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2020年3月9日 星期一

COVID-19 (the new coronavirus)測試:韓國、新加坡快篩突破;診斷/快篩測試;“咽拭子檢查”、molecular coronavirus diagnostic examinations. China doctors seek tougher discharge criteria after positive COVID-19 tests血液中抗體的分析 use of antibody test to track coronavirus infections.台灣目前每天約可檢驗2450件檢體







中研院快篩:如果成功量產,費時15~20分鐘,尚未知正確率。
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南韓的因應策略不一樣,沒有封城,而是地毯式檢測可能病例,已經做了將近二十萬次逆轉酶檢驗。義大利與南韓的不同因應方式,成效如何剛好可以形成對照,讓未來其他爆發疫情的地區參考。
3. 有人說大規模檢測可能造成一堆偽陽性病例,因此台灣不必學南韓。是這樣嗎?台灣目前為止檢驗一萬多件,只有四十五件陽性,可見偽陽性低於1%。逆轉酶檢驗主要問題是敏感度不夠高,容易有偽陰性,而且耗時數小時。現在,台灣還有其他國家正在開發快速試劑,可以縮短檢驗時間,但偽陰性的問題仍是存在,而且偽陽性率也會增加。
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3 月 5 日,史丹佛大學醫學中心稱,史丹佛大學臨床病毒學實驗室從 1 月下旬開始開發試劑,如今準確性通過驗證並開始在史丹佛醫療中心(Stanford Health Care)和史丹佛兒童醫療中心(Stanford Children’s Health)使用。負責開發試劑的史丹佛臨床病毒學家班傑明·平斯基(Benjamin Pinsky)博士表示,新試劑可「成功偵測新冠病毒,不會與其他種類冠狀病毒或流感病毒交叉反應」。新試劑使用後,可在 12~24 小時完成採集樣本到得出結果,之前美國疾病控制與預防中心(CDC)測試需近 72 小時。
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A group of doctors in China decided to delay the discharge of 18 patients who had already tested negative for the coronavirus twice; 13 came up positive when tested again.

Worrying cases of recovered coronavirus patients in China testing positive again for the infection have raised questions among doctors about the ...

CHANNELNEWSASIA.COM

China doctors seek tougher discharge criteria after positive COVID-19 tests
Worrying cases of recovered coronavirus patients in China testing positive again for the infection have raised questions among doctors about the ...


 COVID-19 (the new coronavirus)

3.診斷測試(準確與速度與價格):
最常見的是從喉嚨取樣做“咽拭子檢查” (中國、韓國等採用),現在武漢應還有十來萬個“咽拭子檢查”待測試。


美國三月初 Meanwhile, the U.S. Food and Drug Administration cleared the way Saturday for some laboratories to conduct diagnostic tests on the virus before an emergency process is fully approved.
The FDA issued guidance to help rapidly expand testing capacity using molecular coronavirus diagnostic examinations. For a period of time while labs submit formal applications, the FDA doesn’t intend to object to the tests for specimen testing, according to a statement.





有快篩 (約15分鐘?日本說在開發一小時之測試法,3月5日)、大量診斷能力的國家:中國、新加坡、韓國、.....可能快有此能力的國家:日本、美國、台灣.......
起初是國家/CDC特選的檢驗單位;擴大到各醫學中心/醫生/護士都能"決策"。
英國的據說是CERTIFIED的?

近日有網友在網路發表言論,指台灣不是個案少,是沒能力驗。中央流行疫情指揮中心駁斥表示,國內從1/15至今,累計檢驗檢體數已超過1萬6000件,而且檢驗能量持續增加,目前每天約可檢驗2450件檢體,呼籲勿輕易發布或轉傳未經查證訊息,以免對整體防疫措施造成妨礙。


2. 以逆轉酶檢測(real time RT-PCR)來說,廣東省至今至少檢測了三十多萬例,其流行病學資料相對可靠,而廣東省的新冠肺炎死亡率是多少?0.5%。這數據跟哪一國一樣?南韓。南韓也是大規模檢測,數據也最可靠。反過來說,日本、義大利,尤其伊朗,檢測數相對較少,因此死亡率都偏高,前兩者達2.5%左右,後者則是高到不可思議,當然後者也跟醫療完整度有關。





各國可能缺試劑,結果更久才能判定是否確診

If epidemics like China's spread to other countries, tests for the virus could soon run short and delays in obtaining results would increase

The Japanese government says it has developed technology that can determine whether a person has the new coronavirus in just 15 minutes.
https://www3.nhk.or.jp/nhkworld/en/news/20200225_51/

