The Abbott test requires an ID NOW instrument to run the test. How widespread is that $10,000 instrument? I guess each instrument could run about 80 test every 24/hours (17 minutes for a negative test).

If I was Gov. Abbott, I'd be buying every single one of those machines I could find and have it in every county in Texas. Could be massive gamechanger.

Player To Be Named Later said:

---

So I'm really getting the vibe that we shouldn't get too encouraged by this treatment protocol, given the fact that it's going to be difficult to even get it to people while it's still effective.

What a kick in the nuts.

---

I expect the testing situation to improve relatively quickly. We have gone from basically no tests to more tests than any other country in 2-3 weeks. All these tests utilize specific machines. there is a significant installed base for each of the machines it isn't like every machine is in every lab. Each new test we bring on activates another batch of installed machines for the fight and means another set of labs can pitch in.

Also, I don't think it is as dire as people are saying. It doesn't appear you need the drugs as soon as symptoms develop, but within a few days is much better than waiting for you to be on a vent. If we cans get through the backlog and get turn around down to a couple days, we should be fine.

We also need the studies to show it works. NY is doing the anti malaria and space observational study so we should get some decent data on that within a week or two. I'm pretty sure people are ramping up production on those drugs currently, but it still has to make it into the distribution channel.

Also, the anti Ebola med resdemivir is currently being tests in far along patients. I know production of that is being ramped up too.

I'm hopeful everything starts to come together over the next week or two. Treatment protocols, reduced testing wait times, and drug availability. Also, I saw duke is using a vaporized hydrogen peroxide to sterilize N95 masks for reuse. Increased production of PPE and good options for reuse will help too.

Thomas Ford 91 said:

---

The Abbott test requires an ID NOW instrument to run the test. How widespread is that $10,000 instrument? I guess each instrument could run about 80 test every 24/hours (17 minutes for a negative test).

If I was Gov. Abbott, I'd be buying every single one of those machines I could find and have it in every county in Texas. Could be massive gamechanger.

---

It is widely deployed and we should be getting close to every med lab in the country having something to test for corona between all the EUA tests. But Abbott isn't making millions of these a week, so it isn't enough on its own. Abbott is talking eventually getting to 5 mil a month between this test and their other test, and I would bet the other test will be more than half of that.

Honestly, if you can do the test in 15 min or you have to wait 4 hours doesn't really make much difference. It is the backlog that is the problem. If you have 100 patients a day coming in and can only run 80 at 24/day, you are still going to have a problem. And staffing a system to run 24/7 and have someone touching it every 15 min to put a new test in is a challenge. If you have the equipment, doing 90 of those tests in 4 hours with about 15 min hands on time is going to be a better solution, but you might need a day (got to get all the samples together first) for the results.

FbgTxAg said:

---

I still don't understand how "testing" is a game-changer. Even if it takes 10 minutes.

If I go to the doctor's office and get tested and they tell me I'm negative, the minute I walk out of the office, get in my truck, fill gas and grab some groceries at the store that test result is obsolete. I have no way of knowing that I didn't pick up the virus on the way home or in the office tomorrow or whatever.

---

Because hopefully they'll figure out that the death rate is .1-.2%.....right now nobody knows how many people have had it, what the true demographics are, etc.

Its not a 5 minute test if you have to send it to a backlogged lab. Its a 5 minute test with a 7-10 day reported result. Better than nothing but not better than what we have.

These devices need to be in the the local facilities, not remote labs. The FEMA director said there are about 18,000 nationwide. Every small county in Texas needs one at their main medical facility. It will make a huge difference weeks from now.

Thomas Ford 91 said:

---

Its not a 5 minute test if you have to send it to a backlogged lab. Its a 5 minute test with a 7-10 day reported result. Better than nothing but not better than what we have.

These devices need to be in the the local facilities, not remote labs. The FEMA director said there are about 18,000 nationwide. Every small county in Texas needs one at their main medical facility. It will make a huge difference weeks from now.

---

The Abbott Labs 5 minute test gives results at the test site. As little as 5 minutes for a positive and 13 minutes for a negative.

https://www.usatoday.com/story/news/health/2020/03/28/coronavirus-fda-authorizes-abbott-labs-fast-portable-covid-test/2932766001/

The antibody tests the UK ordered are supposedly do it yourself and result in 15 minutes. Would be awesome if it was reality.

