And compare that to modern ThermalFischer parallel PCR sequencers, which operate in realtime, 25 tests in parallel, for 2.500€. That's a factor of 1000. With 10 modern sequencers per city you could test 10.000 per day, eg with drive-in.
That said, it’s great to see all the companies that are putting real effort into this. This is their time to serve.
My own employer has assembled a task force for repurposing some kits we have for covid research. Everyone working on it is happy to have someway they can try and help out.
At the moment I feel so incredibly fucking useless lurking at home playing video games.
Sometimes being a hero is boring.
Also, don’t forget to socialize in whatever way you can. Skype your relatives, call your friends, send a letter to your neighbor. Go on a walk and ask people (from 6 Ft away or more of course) how they’re doing. Take time to do the human things. Anyway to make someone else feel slightly normal is this time is a big help!
Actually, getting a sense of the penetration of infection into the general population, among asymptomatic people and mild cases would be very valuable information! Antibody tests could be used to sample test the public at large.
I don't think this is meant to replace large labs running rtPCR tests.
Is that false positives or false negatives or both so to speak? I.e. what is the confusion matrix of these techniques?
But it will give you the second test result after five hours, while the Roche machine will give you the second result after three and a half hours, too. As well as the third, the fourth, and the fifth. Oh, and the onehundredandninetysecond one, too. In the 24 hours the Bosch machine produces ten results, the Roche one will produce more than fourthousand results.
> Never underestimate the bandwidth of a station wagon full of tapes hurtling down the highway.
— Andrew S. Tanenbaum
How much does the ThermoFischer sequencer cost? Is it affordable enough that every hospital just buys one and becomes a regional testing lab? How much specialized training does it need? (in every major city there are tons of biology and biology-adjacent majors who've done lab work but discovered there's no living to be made in bio so have switched to other fields).
Example of high bandwidth connection: van full of books.
These are orthogonal properties and must be considered separately.
The massively parallel machines will give you 200 samples per day, but in the very best case you have to wait until the end of the day to get the first one. This technology gives you a result a couple of hours after taking the sample.
However I suspect that the downside of this device will be the high cost of consumables, as is common for microarray biochip based devices.
But I agree that it's largely unnecessary, the initial "up to ten tests per day" would have been enough.
But it appears to be a new test cartridge for an already deployed machine, so it makes sense to have it anyways. I don't know who the typical customer of an on-site lab in a box like that is, but I guess that as last part of the market will be defined by remoteness and there it absolutely makes sense.
See https://bosch-vivalytic.com/ for the marginally less fluffy product page
Man, I love German advertising. It's like the one for Ritter Sport chocolate. SQUARE! PRACTICAL! GOOD!
Could be very important for screening doctors, nurses, and people in close contact with high risk populations.
The device itself was apparently made available about two years ago: https://www.irishnews.com/business/2018/04/23/news/randox-bo...
So yes, this is a great achievement and excellent marketing.
So it doesn't really say how many tests it can process in a real-world setting.
That describes how this particular test works. It's a small device with self-contained cartridges, so it's designed to be used outside a lab and doesn't require experts to operate. But as far as I can see, it only processes a single sample at a time. A typical PCR setup in the lab can handle 96 reactions at a time, though you also need controls there which I assume are built in the cartridge in some way in this test. And then there are the big automated systems.
I think the benefit of this device here is only present if you already have one, it's not a way to seriously scale up testing as a whole unless these devices are very widely used already.
If it works and they can provide enough devices, this could be great. Logistics (getting samples and material to labs and handling them there) is one of the constraining factors at the moment.
> They should've just written "10 tests per day per device".
Incorrect. Marketing BS works.
"It even works on people who fully understand it and think they are above it."
> Nobody in biotech opens up their wallet for high-ticket items based on a few words on a website.
Sure, but that doesn't mean the wording has no effect.
So if you can install these machines directly in hospitals, clinics etc, they will still be far faster than sending them off to a lab.
>In various laboratory tests with SARS-CoV-2, the Bosch test delivered results with an accuracy of over 95 percent.
I've read a lot of report on the current tests for SARS-CoV-2 having accuracy issues, does anyone know how 95% accuracy compares to the current methods?
We use the terms "sensitivity" and "specificity" to describe diagnostic test performance, and never to my knowledge talk about a test's "accuracy." Usually accuracy refers to the sensitivity, but there's a lot of liberty taken with that term in marketing talk.
