Coronavirus

Hell the flu had killed millions repeat millions in one flu season

Sam Roberts, who’s one of our crack writers—he’s a longtime New York Times correspondent and editor—he’s with our group and he originally floated the idea of whether we should be doing something like our 9/11 Portraits of Grief project. He had the thought maybe before the rest of us did. And he was right.

Portraits of Grief actually was done by the Metro Desk at the time, not the obituary section. But those were a finite number of people who had died. And it took several months for the paper to actually account for, I think, almost all of them, if not all of them.

This is something much different. The scale is different by orders of magnitude. Some people thought, oh, it’s beyond our scope. We’re just a small group. Obviously, we cannot report on all the deaths. There were too many. So we decided to do something like a cross section of deaths. We were getting emails, we were getting notified by others outside too, about the various deaths. It overtook us in a way too, this tide of deaths. It was becoming startling and shocking how many people there were, and with great stories. Great lives were being lost. And we wanted to account for some of them. We wanted to make the point, I suppose, implicitly, that this disease was hitting people from all walks of life.

(Reuters) - As the coronavirus pandemic engulfed the United States, Joe Shia, a consultant to Chinese medical companies, said he was bombarded with inquiries from American firms who saw a golden opportunity in selling tests to determine coronavirus immunity.

Unlike his typical clients, some firms seeking his help had never before sold medical equipment. Others wanted to register test kits with the U.S. Food and Drug Administration without approval from the manufacturer, or to offer home-based tests, which are not allowed by the FDA. One was in the window business, he said.

“They replace windows and do window cleaning,” said Shia, adding that he did not do business with the company. “That is just awful – think about it. Someone who doesn’t know anything about medical devices.”

[...] The rush to obtain, advertise and find buyers for test kits follows the FDA’s unprecedented decision last month to allow any company to sell antibody tests in the United States without prior review by the agency.

Pounded by criticism for a delay in expanding diagnostic tests for coronavirus infection, the FDA has swung in the opposite direction in overseeing tests for coronavirus immunity. This take-all-comers approach, Reuters found, has provided an entree for questionable vendors and middlemen — including an electronics salesman hawking an unauthorized home test kit and a former physician convicted in a fraudulent gold-peddling scheme.

“There are literally dozens and dozens of companies jumping out of the blue that I’ve never heard of, and they are saying to us that, ‘If you put money up front before we deliver tests, we can put you first in line for our allocation,’” said Stefan Juretschko, senior director of infectious disease diagnostics at Northwell Health Laboratories, the laboratory testing division of Northwell Health, one of New York’s largest hospital systems.
[...]
Under the FDA’s new rules, a vendor must only notify the FDA it is selling a test, affirm the product is valid and label it as unapproved. On its website as of April 29, the FDA listed 164 tests that it had been informed would be offered on the market, more than half of them manufactured in China.
[...]
In a statement to Reuters, the FDA said the aim of its policy was to provide laboratories and healthcare providers early access to the tests. But the agency said that it would adjust the approach as needed.
[...]
In a separate statement, FDA spokeswoman Sarah Peddicord said some test developers had falsely claimed that their tests were FDA approved, that they could diagnose COVID-19 - the disease caused by the coronavirus - or that they were appropriate for home use.
[...]
The entry of unqualified or unscrupulous manufacturers and brokers into the antibody testing business poses risks. Perhaps the greatest one is that they’ll sell a test that indicates immunity where there is none - known as a “false positive.” That could lead people to return to the community while unwittingly posing a risk to themselves and others, infectious disease experts say.

A team of scientists in California and Massachusetts recently evaluated 14 blood antibody tests now on the market and found significant variation in their performance.

The tests were generally effective at detecting antibodies three weeks after an infection but much less so for more recent cases, said Patrick Hsu, an assistant professor of bioengineering at the University of California, Berkeley, who was involved in the research.
[...]
Antibody tests are easy to administer, sometimes requiring only a finger prick to derive a blood sample. Some samples are analyzed in laboratories; other test results are readable on a device, like a pregnancy test, within minutes.

But “if you want good quality, (the tests) are not easy to make,” said Alberto Gutierrez, who led the FDA’s office overseeing diagnostic testing from 2009 to 2017. “They do require a fair amount of expertise.”

Some companies that have notified the FDA of their intent to sell kits without securing approval have separately applied for “emergency use authorization (EUA),” a temporary stamp of approval that requires some review but far less than is typical for a medical device.

Nine tests had been approved for emergency use as of Thursday, including those made by Ortho Clinical Diagnostics, an established testing company owned by private-equity firm Carlyle Group Inc.
[...]
Without a rigorous FDA approval process or enough trusted suppliers, hospitals and others in need of antibody tests say they are left to weed out the good products from the bad.

