commenced enrolling children into the trials.

CruelSummer

NH2013 wrote: »

If we didn't have children in the trials, how would we know it was safe enough then to roll out the vaccine among children to then protect them from the disease?

Though I do believe initial safety data had to come back first on the adult trials before they commenced enrolling children into the trials.

I think the focus should be on adults and vulnerable groups. Not children. I’d hazard a guess these poor families badly need some money and enroll their children in these trials to get some. The race shouldn’t be to include vaccinating children - they remain the least affected group.
In time, children can get vaccinated when a tried & tested candidate is identified. We all know that no matter how many trials there are, until mass vaccination happens, it won’t be truly known how each vaccine will perform or what its side effects will be. I’m also skeptical that vaccines will have long term immunity - but the jury and data is out on whether or not Covid will return every year or not.