Player To Be Named Later said:

---

So I'm really getting the vibe that we shouldn't get too encouraged by this treatment protocol, given the fact that it's going to be difficult to even get it to people while it's still effective.

What a kick in the nuts.

---

Many many people are reporting the treatment it is helping them even when severely sick.

EKUAg said:

---

Thomas Ford 91 said:

---

Its not a 5 minute test if you have to send it to a backlogged lab. Its a 5 minute test with a 7-10 day reported result. Better than nothing but not better than what we have.

These devices need to be in the the local facilities, not remote labs. The FEMA director said there are about 18,000 nationwide. Every small county in Texas needs one at their main medical facility. It will make a huge difference weeks from now.

---

The Abbott Labs 5 minute test gives results at the test site. As little as 5 minutes for a positive and 13 minutes for a negative.

https://www.usatoday.com/story/news/health/2020/03/28/coronavirus-fda-authorizes-abbott-labs-fast-portable-covid-test/2932766001/

---

You must have one of the ID NOW machines at the test site for the test to give results at the test site. There are 18,000 of those machines in the US. I'm guessing they are mostly at labs.

Thomas Ford 91 said:

---

Its not a 5 minute test if you have to send it to a backlogged lab. Its a 5 minute test with a 7-10 day reported result. Better than nothing but not better than what we have.

These devices need to be in the the local facilities, not remote labs. The FEMA director said there are about 18,000 nationwide. Every small county in Texas needs one at their main medical facility. It will make a huge difference weeks from now.

---

Small clinic in the middle of nowhere, it will be useful. Any large point of care facility will quickly get too many people needing tests for you to do them one at a time, even if it takes 5 min. It doesn't take 5 min, btw. That is just the quickest you can see a positive result (if you have a heavy viral load). Takes 13 min to get a negative result and depending on your viral load, your positive result is somewhere between 5 and 13 min.

Once you get a backlog because you had too many people come in today for a test, you are back to the same problem. Waiting for your turn in the queue. Or maybe you schedule test appointments but then you are waiting to come in to get the tests rather than waiting for the lab to send you the results.

Not sure if it's been answered, but where are the API's for these drugs manufactured? I doubt they are made in the US but hopefully we can re purpose some existing facilities

Thomas Ford 91 said:

---

EKUAg said:

---

Thomas Ford 91 said:

---

Its not a 5 minute test if you have to send it to a backlogged lab. Its a 5 minute test with a 7-10 day reported result. Better than nothing but not better than what we have.

These devices need to be in the the local facilities, not remote labs. The FEMA director said there are about 18,000 nationwide. Every small county in Texas needs one at their main medical facility. It will make a huge difference weeks from now.

---

The Abbott Labs 5 minute test gives results at the test site. As little as 5 minutes for a positive and 13 minutes for a negative.

https://www.usatoday.com/story/news/health/2020/03/28/coronavirus-fda-authorizes-abbott-labs-fast-portable-covid-test/2932766001/

---

You must have one of the ID NOW machines at the test site for the test to give results at the test site. There are 18,000 of those machines in the US. I'm guessing they are mostly at labs.

---

They are a point of care instrument. Think going to the urgent care for a flu test. Any lab will be using one of the other tests because instead of doing 1 test at a time, you can test dozens of patients at one. And 90+ patients in 4 hours is faster than 1 test every 10 minutes.

BiochemAg97 said:

---

Thomas Ford 91 said:

---

EKUAg said:

---

Thomas Ford 91 said:

---

Its not a 5 minute test if you have to send it to a backlogged lab. Its a 5 minute test with a 7-10 day reported result. Better than nothing but not better than what we have.

These devices need to be in the the local facilities, not remote labs. The FEMA director said there are about 18,000 nationwide. Every small county in Texas needs one at their main medical facility. It will make a huge difference weeks from now.

