The Phantom has been told his blogs are too long, digressive and require too much of the reader.
So here's his boiled down version of TWiV #645:
We can get out of this pandemic thing before the vaccines become available if we believe certain assertions which are likely true, but are as yet unproved:
#1 SARS COV-2 is only infectious briefly. Michale Mina, MD PhD has said this on a couple of TWiV episodes: He tells us who have the virus in their noses, throats and lungs are likely infectious to others for only a few days, like 3-7 days.
During this infectious period they can be super spreaders or just ordinary spreaders and they make millions upon millions of infectious virus units (virions).
But once they pass through this phase, they are no risk to anyone else. They may make virions but only in the thousands which is not enough to infect most contacts.
#2. Detecting the patient who is breathing out millions of virions is best done with a low sensitivity test, which is sensitive enough to catch the big load of virus in the saliva but will miss the patient who only has thousands of virions in his mouth. You really don't want to know about the non infectious patient: He can go to school or to the bar or fly on the airplane. You only want to know about the infectious guy who spreads the disease.
Why would you not care about the asymptomatic or pre-symptomatic person? Because if he does not become sick, it doesn't matter to him or to the rest of us, as long as he doesn't spread virus. If he becomes sick, then you can use other more sensitive tests to confirm he is sick with COVID 19 if he seeks medical attention.
#3 We have on the shelf different versions of a test strip which can be used at home like a pregnancy test with results from saliva in 10 minutes.
According to Mina, you could print these strips by the millions almost as easily as photocopying.
Imagine if you could test kids at home or when they arrive at school each day with a cheap, 10 minute test and you send home or keep home the kids who are infectious but then move on with your day without masks, without contact tracing.
You don't need contact tracing if you can test virtually everyone daily at home.
If all these things are true, then Mina is talking about a game changing approach.
If he is right, he should be talking to the powers that be.
So far Democratic Senators and Congressmen and Republican governors have ignored him or simply not heard of him.
The system for making the bureaucracy aware of scientific advances or changes in thinking is apparently imperfect.
The science and details are summarized by the excellent Medcram youtube:
https://www.youtube.com/watch?v=h7Sv_pS8MgQ&t=9s
There is a long form version now in the Atlantic:
https://www.theatlantic.com/health/archive/2020/08/how-to-test-every-american-for-covid-19-every-day/615217/?utm_source=newsletter&utm_medium=email&utm_campaign=atlantic-daily-newsletter&utm_content=20200814&silverid-ref=NjYzNDQ4NjU4MDY2S0
So here's his boiled down version of TWiV #645:
 |
| Michael Mina, MD, PhD |
We can get out of this pandemic thing before the vaccines become available if we believe certain assertions which are likely true, but are as yet unproved:
#1 SARS COV-2 is only infectious briefly. Michale Mina, MD PhD has said this on a couple of TWiV episodes: He tells us who have the virus in their noses, throats and lungs are likely infectious to others for only a few days, like 3-7 days.
During this infectious period they can be super spreaders or just ordinary spreaders and they make millions upon millions of infectious virus units (virions).
But once they pass through this phase, they are no risk to anyone else. They may make virions but only in the thousands which is not enough to infect most contacts.
#2. Detecting the patient who is breathing out millions of virions is best done with a low sensitivity test, which is sensitive enough to catch the big load of virus in the saliva but will miss the patient who only has thousands of virions in his mouth. You really don't want to know about the non infectious patient: He can go to school or to the bar or fly on the airplane. You only want to know about the infectious guy who spreads the disease.
Why would you not care about the asymptomatic or pre-symptomatic person? Because if he does not become sick, it doesn't matter to him or to the rest of us, as long as he doesn't spread virus. If he becomes sick, then you can use other more sensitive tests to confirm he is sick with COVID 19 if he seeks medical attention.
#3 We have on the shelf different versions of a test strip which can be used at home like a pregnancy test with results from saliva in 10 minutes.
According to Mina, you could print these strips by the millions almost as easily as photocopying.
Imagine if you could test kids at home or when they arrive at school each day with a cheap, 10 minute test and you send home or keep home the kids who are infectious but then move on with your day without masks, without contact tracing.
You don't need contact tracing if you can test virtually everyone daily at home.
If all these things are true, then Mina is talking about a game changing approach.
If he is right, he should be talking to the powers that be.
So far Democratic Senators and Congressmen and Republican governors have ignored him or simply not heard of him.
The system for making the bureaucracy aware of scientific advances or changes in thinking is apparently imperfect.
The science and details are summarized by the excellent Medcram youtube:
https://www.youtube.com/watch?v=h7Sv_pS8MgQ&t=9s
There is a long form version now in the Atlantic:
https://www.theatlantic.com/health/archive/2020/08/how-to-test-every-american-for-covid-19-every-day/615217/?utm_source=newsletter&utm_medium=email&utm_campaign=atlantic-daily-newsletter&utm_content=20200814&silverid-ref=NjYzNDQ4NjU4MDY2S0
No comments:
Post a Comment