On 2019-08-03 19:22:31, user GuyguyKabundi Tshima wrote:

Dear all, here is the daily bulletin on the evolution of the response to the Ebola Virus Disease outbreak of 01 August 2019. The field information verification process has been more painful because of the sensitivity of the events on the ground. .<br /> Please be indulgent for the delay.

EVOLUTION OF THE EBOLA EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI

Thursday, August 01, 2019

Epidemiological Status of Ebola Virus Disease as of 31 July 2019

Since the beginning of the epidemic, the cumulative number of cases is 2,713, of which 2,619 confirmed and 94 probable. In total, there were 1,823 deaths (1,729 confirmed and 94 probable) and 782 people healed.<br /> 423 suspected cases under investigation;<br /> 13 new confirmed cases, including 5 in Beni, 2 in Mabalako, 2 in Mandima, 1 in Nyiragongo (Goma), 1 in Vuhovi, 1 in Katwa and 1 in Mutwanga;<br /> 10 new confirmed cases deaths:<br /> 2 community deaths, including 1 in Beni and 1 in Mandima;<br /> 7 Ebola Treatment Center (ETC) deaths, including 3 in Beni, 2 in Mabalako, 1 in Komanda and 1 in Goma;<br /> 1 death at the ETC of Beni;<br /> 6 people cured out of ETC, including 5 in Beni and 1 in Katwa;<br /> One health worker, living and vaccinated, is among the new confirmed cases in Beni. The cumulative number of confirmed / probable cases among health workers is 149 (5% of all confirmed / probable cases), including 41 deaths.

NEWS

As a reminder, the recommendations of the Ministry of Health are as follows:<br /> Follow basic hygiene practices, including regular hand washing with soap and water or ashes;<br /> If an acquaintance from an epidemic area comes to visit you and is ill, do not touch her and call the North Kivu civil protection hotline directly;<br /> If you are identified as an Ebola patient contact, agree to be vaccinated and followed for 21 days;<br /> If a person dies because of Ebola, follow the rules for safe and dignified burials. It is simply a funeral method that respects funerary customs and traditions while protecting the family and community from Ebola contamination.<br /> For all health professionals, observe the hygiene measures in the health centers and declare any patient with symptoms of Ebola (fever, diarrhea, vomiting, fatigue, anorexia, bleeding).<br /> If all citizens respect the sanitary measures recommended by the Ministry of Health, it is possible to ensure that this case of Ebola detected in Goma is only a sporadic case that does not cause a new outbreak.

Follow-up of the situation of contacts of the second case confirmed Ebola of Goma<br /> 151 contacts have been reported around the 2nd confirmed case of EVD in Goma since 22 July 2019. Among these contacts, 118 have already been vaccinated, including 70 at high risk (CHR) and 48 contact contacts (CC);<br /> The girl and the woman of this case of Goma constitute to date the 3rd and 4th positive cases of EVD recorded in Goma;<br /> The sister of this same case, who fled to the province of South Kivu, was found in Biara in the health zone of Muti Muresa. 40 contacts have already been vaccinated around this contact this Thursday, August 1, 2019, including 9 high-risk contacts and 31 contacts.

A traditional healer among the confirmed cases of Mabalako<br /> This is a 25 year old man, living and vaccinated on July 20, 2019 (geographical vaccination). He practiced self-medication on July 24-29, 2019 with a gradual worsening of symptoms.

It was taken to the CTE after validation on July 30, 2019 after the alert launched by a Community Relay (ReCo). It was confirmed MVE on July 31, 2019. 22 contact persons are listed around this case, whose investigations are ongoing.<br /> The confirmed case of Lubero on the run<br /> The confirmed case of July 25, 2019 in Lubero Health Zone (ZS), who fled into the community, is reported to be in Lukanga in the Masereka SZ, 17 km from Lubero. A team went there on Thursday, August 1st, 2019 for its transfer to CTE.

80,481,013<br /> Controlled people<br /> 98 entry points (PoE) and operational sanitary control points (PoC).

149<br /> Contaminated health workers<br /> 1 health workers, living and vaccinated, are among the new confirmed cases of Beni.<br /> The cumulative number of confirmed / probable cases among health workers is 149 (5% of all confirmed / probable cases) including 41 deaths.

Source: The press team of the Ministry of Health.

On 2019-09-30 05:15:29, user Guyguy wrote:

EVOLUTION OF THE EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI AS AT SEPTEMBER 22, 2019

The epidemiological situation of the Ebola Virus Disease dated September 22, 2019

Monday, September 23, 2019

Since the beginning of the epidemic, the cumulative number of cases is 3,168, of which 3,057 are confirmed and 111 are probable. In total, there were 2.118 deaths (2007 confirmed and 111 probable) and 975 people healed. <br /> • 343 suspected cases under investigation; <br /> • 4 new confirmed cases, including: <br /> • 1 in North Kivu in Butembo; <br /> • 3 in Ituri, including 2 in Mandima and 1 in Mambasa. <br /> • 3 new confirmed deaths, including: <br /> • 2 community deaths, including 1 in North Kivu in Butembo and 1 in Ituri in Mambasa; <br /> • 1 confirmed death in Ituri in Mandima. <br /> • No health worker is among the new confirmed cases. The cumulative number of confirmed / probable cases among health workers is 160 (5% of all confirmed / probable cases), including 41 deaths.

NEWS

Beginning of trainers training in Goma on good clinical practices related to the second Ebola vaccine <br /> • The Ebola Virus Disease Response Information Management Coordinator, representing the Technical Secretariat, Mathias Mossoko, launched on Monday in Goma the training of trainers which runs from 23 to 28 September 2019 on the good clinical practices (PCBs) related to the second Ebola vaccine. <br /> • This training benefits from the expertise of CVD's Malians on the transmission of notions about good clinical practice. It aims to provide participants with the standards applicable to the design, conduct, monitoring and stopping of studies, to teach them the activities of audit, analysis, reporting and documentation with the guarantee that these studies 'rely on sound scientific and ethical principles. It is also intended to introduce participants to the correct documentation of the clinical properties of the vaccine tested or evaluated. <br /> • The Response Information Management Coordinator called the attendance participants to demonstrate better actors for the implementation of good practice in this second vaccine. <br /> • For its part, the chairman of the Immunization Committee, Stéphane Hans, said that this five-day training announces the forthcoming launch of the second vaccine that will come at any time in the targeted health zones. "We welcome this supplementary vaccine very positively compared to the first vaccine. This second vaccine has the advantage of preventing all strains of the Ebola virus. It is therefore positive for the population that will receive it, "he said while inviting all communities targeted by this vaccination to take ownership of this activity, once launched. <br /> • The training on good clinical practice will revolve around several presentations on different topics, among others, the Ebola virus disease, the responsibilities of the INRB for the QA system, study vaccines (storage, management, chain cold and accounting), inclusion and follow-up of pregnant women, community involvement and informed consent, etc. <br /> • This training was organized for the different actors involved in this project, including doctors, epidemiologists, clinicians and pharmacists. A total of 25 people from Kinshasa, including the INRB, UNIKIN, CUK and specialized programs and North Kivu, including the Provincial Health Inspectorate (IPS), the Provincial Division of Health Centers (DPS) and Health Zone Coordinating Offices (BCZS) are participating in this meeting. <br /> As a reminder, the recommendations of the MULTISECTORAL COMMITTEE ON THE RESPONSE TO THE EBOLA VIRUS DISEASE are as follows: * <br /> 1. Follow basic hygiene practices, including regular hand washing with soap and water or ashes; <br /> 2. If an acquaintance from an epidemic area comes to visit you and is ill, do not touch her and call the North Kivu Civil Protection toll-free number; <br /> 3. If you are identified as a contact of an Ebola patient, agree to be vaccinated and followed for 21 days; <br /> 4. If a person dies because of Ebola, follow the instructions for safe and dignified burials. It is simply a funeral method that respects funerary customs and traditions while protecting the family and community from Ebola contamination. <br /> 5. For all health professionals, observe the hygiene measures in the health centers and declare any person with symptoms of Ebola (fever, diarrhea, vomiting, fatigue, anorexia, bleeding). <br /> If all citizens respect these health measures recommended by the Secretariat, it is possible to quickly end this 10th epidemic.

VACCINATION <br /> Opening of an expanded vaccination ring around two confirmed cases from 19-21 Sept 2019 in the Madidi health area in Mambasa, Ituri. Another satellite ring was opened at the Kitatumba General Referral Hospital in the Butembo Health Zone in North Kivu around the case notified on 22 09 2019. This case started the disease in the health area of Kasindi in Mutwanga, North Kivu. <br /> • The Expanded Program of Vaccines has received 4320 doses of vaccine at the national level; <br /> • Since vaccination began on August 8, 2018, 226,722 people have been vaccinated; <br /> • The only vaccine to be used in this outbreak is the rVSV-ZEBOV vaccine, manufactured by the pharmaceutical group Merck, following approval by the Ethics Committee in its decision of 20 May 2018.

MONITORING AT ENTRY POINTS <br /> • High-risk contact was intercepted at Kangote PoC in Butembo, North Kivu. This is a 28-year-old unvaccinated woman on the 14th day (D14) follow-up who was listed around a confirmed case in the Katwa Health Zone. During her interception, this woman presented some signs related to the #Ebola Virus Disease. She was sent to the Butembo CTE for treatment. <br /> • Kituku PoC providers in Goma, North Kivu, were assaulted by about 20 onlookers called "Maibobo" who were avenging one of their drowned during the night of 20 to 21 September 2019. These providers feel insecure and ask to be supported by officers of the National Police (PNC) or FARDC. <br /> • Since the beginning of the epidemic, the total number of travelers checked (temperature measurement) at the sanitary control points up to 22 September 2019 is 96,998,860; <br /> • To date, a total of 111 entry points (PoE) and sanitary control points (PoCs) have been set up in the provinces of North Kivu and Ituri to protect the country's major cities and prevent the spread of the epidemic in neighboring countries.

LEXICON <br /> • A community death is any death that occurs outside a Ebola Treatment Center. <br /> • A probable case is a death for which it was not possible to obtain biological samples for confirmation in the laboratory but where the investigations revealed an epidemiological link with a confirmed or probable case.

On 2019-10-04 22:38:03, user GuyguyKabundi Tshima wrote:

EVOLUTION OF THE EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI AS AT 03 OCTOBER 2019

Friday, October 04, 2019

Since the beginning of the epidemic, the cumulative number of cases is 3,201, of which 3,087 are confirmed and 114 are probable. In total, there were 2.139 deaths (2025 confirmed and 114 probable) and 999 people cured.<br /> 451 suspected cases under investigation;<br /> 3 new confirmed cases, including:<br /> 1 in North Kivu in Beni;<br /> 2 in Ituri, including 1 in Mambasa and 1 in Mandima;<br /> 2 new confirmed deaths in North Kivu, including 1 in Beni and 1 in Mabalako;<br /> 4 people healed from the CTE in North Kivu in Beni;<br /> No health workers are among the newly confirmed cases. The cumulative number of confirmed / probable cases among health workers is 161 (5% of all confirmed / probable cases), including 41 deaths.<br /> Day 18 without response activities in the Lwemba Health Area in Mandima, Ituri.

LEXICON<br /> • A community death is any death that occurs outside a Ebola Treatment Center.<br /> • A probable case is a death for which it was not possible to obtain biological samples for confirmation in the laboratory but where the investigations revealed an epidemiological link with a confirmed or probable case.

NEWS<br /> The 10th Ebola Virus Disease epidemic in the DRC reaches its 1000th cure<br /> - The thousandth cured of the Ebola Virus Disease came out Friday of the Mangina CTE in Mabalako in North Kivu Province;<br /> - Indeed, this 1000th cured is part of four healed Friday of this CTE. It is about a woman, quarantine gone, case contact of her nephew with the Air of Health of Lwemba with Mandima in Ituri. As soon as she felt the fever, she went to the Health Center, where she was detected as a suspected case and transferred directly to the CTE. She was confirmed and followed her treatment until recovery. She advises the population to go quickly to the Health Center and not fear the CTE to cure Ebola Virus Disease;<br /> - Among these four cures, there is also a health provider. This is an ambulance hygienist, the 1001 st healed, who was contaminated during the unloading of his personal protective equipment (PPE). He recommended a lot of protection and precautions to all hygienists when removing PPE. And in case of possible contamination, do not panic, but rather go quickly to the Health Center for appropriate treatment;<br /> - For the Ebola Epidemic Epidemic Response Coordinator, Dr. Faustin Bile Saka, these healers will be the ambassadors for the response in their respective communities and testify that when we arrive early we have the chance to come out healed like them. He handed out the certificates of release to the cured, with the various partners of the response, WHO and IMC to the 1000, 1001, 1002 and 1003 th cures of the Ebola Virus Disease in the DRC;<br /> - As a miracle, the 10th epidemic of the Ebola Virus Disease began around the end of July 2018 and declared in early August 2019 in Mangina and it is still in Mangina, where came the 1000th cured.

