Not all news about COVID-19 is bad - Part 3
Dear friends,
This is part 3 in my blogpost series titled "Not all news about COVID-19 is bad" where I attempt to capture scientifically-rigorous, evidence-based, and data-driven synthesis of promising news items and peer-reviewed articles relating to the COVID-19 global pandemic. My goal is to present topics in health care, life sciences and health IT in a simple language for anyone who may be interested. I prioritize current topics from medical/scientific literature and social media that overlap with the interests of folks in my personal and professional networks.
You can read part 1 and part 2 of this series here.
In this post, I review contact tracing, saliva-based rapid test for COVID, open COVID clinical trials platform and COVID-19 State-by-state testing data and plans for reopening in the US.
2. Rapid testing with Saliva samples is promising. Current testing methods for COVID-19 involve collecting a deep sample from the nasal passage. This method increases the risk for healthcare professionals and also requires use of personal protective equipment while collecting these samples from patients. What if the test sample could be collected by the patient himself/herself in the comfort of their homes? A team of scientists at the Yale School of Public Health compared self-collected saliva samples with clinician collected nasal swabs. They reported in medRxiv that the saliva samples were not only more sensitive to detecting SARS-CoV-2, the virus that causes COVID-19, but also provided consistent results throughout the course of infection. I found the figures in Exhibit 2 from this article most informative. It shows that the more copies of the virus were detected in saliva samples compared nasal samples, in all COVID-positive samples (Exhibit 2A) as well as in matched samples where both nasal and saliva samples were collected from the same individual (Exhibit 2B). Along these lines of making saliva-based COVID-19 tests available to the public, the Food and Drug administration has granted emergency use authorization for a saliva-based test for COVID-19 developed by Rutgers University Cell and DNA Repository (RUCDR).
This is part 3 in my blogpost series titled "Not all news about COVID-19 is bad" where I attempt to capture scientifically-rigorous, evidence-based, and data-driven synthesis of promising news items and peer-reviewed articles relating to the COVID-19 global pandemic. My goal is to present topics in health care, life sciences and health IT in a simple language for anyone who may be interested. I prioritize current topics from medical/scientific literature and social media that overlap with the interests of folks in my personal and professional networks.
You can read part 1 and part 2 of this series here.
In this post, I review contact tracing, saliva-based rapid test for COVID, open COVID clinical trials platform and COVID-19 State-by-state testing data and plans for reopening in the US.
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| Exhibit 1: Aarogya Setu - Indian Government's contract tracing mobile App |
2. Rapid testing with Saliva samples is promising. Current testing methods for COVID-19 involve collecting a deep sample from the nasal passage. This method increases the risk for healthcare professionals and also requires use of personal protective equipment while collecting these samples from patients. What if the test sample could be collected by the patient himself/herself in the comfort of their homes? A team of scientists at the Yale School of Public Health compared self-collected saliva samples with clinician collected nasal swabs. They reported in medRxiv that the saliva samples were not only more sensitive to detecting SARS-CoV-2, the virus that causes COVID-19, but also provided consistent results throughout the course of infection. I found the figures in Exhibit 2 from this article most informative. It shows that the more copies of the virus were detected in saliva samples compared nasal samples, in all COVID-positive samples (Exhibit 2A) as well as in matched samples where both nasal and saliva samples were collected from the same individual (Exhibit 2B). Along these lines of making saliva-based COVID-19 tests available to the public, the Food and Drug administration has granted emergency use authorization for a saliva-based test for COVID-19 developed by Rutgers University Cell and DNA Repository (RUCDR).