For example, the existing PCR test being used does not have ideal sensitivity, which for practical purposes means that there is a substantial false-negative rate. Which is why (among other reasons) we weren't testing asymptomatic patients in the early phase.
That's why you look at True Positive Rate (sensitivity) and True Negative Rate (specificity) to factor that bias out.
If TPR is 95%, that means that 95% of the people that are actually infected (10% of the pop in the previous ex.) will be detected as such.
IF TNR is 20%, that means you'll mistakenly detect 20% of people that don't have it as infected, which would be really bad.
In other fields, people use Precision and Recall. Precision = % of times the test is right when it predicts a positive. Recall = how many of the real positives were detected as such.
Would it though? It's my understanding that most people who test positive are still being sent home, not forcefully hospitalized. And given that we don't actually have a widely used pharmaceutical intervention protocol, there's no side effects to worry about from false positives (eg of the opposite of this: if we were giving every confirmed case chloroquine or interleukin). The worst case outcome from a high false positive rate (low TNR) would seem to me that people would be extra good at self quarantining.
For them and others one cost is that they'll feel themselves somewhat immune when they're not and may not take precautions. It will also confuse study of the disease if it starts to look like your "2nd" infection can be much worse than your first.
Hospitals in an epidemic are major spreaders of the infection. If false positive results lead to patients being put together with real carriers, they will soon be infected.
From a recent report from Italy:
> For example, we are learning that hospitals might be the main Covid-19 carriers, as they are rapidly populated by infected patients, facilitating transmission to uninfected patients. Patients are transported by our regional system, which also contributes to spreading the disease as its ambulances and personnel rapidly become vectors. Health workers are asymptomatic carriers or sick without surveillance; some might die, including young people, which increases the stress of those on the front line.
It could mean that some of the major causes of the large death toll in Italy are the lack of personal protection equipment, and, possibly, laxity in following protocol.
Wrong. The major cause is that the number of people getting sick at once was much higher than the infrastructure can handle. That's what other governments saw and now try to avoid with the lockdowns.
This was made 10 days ago by the Italian biotech Association it's the number of new cases and deaths per week (red), compared with the number of cases per week at the peak of the "normal" flu (blue):
It can happen everywhere if the growth continues, simply because nothing can cope with fast exponential growth. At the moment, wherever it is uncontrolled, it's around 3 days to double. Sounds like small numbers, just 2 and 3? That gives however a thousandfold growth in 30 days: everybody working with computers should be very familiar with the equation 2^10 = 1024 (it's 2^(30/3) == 2^10 == 1024, 30 being the number of days for the projection, 3 the doubling time and 2 the doubling itself).
Nobody has thousandfold more hospital beds and doctors ready, even less a million times more, which is the two month's growth.
Discussing other factors without first admitting the major one is obviously biased.
> Nobody has thousandfold more hospital beds and doctors ready, even less a million times more, which is the two month's growth.
And in a few additional months, we will need more ICU beds than the number of atoms in the universe.
Infection rates are already significant, there just aren't enough people to sustain two months' growth.
This is wrong, of course there are enough people for this to grow for months even with no containment efforts.
Again, these models are not robust to minor changes in their assumptions.
It can be simply calculated: it is expected that without measures the growth to 70% of population would be continuous (very approximately, the end phase wouldn't, we're estimating the limit). So the target is 6e9 people. If we assume that 4/5ths are the people who remain undetected by our current sampling, we want to know the growth between the current known infected and the target which is then 1.26e9 people. Currently known are 0.5 million infected. So the fastest end of growth phase would be just: 2520 times or around 2^11=2048 == just 11 times 3 day doubling time, or 33 days.
The growth will surely not be always exactly 3 days however, so it will be slower, but still not less dramatic, because the resources are many, many times smaller, in the poorer countries many tens of times smaller.
In short it can be very, very bad, and that will be much longer than just a month, just not the exact growth as now.
See the papers from Imperial College London for the exact shapes of the curves and the examples of their speed and growth.
The last one is from today.
The measure does sometimes get used when discussing diagnostic tests - for an example from psychology/psychiatry see https://insar.confex.com/insar/2019/webprogram/Paper29391.ht...
Accuracy: ACC = (TP+TN)/(P+N)
Balanced Accuracy: BA = (TPR+TNR)/2
The definition I gave is the second not the first. You are probably correct that the conference abstract I linked to is using it in the first sense not the second. (I'm not 100% sure though.)
"Accuracy" is a bit more scientific- leaning and therefore easier to translate.