VACCINATION

• Since vaccination began on August 8, 2018, 232,725 people have been vaccinated;
• The only vaccine to be used in this outbreak is the rVSV-ZEBOV vaccine, manufactured by the pharmaceutical group Merck, following approval by the Ethics Committee in its decision of 20 May 2018.

MONITORING AT ENTRY POINTS

• Since the beginning of the epidemic, the total number of travelers checked (temperature measurement ) at the sanitary control points is 102,092,950 ;
• To date, a total of 111 entry points (PoE) and sanitary control points (PoCs) have been set up in the provinces of North Kivu and Ituri to protect the country's major cities and prevent the spread of the epidemic in neighboring countries.

As a reminder, the recommendations of the MULTISECTORAL COMMITTEE OF THE RESPONSE TO EBOLA VIRUS DISEASE are as follows:

1. Follow basic hygiene practices, including regular hand washing with soap and water or ashes;
2. If an acquaintance from an epidemic area comes to visit you and is ill, do not touch her and call the North Kivu Civil Protection toll-free number;
3. If you are identified as a contact of an Ebola patient, agree to be vaccinated and followed for 21 days;
4. If a person dies because of Ebola, follow the instructions for safe and dignified burials. It is simply a funeral method that respects funerary customs and traditions while protecting the family and community from Ebola contamination.
5. For all health professionals, observe the hygiene measures in the health centers and declare any person with symptoms of # Ebola (fever, diarrhea, vomiting, fatigue, anorexia, bleeding).<br /> If all citizens respect these health measures recommended by the Secretariat, it is possible to quickly end this 10th epidemic.

On 2019-10-07 13:54:02, user GuyguyKabundi Tshima wrote:

EPIDEMIOLOGICAL SITUATION

EVOLUTION OF THE EBOLA EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI OCTOBER 05, 2019<br /> Sunday, October 06, 2019<br /> Since the beginning of the epidemic, the cumulative number of cases is 3,204, of which 3,090 are confirmed and 114 are probable. In total, there were 2,142 deaths (2028 confirmed and 114 probable) and 1004 people healed.<br /> 414 suspected cases under investigation;<br /> No new cases confirmed;<br /> 1 new confirmed death at CTE in Ituri in Komanda;<br /> No one healed out of ETCs;<br /> No health workers are among the newly confirmed cases. The cumulative number of confirmed / probable cases among health workers is 161 (5% of all confirmed / probable cases), including 41 deaths.<br /> Day 19 without response activities in the Lwemba Health Area in Mandima, Ituri, where the dialogue continues in the community.

NEWS

Reconciliation between displaced people from Lwemba to Biakato and communities left in Lwemba in Mandima in Ituri

The Lwemba communities that moved to Biakato in Mandima in Ituri reconciled on Sunday 06 October 2019 with the communities that had remained in Lwemba in the presence of the response team led by the Deputy General Coordinator, Dr. Justus Nsio Mbeta, head of the Cheffery and Mandima MCZ, coordinator of Mangina's sub-coordination of the response, as well as some partners from the Ministry of Health, including WHO, MSF, UNICEF and United Nations ;<br /> - From this meeting, follows the following recommendations: setting up a community committee to support the response, the local recruitment of sensitizers in the monitoring of community-based surveillance, decontamination and the workforce in the community. burning houses. The Ministry of Health has promised the next supply of drugs to Lwemba;<br /> - The Deputy General Coordinator for the Ebola Virus Epidemic Response, representing the Ministry of Health and the Technical Secretariat of the CMRE, Dr. Justus Nsio Mbeta, took this opportunity to recall the regulatory role of the Ministry of Health and the role of each partner involved in the response;<br /> - For the community victim of the fire, they ask for the guarantee of their security, the emergency humanitarian aid, the compensation of their destroyed property and the reconstruction of their burned houses, the commitment or the hiring of all victims in the various services at all levels, the immediate arrest of all the alleged perpetrators of these uncivil acts and the care of the children affected;<br /> - These fires occurred following the death of a nurse from Lwemba, confirmed with Ebola Virus Disease. His death sparked the uprising of the population to burn down the houses and other property of all the unknowns of Lwemba. This remains the cause, even, the cessation of the activities of the response in this Health Area for more than 15 days;<br /> - The leaders of the Lwemba community also asked for the construction of the houses for the displaced, the organization of an intercommunal dialogue session by the Administrator of the territory or his delegate and the rehabilitation of the road leading to Lwemba ;<br /> - In the response, WHO is responsible for epidemiological surveillance, communication and prevention against infection (IPC) and immunization, UNICEF is in charge of communication, psychosocial care and PCI, MSF and ALIMA take care of the treatment of patients in Ebola treatment center and PCI and psychosocial support within CTE, WFP brings food products to contacts, IOM deals with Entry and Control Points (water supply, soap and chlorine);<br /> - As for the National Institute for Biomedical Research (INRB), Dr. Nsio stated that he is in charge of the diagnosis and gives MSF and ALIMA the medicines to treat patients with CTE.<br /> - The World Health Organization has pledged to rebuild burned houses, to provide community surveillance (community watch) and investigations of all suspected cases, as well as to build a transit center in LWEMBA, while UNICEF has pledged to improve communication and awareness through the use of space, to support ICH, decontamination and psychosocial, to provide water sources and to build latrines in 5 priority schools;<br /> - On the other hand, Médecins Sans Frontières intends to help the community of Lwemba to resume primary health care, to organize triage in the Health Zones present in the village and to break the PCI, as well as to train sensitizers;<br /> - At the end of this Lwemba meeting, all partners, including WHO, UNICEF and MSF, met around the Deputy General Coordinator at the Biakato Reference Health Center to review the joint and shared planning of activities in Lwemba.

VACCINATION

• Since vaccination began on August 8, 2018, 234,108 people have been vaccinated;
• The only vaccine to be used in this outbreak is the rVSV-ZEBOV vaccine, manufactured by the pharmaceutical group Merck, following approval by the Ethics Committee in its decision of 20 May 2018.

MONITORING AT ENTRY POINTS

• Three high-risk contacts were intercepted on Saturday 05 October 2019 at Maboya Checkpoint (PoC) in Butembo. They are all from the same family and came from the Kabasha Health Area to Kalunguta for Bunyuka in Vuhovi;
• They are all contacts of a confirmed case, died of the Ebola Virus Disease (EVD) of September 30, 2019 in Kabasha;
• The first contact is an unvaccinated 8-year-old girl who presented fever at 38 ° C. She was taken to the CTE of Butembo for the care after validation of the alert was validated;
• The 2nd contact is a 24 year old man vaccinated and asymptomatic. He is the biological father of the first contact;
• 3rd contact, first contact grandmother, 54 years old, unvaccinated and asymptomatic;
• Since the beginning of the epidemic, the cumulative number of travelers checked (temperature measurement ) at the sanitary control points is 102,840,774 ;
• To date, a total of 111 entry points (PoE) and sanitary control points (PoCs) have been set up in the provinces of North Kivu and Ituri to protect the country's major cities and prevent the spread of the epidemic in neighboring countries.

As a reminder, the recommendations of the MULTISECTORAL COMMITTEE OF THE RESPONSE TO EBOLA VIRUS DISEASE are as follows:

1. Follow basic hygiene practices, including regular hand washing with soap and water or ashes;
2. If an acquaintance from an epidemic area comes to visit you and is ill, do not touch her and call the North Kivu Civil Protection toll-free number;
3. If you are identified as a contact of an Ebola patient, agree to be vaccinated and followed for 21 days;
4. If a person dies because of Ebola, follow the instructions for safe and dignified burials. It is simply a funeral method that respects funerary customs and traditions while protecting the family and community from Ebola contamination.
5. For all health professionals, observe the hygiene measures in the health centers and declare any person with symptoms of # Ebola (fever, diarrhea, vomiting, fatigue, anorexia, bleeding).<br /> If all citizens respect these sanitary measures recommended by the Secretariat, it is possible to quickly end this 10th epidemic.

On 2019-10-16 13:01:03, user GuyguyKabundi Tshima wrote:

EVOLUTION OF THE EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI AS AT OCTOBER 13, 2019<br /> Monday, October 14, 2019<br /> Since the beginning of the epidemic, the cumulative number of cases is 3,220, of which 3,106 confirmed and 114 probable. In total, there were 2,150 deaths (2036 confirmed and 114 probable) and 1033 people healed.<br /> 383 suspected cases under investigation;<br /> 2 new confirmed cases at CTE in Ituri in Mandima;<br /> No new confirmed deaths have been recorded;<br /> 1 person healed out of CTE in Ituri in Mambasa;<br /> No health workers are among the newly confirmed cases. The cumulative number of confirmed / probable cases among health workers is 161 (5% of all confirmed / probable cases), including 41 deaths.

NEWS

Governors of North Kivu and Ituri Raise Awareness on Ebola Virus Disease in Biakato, Ituri<br /> - The Technical Secretariat of the Multisectoral Ebola Epidemic Response Committee (CMRE) in collaboration with the Governor of North Kivu, Carly Nzanzu and Ituri, Jean Bamanisa, organized this Monday October 14, 2019 an awareness raising day on Ebola Virus Disease in Biakato, Ituri;<br /> - This tripartite awareness-raising aimed to share the experience of North Kivu on Ebola Virus Disease and to show that the movement of people between the two provinces can encourage further spread of this epidemic in the region, as much as the last four cases recorded in North Kivu (in Beni and Kalunguta) came from Biakato;<br /> - The governor of North Kivu has indeed responded favorably to the invitation of the Technical Secretariat of the CMRE because he wants to reinforce the surveillance in his province and refuses to see his province plunge into the epidemic;<br /> - To achieve their objectives the two governors were accompanied each by a strong delegation, where one finds the presidents of their provincial assemblies and some influential deputies of their respective countries;<br /> - In addition, the Ebola Virus Epidemic Response Coordination Team, which has been in the Mambasa Health Zone in Ituri for the past week, has been monitoring Bavalakaniki Control Points and Mabakese in this health zone.

VACCINATION

• Since vaccination began on 8 August 2018, 237,956 people have been vaccinated;
• The only vaccine to be used in this outbreak is the rVSV-ZEBOV vaccine, manufactured by the pharmaceutical group Merck, following approval by the Ethics Committee in its decision of 20 May 2018.

MONITORING AT ENTRY POINTS

• Since the beginning of the epidemic, the total number of checked travelers (temperature rise) at the sanitary control points is 105,840,505 ;
• To date, a total of 111 entry points (PoE) and sanitary control points (PoCs) have been set up in the provinces of North Kivu and Ituri to protect the major cities of the country. countries and prevent the spread of the epidemic in neighboring countries.

As a reminder, the recommendations of the MULTISECTORAL COMMITTEE OF THE RESPONSE TO EBOLA VIRUS DISEASE are as follows:

1. Follow basic hygiene practices, including regular hand washing with soap and water or ashes;
2. If an acquaintance from an epidemic area comes to visit you and is ill, do not touch her and call the North Kivu Civil Protection toll-free number;
3. If you are identified as a contact of an Ebola patient, agree to be vaccinated and followed for 21 days;
4. If a person dies because of Ebola, follow the instructions for safe and dignified burials. It is simply a funeral method that respects funerary customs and traditions while protecting the family and community from Ebola contamination.
5. For all health professionals, observe the hygiene measures in the health centers and declare any person with symptoms of # Ebola (fever, diarrhea, vomiting, fatigue, anorexia, bleeding).<br /> If all citizens respect these health measures recommended by the Secretariat, it is possible to quickly end this 10th epidemic.

On 2019-11-19 17:15:54, user Guyguy wrote:

EPIDEMIOLOGICAL SITUATION OF THE EVOLUTION OF THE EBOLA VIRUS DISEASE EPIDEMIC IN THE PROVINCES OF NORTH KIVU AND ITURI IN THE DEMOCRATIC REPUBLIC OF THE CONGO AT NOVEMBER 17, 2019

Monday, November 18, 2019

• Since the beginning of the epidemic, the cumulative number of cases is 3,296, of which 3,178 are confirmed and 118 are probable. In total, there were 2,196 deaths (2,078 confirmed and 118 probable) and 1,070 people healed.<br /> • 407 suspected cases under investigation;<br /> • 4 new confirmed cases in North Kivu, including 2 in Mabalako, 1 in Beni and 1 in Oicha;<br /> • 1 new death of confirmed cases, including:<br /> o 1 new community death in North Kivu in Oicha;<br /> o No new deaths among confirmed cases in CTEs;<br /> • No cured person has emerged from CTEs;<br /> • No health worker is among the new confirmed cases. The cumulative number of confirmed / probable cases among health workers is 163 (5% of all confirmed / probable cases), including 41 deaths;

NEWS

NOTHING TO REPORT

VACCINATION

• 147 people were vaccinated, until Saturday, November 16, 2019, with the 2nd Ad26.ZEBOV / MVA-BN-Filo vaccine (Johnson & Johnson) in the two health zones of Karisimbi in Goma;

• Since the start of vaccination on August 8, 2018 with the rVSV-ZEBOV vaccine, 253,545 people have been vaccinated;

• Approved October 22, 2019 by the Ethics Committee of the School of Public Health of the University of Kinshasa and October 23, 2019 by the National Ethics Committee, the second vaccine, called Ad26.ZEBOV / MVA-BN -Filo, is produced by Janssen Pharmaceuticals for Johnson & Johnson;

• This new vaccine is in addition to the first, the rVSV-ZEBOV, vaccine used until then (since August 08, 2018) in this epidemic manufactured by the pharmaceutical group Merck, after approval of the Ethics Committee on May 20, 2018. has recently been approved.

