Developments at Dadhaleh Institute

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Research: Diagnostic Testing and Treatment

WHO lists two COVID-19 tests for emergency use 7 April 2020 https://www.who.int/news-room/detail/07-04-2020-who-lists-two-covid-19-tests-for-emergency-use WHO listed the first two [ ... ]

Research on Forecasting Peak Transmission and Health System Utilization

Short-term forecasts of COVID-19 deaths in multiple countries Imperial College London, 8 April 2020 https://sangeetabhatia03.github.io/covid19-short-term-forecasts/index.html This weekly [ ... ]

Government of Canada accelerates approval for diagnostic tests

The Government of Canada has accelerated approval for the Cepheid and Abbott diagnostic tests, following the issuance [ ... ]

Increasing diagnostic testing

Many countries are experiencing shortages in diagnostic testing kits, as the development, production and distribution remain critical [ ... ]

Anticipated Drug Shortages

COVID-19: Predicting Healthcare Resource Needs in Ontario (March 23) Critical inhaler medication shortage looms as coronavirus cases [ ... ]

Accelerating access to rapid diagnostic testing

Health Canada expedites access to diagnostic lab test kits (March 18) FDA fast-tracks approval for rapid (45 [ ... ]

ngq, you sexy beast! Here is a sanity check for that clean meta. ;)

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                    [post_content] => WHO lists two COVID-19 tests for emergency use
7 April 2020
https://www.who.int/news-room/detail/07-04-2020-who-lists-two-covid-19-tests-for-emergency-use
WHO listed the first two COVID-19 diagnostic tests under the Emergency Use Listing Procedure. The move should help increase access to quality-assured, accurate tests that can now be supplied by the UN and other procurement agencies supporting the COVID-19 response. The two in vitro diagnostics include: (1) genesig Real-Time PCR Coronavirus (Primerdesign, U.K.), an open system suitable for laboratories with moderate sample testing capacity, and (2) cobas SARS-CoV-2 Qualitative assay (Roche, U.S.) is a closed system assay for larger laboratories using the cobas 6800/8800 Systems.
The FDA-approved Drug Ivermectin inhibits the replication of SARS-CoV-2 in vitro
Caly et al, Antiviral Research, 3 April 2020
https://www.sciencedirect.com/science/article/pii/S0166354220302011?via%3Dihub
Findings
Ivermectin is a widely available and used treatment for parasite infections in humans and animals, and it has an established safety profile for human use. It is also FDA-approved and appears on the WHO Model List of Essential Medicines. A single treatment of Ivermectin resulted in a 5,000-fold reduction in the SARS-Cov-2 virus at 48h in cell culture.
Interpretation
Ivermectin shows the potential to inhibit the causative virus in vitro. Further studies are needed to evaluate whether ivermectin has human clinical impact in limiting the viral load, preventing severe disease progression, and limiting person-person transmission.
An overview of the rapid test situation for COVID-19 diagnosis in the EU/EEA
European Centers for Disease Control, 1 April 2020
https://www.ecdc.europa.eu/sites/default/files/documents/Overview-rapid-test-situation-for-COVID-19-diagnosis-EU-EEA.pdf
Timely and accurate laboratory testing is an essential part of the management of COVID-19 to slow transmission, support decisions on infection control strategies, and detect asymptomatic cases that could spread the virus further. At present, clinical public health guidelines (including by the WHO) recommend COVID-19 diagnosis by molecular testing which detect the virus RNA. However, these tests require well-equipped laboratory facilities, skilled technicians and expensive reagents. Infrastructure limitations and supply shortages are currently limiting testing capacity below the growing demand for COVID- 19 diagnostics. This report surveys the range of rapid diagnostic tests that are currently available – including rapid antigen testing – in order to alleviate the pressure on laboratories and expand testing capacity to meet the most urgent medical and public health needs.

