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A Third Solution

paulbuchheit.blogspot.com

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Re: A Third Solution

#291

Post by predxionbio »

johncolanduoni wrote: post #257
tptacek wrote: post #229

Earlier quoted context omitted.

According to my biochem-undergrad kid, surface plasmon resonance is a thing; it had come up in classes. "It's like doing an ELISA with no secondary antibody". Someone here will know what that means. I don't!

It’s a thing, but doing a saliva test with limited sample prep (which you need to be beat PCR, otherwise you might as well just make more known to work qPCR machines) is not something anyone has accomplished with it for any virus. It’s a promising technology; but not for having a widely deployable test before we have boring old ELISA antigen tests. Which we have developed for plenty of viruses, and which some individ…

Test complexity (sample prep, test workflow) is a real challenge to achieving testing scales at orders of magnitude above what is presently available.

We should hopefully have boring old ELISA antigen tests shortly, thanks to Abbott and many of the other folks we've all heard from. The real challenge is scaling testing beyond what can be reasonably implemented from central lab facilities.

Re: A Third Solution

#292

Post by evross »

marcell wrote: post #21
johnnyo wrote: post #12

Earlier quoted context omitted.

The things that generally kill Americans (heart disease, cancer, car crashes, diabetes, etc) aren’t contagious, so this is a bad analogy.

No analogy is perfect, but people need context to understand fatality rates, and see what risk is acceptable. Society doesn't have a goal of 0% death rates. We all accept some risk of death as a cost of continued existence. New data is showing that the fatality rate from covid-19 is more like existing risk we were all previously exposed to in the course of our existence, and not like a second version of smallpox.

The graphs on this page shows the situation for NY. It is clear that the risk can't be compared with 2009's H1N1. It's sobering. https://www.nytimes.com/interactive/2020/04/10/upshot/corona...

We need to give the scientists and medical professionals and industry more time to figure out how best to prevent this. There are many reports of 40-50 day illnesses in young people due to not clearing the virus. And the poorly named 'mild' case can be rough. It's (badly imo) defined as when a patient doesn't require hospital. It should be called moderate I think. [1]

[1] https://www.businessinsider.com/what-coronavirus-mild-sympto...

Re: A Third Solution

#294

Post by user5994461 »

toyg wrote: post #262
distantaidenn wrote: post #218

This is essentially what South Korea did. Granted it was done in a different way but everyone was “tested.” I was there just as covid-19 was on the rise and every shop, every station, and every high traffic area had people set up with thermal guns. Shop staff were having their temps checked before their shifts started. Everyone was gloved and masked. And once they had a proper test in place it was made easily accessi…

They learnt from the previous SARS bout, reportedly thanks to a number of political factors aligning properly. The sad thing is that basically nobody else did, among major players. Even other countries in the area (i.e. Japan and China) just went “phew!” after SARS and didn’t substantially review their response strategies. Which is how China was caught napping, Japan is still fundamentally in denial, and everyone els…

China had dispatched detachments of specialists to evaluate the unknown disease in mid December. They knew they were facing a new coronavirus ala SARS end of December and started closing Wuhan then other provinces in January. Not the chill lockdown like Europe, real lockdown where they close all transports, scan all citizens at checkpoints and have the police beatup people going out without masks.

Napping is not the word for that.

Re: A Third Solution

#295

Post by predxionbio »

new299 wrote: post #247
dekhn wrote: post #216

I was curious about the company that's being touted in this post so I did a little searching. The website doesn't seem to have much on it. I guess it's a YC17 company. The founders are Caroline Landau, Tim Cornell, Walker McHugh. From 2016: Landau was an MBA candidate, the other two founders have biomedical research/medical backgrounds: Walker McHugh, Co-Founder, PreDxion Bio / Biomedical engineering candidate, Unive…

Right, I think we’ve probably missed boat on developing new diagnostic methods for Sars-CoV2. In particular, this method appears to be antibody based? (Which has accuracy issues) and uses SPR, which may involve some technical risk. However, I think there’s mileage in developing methods now for the next pandemic. My personal interest is in developing programmable qPCR-like systems [1]. So that kits can be deployed ahe…

I'm not familiar with the acronym PSM. Can you expand?