MONITORING AT ENTRY POINTS

• New positive case among Mukulya Checkpoint alerts in Beni, North Kivu. It is a lifeless body of a 35-year-old man from Oicha for burial at Kabasha in Butembo;<br /> • Since the beginning of the epidemic, the total number of travelers checked (temperature rise) at the sanitary control points is 117,987,763 ;

• To date, a total of 112 entry points (PoE) and sanitary control points (PoCs) have been set up in the provinces of North Kivu and Ituri to protect the country's major cities and prevent the spread of the epidemic in neighboring countries.

As a reminder, the recommendations of the MULTISECTORAL COMMITTEE OF THE RESPONSE TO EBOLA VIRUS DISEASE are as follows:

1. Follow basic hygiene practices, including regular hand washing with soap and water or ashes;
2. If an acquaintance from an epidemic area comes to visit you and is ill, do not touch her and call the North Kivu Civil Protection toll-free number;
3. If you are identified as a contact of an Ebola patient, agree to be vaccinated and followed for 21 days;
4. If a person dies because of Ebola, follow the instructions for safe and dignified burials. It is simply a funeral method that respects funerary customs and traditions while protecting the family and community from Ebola contamination.
5. For all health professionals, observe the hygiene measures in the health centers and declare any person with symptoms of Ebola (fever, diarrhea, vomiting, fatigue, anorexia, bleeding).<br /> If all citizens respect these health measures recommended by the Secretariat, it is possible to quickly end this 10th epidemic.

On 2019-10-28 19:46:45, user Mark Yarbrough wrote:

Does anybody have any code examples of how to extract data in the proper structure from the MIMICIII data, (I have official access), into PheWAS for r? I/We are working on our practicum and focusing on type - 2 diabetes - we also want to try clustering on such data using K-mediods for mixed-type features in many columns - with ICD9 codes one-hot encoded.

On 2020-01-25 10:47:13, user stucash wrote:

I am not sure if this is due to the "preprint" nature of paper, but a few points that look a bit suspicious:<br /> 1. The actual data set used to conduct the estimation was not disclosed in paper;<br /> 2. The research method for estimation was also not disclosed in paper<br /> 3. Reasoning for the employed assumptions and not others? Reasoning for the employed transmission model and not others? Apparently this should be part of research method elaboration yet there's none. <br /> 4. Do all med papers come in this short?? This paper is just too descriptive and only estimation results were presented.

I'd really wait for a full-fledged version, I am reluctant to call this research.

On 2020-01-26 02:10:01, user Dzogchen wrote:

The r0 estimated here at 3.8 seems significantly higher than first estimates by WHO and is likely the biggest factor and assumption above. Only thing I think we can say for certain is r0 is > 1 at this point.

On 2020-01-26 06:35:13, user Wes Wong wrote:

Is the methods supplement available anywhere? I can't find it

On 2020-01-27 17:59:25, user robertinventor wrote:

Just to say the author of this paper tweeted that they now estimate it as 2.5 95% CI 2.4, 2.6 for R0 which would change all the projectons.

This version says 3.8 (95% confidence interval, 3.6-4.0),

Likely those confidence intervals need revising to, if it changes so much with an extra day of data. It is a non peer reviewed preprint.

https://twitter.com/JonRead...

On 2020-01-27 18:30:54, user Cyborg Gabe wrote:

In reviewing the supplementary model details, I note that the rate of exposure in each city is assumed to be directly proportional to the number of infected individuals in that city. However, if quarantine measures being taken in affected areas are at all successful, then this assumption will not be correct. Instead, a declining proportion of the infected will infect others as successful quarantines take effect. I suspect that implementing this change in the model would significantly change the model predictions, though it would require some method of estimating the success of the quarantines.

On 2020-02-02 21:55:47, user hvoltbb wrote:

Also see this one:<br /> https://doi.org/10.1016/S01...

Those people did exactly the same thing as in this article but with better traffic data, and better discussion. They also paraphrased the terms pretty good.

On 2020-01-28 21:44:55, user Nan-Hung Hsieh wrote:

A minor comment for your result. According to the code you shared, the interval you used in the paper is confidence interval, not credible interval. For example, on page 4, the 95% credible interval should be [4.5, 7.5]. You can use bayestestR package to double-check the result.

On 2020-02-06 06:41:02, user Ben Berman wrote:

I want to point out that we recently reported a strong association between global hypomethylation and a proliferative gene expression signature (including key cell cycle markers like FOXM1) in a pan-cancer analysis of TCGA tumors (Zhou and Dinh et al., Nat. Genetics 2018 https://doi.org/10.1038/s41... ). We also reported increased copy number alterations and transposable element insertions in the hypomethylated tumors. We proposed a passive demethylation mechanism, whereby late replicating regions are less efficiently maintained during mitosis in both normal and cancer cells, resulting in both age- and cancer-associated hypomethylation. In our pan-cancer analysis, we found relatively high expression of DNMTs and UHRF1 in hypomethylated tumors, so your findings of low expression in these genes may be a consequence of your normalization to proliferation markers, or something ovarian cancer specific (we did not include ovarian cancer in our analysis, since we did not have 450k data for that cancer type). Please let me know if you have any questions.

On 2020-02-16 21:25:17, user Paul Curto wrote:

You can check this site for daily updates:

https://www.worldometers.in...

The formula which you may use to provide a first-order estimate for <br /> how many deaths daily may occur within a given number of days can be <br /> expressed by:

1.1 raised to the power of the number of days into the future from today, times the current daily death toll

The 1.1 is the ratio of today's death toll divided by yesterday's <br /> death toll as of February 12, 2020. We may use a three day running <br /> average to smooth out the data for spurts of death.

If you use this data and formula, you get over half a million deaths per day within 90 days.

You get over 10 million deaths per day after 120 days.

You get a number in the billions by Thanksgiving.

So much for a seasonal flu. This is a weaponized killer of billions of people.

Since the cat is out of the bag and we still allow cruise ships and <br /> aircraft to use the facilities of over 27 nations outside of China that <br /> have infections, we won't be far behind, at most a few weeks, before we <br /> succumb. Expect a very sad Christmas, indeed.

On 2020-02-27 04:02:53, user ShangShang Gao wrote:

They recruited 125 patients from Nanjing Second Hospital, of which 103 were patients with new coronary pneumonia. The official data till 2.27 showed a total of 93 confirmed diagnoses in Nanjing. How did this sample data come?

On 2020-02-28 01:21:33, user RQ wrote:

It was an easy method to calculate the true T value and CFR without any indigestible mathematical formulas or models requiring severe calculating conditions. Actually, when different T was assumed, if it was smaller (bigger) than the true T, calculated daily CFRs would gradually increase (decrease) to infinitely near the true CFR with time went on. Left of true T is decreasing, right is increasing,so T could be easily determined, then the true CFR could be calculated. The calculated true CFR had accurately predicted the death numbers more than two weeks continuously

On 2020-03-02 16:40:24, user Abed Ghanbari wrote:

We estimated that 18,300 (95% confidence interval: 3770 – 53,470) COVID-19 cases would have had to occur in Iran, assuming an outbreak duration of 1.5 months in the country, in order to observe these three internationally exported cases reported at the time of writing.

How did you reach to these numbers?

On 2020-03-07 17:48:10, user fuyutao wrote:

Figure2 has Leucine and Serine codons swapped.

On 2020-03-08 05:57:17, user James Nokes wrote:

Highly informative paper. Thank you. A few points/questions:

1. Table 1 indicates it is contact-based surveillance with higher proportion male than female contrary to the results text.

2. How was temperature measured and what was the definition of fever?

3. How were nasal samples collected (eg nasopharyngeal swab, per-nasal swab, aspirates). Did the method differ for contact and case-based surveillance?

4. Assessing severity status - (i) can you clarify if moderate required all three of fever, respiratory symptoms, and radiographic evidence of pneumonia? What is included in 'respiratory symptoms'? (ii) How did you measure oxygen saturation?

5. Table S1. It would be useful to include the proportions with fever. The proportion of cases from symptom-based surveillance with shortness of breath (4%) or difficulty breathing (3%) is remarkably low.

On 2020-03-16 13:08:45, user Karl Milhon wrote:

I have been pushing for people to investigate the role of children in transmission very hard since the Chinese CDC first put out their descriptive epi piece. there are numerous articles and quotes pointing toward this element of Covid 19 transmission but it appears that no one is truly trying to get at the problem. Simply utilizing serology testing to do quick and dirty seroprevalence studies would provide some insight. Singapore has developed and utilized some decent serologic tests. I do not understand why this is not being more aggressively pursued.

On 2020-03-11 10:09:13, user Bob Phillips wrote:

Needs the units for bilirubin and ALT, and a very clear description of WHEN these lab tests were taken ('predicting' severe disease when a child has severe liver dysfunction on an ICU isn't that useful)

On 2020-03-13 23:55:07, user Cadence C wrote:

Singapore health ministry stated that pre-symptomatic transmission is not a prominant mode. How did the authors conclude that 40% to 80% there are asymptomatic transmission ?

On 2020-03-14 16:58:24, user J Belcar wrote:

RE immune imprinting, has anyone looked at attack rate or severity of illness in relation to previous (or recent) influenza vaccine?

On 2020-03-17 19:20:48, user RealConspiracy wrote:

And what about "-" Rh-factor?

On 2020-03-20 11:57:18, user Romain G. wrote:

No data about hypertension and diabetes mellitus in these patients, which increase risk for COVID-19 infection and severity. Should be interesting to cross the informations. Here, it is pure speculations. Has to be reviewed, but many other parameters have to be included.

On 2020-03-20 15:00:35, user Jane Ford wrote:

What about those of us with blood type B?

On 2020-03-21 17:15:33, user escabatum wrote:

There's no mention of rates of smoking, underlying lung disease, or other major risk factors between groups. This seems like a pretty useless study.

On 2020-03-20 16:15:46, user Juan B. Gutierrez wrote:

Supplemental material, data, and source code: https://tinyurl.com/USA-COV...

On 2020-03-23 16:03:24, user Ing. Alessandro Zivelonghi wrote:

no ambient temperature is reported in the study... ?????!!!!!

On 2020-03-24 14:01:51, user Sinai Immunol Review Project wrote:

Main findings<br /> The authors collected data on 25 COVID-19 patients (n=11 men, n=14 women) using standard laboratory tests and flow cytometry. All patients were treated with antibiotics. Twenty-four of the 25 patients were also treated with anti-viral Umefinovir and 14 of the patients were treated with corticosteroids. 14 patients became negative for the virus after 8-14 days of treatment. The same treatment course was extended to 15-23 days for patients who were still positive for the virus at day 14. <br /> The authors found a negative association between age and resolution of infection. Patients with hypertension, diabetes, malignancy or chronic liver disease were all unable to clear the virus at day 14, though not statistically significant.<br /> Elevated procalcitonin and a trend for increased IL-6 were also found in peripheral blood prior to the treatment.<br /> A trend for lower NK cell, T cell and B cell counts in patients was also reported. B cell, CD4 and CD8 T cell counts were only increased upon treatment in patients who cleared the virus. NK cell frequencies remained unchanged after treatment in all the patients.

Limitations of the study<br /> 73% of the patients who remained positive for SARS-CoV2 after the 1st treatment, and 43% of all patients who cleared the virus were treated with corticosteroids. Corticosteroids have strong effects on the immune compartment in blood{1}. The authors should have accounted for corticosteroid treatment when considering changes in T, NK and B cell frequencies.<br /> Assessing if IL-6 concentrations were back to baseline levels following treatment would have provided insights into the COVID-19 cytokine storm biology. Patients with higher baseline levels of IL-6 have been reported to have lower CD8 and CD4 T cell frequencies{2}. Correlating IL-6 with cell counts before and after treatment would thus have also been of interest.<br /> The report of the laboratory measures in table 2 is incomplete and should include the frequencies of patients with increased/decreased levels for each parameter.<br /> Correction is needed for the 1st paragraph of the discussion as data does not support NK cell restoration upon treatment in patients who cleared the virus. NK cells remain unchanged after the 1st treatment course and only seem to increase in 2 out of 6 donors after the 2nd treatment course in those patients.

Relevance<br /> Previous reports suggest an association between disease severity and elevated IL-6 or pro-calcitonin concentrations in COVID-19 patients3,4. IL-6 receptor blockade is also being administered to patients enrolled in clinical trials (NCT04317092). This report thus contributes to highlight elevated concentrations of these analytes in COVID-19 patients. Mechanisms underlying the association between viral clearance and restoration of the T cell and B cell frequencies suggests viral-driven immune dysregulation, which needs to be investigated in further studies.