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                    [post_content] => Short-term forecasts of COVID-19 deaths in multiple countries
Imperial College London, 8 April 2020
https://sangeetabhatia03.github.io/covid19-short-term-forecasts/index.html
This weekly report by Imperial College London presents forecasts of transmission and mortality estimates over the coming week for 42 countries with active transmission, accounting for the impact of control measures. The caveat with these forecasts is that accuracy varies with the quality of surveillance and reporting, i.e. presenting likely underestimates for countries with poor reporting. That said, based on transmissibility estimates, the COVID-19 epidemic is expected to demonstrate:

Stabilizing patterns in 14 countries (including Italy, Iran, Iraq, South Korea);
Slow-growth transmission (1<Rt<2) in Spain and Netherlands; and
Rapidly growing transmission (Rt>2) across 26 countries (including Algeria, Brazil, Canada, China, Egypt, France, Germany, India, Japan, Peru, Turkey, U.K. and U.S.).

Based on central forecasting trends, reported deaths in the coming week are expected to be:

Relatively small (<100) and large (100-1000) in 29 countries;
Large (1,000-5,000) in 8 countries (including Algeria, Brazil, Germany, Iran, and Turkey); and
Very large (5,000+) in 5 countries (France, Italy, Spain, U.K. and U.S).

New COVID-19 forecasts for Europe: Italy & Spain have passed the peak of their epidemics; UK, early in its epidemic, faces a fast-mounting death toll
Institute for Health Metrics and Evaluation, 7 April 2020
http://www.healthdata.org/news-release/new-covid-19-forecasts-europe-italy-spain-have-passed-peak-their-epidemics-uk-early-its
New COVID-19 forecast from IHME found that among European nations, the peak daily death rate from the pandemic will occur during the third week of April, with the pandemic spreading from Southern Europe. According to current trajectories, 151,680 COVID-19 deaths could occur during the “first wave” of the pandemic in Europe, while the U.S. is expected to face 81,766 deaths. Declines in deaths are now occurring in Italy and Spain as most regions in the two countries have passed their peaks in the number of deaths, while other nations are approaching their peaks and still others facing peak mortality later in April. The death toll in many countries is compounded by demand for hospital resources well in excess of what is available. Predicted peaks in daily COVID-19 deaths appear to be highly variable among EEA countries, likely reflecting the equally variable ways that the novel coronavirus initially spread and then continued to affect Europe.
Projecting hospital utilization during the COVID-19 outbreaks in the United States
Moghadas et al, National Academy of Sciences, 3 April 2020
https://www.pnas.org/content/117/16/9122
Findings
Without isolation and with R0 = 2.5, treatment of critically ill patients at the outbreak peak would require 3.8x more ICU beds than exist in the U.S. (or 2x if R0 = 2). With self-isolation by 20% of cases within 24 hours of symptom onset, the outbreak trajectory would delay and flatten, and the number of ICU beds needed at the peak would reduce by 48.4% (or 73.5% if R0 = 2).
Interpretation
Hand washing and self-isolation is shown to significantly contribute to reducing the rate of spread of COVID-19, and therefore reducing the number of ICU beds needed at any one time. This could facilitate emergency mobilization to expand mobilization of critical care capacity to handle the burgeoning outbreak.

                    [post_title] => Research on Forecasting Peak Transmission and Health System Utilization
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                    [post_content] => The Government of Canada has accelerated approval for the Cepheid and Abbott diagnostic tests, following the issuance of an Interim Order by the Minister of Health on March 18 to expedite access to COVID-19-related medical devices. The COVID-19 Emergency Response Act (Bill C-13) also received royal assent on March 25. Among the sweeping number and scope of measures, the COVID-19 Emergency Response Act amends the Patent Act in order to allow the Government of Canada to issue compulsory licenses to respond to a “public health emergency that is a matter of national concern,” which could apply to diagnostic kits but also personal protective equipment, medical devices and therapeutic products.