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| Exhibit 2: Wyllie et. al., doi: https://doi.org/10.1101/2020.04.16.20067835 |
3. Open COVID clinical trial platform to find treatments faster. As of this writing, the US clinical trials database has registered 796 COVID-19 studies that are either recruiting or getting ready to recruit patients. Many of these studies are designed to answer similar questions. Combining data or aggregating evidence could dramatically increase their efficiency and precision, getting reliable answers to doctors faster. The New England Journal of Medicine recently published an article on how best to conduct clinical trials during a pandemic to get accurate and fast results to clinicians, patients and public health officials. This new framework for COVID-19 clinical trials, powered by the US NCATS Trial Innovation Network and a SMART single Institutional Review Board (IRB) encourages study teams to collaborate on existing, ongoing clinical protocols rather than starting new and independent trials. Using this new, open platform, researchers can submit a new protocol, collaborate on existing protocols, and conduct aggregate data analysis from multiple sites to rapidly arrive at answers to their pressing clinical questions on COVID-19 diagnosis, hospitalization, resource utilization, ICU admissions, testing, deaths and much more. Participating investigators can choose to share trial data and outcomes through the Vivli Global clinical research data sharing platform.
4. April 22, 2020 was a clear inflection point for testing in the US. Widespread testing is important for COVID-19 containment efforts. While testing started late and has been rolled out very slowly in US States and territories, good news is that the number of tests administered is increasing rapidly now (Exhibit 3). Why is this important? Case counts, as maintained by the Johns Hopkins University tracker, alone do not give us the full picture of the pandemic life cycle. For example, a State reporting 5 positive cases after testing 5000 probable cases is at a very different stage of the outbreak compared to a State reporting 5 positive cases after testing only 50 probable cases. The COVID Tracking Project is collecting and reporting testing data from State/County/Territory public health officials to help us understand how this outbreak is evolving in each State. The COVID Tracking project has tracked a total of 5.4 million tests so far in the US, up on April 26, 2020 by 257K tests administered from April 25, 2020. State by State testing data tracks number of tests administered, number tested positive, quality of test results reported, data completeness, patient outcomes, and demographics. This meticulous tracking will help our Government public health officials carefully plan the reopening in each State. If you would like to delve deeper into this dataset, the tracking project makes this dataset available through APIs.
A few final thoughts
Together, we will beat COVID-19!
4. April 22, 2020 was a clear inflection point for testing in the US. Widespread testing is important for COVID-19 containment efforts. While testing started late and has been rolled out very slowly in US States and territories, good news is that the number of tests administered is increasing rapidly now (Exhibit 3). Why is this important? Case counts, as maintained by the Johns Hopkins University tracker, alone do not give us the full picture of the pandemic life cycle. For example, a State reporting 5 positive cases after testing 5000 probable cases is at a very different stage of the outbreak compared to a State reporting 5 positive cases after testing only 50 probable cases. The COVID Tracking Project is collecting and reporting testing data from State/County/Territory public health officials to help us understand how this outbreak is evolving in each State. The COVID Tracking project has tracked a total of 5.4 million tests so far in the US, up on April 26, 2020 by 257K tests administered from April 25, 2020. State by State testing data tracks number of tests administered, number tested positive, quality of test results reported, data completeness, patient outcomes, and demographics. This meticulous tracking will help our Government public health officials carefully plan the reopening in each State. If you would like to delve deeper into this dataset, the tracking project makes this dataset available through APIs.
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| Exhibit 3: US COVID Tracking Project |
A few final thoughts
If not already, you can read the 4-phase roadmap to reopening in the United States by Scott Gottlieb and colleagues. Other countries are following similar approaches.
Follow your Country/State's reopening plans and guidelines closely. For instance, Governor Hogan has posted the following plan for recovery from COVID-19 for the State of Maryland where I live.
Want to fight COVID-19 from home? Join the Pandemic Data Room organized by the QED group, Georgetown University and other national and international partners for the data visualization challenge on international COVID-19 datasets. Register now to participate and for a chance to win award money up to $10,000. You can view featured early submissions here for this COVID-19 data visualization challenge. Be sure to select "COVID-19" from the challenge dropdown. There is still time to submit your visualization for this challenge until May 3.
I am humbled and inspired by all the feedback, scientific articles, and (good) news items sent to me. Please keep them coming so I can share them here. You can find me on twitter @subhamadhavan.
All of us are finding different/creative ways to cope with this global crisis. This blogpost series researching and sharing scientifically-rigorous, evolving good news about COVID-19 is my way of coping.
Together, we will beat COVID-19!
Thank you for reading and sharing.
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