References

1. The CHI Consortium et al. Effects of Systemically Administered Hydrocortisone on the Human Immunome. Sci Rep 6, 23002 (2016).
2. Zhao, Z. et al. Clinical and Laboratory Profiles of 75 Hospitalized Patients with Novel Coronavirus Disease 2019 in Hefei, China. http://medrxiv.org/lookup/d... (2020) doi:10.1101/2020.03.01.20029785.
3. Chen, X. et al. Detectable serum SARS-CoV-2 viral load (RNAaemia) is closely associated with drastically elevated interleukin 6 (IL-6) level in critically ill COVID-19 patients.<br /> http://medrxiv.org/lookup/d... (2020) doi:10.1101/2020.02.29.20029520.
4. Lippi, G. & Plebani, M. Procalcitonin in patients with severe coronavirus disease 2019 (COVID-19): A meta-analysis. Clinica Chimica Acta 505, 190–191 (2020).

Review by Bérengère Salomé as part of a project by students, postdocs and faculty at the Immunology Institute of the Icahn school of medicine, Mount Sinai.

On 2020-03-25 03:52:12, user Renee Chan wrote:

Hi Dr Liao, Prof Zhang and Prof Zheng, May I know if you have done any fixation of the cell isolated from BAL before doing the downstream procedure using 10X genomics?

On 2020-03-26 20:05:32, user Pedro Perez wrote:

Hemoglobinas could escape for diferent PH with cloroquina

On 2020-03-29 17:21:35, user Sinai Immunol Review Project wrote:

Title: A New Predictor of Disease Severity in Patients with COVID-19 in Wuhan, China

Keywords: disease severity – clinical data – Neutrophils/lymphocytes ratio – CRP – D-dimer

Main findings:<br /> 377 hospitalized patients were divided into two groups: severe and non-severe pneumonia. The laboratory results of their first day of admission were retrospectively analyzed to identify predictors of disease severity.<br /> After adjusting for confounding factors from chronic comorbidities (such as high blood pressure, type 2 diabetes, coronary heart disease, and chronic obstructive pulmonary disease), the independent risk factors identified for severe pneumonia were age, the ratio of neutrophil/lymphocytes counts, CRP and D-dimer levels.<br /> To further increase the specificity and sensibility of these markers, they showed that their multiplication [(Neutrophil/lymphocyte count) * CRP * D-dimer] was a better predictor of disease severity, with higher sensitivity (95.7%) and specificity (63.3%), with a cutoff value of 2.68.

Limitations:This study included 377 hospitalized patients. Among them, 45.6% patients tested positive for SARS-Cov-2 nucleic acid test results, and others were included in the study based on clinically diagnosis even if the molecular diagnosis was negative. Thus, additional studies are needed to verify this on a larger number of covid-19 certified patients and the cutoff value might be adjusted. Also, all the patients that did not have the clinical characteristics of severe pneumonia were included in the non-severe pneumonia group, but usually patients are also divided into moderate and mild disease.

Also, studying different subset of lymphocytes could lead to a more specific predictor. Another study showed that the neutrophils to CD8+ T cells ratio was a strong predictor of disease severity [1]. Another more precise study showed that the percentage of helper T cells and regulatory T cells decrease but the percentage of naïve helper T cells increases in severe cases [2]. Taking these subpopulations into account might make the predictor more powerful.<br /> Other studies also noted an inverse correlation between disease severity and LDH [3] or IL6 [4] levels, but the authors here do not discuss LDH nor IL6 levels, although this could help to strengthen the predictor.

The study is based on the results obtained on the first day of admission, studying the dynamic of the changes in patients might also be interesting to better predict disease severity.

Relevance:This study confirms that the neutrophil to lymphocyte ratio can be a predictor of disease severity as shown by many others [2], [5], [6]. The novelty here is that they show that a combination with other markers can enhance the specificity and sensibility of the predictor, although the study could be improved by taking into account sub-populations of lymphocytes and more biological factors from patients such as LDH and IL6.

References:<br /> 1. Longitudinal characteristics of lymphocyte responses and cytokine profiles in the peripheral blood of SARS-CoV-2 infected patients | medRxiv. https://www.medrxiv.org/con.... Accessed March 29, 2020.<br /> 2. Dysregulation of immune response in patients with COVID-19 in Wuhan, China | Clinical Infectious Diseases | Oxford Academic. https://academic-oup-com.do.... Accessed March 29, 2020.<br /> 3. Clinical findings in critical ill patients infected with SARS-Cov-2 in Guangdong Province, China: a multi-center, retrospective, observational study | medRxiv. https://www.medrxiv.org/con.... Accessed March 29, 2020.<br /> 4. Mortality of COVID-19 is Associated with Cellular Immune Function Compared to Immune Function in Chinese Han Population | medRxiv. https://www.medrxiv.org/con.... Accessed March 29, 2020.<br /> 5. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. - PubMed - NCBI. https://www-ncbi-nlm-nih-go.... Accessed March 29, 2020.<br /> 6. Neutrophil-to-Lymphocyte Ratio Predicts Severe Illness Patients with 2019 Novel Coronavirus in the Early Stage | medRxiv. https://www.medrxiv.org/con.... Accessed March 29, 2020.

Review written by Emma Risson as part of a project of students, postdocs and faculty at the Immunology Institute of the Icahn school of medicine, Mount Sinai.

On 2020-03-30 13:40:15, user Viktor Szathmáry wrote:

This study has fundamental flaws, both in the chosen metrics as well as the stats, plus misleading visualizations.

Details: https://www.facebook.com/53...

On 2020-03-31 15:52:10, user Pedro Thompson wrote:

Is it valid to compare an Italy with a destroyed health system against a Brazil just beginning the problem? I mean, is the mortality rate a constant, in the same country during all the epidemic?

On 2020-04-01 15:52:32, user Peter Hansen wrote:

Comments.<br /> This is a very noisy signal, because data are changing very much from week to week. Current country statistics are more influence by: <br /> 1) The time where COVID-19 began to spread in each country<br /> 2) The degree of preventive measures (e.g. compare Denmark and Sweden).<br /> So all figures in the paper might look very different 2 weeks from now.

Smaller comments.<br /> Would be nice to have a table with actual data for each country, rather than just highlighting selected countries in the figures. BTW.

Where is France in Figure 2? <br /> Number of deaths per capita in France is relatively large (higher than Denmark). <br /> The BCG was mandatory in France for school children between 1950 and 2007, and for healthcare professionals between 1947 and 2010. (Whereas Denmark stopped BCG in the mid 1980s).

On 2020-04-02 02:05:24, user Jesus Bejarano wrote:

Hi, all how can I compute (or derived) the R0 from this model?

On 2020-11-25 05:08:10, user ArthurConanDoyle wrote:

Layman here, w/Covid. Wondering why you don't use sputum for greater accuracy?

Of course, it's not as easy or ubiquitous as saliva, but maybe a sample option?<br /> The major point being accuracy is almost everything, other factors count, but...

On 2020-11-27 19:55:21, user John Butler wrote:

There seems to be either something wrong with the risk calculator or the paper text. If I choose White Female age 70-74, no comorbidities, it says 18.9% higher. I take it that means "multiply the base rate time 1.189". If I switch that to "male" it reports 119.1% higher, which would, to be consistent with the female, mean "multiply the base rate times 2.191". However, if I select Hispanic Male, 80-84 with Chronic Kidney Disease, it report 601.8%, the text reports "6 times higher". All this suggests that the White Female 70-74, as an example, is inconsistent with the form of the others.

On 2020-12-01 04:48:42, user Sandeep B wrote:

Another one !

https://www.statnews.com/20...

On 2020-12-02 11:30:50, user Rafael Moraes wrote:

This preprint has been published in a peer-review journal:

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0242251

On 2020-12-02 20:32:21, user Roberto Etchenique wrote:

Great work !! We had done the same procedure, but a bit cruder, for City of Buenos Aires, Argentina. Our results for our country (not published) are coincident with these ones. https://www.medrxiv.org/con...

On 2020-12-10 00:06:10, user Amandeep Goyal wrote:

What kind of scores or testing was used to diagnose polyneuropathy ?

What tests were used if polyneuropathy was due to Diabetes or Amyloidosis ?

On 2020-12-10 17:00:23, user Susan Bewley wrote:

Thanks Russell & team. Would it be possible for you to share the following on #medRxiv too? (i) the research information leaflet you describe, (ii) the informed consent form, (iii) the statistical plan mentioned as S2. Best wishes

On 2020-12-14 08:49:55, user Patrick Schmidt wrote:

Interesting connection between network models and standard inference on contact tracing data.

I have a paper showing that the tendency of superspreading can be estimated without contact tracing data from aggregated surveillance data alone. In line with the results here, I estimate a dispersion of 0.61 (95%-CI: [0.49, 0.77]) for Germany in spring 2020.

https://arxiv.org/pdf/2011....

On 2020-12-20 22:06:38, user Sam Smith wrote:

Is it possible to begin this treatment too early or too late, or to continue for too long?

On 2020-12-29 00:37:11, user Olga Matveeva wrote:

Several recent preprints support some of this manuscript findings.<br /> 1. Authors from Sweden and China in a study entitled “Pulmonary stromal expansion and intra-alveolar coagulation are primary causes of Covid-19 death” demonstrated that “The virus was replicating in the pneumocytes and macrophages but not in bronchial epithelium, endothelial, pericytes or stromal cells. doi: https://doi.org/10.1101/202...<br /> 2. Researchers in Brasil investigated SARS-CoV-2 infection of PBMCs and found that in vitro infection of whole PBMCs from healthy donors was productive of virus progeny. They also found that “SARS-CoV-2 was frequently detected in monocytes and B lymphocytes from COVID-19 patients, and less frequently in CD4+T lymphocytes” The preprint is entitled “Infection of human lymphomononuclear cells by SARS-CoV-2”. <br /> doi: https://doi.org/10.1101/202...<br /> 3. SARS-CoV-2 infection of macrophages and some other immune cells in deceased patients was suggested in other autopsy related preprint entitled “Broad SARS-CoV-2 cell tropism and immunopathology in lung tissues from fatal COVID-19” doi: https://doi.org/10.1101/202... The study was done by US researchers from Pittsburgh. <br /> 4. Researchers in France demonstrated “that SARS-CoV-2 efficiently infects monocytes and macrophages without any cytopathic effect.” Their findings are reported in the preprint entitled “Monocytes and macrophages, targets of SARS-CoV-2: the clue for Covid-19 immunoparalysis” doi: https://doi.org/10.1101/202...

On 2020-12-29 21:12:44, user Meerwind7 wrote:

It seems these evaluations assume that all non-pharmaceutical intervention and prevention measures (e.g. masks and “lockdowns”) would be abolished once the vaccinations start. In a different approach, these measure would be upheld for a while, for example such as to limit prevalence to a certain level for some time, or to limit the number of overall deaths. One such target could be called “partial herd immunity”, which is achieved when the combination of partial vaccination and some amount of precaution measures would in combination be sufficient to assure the reproduction factor not to exceed 1 or to achieve quick shrinking of infection numbers. The combination of some vaccine plus non-pharmaceutical interventions thus would have an effect similar to full herd immunity that is achieved when recurrent infection is avoided with fully “normal” life.

If there was only one type and scope of non-pharmaceutical intervention, an objective could be formulated as “how to minimize the duration of that intervention, when a certain maximum number of deaths (or of severe illness) shall be maintained”, taking into account vaccine doses become available slowly or other restrictions apply. A further objective should be to minimize or cap the number of vaccinated persons that are exposed to virus, because each such expose gives mutants an opportunity to break the barrier from vaccination, just like an evolutionary training.

It would also be possible to optimize vaccine distribution and non-pharmaceutical intervention while setting a target for a particular age group. Even if an upper limit of the death count of, for example, people of 75+ years was a binding target, and some non-pharmaceutical intervention is available, it may be better to vaccinate younger people first, to reduce overall transmission more quickly and then be able to “open” the society quicker, than if 75+ obtain vaccine first.

In further modeling, the extent (effect strength) of the non-phamaceutical measure could be gradually increased, while maintaining a goal like low nomber of overall deaths, lost lifetime or deaths of old people. I believe there could be some point where the results suddenly switch from vaccines for the old to vaccines for the young, and that beyond that point, the duration of the intervention could suddenly be reduced in a non-continuous way while upholding aggregate goals.

On 2020-12-30 01:49:12, user Franko Ku wrote:

Perhaps you should start over based on others' comments..<br /> Only one dose? Should be calcifediol?<br /> What were measured levels of Vit, D in those that received placebo?<br /> Many other studies show those with very low hormone (not a "vitamin" D have much more risk of dying.<br /> https://www.researchsquare....<br /> https://link.springer.com/a...<br /> https://www.sciencedirect.c...<br /> https://www.ncbi.nlm.nih.go...<br /> https://medium.com/microbia...