                    [post_title] => Government of Canada accelerates approval for diagnostic tests
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                    [post_content] => Many countries are experiencing shortages in diagnostic testing kits, as the development, production and distribution remain critical challenges that impede early detection and access to care. There are also reports of significant backlogs, in some cases taking over a week to provide results. Further efforts are needed in the development and scaling up of rapid (real-time) diagnostic tests.
The Foundation for Innovative New Diagnostics (FIND), a WHO Collaborating Centre for Laboratory Strengthening and Diagnostic Technology Evaluation, has curated a list of the current Diagnostic Pipeline, while the U.S. FDA has now issued Emergency Use Authorizations to at least three COVID-19 rapid diagnostic tests over the last week, including:

Cepheid Xpert Xpress SARS-Cov-2 Test (45min)
Mesa Biotech Accula SARS-Cov-2 Test (30min)
Abbott ID NOW COVID-19 Rapid Test (5-15min)


                    [post_title] => Increasing diagnostic testing
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COVID-19: Predicting Healthcare Resource Needs in Ontario (March 23)
Critical inhaler medication shortage looms as coronavirus cases soar (March 23)
Drug Shortage Concerns Are Top of Mind Amid COVID-19 Outbreak (March 20)
Real-World Shortages Not Addressed in New COVID-19 Guidance (March 20)


                    [post_title] => Anticipated Drug Shortages
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                    [post_content] => Health Canada expedites access to diagnostic lab test kits (March 18)
FDA fast-tracks approval for rapid (45 min) diagnostic test (March 20)

                    [post_title] => Accelerating access to rapid diagnostic testing
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            [post_content] => WHO lists two COVID-19 tests for emergency use
7 April 2020
https://www.who.int/news-room/detail/07-04-2020-who-lists-two-covid-19-tests-for-emergency-use
WHO listed the first two COVID-19 diagnostic tests under the Emergency Use Listing Procedure. The move should help increase access to quality-assured, accurate tests that can now be supplied by the UN and other procurement agencies supporting the COVID-19 response. The two in vitro diagnostics include: (1) genesig Real-Time PCR Coronavirus (Primerdesign, U.K.), an open system suitable for laboratories with moderate sample testing capacity, and (2) cobas SARS-CoV-2 Qualitative assay (Roche, U.S.) is a closed system assay for larger laboratories using the cobas 6800/8800 Systems.
The FDA-approved Drug Ivermectin inhibits the replication of SARS-CoV-2 in vitro
Caly et al, Antiviral Research, 3 April 2020
https://www.sciencedirect.com/science/article/pii/S0166354220302011?via%3Dihub
Findings
Ivermectin is a widely available and used treatment for parasite infections in humans and animals, and it has an established safety profile for human use. It is also FDA-approved and appears on the WHO Model List of Essential Medicines. A single treatment of Ivermectin resulted in a 5,000-fold reduction in the SARS-Cov-2 virus at 48h in cell culture.
Interpretation
Ivermectin shows the potential to inhibit the causative virus in vitro. Further studies are needed to evaluate whether ivermectin has human clinical impact in limiting the viral load, preventing severe disease progression, and limiting person-person transmission.
An overview of the rapid test situation for COVID-19 diagnosis in the EU/EEA
European Centers for Disease Control, 1 April 2020
https://www.ecdc.europa.eu/sites/default/files/documents/Overview-rapid-test-situation-for-COVID-19-diagnosis-EU-EEA.pdf
Timely and accurate laboratory testing is an essential part of the management of COVID-19 to slow transmission, support decisions on infection control strategies, and detect asymptomatic cases that could spread the virus further. At present, clinical public health guidelines (including by the WHO) recommend COVID-19 diagnosis by molecular testing which detect the virus RNA. However, these tests require well-equipped laboratory facilities, skilled technicians and expensive reagents. Infrastructure limitations and supply shortages are currently limiting testing capacity below the growing demand for COVID- 19 diagnostics. This report surveys the range of rapid diagnostic tests that are currently available – including rapid antigen testing – in order to alleviate the pressure on laboratories and expand testing capacity to meet the most urgent medical and public health needs.

            [post_title] => Research: Diagnostic Testing and Treatment
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