Are you familiar with the work of Dr. Chui at UCSF? His group has done some really cool work using mNGS to detect/diagnose emerging/rare infections in critically-ill patients with refractory encephalopathy

Re: A Third Solution

#296

Post by downerending »

jedberg wrote: post #71
downerending wrote: post #59

This is a pleasant thought, but we can't even get most people to obey speed limits most days, even though it's far easier and we know it would save large numbers of lives.

He's proposing scanning when you enter a public space. Public spaces generally comply with these types of things because of the fear of getting caught by random inspections and steep fines and penalties.

That actually does sound a lot like the situation with speeding on freeways, at least in flyover country.

Re: A Third Solution

#297

Post by johncolanduoni »

predxionbio wrote: post #291
johncolanduoni wrote: post #257

Earlier quoted context omitted.

It’s a thing, but doing a saliva test with limited sample prep (which you need to be beat PCR, otherwise you might as well just make more known to work qPCR machines) is not something anyone has accomplished with it for any virus. It’s a promising technology; but not for having a widely deployable test before we have boring old ELISA antigen tests. Which we have developed for plenty of viruses, and which some individ…

Test complexity (sample prep, test workflow) is a real challenge to achieving testing scales at orders of magnitude above what is presently available. We should hopefully have boring old ELISA antigen tests shortly, thanks to Abbott and many of the other folks we've all heard from. The real challenge is scaling testing beyond what can be reasonably implemented from central lab facilities.

ELISA tests don’t need to be done at central lab facilities; there are plenty of machines on the market with varying levels of automation (and many already in hospitals, even in ones that aren’t particularly outstanding). I’m curious what barrier to scaling those with COVID (either by making more of these machines, or repurposing other test capacity) you’ve identified that makes bringing a totally new machine to market more attractive, from a scaling perspective.

Re: A Third Solution

#298

Post by predxionbio »

flaque wrote: post #293

I may have missed this, but how physically is this test done? Is it “spit in a tube” or “swab the back of the throat”?

Hi there. We are developing a saliva (e.g., spit in tube) type test. There are a couple of reasons for this including: - supply chain issues with flocked nasal swabs and viral transport media - enable self-sampling limiting healthcare workers SARS-CoV-2 exposures and PPE utilization

Re: A Third Solution

#299

Post by fzeroracer »

marcell wrote: post #230
fzeroracer wrote: post #139

Earlier quoted context omitted.

So would you be willing to roll the dice then for the sake of opening up society? In fact, are you willing to die for it? If given the choice between dying of COVID-19 or shutting down society, you're saying that you personally would choose to die? I'm bringing this up because the difference between this and other causes of death is that not only is this transmissible, but it also has knock-on effects that we current…

> If given the choice between dying of COVID-19 or shutting down society Obviously shut down society, but that's not the choice that exists. The choice in reality is an acceptable risk of death, or shut down society. Between those I pick the acceptable risk of death. We all make the same choice for many, many other situations.

No, what I'm directly asking you is: Are you willing to die to reopen society? I'm not asking you to to take an acceptable risk.

The reason why I bring this up is because when you argue for reopening society based on 'acceptable risk', you're not just risking your own life. You're asking other people who are at risk (ie people with asthma or other issues) to die for you.

Re: A Third Solution

#300

Post by predxionbio »

seafoam wrote: post #65

Thank you Paul. Two questions : Does this approach bypass the reagent shortages ? What are the specificity / sensitivity metrics ?

Couple of things at play here. First is we are developing a non-PCR based viral detection test. Many of the molecular tests approved rely on many of the same ancillary components (RNA extraction kits, flocked nasal swabs, viral transport media) as well as instrument systems. What we are developing is a non-molecular based test to directly detect SARS-CoV-2 particles in fluids, specifically saliva.

We've just begun our clinical testing so don't have specificity/sensitivity metrics yet, but will be sharing them when they're available.

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