Needed for Prevention - your paper will prevent some from supplementing as Dr Fauci said he does.:<br /> https://www.healthline.com/...

On 2020-11-18 16:18:54, user LB wrote:

Please add, in the Limitations, a comment about the fact that, "The mean time between the onset of symptoms and randomization was 10.2 days." It is quite possible that by the time the vitamin D levels were raised, the "cytokine storm" was already well underway. Thank you!

On 2020-11-19 15:54:00, user Lorenzu Borsche wrote:

Hello, this sentence:

Subsequently, we calculated sample size assuming a 50% between-group difference in hospital length of stay (considering 7 days as a median time of stay, with an expected variability of 9 days).

to me is not quite clear: do you mean, that you preset a desired length of stay to 7 days and the grouped the data so that both groups fit these 7 days? Thus did you mean a 50:50 distribution wrt the 7 days? If so, this cannot be done without distorting the data. If not, please explain, TIA Lorenz Borsche

On 2020-11-28 13:16:44, user Angie wrote:

The description of the amount of vitamin D used doesn't account for the mistake made in calculating vitamin D needs, nor is that mistake discussed in the article. In addition, making active forms of VitD from what is ingested is not an instant magic process. A body under attack may lack the energy to carry it out. Maybe it's just giving something by a pill is ineffective right now. What if you did transdermal? That would avoid the stomach/gut which is a place we know the virus attacks. Also vitamin D doesn't act alone. A person in ICU may not get a lot of vitK and may even be on anti-K blood thinners if they are a stroke risk. How many patients were on Lovenox vs something that thins blood via the vitamin K route? A daily exposure to a UV lamp may be more efficient for providing Vitamin D.

Anyway, the point is, I am not convinced that this test was properly done with reference to vitamin D. It takes weeks to normalize vitamin D in tissues where it is needed. Just testing the blood level after you gave a bolus pill is lying to yourself. It's like adding dye to water and saying, look, the sand at the bottom of the river turned all blue, we can assume it goes deep. What's the vitamin D status of hepatocytes after the one pill you gave? How much enzyme activity was there in the kidney to activate the D you gave?

Giving someone a vitamin is not like giving them a drug. The vitamin has to go to the tissues and do its work. You're thinking far too simplistically. VitaD affects thousands of reactions in the body and is not actively excreted as if it were an invader. That's nothing like a drug. Vitamins aren't drugs, that goes double for the fat soluble ones.

On 2020-12-24 23:19:01, user Matthias Fax wrote:

By design, this study could only fail to meet its hypothesis. It only proves what was to be expected. They used inappropriate dosage in oral form. They accepted an inappropriate delay after onset of symptoms. They didn't mention the significance of 25OHD sufficiency for patient outcome, indicating that the oral dosage was given too late to be of any immunological use.

On 2020-11-18 12:16:47, user Robin Whittle wrote:

I did not see any mention about how long after supplementation the 25OHD levels were tested. D3 takes some days to be converted in the liver to circulating 25OHD.

Since the intervention was with already-hospitalised patients, on average 10 days after their symptoms began - and with 25OHD levels rising over a period days, with the average length of stay about 7 days, this intervention may have been too late, and perhaps too little.

In the Cordoba trial (Castillo et al. https://doi.org/10.1016/j.j... "https://doi.org/10.1016/j.jsbmb.2020.105751)") 0.532 mg 25OHD calcifediol would have raised 25OHD levels within a few hours, probably above 100ng/ml on average - if one extrapolates from the curve shown for 0.266mg (a single Hidroferol capsule, of which two were used in Cordoba) in this patent: https://patents.google.com/... This greatly reduced the need for intensive care and eliminated deaths.

Since hospitalised COVID-19 patients have an extremely urgent need for raised 25OHD levels, so the autocrine signaling systems of their immune cells and many other cell types can function properly (McGregor et al. https://www.biorxiv.org/con... "https://www.biorxiv.org/content/10.1101/2020.07.18.210161v1)"), a combination of 25OHD calcifediol with bolus D3 may prove more effective than either treatment alone. The bolus D3 would sustain 25OHD levels for weeks, and the D3 itself may protect the endothelium (Gibson et al. https://doi.org/10.1371/jou... "https://doi.org/10.1371/journal.pone.0140370)").

On 2021-01-05 22:41:19, user Troy Richlen wrote:

An important variable that this and other studies have not been able to adequately incorporate into this analysis is the effect of comorbidities on life expectancy of COVID-19 deaths which is due to a lack of appropriate statistical information.<<<br /> This is calculating the delta of the age of death due to Covid versus the average age of death for the population not the population of people who average 2.6 comorbidities. People who are obese, have diabetes and other significant health issues also will have a negative offset from the average age of death.

On 2021-01-15 14:43:05, user Rafael M wrote:

I would like to know the false positivity of PCR compare with the result published by the press .

On 2020-09-11 14:12:07, user Kamran Kadkhoda wrote:

Great paper but it is pivotal to highlight that correlate of protection is ONLY inferred from prospective vaccine efficacy trials instead of from convalescent cases... <br /> The inflation in MBC population shown here may very well partly be from the common CoVs

On 2020-09-13 07:31:07, user OxImmuno Literature Initiative wrote:

https://www.immunology.ox.a...

On 2020-09-14 11:45:41, user Andrew Boswell ???????????? wrote:

"We found that an increase of only 1 ????g/m3 in PM2.5 is associated with an 8% increase in the COVID-19 death rate"

Is your COVID evidence actually reflecting a more general extreme sensitivity to PMs across underlying respiratory conditions which has been detected through the lense of the COVID research. I found this tweet (https://twitter.com/AliNour... "https://twitter.com/AliNouriPhD/status/1296554508684754945?s=20)") where Dr Ali Nouri says that the same effect has also been observed for other respiratory viruses like Influenza and SARS-1, and reflects the impacts of PMs to the underlying respiratory and cardiac system.

Have you looked into this with your research?

Is there other studies out there which suggests COVID is a lense to see other more underlying effects?

On 2020-09-16 21:36:10, user Qunfeng Dong wrote:

An updated version of this manuscript is now accepted for publication at JAMIA (Journal of the American Medical Informatics Association)

On 2020-09-17 11:50:43, user Brian Kennedy wrote:

Semi - comment, also a question.

I am an economist living in Bangkok, Thailand, so this is pretty far out of my area of expertise. Thailand was the first country to get the virus outside China, but it never took off here, at this date still less than 4,000 total cases, and 60 deaths. I think there were a variety of things that led to this, but clearly early and near universal mask usage was part of it.

Your paper looks very interesting, but I could not really follow all the math. So I will trust you on it :)

My question is one of emphasis by public health officials in the U.S. Why has there not been a push on the issue of Viral Load? It seems to me that it is very important concept - even if using the mask doesn't always prevent you from getting infected, it will still reduce the viral load, giving your body more time to deal with the virus, significantly increasing your bodies chances of fighting it off.

Why has this issue been (it seems to me) largely absent from the public sphere, and from the arguments public health officials use to promote mask usage? Note if it has been there and I am missing it from far away, just say so.

Thank you for helping a laymen in your field understand :)

On 2020-09-22 20:47:31, user Scandinavian Journal wrote:

Outpatient treatment has not been the focus of almost any clinical study and this may be among the first that examine the side effects. <br /> Since the doses are very low for the hydroxychloroquine in early treatment it is no surprise that side effects is less of an issue. <br /> In fact a popular treatment is where zinc is the active component that slows virus replication and where the role of hydroxychloroquine is to act as a so called zinc ‘ionophore’ where it works to increase zinc uptake into cells. Early treatment really show so much potential and where the alarms of danger seems based on improper data for outpatient use.

Those hospital studies that gave overdose treatments to seriously ill patients showed several side effects and was incorrectly taken to represent the risks for ALL Covid-19 usage.

On 2020-09-24 14:24:26, user Uri Goldsztejn wrote:

The source code is available on Github:<br /> https://github.com/uri-gold...

On 2020-09-28 09:44:58, user markd wrote:

• very low copies number for air samples, would like to know the LOD for the detection method(s)
• 300l/' x 10' = 3mc, 50l/' x 10' = 0.5mc - why didn't you keep analysis volume the same across sites/samplers?
• can you report on the state/condition of ventilation in the sampled rooms?

On 2020-09-29 09:17:54, user Carlo Wilke wrote:

The article has been published in EMBO Molecular Medicine:

Wilke, C. et al. Neurofilaments in spinocerebellar ataxia type 3: blood biomarkers at the preataxic and ataxic stage in humans and mice. EMBO Mol Med, 2020.<br /> https://doi.org/10.15252/em...

On 2020-09-30 15:25:51, user Sinai Immunol Review Project wrote:

Very interesting paper!

Main Findings<br /> In this preprint, Zietz and Tatonetti explore the relationship between blood type and risk of SARS-CoV-2 infection, disease severity, and mortality. Using data from the electronic health records (EHR) of 1,559 patients who presented with suspected COVID-19 (with only 682 who tested SARS-CoV-2 positive) at New York Presbyterian Hospital (NYP), they analyzed four outcome pairs. Two pairs were used to test risk for infection: i) positive for infection vs negative for infection and ii) positive for infection vs general patient population. Another pair was used to test for infection severity: iii) positive patients intubated (179) vs positive patients not intubated. The last pair was used to test risk of infection-related death: iv) deceased vs surviving patients. As a measure of exposure, they used ABO blood type (A, B, AB, or O) alone or with Rh factor. In total, they generated eight contingency tables, two for each outcome pair, one with Rh and one without. Blood type was found to be significantly associated with SARS-CoV-2 infectivity after chi-squared analysis of positively vs negatively tested patients (p=0.006 for ABO system and p=0.031 for ABO+Rh system). To identify specific blood types that may predict viral test outcomes, they specifically tested each blood type against those of a different blood type for all four outcome pairs tested in the chi-squared analysis. Fisher-exact test showed that a significantly higher proportion of patients with the blood type A tested positive for the virus, and a lower proportion of patients with O and AB tested positive (p=0.009, 0.036, 0,033 respectively). When the Rh factor was included in the analysis, Rh-positive patients with the blood type A were at a 38.2% higher risk for testing positive (p=0.004), while those with the blood type O were at a 21.0% lower risk (p=0.024). Furthermore, they performed a meta-analysis by pooling data from NYP and Zhao et al’s data from China, which substantiated the findings on blood types A and O in a random-effects analysis that compared the positively infected patients with the general populations of NYP (USA), Wuhan, and Shenzhen (China) (OR=1.164, p=0.0291, for A, and OR=0.7252, p=0.0012 for O). This analysis also revealed a new increased risk of testing positive for those with blood type B (OR=1.1101, p=0.0361). Logistic regression models confirmed that although other risk factors such as diabetes, age, and obesity correlate with certain blood types, adding the blood type as a variable to the model significantly strengthens the prediction for SARS-CoV-2 positive versus negative outcome. On the other hand, blood type was not found to be a risk factor for disease severity or mortality in any of the analyses.

Limitations<br /> The study should be considered in the context of its limitations. Firstly, blood type-disease association was significant when comparing patients who tested positively for COVID-19 to those who tested negative, but the result was not replicated when comparing positively-tested patients to the general patient population. As the authors note, only a specific population received testing for COVID-19 while the majority of the patients in the EHR system were never tested, which could explain the discrepancy. Another related limitation is that the sample meant to be representative of the general population consisted only of people in NYP’s EHR database, which may be biased toward a specific population, and it is therefore unclear if the results would replicate in another cohort. Additionally, the finding that AB blood type is associated with lower risk of infection can only be taken as preliminary; the sample size was quite small (only 4.4% of the cohort had that blood type), and the result was not replicated in the meta-analysis with the data from China. Furthermore, the analyses that included Rh factor, the sample sizes for all Rh-negative subtypes were also small, and there were no patients with AB-negative blood who tested positive for the virus. This highlights the necessity for larger cohorts from multiple sites, but the preliminary results are promising.

Significance<br /> This preprint on NYP patients supports the previous results by Zhao et al on Chinese Wuhan and Shenzen patients that showed that individuals with the blood type A are at a greater risk of testing positive while those with type O are at a lower risk. As the authors reported, blood type distribution is different in NYP than in China, this substantiates their results and indicates it may be replicable in other geographical and ethnic populations despite blood type heterogeneity. Furthermore, they provide a more detailed picture through a meta-analysis with both NYP and China data, and include the Rh factor in the NYP analysis. Notably, they introduce new findings: a decreased risk for testing positive for those with AB blood in the NYP-only analysis, and an increased risk in those with blood type B in the pooled analysis. With the use of convalescent serum as a disease therapeutic, the knowledge that those with A-positive and B blood types may be at an increased risk of contracting COVID-19 can help ensure that sufficient amounts of plasma donors are compatible with that blood type. Finally, the study shows that blood type is not a significant predictor of disease prognosis in those infected with SARS-CoV-2, highlighting the need for other immunological and serological predictors of disease severity and mortality.