---

The Abbott Labs 5 minute test gives results at the test site. As little as 5 minutes for a positive and 13 minutes for a negative.

https://www.usatoday.com/story/news/health/2020/03/28/coronavirus-fda-authorizes-abbott-labs-fast-portable-covid-test/2932766001/

---

You must have one of the ID NOW machines at the test site for the test to give results at the test site. There are 18,000 of those machines in the US. I'm guessing they are mostly at labs.

---

They are a point of care instrument. Think going to the urgent care for a flu test. Any lab will be using one of the other tests because instead of doing 1 test at a time, you can test dozens of patients at one. And 90+ patients in 4 hours is faster than 1 test every 10 minutes.

---

So an urgent care facility probably has one of these machines? That would be awesome.

Tx-Ag2010 said:

---

Not sure if it's been answered, but where are the API's for these drugs manufactured? I doubt they are made in the US but hopefully we can re purpose some existing facilities

---

resdemivir is currently being manufactured in the US. Facility is in an eastern state.

I don't know if we (the company I work for) have switched any facilities to making the hydroxychloroquine or Zpac. How easy it would be would depend on the production method. You need different facilities for bio production vs chemical synthesis.

Thomas Ford 91 said:

---

BiochemAg97 said:

---

Thomas Ford 91 said:

---

EKUAg said:

---

Thomas Ford 91 said:

---

Its not a 5 minute test if you have to send it to a backlogged lab. Its a 5 minute test with a 7-10 day reported result. Better than nothing but not better than what we have.

These devices need to be in the the local facilities, not remote labs. The FEMA director said there are about 18,000 nationwide. Every small county in Texas needs one at their main medical facility. It will make a huge difference weeks from now.

---

The Abbott Labs 5 minute test gives results at the test site. As little as 5 minutes for a positive and 13 minutes for a negative.

https://www.usatoday.com/story/news/health/2020/03/28/coronavirus-fda-authorizes-abbott-labs-fast-portable-covid-test/2932766001/

---

You must have one of the ID NOW machines at the test site for the test to give results at the test site. There are 18,000 of those machines in the US. I'm guessing they are mostly at labs.

---

They are a point of care instrument. Think going to the urgent care for a flu test. Any lab will be using one of the other tests because instead of doing 1 test at a time, you can test dozens of patients at one. And 90+ patients in 4 hours is faster than 1 test every 10 minutes.

---

So an urgent care facility probably has one of these machines? That would be awesome.

---

Or one like it by a different manufacturer. FDA keeps approving tests so we likely get to a point where every urgent care or large doc office has a machine to run a COVID 19 test.

If only we could get to the point where we clear the backlog and have a relatively small number of new cases that they just don't end up overwhelmed with trying to run tests.

https://www.mediterranee-infection.com/wp-content/uploads/2020/03/COVID-IHU-2-1.pdf

Another positive study from France. Interesting.

DadHammer said:

---

https://www.mediterranee-infection.com/wp-content/uploads/2020/03/COVID-IHU-2-1.pdf

Another positive study from France. Interesting.

---

This is the same French trial from before, just with additional patients. At this point, we probably shouldn't be giving this Dr. Raoult anymore attention. He apparently has an extensive history of sketchy work. Read the thread below.

So what study should we take seriously, when will it be out, and will you be satisfied with the result?

barnyard1996 said:

---

So what study should we take seriously, when will it be out, and will you be satisfied with the result?

---

Well controlled, observational studies with a decent N and RCTs. Studies you should not take seriously are small case studies that have no control groups and remove patients that get sicker from their data. Unfortunately results from studies like that are not useful for guiding therapy. The only study that would completely satisfy me is a large RCT with patient centered primary outcomes (like mortality, mechanical intubation, etc.); however, that is not reasonable in the short term, so I would be okay with smaller RCTs and well controlled observational data, and then pool data from those. Many such studies are currently underway, and there has been at least one pilot RCT I posted earlier in this thread which appears to have excellent methodology, but low N.

Dr. Not Yet Dr. Ag said:

---

DadHammer said:

---

https://www.mediterranee-infection.com/wp-content/uploads/2020/03/COVID-IHU-2-1.pdf

Another positive study from France. Interesting.

---

This is the same French trial from before, just with additional patients. At this point, we probably shouldn't be giving this Dr. Raoult anymore attention. He apparently has an extensive history of sketchy work. Read the thread below.