Remember, COVID-19 is a global phenomenon, its not just relegated to the Anglo-sphere. Bosch, being a German company, is probably a bit sensitive to the accuracy of translations that will be needed to market this thing effectively around the world .. ;)
I was only trying to help the parent find a way to remember which one is sensitivity and which one is specificity...
Especially apropos life-support systems where, indeed, RTFM||die is a thing.
This test by Singapore a*star nanobiolab can test in 5 minutes : https://www.straitstimes.com/singapore/health/singapore-scie...
Inaccuracy of up to 15% could still keep the viral R0 under 1.0 (the critical value for eliminating an epidemic).
From the article:
> "False negative rates up to 15% could be tolerated if 80% comply with testing, and false positives can be almost arbitrarily high when a high fraction of the population is already effectively quarantined"
For example a 150,000 batch of rapid tests China recently sent to Czechia had 80% error rates. You don't want to be mass quarantining people because of such terrible testing supplies.
Up to 1,000
(in smaller font) tests per day on just 100 devices
So.. 10 tests per day per device? That doesn't sound THAT impressive.
Well i see here a big improvement...
Is that because it takes 2 days for the test to complete, or because there a 2 day delay from backlog + administrative time?
The biggest waiting time comes from logistics with transportation to the labs, which is where the Bosch test is advantageous.
If accuracy is an issue, why not doing a two pass procedure ? 1) test quick and cheap 2) if results have low confidence, move to longer/more reliable testing method
their advantage seems to be that they don't need extra personell to run , so anyone with sufficient safety precautions could use them in a hospital
Bonus article with biohackers in Sydney: https://www.abc.net.au/news/2020-03-25/amateur-scientist-mak...
It doesn't appear to have an FDA EUA so it may not be immediately usable in the US.
The user-friendly UX and compact size seem good.
The cycle time seems to be on the slow side when minutes count in an ER / ICU situation. ~9 tests per day per machine seems slow, costly and likely to occupy a lot of space for the machines and the cartridges (which contain reagents that have to be kept chilled).
This seems overall like a timely product to solve immediate needs. It could've been better but it was designed quickly.
> ... on just 1,000,000 devices
Also, it seems like the actual test is the cartridge which is inserted into an existing device. So the device is probably already in use in some places and can get this extra test capability by just inserting the cartridge.
Curious what the false negative rate is.
>[The device] can perform up to ten tests in the space of 24 hours
>[Testing] can be performed directly at the point of care. This eliminates the need to transport samples, which takes up valuable time. ... With the tests currently in use, patients must usually wait one to two days for a result
>... even medical personnel who have not been specially trained on it can reliably perform the test.
>... it allows a single sample to be tested not just for COVID-19 but also for nine other respiratory diseases, including influenza A and B, simultaneously
Serology tests are already used in several countries in Asia, I have little doubt they will arrive in Europe and the US soon-ish.
I wonder how much 100 Vivalytic devices cost and how much those cartridges cost.
Can they mix multiple samples into one test? If you take sample from 10 people, mix them to find that nobody is infected, it increases testing capability 10X.
”The widely available Roche’s cobas 6800/8800 Systems, which are used to perform the cobas SARS-CoV-2 Test, provide test results in three and half hours and offer improved operating efficiency, flexibility, and fastest time-to-results with the highest throughput providing up to 96 results in about three hours and a total of 384 results for the cobas 6800 System and 960 results for the cobas 8800 System in 8 hours. The test can be run simultaneously with other assays provided by Roche for use on the cobas 6800/8800 Systems.”
The testing devices themselves seem to be around 15.000 Euros. So you'd have to have a very good reason to buy one - a reason that isn't throughput.
Seems like that would be handy if not just fascinating
I think cost firstly and then speed of result would be useful right now never mind the throughput.
You need stuff that works first.
At this point, isn't the virus considered to be "everywhere" and testing pointless?
Half the things I read still reflect fantasies of Asian-style containment in the West.
The other half acknowledge that this is too late. That we're heading up an exponential curve now, and will be on the other side in 3-6 months (depending on measures taken).
I'm no expert. But knowing what I know about my nation's government, and the likelihood of its people fully cooperating with any measures, I suspect that the second half is more realistic.
Meaning that testing and contact tracing is really only going to become relevant later this year. To snuff out any minor flare-ups that occur after most of society has gotten over the curve and built up herd immunity.
We really need a whole suite of tests and so the more the merrier. Doctors and healthcare systems will need to figure out what works best for their needs.
Wait. 10 tests per day? That's nothing.