Credit<br /> Reviewed by Miriam Saffern as part of a project by students, postdocs and faculty at the Immunology Institute of the Icahn School of Medicine, Mount Sinai.

On 2020-09-30 16:10:46, user Dan Housman wrote:

The paper is interesting although I would have expected to see some associations between genetic SNPs/genes etc, and certain 'eating types'. There is only one mention I saw of a single gene. Is that type of analysis in the works? I'd be interested to see such an association study.

On 2020-10-06 12:01:01, user Jani Ruotsalainen wrote:

I'm teaching systematic review methods on two occasions this autumn and I'm using this article as an example to be evaluated using the AMSTAR II tool. And yes, I'm doing this even though the authors do not in fact identify their work as a systematic review. My point is to show how a meta-analysis (MA) without all the supporting structures of a thorough systematic review does not really make much sense. AMSTAR II has 16 domains that one scores Yes or No. In some cases it also allows also Partial yes and some items might not be applicable when a review does not include MA. However, in the end there is no overall sum score. Anyway, according to my assessment, the manuscript as it is now scored two instances of Yes and fourteen instances of No. In other words, it didn't do too well. The biggest cause of problems is, in my opinion, the lack of a protocol published a priori that would have established the methods to be used in sufficient detail. Now it is impossible to tell if the authors deviated from their original plans along the way and what effect this might have had on their findings. Other problems include not using a satisfactory technique to assess the risk of bias of results extracted from included studies or its possible effects on results obtained with MA. The description of included studies is minimal and the description of excluded studies is nonexistent. There are also issues with the MA itself (proficiently examined by Jesper Kivelä on Twitter: https://twitter.com/JesperK... "https://twitter.com/JesperKivela/status/1291697936842338305)") and more. I'm happy to share my full assessment with the authors.

On 2020-10-06 15:42:18, user T_Rogers wrote:

How do we know that NR was the effective factor?? Perhaps it was the other ingredients in the mixture. Also, only 71 patients with mean age of 35 and limited to no co-morbidities. IOW, exactly the profile that would be expected to recover. So, good result, but inconclusive as to efficacy of NR.

On 2020-10-07 11:50:31, user Zed wrote:

it is confirming this meta-analysis published in CMI: https://www.clinicalmicrobi...

Maybe authors can discuss the main differences and/or similarity?

On 2020-10-09 12:40:32, user Zed wrote:

ooh nice paper ! <br /> The conclusion is pretty much similar to this meta-analysis: https://www.clinicalmicrobi...

On 2020-10-14 20:35:53, user BannedbyN4stickingup4Marjolein wrote:

If "A fraction of the population may also already be intrinsically resistant to infection as a consequence of high functioning innate immunity" as the paper claim, how is it that infection rates of c. 85%, with the potential to rise further upon further exposure (for example https://www.medrxiv.org/con... "https://www.medrxiv.org/content/10.1101/2020.08.13.20173161v1)"), have been observed in homogenous populations?

Such phenomena should surely be referenced in the authors' discussion, without which an entirely theoretical model such as that produced is perhaps an unreliable basis upon which to formulate policy prescriptions.

There is also a recent paper commenting on cross-immunity (https://www.nature.com/arti... "https://www.nature.com/articles/s41577-020-00460-4)") the conclusions of which the authors should carefully consider.

On 2020-10-16 12:16:12, user Torbjørn Wisløff wrote:

I would seriously consider revisiting the analyses. In Figure 2c, the RR of 1.00 seems not to correspond with the somewhat diverging curves. In Figure 2a, on the other hand, the RR is 0.95, but the curves follow each other very closely.

On 2020-10-17 15:54:52, user Dan Myers wrote:

The results make sense, actually. Antivirals are usually not as useful unless used early.

On 2020-10-18 07:14:28, user Robert Clark wrote:

A key comparison was left out of the report, the effect of HCQ on patients specifically under invasive mechanical ventilation. This is a key category beyond just being “ventilated”. This is when the lung inflammation is so severe the patients have to be intubated, i.e., given a breathing tube inserted down the throat.

HCQ is a highly effective anti-inflammatory. Then it would be this case where it would be most effective for hospitalized patients. Note that the study was primarily focused on these drugs anti-viral effects. HCQ is the only one of them that also has an anti-inflammatory effect. Indeed it may be the only drug among all those being considered for COVID-19 that has both characteristics.

Note that in the RECOVERY trial it was specifically for THIS type of ventilation that the steroid dexamethasone was found to cut mortality, via its anti-inflammatory effect.

But in Table S1 of the Supplementary file to this SOLIDARITY report it states the “ventilation” discussed includes both invasive and non-invasive types:

Table S1

The authors need to add to the report the effect of HCQ specifically for patients under invasive mechanical ventilation.

BTW, the report does show the result of Remdesivir on invasive mechanical ventilation patients in Fig. 3 of the report itself, showing null effect. But this was not a useful set of data anyway because Remdesivir does not have an anti-inflammatory effect.

The more important and relevant case of HCQ was not shown.

Robert Clark

On 2020-10-16 12:17:32, user Criticical Opinion wrote:

Unfortunately it is not clear if there was a difference between a diagnosis of OSA vs treatment for OSA, severity or degree of OSA, or type of treatment for OSA. Without this information, the utility of these findings is questionable at best.

On 2020-10-18 04:17:11, user C Jones wrote:

My family has used the self-administered oral swab at an LA City Covid testing site each time we've tested.<br /> My son (19 yrs) tested last Friday 10/09 & received Negative result.<br /> He was out late on Saturday & I had him retest on Monday 10/12, and he received a Positive result.<br /> He tested again yesterday 10/16 and received a Negative result.<br /> His father & I both tested on 10/09, 10/14, and 10/16 - all results Negative.<br /> Very confusing. How do we proceed?

On 2020-10-20 17:57:35, user Dinofelis wrote:

It is strange to conclude that one observes statistically significant "<br /> PCR negativity in intervention and control groups were (day 7, 182 (52.1%) vs. 54 (35.7%) (P value = 0.001)"and concludes that there is no effect.

Let us remember that statistical non-significance of rejection of H0 is not equivalent to proof of absence of effect. It simply means that the test didn't have enough power to prove anything.

In order to prove absence of effect, one needs to reject with statistical significance the hypothesis that the effect is larger than a given threshold.

I have seen many papers confusing "statistical absence of significance" with "proof of H0".

On 2020-10-31 12:07:38, user Scandinavian Journal wrote:

One issue not talked about much is that a normal HCQ dose as per on the package is not considered lethal, has been around for 50 years with good reliability and costs a few dollars for a package. If I caught the virus would I decide that this is useless because some study say so while others say it is effective ? I would of course put myself under this treatment.<br /> If it is useless well what damage did it do. If it was effective it may have saved my life or made the disease progression milder. For a few dollars. Easy choice.

On 2020-10-21 14:08:08, user Darren Brown; HIV Physiotherap wrote:

The EUROQoL EQ-5D-5L self-reported health related quality of life (HRQOL) measurement tool has been used for statistical purposes, however this baseline data of EQ-5D-5L scores across 5 domains (health status) and index value are not reported. This would be useful data to understand the HRQoL of the sample, with respect to population normative data (https://euroqol.org/eq-5d-i... "https://euroqol.org/eq-5d-instruments/eq-5d-5l-about/population-norms/)").

On 2020-10-21 19:18:46, user Alan Wilson wrote:

I would recommend the authors to check other recently published ASRM abstracts in the topic:

https://www.fertstert.org/a...

https://www.fertstert.org/a...

On 2020-10-23 11:44:52, user Alexander Samuel wrote:

Dear authors,

I fully agree with your introduction, discussion, and everything is done correctly in this paper. After scientific misconducts from Gautret et al. in Didier Raoult's IHU Marseille, and its transfer to USA through J. Todaro followed by Zev Zelenko's strange comments, there is clearly a situation that went out of control about hydroxychloroquine.

My comment on your work is that Recovery + Solidarity weight almost for 90% of the results, In a meta-analysis, I expect a significant effect of all (or most) studies, here it seems like the results are a new read of Recovery + Solidary, with comments on very low weighted unpublished or published clinical trials. Of course, authors mention that there is still no effect in the absence of Recovery, indirectly (published vs unpublished, high dose vs low dose). I think it would be important to not just make a "second read of recovery data" (exagerated statement, sorry for the way it is said). The discussion on the difference between high / low dose is what interested me most in your paper, and would be worth more comments or even analysis.

I would suggest more theoretical molecular biology bibliography (molecular effects of HCQ might reduce the immune reaction more than affect viral cell entry), more introduction elements on in vitro data (which clearly did not favor HCQ that much) for the next effort mentioned in this paper !

Anyways, this is a good paper since it is very honest and shows data properly, congratulations for this work.

Best regards.

On 2020-10-26 00:13:04, user Mahdi Rezaei wrote:

The accepted and peer-reviewed version of the article is now available via open-access Journal of Applied Sciences. DOI: https://doi.org/10.3390/app...

On 2020-10-27 03:12:46, user Critical Dissection 2 wrote:

Dear authors,

First I just want to say I think that it was great you pursued such an important topic. There were a lot of good things about your article like your clear abstract that very well laid out the different parts of the paper and the main summary of each section. I also like that you laid out the limitations of your study and how they should be solved for in further investigation of this topic. However, there is still some room for improvement in this paper. I thought that the introduction could use more background to contextualize the issue and put some scope into it to explain why people should expand upon your results and see if the data is helpful in the future. I also think that the figures need more explanation in the results section, unless a highly experienced physician is reading it, it is a little hard to tell what we are supposed to be looking at and drawing from the figure that supports your hypothesis. There was also an emphasis drawn between the two patients whose ablation was done with a little more targeting of certain factors compared to patients who underwent standard ablations that was only mentioned in the discussion but is a great point that I think should be brought up earlier maybe somewhere in the results section. I think with these changes you will have a good paper.

On 2020-10-27 16:42:24, user Kamran Kadkhoda wrote:

Again no good panel of confirmed common CoVs to exclude cross-reactivity especially to an Ab like IgM with poor affinity maturation.

On 2020-10-28 08:35:30, user Rasmus Skov Husted wrote:

The final peer reviewed article is published open access - please follow this link: https://bit.ly/3mrLlvZ

On 2020-10-28 16:35:38, user Edsard wrote:

I think we have a chicken and egg issue here. Your pollen theory is pretty good but also the reason why scientist always say: Correlation is not causation. Your pollen is the result of the weather (temperature and humidity, which has explained seasonality of the flu for 10 years already). Here is our paper. https://www.medrxiv.org/con...

On 2020-10-28 17:53:21, user Sam Wheeler wrote:

It it so that non-vaccinated hospital personnel are forced to wear a mask almost all the time to prevent flu, so the protection of flu vaccine is even greater than this study tells?

On 2020-10-30 17:10:52, user gatwood wrote:

I suspect there could be a strong corellation between vaccination status and following a strict adherence to all COVID anti-infection guidelines, PPE etc... Experienced and medically trained Drs and nurses more likely have been vaccinated and also are more likely to follow PPE wearing and careful anti-infection routines. Support staff (food service, assistants and claening staff) with less formal medical training and understanding of infection are probably less likely to be vacinnated and also may be less likely to carefully employ all technical anti-infection measures. Would this account for the vaccinated folks having less COVID infection?

On 2020-10-31 07:52:03, user Robert Eibl wrote:

This looks interesting, although there are a few caveats mentioned in the paper. Nevertheless, it should be possible almost everywhere, and even restrospectively, to check the vaccination status of Covid-19 patients, not only for influenza - and compare this with the average vaccination status of a whole country. Then it should be immediately clear, if there is a major benefit.

On 2020-10-29 15:18:11, user bljog wrote:

In the results you mention "A cluster of sequences in clade 20A has an ad- ditional mutation S:A222V colored in blue" but the Figure 1 has an annotation in blue for S477N.

On 2020-11-03 23:04:46, user David Markun wrote:

Nice study. Copy edit: " If we instead look after September 1, 2002" should refer to 2020.

On 2020-11-04 14:41:47, user Rodrigo Quiroga wrote:

Are´t these results expected regardless of children´s proneness to infection and infectivity? Up until August, the time periods with open schools were also periods with low viral propagation in the UK.

Wouldn´t the interesting period to observe with such an analysis be precisely August-November, with open schools and increasing case numbers?

On 2020-11-05 12:26:14, user Sandra Chydé wrote:

Dear authors,

You are citing one of my papers (reference 15) in a misleading way here : " There are concerns that the use of e-cigarettes in never-smokers may increase the probability that they will try combustible tobacco cigarettes and go on to become regular smokers, particularly among youth and young adults [13-15].".

First, our methodology focused ONLY on ever-smokers aged 17 having experimented with e-cigarette.

Second, we found that in this population of 17 yo, among ever-smokers, those who declared having ever used e-cigarettes were LESS likely than those who did not to transition to daily smoking at 17: RR =0.62 95 %CI [0.60 – 0.64].