---

NY is doing an observational study of hydrocholoquine and zpac. It isn't a randomized control trial, but will be considerably larger than the French doctor. Also, they are gathering a lot of important data, like days on a vent, etc.

Duke and others are taking part in a randomized controlled trial of Remdesivir with a 10 day course administered by IV for patients pretty far along. That is using patients from hospitals nationwide.

Dr. Not Yet Dr. Ag said:

---

DadHammer said:

---

https://www.mediterranee-infection.com/wp-content/uploads/2020/03/COVID-IHU-2-1.pdf

Another positive study from France. Interesting.

---

This is the same French trial from before, just with additional patients. At this point, we probably shouldn't be giving this Dr. Raoult anymore attention. He apparently has an extensive history of sketchy work. Read the thread below.

---

So how are treating patients? Tylenol or just letting them get sicker and die?

What's your experience?

Dr. Not Yet Dr. Ag said:

---

barnyard1996 said:

---

So what study should we take seriously, when will it be out, and will you be satisfied with the result?

---

Well controlled, observational studies with a decent N and RCTs. Studies you should not take seriously are small case studies that have no control groups and remove patients that get sicker from their data. Unfortunately results from studies like that are not useful for guiding therapy. The only study that would completely satisfy me is a large RCT with patient centered primary outcomes (like mortality, mechanical intubation, etc.); however, that is not reasonable in the short term, so I would be okay with smaller RCTs and well controlled observational data, and then pool data from those. Many such studies are currently underway, and there has been at least one pilot RCT I posted earlier in this thread which appears to have excellent methodology, but low N.

---

So your solution is to just wait it out and let more get infected and die?

Not acceptable!!!

Dr. Not Yet Dr. Ag said:

---

The large majority get better on their own. Even the 80+ yo on chemo I admitted is still doing well with just supportive care (his QTc was too long to initiate HCQ). Our hospital is reserving HCQ for those requiring ICU admission.

---

Glad to hear

Dr. Not Yet Dr. Ag said:

---

barnyard1996 said:

---

So what study should we take seriously, when will it be out, and will you be satisfied with the result?

---

Well controlled, observational studies with a decent N and RCTs. Studies you should not take seriously are small case studies that have no control groups and remove patients that get sicker from their data. Unfortunately results from studies like that are not useful for guiding therapy. The only study that would completely satisfy me is a large RCT with patient centered primary outcomes (like mortality, mechanical intubation, etc.); however, that is not reasonable in the short term, so I would be okay with smaller RCTs and well controlled observational data, and then pool data from those. Many such studies are currently underway, and there has been at least one pilot RCT I posted earlier in this thread which appears to have excellent methodology, but low N.

---

So what is your preferred treatment plan for C19?

isn't that way too late for HCQ to show efficacy?

From stories around the country we're seeing a lot of younger patients recovering well but also some seemingly healthy middle age and younger patients dying somewhat unexpectedly (or at least having serious medical issues).

Are there any theories on why it's hitting some of those healthy patients much harder than most? Or are you seeing any trends there?

HowdyTAMU said:

---

Dr. Not Yet Dr. Ag said:

---

barnyard1996 said:

---

So what study should we take seriously, when will it be out, and will you be satisfied with the result?

---

Well controlled, observational studies with a decent N and RCTs. Studies you should not take seriously are small case studies that have no control groups and remove patients that get sicker from their data. Unfortunately results from studies like that are not useful for guiding therapy. The only study that would completely satisfy me is a large RCT with patient centered primary outcomes (like mortality, mechanical intubation, etc.); however, that is not reasonable in the short term, so I would be okay with smaller RCTs and well controlled observational data, and then pool data from those. Many such studies are currently underway, and there has been at least one pilot RCT I posted earlier in this thread which appears to have excellent methodology, but low N.

---

So what is your preferred treatment plan for C19?

---

Unfortunately there really is no preferred therapy at the moment. There is just as much evidence for HCQ as there is remdesivir. Convalescent plasma therapy is another promising treatment that has just started being utilized. Most of these are being reserved for severe patients at the moment, however, given lack of evidence of efficacy.