據了解,新的檢查機器是使用由產業技術綜合研究所開發、可加快遺傳物質增幅的技術,因此約15分鐘便能得出結果。

第9次才驗出確診
Daily Mail
The woman was tested EIGHT times in 17 days

新冠肺炎(武漢肺炎)疫情持續,廣州出現隔壁期滿後發病個案。有潘氏一家六口於1月22日亦即武漢封城前,從武漢返廣州,一家回廣州後接受了14日居家隔離觀察,並無異常。豈料隔離13日後,其中4人突然發病,先後確診。



【血清檢測】新加坡在新型冠狀病毒檢測上取得進展
https://bit.ly/385zBIl

新加坡衛生部週二宣布,利用美國杜克大學和新加坡國立大學醫學院研究人員開發的血清學檢測方法,在新加坡確認第一宗病例後,研究人員在不到一周的時間內就成功培養出COVID-19病毒。使用病毒和源自病毒的遺傳物質,該研究團隊開發出幾種特定的實驗室檢測方法,以發現病毒特異性抗體,用於追蹤接觸者以及其他應用。


Examining coronavirus patients' CT scans could lead to a quicker diagnosis of those with suspected symptoms, doctors have discovered 







FTVNEWS.COM.TW

夜線/武漢肺炎篩檢再進化!國衛院研發快篩試劑只需5到15分鐘-民視新聞網
杜克—新加坡國立大學醫學院 (Duke-NUS Medical School) 成功研發首個血清測試,以追查引致兩個教會聚組 (cluster) 感染個案爆發的「中間人」。
研究人員在實驗室測試中,發現康復病人血液樣本的抗體會可針對病毒尖刺狀蛋白,以阻止病毒獲殺死細胞。同時,他們再製造一個個成病毒蛋白,在無需利用病毒之下,測試血液樣本是否存有病毒抗體。流行病及病毒學專家均指出,類似的血清測試對於了解人口感染的情況,由此解開他們的流行病學特性,幫助制定抗疫策略。

2.27
"UC Davis Health does not control the testing process," the hospital noted.
The new patient, who lives in Solano County and has not been identified, was transferred to UC Davis Medical in Sacramento County from another hospital this month. Staff at UC Davis then suspected the patient might be infected with the coronavirus that has caused more than 2,800 deaths.
"Upon admission, our team asked public health officials if this case could be COVID-19," the hospital said. "We requested COVID-19 testing by the CDC, since neither Sacramento County nor CDPH [California Department of Public Health] is doing testing for coronavirus at this time. Since the patient did not fit the existing CDC criteria for COVID-19, a test was not immediately administered. UC Davis Health does not control the testing process."
Health and Human Services Secretary Alex Azar said Thursday morning that the CDC is streamlining the process it uses to test for the coronavirus across the country, saying it will spread the new process to all of its labs.CDC Has Fixed Issue Delaying Coronavirus Testing In U.S., Health Officials Say SHOTS - HEALTH NEWSCDC Has Fixed Issue Delaying Coronavirus Testing In U.S., Health Officials SayAzar said all of the CDC's network of nearly 100 public labs will soon be using the modified process. The next step, he said, is to develop a "bedside diagnostic" that doctors and hospitals could use. He did not give details about when that might occur.




The CDC has completed more than 3,600 coronavirus tests, Azar said during a congressional budget hearing on Thursday. While he said it hasn't had a testing "backlog," he added that the agency's test has three steps — and that the last step has posed some problems.
"What we found was that in some labs, the third step of that, they were having trouble with getting a quality control validation on that, so it led to inconclusive results," Azar said. "We now, as of yesterday afternoon, the FDA authorized the use of those tests by using just the first and second step."

血液中抗體的分析:關鍵資訊

13 時間前 - As the coronavirus spreads more widely around the globe, scientists are starting to use a powerful new tool: a blood test that identifies people who have previously been exposed to the virus. This kind of test is still under ...
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In what appears to be a first, disease trackers in Singapore have used an experimental antibody test for COVID-19 to confirm that a suspected patient was infected with the coronavirus.

Researchers hope serological testing will help them better understand the epidemic
SCIENCEMAG.ORG

Singapore claims first use of antibody test to track coronavirus infections


武漢肺炎全球擴散,各地科學家開始嘗試研發新血清測試,幫助判斷身體有沒有曾遭病毒感染,由此幫助追...

Researchers say the domestically developed kits are more than 99 per cent accurate and take less than half the time of tests currently used in hospitals.

These new coronavirus test kits developed in Singapore promise results in three hours.

2020.2.6
Takara Bio is preparing to produce 50 times more of a coronavirus testing reagent at its plant in Dalian.


#國際視窗【南韓如何開發出全球最快檢測技術?】
  
新冠肺炎疫情在南韓持續延燒,目前確診5766人。數字上看起來是疫情迅速爆發,但其實跟南韓大量且快速的篩檢有關。
 
南韓如何記取5年前MERS疫情的教訓,開發出全球最快的檢測技術?

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