This analysis is strongly robust and relies on a sample of 21,401 respondents.

Best,

Sandra Chyderiotis, Pharm.D, MPH

On 2020-11-07 10:32:09, user Ivan Ivanov wrote:

They will never share the primer sequences as the test is being commercialized already. The idea is interesting however I cannot imagine the price for 500ul LAMP reaction. Also what's the point to put DNase and carrier DNA together in the mastermix.

On 2020-11-14 02:00:10, user Melimelo wrote:

Hi, very interesting article. Which software did you use for initial qualitative coding and subsequent text mining? are there particular commands or functions in a given software package that were useful? are you sharing your code anywhere (eg github?)

On 2020-11-14 04:23:20, user Rich Kibbee wrote:

Error, this pdf lists a Centricon 70 Plus 100 kDa filter ...the first version lists it at 10 kDa.

On 2020-11-15 21:48:01, user Ands Hofs wrote:

We in germany do re-testing of positives on a regular basis, and the result is that false-positive diagnostic findings that are actually filed to the patient are in the range of 0,001 %. Even if testing activity of healthy subject was high up to September, the number of people that had a wrong test result is something like a handful a week and totally acceptable in the face of the alternative. Especially since one does a second test some days later.

But right now we have positive testing of 25% of samples in Frankfurt (Main),e.g., just mentioning this to get the perspective right, water is rising above neck to the lips...

A few people (like 1-5%) mentally infect 30% insecure anxious people here, damaging our wakefulness to keep our viruses for ourselves, prohibiting smart distancing to be practice in private contexts, behind closed doors in companies and among friends and neighbors all the same, and this is making the 2nd lockdown necessary.

And causing thousands of deaths not necessary when they would obey the democratic decision: we do not want to do triage. We want to keep the numbers low. We want to keep our viruses to ourselves. We do not want to have unnecessary lockdowns burning away existences, jobs, money... But what choices do we have?

Since we wasted the summer where we had the chance to get incidence real low.

Now the only thing that can save our neck is a (pre-) test that is really free for everyone, and MIT has one: https://digitalreality.ieee...

Every one writing about false positives should weigh his words thoroughly.<br /> Not the rate of one single test method is what people want to know. <br /> They want to have approved quality testing and numbers for "their" lab.

These numbers are there in every German lab, since they are obliged to certify every test they offer and to take part in Ring Tests where labs and their certified tests are tested. This is done by sending a lab unknown but specially prepared samples that each lab has to let run through the lab on a regular basis. This also is done to get quantitative tests to comparable levels between labs.

Comparable Levels for Covid-19-Infected patients:<br /> It is a pity that we do not let some piece of human DNA normally found from throat swabs run together with the Sars-CoV2 Test on a regular basis, resulting in viral units per human DNA count, because this would enable us to estimate the viral load at the place where the sample was taken. It would outrun many variabilities that occur when taking samples that affect the amount of material gained in the sampling process, and one could monitor viral loads across the time line for each infection with high therapeutic value. <br /> I'm so curious if someone has done this with the gargling method for probing, since here the local variability in infection density is not playing any role any more, as is the case for the question how infectious one could be in a certain state of the infection.

Boston children hospital has done this in their study on viral loads in children, where for the first time it was found that children, regardless if having symptoms or not, have viral loads like heavily ill adults. <br /> Since their lungs are smaller proportional to their age and development, of course the net amount of aerosols produced by a small child e.g. up to 8 or 10 years is smaller ( - but proportional to the loudness of their voices ;)) <br /> Still - starting with 11 or 12 years, it starts to reach adult levels, meaning we must do DIY patchwork air ventilation with heat recovery mechanisms out of vapor barrier film and 2 vents in schools or let the pupils sit in the cold of fresh air or 8hrs / day under some masks that muffle sound (many innovative ideas for DIY masks are asked here for).<br /> I like the nordic approach either to do home schooling or do classes under the trees for the younger ones, leaving a lot of space in the school for elderly pupils, especially in classes wanting to have their final exams ;)

Andi

On 2020-11-20 16:49:15, user Jean Kaweskars wrote:

Hello,

Your figures are not consistent.<br /> If you have 11% IFR for 80-90-year-old subjects who represent 6,3% of France population (> 80 years old), it does translate into a minimum of 0,69% overall IFR. If you apply your IFR rates by age, you would actually get an overall 0,91% IFR at minimum.

Regards

On 2020-11-25 15:49:17, user James Wyatt wrote:

In the discussion of weaknesses, you failed to mention that you eliminated approximately 1/3 of the cases for lack of complete data. Did you study these cases to see if their exclusion could possibly have biased your results? What was the crude death rate among these cases?

In Table 1, the disparity between mortality rates per 100k population is solely a function of the difference in incidence rates. That's significant, for sure, but the fact that CFR is the same for whites and blacks is also significant. In its rawest state, that indicates that, once someone is sick, race seems not to matter in the outcome. Doesn't that bear some discussion?

How did you determine cause of death? Covid-19 is rarely the sole cause when death certificates are completed competently and there is some judgment required to clearly identify a covid death. As follow-ups, were there non-Covid-19 deaths in your data? How were they identified? If there were none, can you justify that?

In mortality studies, the key question often is: How did you calculate the exposure? That is, how did you determine the denominators for your ratios? You reference some models, but you give no details.

The paper needs a lot more work, don't you agree?

On 2020-11-25 19:54:26, user Puya Dehgani-Mobaraki wrote:

Interesting data, which are also seen on our study were the persistency of the antibodies were detected and persisted during 8 months.

https://www.medrxiv.org/con...

I do would like to have more informations in regards of the patients selection for the 8 months analysis.<br /> Our cohort was based in patients resulted positive for Sara-Cov-2 early days of March, Italy. As far as my knowledge, very few cases were reported in Australia at that time.<br /> Puya Dehgani-Mobaraki

On 2020-12-04 13:43:42, user Ben Finn wrote:

Why does the paper make no mention at all of the large risk differences between sexes & races? (Men, Black and most Asian people have 2+ times COVID mortality of others.) Straightforward to model. Without considering this it can’t claim to be an ‘optimal vaccination strategy’.

On 2020-12-04 20:45:12, user Sam Wheeler wrote:

Is the full text possible to read as HTML somewhere? I did find the PDF.

On 2020-12-08 09:28:26, user Neville Calleja wrote:

Obviously the people receiving the influenza vaccine are (a) the most at risk of dying with COVID-19, either as an underlying cause of death, or as a contributory cause, and (b) more likely to be coming from affluent countries wherein identification of deaths as a COVID-related death is much more likely due to enough resources permitting testing of all patients. The latter could have been corrected by using excess mortality figures rather than reported COVID-19 deaths, which is highly dependent on the countries' capacity to test. Nonetheless, the first clearly explains the findings completely wherein countries with high life expectancy and therefore high proportion of elderly population with co-morbidities who are typically protected in winter using the influenza vaccines, could not be protected from COVID-19. This could be considered a correlational study at best.

On 2020-12-08 11:30:27, user Abdur Rahman wrote:

This preprint is accepted for publication, and the new link is: <br /> https://onlinelibrary.wiley...

On 2020-12-09 12:20:53, user Vladimir Gusiatnikov wrote:

The authors appear to treat viral loads quantified in transfer media as viral concentrations in mucus, however there typically is a 1.5 to 2 order-of-magnitude dilution as material is eluted from swab into media. As a result, the authors' estimates for the copy generation rate and copies per infectious quantum may be 1.5 to 2 orders of magnitude too low.

On 2020-12-09 16:34:09, user Livia Dovigo wrote:

The elegebility criteria (that lead to only 5 studies to be included) has not be clearly described... Searches returned more than 90 entries, the authors needed to inform the methodology for studies selection. Otherwise, results may not be reliable.

On 2020-12-11 00:07:54, user Peter Novák wrote:

PARTICIPANT CONSENT?

Authors claim, cite: "All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived."

I find this proclamation highly dubious.

I'm not sure how many of the the mass tested people have signed a form of informed consent, and I'd like to see how would the authors prove that. I personally have asked several participants and they insist they did not sign anything. But even in the case some, or even the majority signed something, what weight would that have under circumstances?

The people subjected to the mass testing (that technically means biological material extraction) with consideration, that those who do not subject, will be quarantined for week or two - that means, forced to stay home under threat of penalty as high as 1650 EUR (average monthly income in Slovakia is 1100 EUR brut), with few exceptions (e.q. nearest grocery store, drugstore and necessary health care), but certainly denied the access to workplace with no lost worktime salary compensation at all, neither from state nor employer.[1] A proposition effectively resembling a home prison in my opinion, and what's even worse in situation of economical crisis - with published threats from some employers that untested employees may lose their job eventually, thus undermining the public confidence in freedom of choice furthermore.[2]

It is known that criminal complaints on the accounts of possible coercion, health care law violations, human rights violations etc have been filled to the public prosecutor office. These are yet to be resolved.<br /> I acknowledge that some of the people have attended the testing voluntarily indeed, probably a minority though, as indicated by low compliance (15%) to the third round of testing where quarantine threat was removed.

Nevertheless, I doubt anyone could assume the actions under such circumstances constitute a "participant consent" by standards of any possibly existing ethical guidelines.

Or maybe I just read the citation wrong and the authors did not mean the 3,6 million people undergoing the biologic material extraction to be the subject of the "necessary patient/participant consent"...?

[1] Public Health Office Edict No. 16 from 30.10.2020. Government Bulletin vol. 30 no. 12. http://www.minv.sk/swift_da...

[2] Dobrovolne nasilu? Niektorým ludom bez testovania hrozia výpovedou. Pravda, 26.10.2020. https://ekonomika.pravda.sk...

On 2020-12-13 13:26:48, user Sam Smith wrote:

A concern about the Córdoba study is that 25OHD serum levels were not measured, so we do not know if the treatment was associated with a benefit only in patients who were deficient. A randomized controlled trial will be needed to determine whether calcifediol will benefit hospitalized COVID-19 patients who are not deficient.

Sadly, calcifediol is sold in some European countries, including Finland?

On 2020-12-15 10:43:49, user NK wrote:

Re: article pre-published at https://www.medrxiv.org/con...

There are several methodological problems in this study.

1. Findings that suggest increased ORs among primary school teachers, child care workers and secondary education teachers are not properly presented and discussed

The summary states: "Teachers had no or only moderately increased odds of COVID-19". This finding is mentioned several places in the text of the article. Teachers are repeatedly referred to as having a low risk, even when the results for teachers show a significant increase in admissions and borderline significant increase in infection rates. Quotes: «First, our findings give no reason to believe that teachers are at higher risk of infection», and in the conclusion: “Teachers had no increased risk to only a moderate increased risk of COVID-19”. We wonder why the authors find it important to repeatedly mention this the result for teachers when the results for the last period does not exclude a substantial increased risk for teachers, whereas occupational groups with lower risk than teachers are not mentioned in the summary.

The part of “Supplementary table 1” shown below does not provide a basis for such a conclusion that teachers are a low risk group.

The OR (95% CI) for 1) primary school teachers 2), child care workers and 3) secondary education teachers were 1.142 (0.99-1.32), 1.145 (1.02-1.29) and 1.095 (0.82-1.47) respectively. The upper confidence limits are does not exclude 29 % to 47 % increased ORs, which represent substantial increases.

Concerning the results on the risk of admission, it is stated: «None of the included occupations had any particularly increased risk of severe COVID-19, indicated by hospitalization, when compared with all infected in their working age (Figure 3, S-table 2), apart from dentists, who had 7 ( 2-18) times increased odds ratio, and pre-school teachers, child care workers and taxi, bus and tram drivers who had 1-2 times increased odds ratio”.

This finding is not discussed or mentioned in the summary, even if the findings were statistically significant for pre-school teachers as well as for child care workers.

1. The study periods include periods when the schools were closed and include no period with high infection rate among children and youths.

It is not to be expected that teachers have higher infection rates than the average working population in periods when school are closed and when the infection rates are low in the age groups 0 - 9 and 10 -19 years. This problem is not discussed in the paper. Schools were closed from 12 March to 27 April. For a majority of the schools, holiday started from Friday 19 June.

The first study period lasted from February 27 to July 17. Thus, schools were closed for over 70 days of the first study period of 139 days. The infection rates in children at school age in the first study period were rather low (3.6 per 100 000 children per week between in the age group 10 -19 in week 19, 1.1 per 100 0000 children per week in week 25). In the last study period, the infection rates varied between 7 to 17 per 100 000 per week in the age group 10 - 19. Even if these rates are much lower than later weeks that were not studied (after week 42), the results from this second part of the study suggest an increased risk for teachers.

Thus, the infection rates among children started to increase from week 43, after the end of the study period. By not including this period, the study design excludes the possibility to detect if these high rates among pupils could be related to increase infection rates among teachers.