“All they want to talk about is price and quantity,” Wyatt of Premier said of testing companies whose claims strike her as dubious. Those pitches lack the usual scientific documentation and generally are not from established distributors, she added. The offers often are full of misspellings or appeals to emotion such as, “In order to help America,” she said.

“It’s just been extremely distracting for our member health systems,” she said. “They’re under such pressure to maximize testing capacity.”
[... ... ...]
Though virtually unrestricted by the FDA, many antibody test distributors in the United States have run into obstacles posed by China’s export policy.

After European countries criticized the quality of China’s coronavirus tests, China adopted a new policy on April 1 that holds up exports of tests until the products have a certificate from the country’s regulator, the National Medical Products Administration.

Thus far, China has only certified about a dozen of the 90 China-made antibody tests on the FDA list of prospective sellers, leaving many U.S. distributors without kits to sell.

This past weekend, however, China’s commerce ministry said it would loosen those restrictions. It would allow domestic manufacturers to export test kits, provided an authorized trade association verifies that the tests are approved for use in the importing countries.

It was not immediately clear how the move would affect exports to the United States, since FDA approval is not required for antibody tests.

Some medical experts and policy makers say that as the market expands and the stakes grow higher for the tests, the U.S. regulator needs to take on a more assertive role.

Historically, “the FDA has been there as a bulwark for accuracy and reliability,” said William Schaffner, an infectious disease professor at the Vanderbilt University School of Medicine. “If they give up that role, that opens the door to all kinds of mishaps.”

On March 31, there were 187,347 cases in the US (per Worldometers).

Right now, there are 1,064,737.

We've gotten 877,390 cases in a month in the US>

jespah wrote:

On March 31, there were 187,347 cases in the US (per Worldometers).

Right now, there are 1,064,737.

We've gotten 877,390 cases in a month in the US>

sometimes all I can think when I see information like this is ... if it's like this in a first world country what is going on in the rest of the world

it's an absolutely crappy crapshoot out there https://www.worldometers.info/coronavirus/#countries

“I’m a hematologist, and this is unprecedented,” says Jeffrey Laurence of Weill Cornell Medical College, who has been in the field for three decades. “This is not like a disease we’ve seen before.”

Nearly every patient he has seen for blood disorders in the past month and a half has had Covid-19. “I’ve never had so many consults in my life. These people are clotting, and we can’t shut it off.”

Winter is a 4-year-old chocolate-colored llama with spindly legs, ever-so-slightly askew ears and envy-inducing eyelashes. Some scientists hope she might be an important figure in the fight against the novel coronavirus.

She is not a superpowered camelid. Winter was simply the lucky llama chosen by researchers in Belgium, where she lives, to participate in a series of virus studies involving both SARS and MERS. Finding that her antibodies staved off those infections, the scientists posited that those same antibodies could also neutralize the new virus that causes Covid-19. They were right, and published their results Tuesday in the journal Cell.

What we know
While men account for the majority of COVID-19 cases in some countries but a minority of cases in others, they consistently make up the majority of deaths. Out of 35 countries that have reported their COVID deaths in ways that break out victims by sex, 33 had a male-female death ratio greater than 1, meaning men who were confirmed to have the disease were more likely to die than women who were confirmed to have it, according to data compiled by Global Health 50/50, an independent health equity research organization based at University College London. “So far, the mortality disadvantage for men is quite large,” said Jennifer Dowd, a professor of demography and population health at the University of Oxford.
...
This dynamic isn’t new to medicine. “Women have stronger adaptive immune responses and die less of infectious disease their entire lives, starting from infant mortality,” Dowd said. In general, women’s bodies kick out bacterial and viral invaders faster than men’s do, and vaccines work better for women than for men.
...
But if you’re tempted to think those sex differences boil down to “men are more likely to die from infectious disease,” Klein cautioned that the generalization is not true across the board. Sex differentiation in influenza has been pretty well studied, she told me, and, in that case, women’s more aggressive immune systems don’t give us an advantage. Having too much of an inflammatory immune response to the flu can actually increase your risk of complications — including acute respiratory distress syndrome, when the lungs’ tiny air sacs, called alveoli, are damaged and fill with fluid. “Reproductive-age women do worse, not better,” Klein said.

Even though the restrictions in Germany were comparatively moderate compared to other European countries such as France or Spain: were they even necessary in their severity? Couldn't the pandemic have been brought under control with less rigid measures? And has the number of healthy people infected with the virus by a sick person, the so-called reproduction rate, not already fallen before the official announcement of the measures?