It is a problem that the results from this pre-published study has been quoted in the media and referred to as if teachers have no excess risk, or even possibly a reduced risk at the time that several municipalities were to decide what type of restrictions at schools should be introduced to reduce the risk of transmission among school children, see https://www.barnehage.no/korona/ny-forskning-nei-barnehagelaerere-har-ikke-okt-risiko-for-smitte/211143

On 2020-12-20 20:25:16, user Pablo Pablo wrote:

I can't explain why this result is in contradiction with this other one.eurosurveillance<br /> Could it be because of the Simpson paradox?

On 2021-01-05 09:55:32, user Disqus wrote:

In addition to the previuos comments I read, page 7 "SARS-CoV-2 positive incidence rates were calculated for staff and students attending an educational setting, irrespective of whether the infection was acquired within or outside the educational setting."

thus it is evident that if the incidence is higher among teachers than the general population, <br /> schools are not the safest places, with a perhaps low transmission rate among students but a <br /> greater transmission rate from students to teachers

On 2020-12-22 08:44:55, user Maxime Baud wrote:

Study published in Lancet Neurology, now available at https://www.thelancet.com/j...

On 2020-12-28 23:51:01, user ErikCarter wrote:

You really ought to test for infectious virus, rather than just RNA. Otherwise you can't truthfully claim that the variant results in higher "viral load"...you've not measure viral load, you've measured RNA load. These are not the same thing.

On 2021-01-08 15:09:29, user Kevin McKernan wrote:

Can the authors explain the mess in Table 2? This dilution series is non-linear and any student delivering such data would be told to repeat it. If it is in 6 replica's, you should share the dispersion in that data. There should a clear 3.3 Ct shift in each 10X dilution. If you dont have linearity in your dilution series how can you make a Ct cutoff? The non-linearity is non-concordant across different amplicons? It is frightening this is being used as a diagnostic test. Are there any internal controls in the test to ascertain the sample prep variance? Dahdouh et al demonstrates 10-16 Ct variance in RNaseP signals (human gene) suggesting tests that lack internal controls to normalize for swab and sample prep variance are random number generators. Table 2 also looks like a random number generator.

On 2020-12-29 01:55:20, user F Alexander Diaz-Quijano wrote:

This article is now published in the Journal of Clinical Epidemiology.

Share Link:<br /> https://authors.elsevier.co...

On 2020-12-31 14:23:25, user Don Wheeler wrote:

Interesting. Additional research with a larger sample size featuring a broader cross section of the population will be most beneficial. Let's see where this leads.. Great work! @ComaRecoveryLab #covid19

On 2021-01-05 03:55:19, user mahejibin khan wrote:

Though air transmission of the virus has been suspected , swab samples collected in unsterile conditions for RT-PCR screening of human subjects continues to be a practice in many regions/countries. <br /> Two mass scale nasopharyngeal swabs of employees of an establishment in Mysore, Karnataka, India, collected under unsterile conditions in their premises, by seating them in an open ground and screened for SARS-CoV-2 infection by RT-PCR, identified a large number of asymptomatic SARS-CoV-2 positive cases. Thus the establishment forced a two-day campus lockdown, on both the occasions, in order to sanitize and break the virus transmission chain. Since most of the infected subjects remained asymptomatic through their home quarantined period, they were certified for fitness to resume work. Since reports have shown patients fighting SARS-CoV2 infection developing IgM and IgG antibodies between 6–15 days after disease onset. Blood samples of two RT-PCR positive asymptomatic subjects after 17 day home quarantine were analysed for the presence of IgM and IgG antibodies. Absence of detectable titres of antibodies to SARS-CoV-2 virus in the two blood samples suggested lack of acquired immunity due to asymptomatic patients unexposed to the virus. Nasopharyngeal swabs positive for the virus by RT-PCR inferences establishment of the Covid-19 pathogen infection in the host. Absence of prodromal symptoms for the disease in these subjects and some of them testing negative in a second Rapid Antigen Detection Test (RAD) opinion, when swabs were sampled in designated hospital rooms, suggested occurrence of air borne virus and swab contamination during sample collection under unsterile conditions. <br /> Droplets that are sneezed or coughed behave differently in the open air, according to environmental conditions like temperature, humidity, ventilation, and the amount of virus deposited.<br /> My observations on plausibility of air borne SARS-CoV2, RT-PCR determining their fairly high numbers and prevalence of asymptomatic subjects living in that environment provides leads for studies with reference to herd immunity from the purview of viral attenuation due to environment and/or innate immunity initiation through pattern recognition receptors

On 2021-01-05 15:56:38, user Ti wrote:

You write that "the best performing method is XRAI (AUPRC = 0.224 ± 0.240)". Meaning that the AUPRC ranges from -0.016 to 0.464. Surely, you cannot have a negative area under the curve.

On 2021-01-05 16:49:15, user Ania Lorenc wrote:

Hi, I was wondering - have you excluded known factors contributing to severity - sex + age?

On 2021-01-09 15:11:56, user Derek Enlander, MD, MRCS, LRCP wrote:

The "long Haul Post Viral" SARS 2 Covid19 effects, Fatigue, Myalgia, Cognative defect, insomnia etc are reminiscent of the symptoms reported historically by Melvin Ramsay in 1955 when he reported these symptoms in a cohort of young doctors and nurses in the Royal Free Hospital in London. He termed the outbreak as Post Viral Fatigue, renamed Myalgic Encephalomyelitis (ME) and later Chronic Fatigue Syndrome (CFS).

On 2021-01-10 22:17:22, user Wayne Griff wrote:

Single dose vaccine efficacy is not 90%. It's less than 50%, and that's after only 3 weeks. It would be even less effective at 6, 9, 12 weeks or more. More importantly, at 3 weeks the neutralizing ability of 1 dose is only 1/5th as much as Convalescent Plasma (NEJM)

On 2021-01-11 23:14:43, user Chaitanya wrote:

Excited to read the paper since its amazing that the authors have both in vitro and patient sample data. I a curious to read more with regard to false positive/negative and the role of NASBA amplification

On 2021-01-13 11:39:34, user carina brehony wrote:

hopefully a full published paper will acknowledge the laboratories, public health departments and the Health Protection Surveillance Centre that collected, validated and provided the data which was then made available publicly

On 2021-01-15 16:00:23, user Martin Reijns wrote:

Congratulations on this work. One comment though: I know it's difficult (if not impossible) to keep up with all the literature on SARS-CoV-2, but I just wanted to say that the statement "Currently, no test combines detection of widely used SARS-CoV-2 E- and N-gene targets and a sample control in a single, multiplexed reaction" is incorrect. Our paper on this has been on medRxiv since June:

https://www.medrxiv.org/con...

and was recently published in PLoS Biology

https://journals.plos.org/p...

All the best, Martin

On 2021-01-18 05:38:05, user Benjamin Seng wrote:

This paper has been published in General Hospital Psychiatry (journal) and is available at the following link: https://doi.org/10.1016/j.g...

On 2021-01-21 09:05:28, user Dominik wrote:

The conclusion drawn here is simply wrong: "suggesting that current SARS-CoV-2 vaccines will protect against the 20B/501Y.V1 strain" when in fact they didn't check for all 17 epitope changes of mentioned strain but only N501Y which was never thought to be immune evasive. The same erroneous conclusion was drawn in the paper of Uni Texas which also only tested against N501Y but not all mutations.

On 2021-01-24 20:42:28, user Thomas Arend wrote:

Just some short remarks to table 5:

(35-5)/35 is 85.71% and not 82.86%

If you round 32/23 = 91.4285.. you get 91.43 not 91.42

Typo? 34/35 = 97.1428 ~ 97.14 ... not 97.12

And I agree with Michel Schrader comments to the presicion of 4 digits.

The hypothesis H0: specifity = 94% / Ha: specifity <> 94% you can only be rejected for AgPOCT V. p=0,0168.

H0: Specifiy = 92% cant be rejected for any AgPOCT.

You should calculate a CI for the specifity.

On 2021-01-26 23:19:50, user Janet Aisbett wrote:

The analysis as presented does not appear to support the conclusion that “individuals discharged from hospital following COVID-19 face elevated rates of multi-organ dysfunction…..”. We can conclude that these individuals have elevated rates of multi-organ dysfunction, but we have no way of knowing whether these were ‘new-onset’ events after discharge or were factors contributing to the severity of the individual’s COVID episode. This is because ‘new-onset’ events are defined with respect to HES APC and GDPPR extracts over the ten years prior to 2020. It would help if counts of ‘new-onset events’ were provided, broken into those which first appear in 2020 but before discharge (e.g., as secondary diagnostic codes alongside the COVID primary) and those which first appear post-discharge.

Forgive me if I have missed something, but I also have concerns about the 1:1 matching of the COVID cases to controls. Supplementary Table 1 suggests very coarse matching criteria. The use of an age category 70+ is particularly striking, given the comparative age distributions of COVID versus all hospitalisations. The matching of clinical characteristics also deserves further explanation. As presented, it appears that an episode of skin cancer eight years ago could allow a match to an individual with metastasised tumours requiring palliative care. Since more serious comorbidities may be a factor in COVID hospitalisation, matching on coarse clinical characteristics may tend to select a healthier control group. Presenting frequencies of selected sets of ICD-10 codes by age for the COVID cohort versus the control group would help resolve this question. Also worthy of explanation are the decisions not to include dementia in the matched histories, and not to consider previous hospitalisation.

Finally, the Supplementary Table 3 shows quite different outcomes for controls matched to ICU COVID cases compared with controls matched to non-ICU cases. These differences are not reflected in the COVID cohort. Although numbers are small for the ICU control group, the discrepancy is worthy of comment.

On 2021-01-27 14:15:18, user Antonio Beltrão Schütz wrote:

I think that this article is important, considering that in spite of does not proof by mean RT-PCR test that ivermectin can turn negative viral load in patients with increased viral load of Covid-19, it decreased the mortality (4/112) patients. This data extrapolated to 100.000 or 1,000.000 cases is significant.

On 2021-02-04 14:21:22, user Peter Ray wrote:

The suggested reason for the increased case rates for the first 10 days or so after injection is a possible change in behaviours to being less cautious.

Another possible reason is the dramatic increase in Covid prevalence occurring in Israel generally at the start of the vaccination program (late December). Given that the positive case data is available in public it might be worthwhile including a comparison of general population case rate on the daily incidence chart.

On 2021-02-05 13:36:40, user Marie wrote:

Could you, as required by law, please declare your conflict of interest?

On 2021-02-06 02:50:56, user Crystal Sonia wrote:

How accurate and reliable is this SIR model? With the mco arent the cases still increasing? How are the beta and gamma estimated? What's the sensitivity and specificity of this model?

On 2021-02-15 15:10:33, user Paul Wolf wrote:

Near the end of the abstract, you say the data is "suggesting parallel evolution of a trait that may confer an advantage in spread or transmission." Why would this mutation be occuring in different parts of the US and nowhere else in the world? That doesn't suggest convergent evolution, but a common origin.

On 2021-02-16 20:47:03, user jiver wrote:

NHS are obsessed with over simplifying race. Why ask people to self report in only 3 categories? And two are skin colour but the other is geographical. Why on earth? What did you hope to achieve by only going this far? Already people are using this to discredit non whites. And NHSP have done it before, exactly the same, 3 categories allowed only.

On 2021-02-19 20:04:10, user Jacqueline J Clarke wrote:

Have you confused the symbols lesser than and greater than ? The occupying sentences don't make sense ?

On 2021-03-09 09:36:30, user Raph Ohuru wrote:

Published here https://doi.org/10.1093/cli...

On 2021-03-20 14:23:19, user Alexander Mathioudakis wrote:

This study has now been published here:

https://www.mdpi.com/2075-1...

On 2020-11-16 06:38:23, user whitecat31 wrote:

At the 39th replicant when the exponential phase is basically over? Am I understanding that correctly? Seriously? Did you guys run a comparison standard curve with 39 points? Something like the 39th replicant would be considered below the limit of detection and LOQ. So yeah.. your sample was contaminated.

On 2021-06-02 11:15:56, user Philip Ward wrote:

The authors of the paper have now published a second study that states their earliest positive sewage sample is from January 15th 2020 and does not make any reference to this preprint:

https://journals.asm.org/do...

On 2021-06-01 09:39:20, user Facundo Muñoz wrote:

Very nice paper.

I'd just like to point out a minor mistake in the text. At the top of page 6 it is stated that alpha_lockdown has a Gamma prior of mean 0.1667 and standard deviation 1.

This didn't match the stated 50/50 chance for decreasing/increasing effects. And indeed, thanks to your open-science approach to publishing I could verify that in the code [1] you used a Gamma prior with shape and rate parameters of values 0.1667 and 1 respectively.

Best wishes.

[1] https://gitlab.in2p3.fr/bou...

On 2021-08-15 11:06:56, user Dorian Dale wrote:

The most obvious flaw is depending on honest self-declarations of educational status. Go to LinkedIn for innumerable examples of resume inflation. The huge disparity between masters at 8.3% and PhDs at 23.9%. We are now seeing much analysis of how pervasive are dishonest responses to polling. If one is an anti-vaxxer, why not claim PhD status to add cred at the expense of over-educated elite?