[HN Gopher] Project Covalence
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Project Covalence
Author : dmnd
Score : 69 points
Date : 2020-06-16 17:09 UTC (5 hours ago)
(HTM) web link (blog.samaltman.com)
(TXT) w3m dump (blog.samaltman.com)
| hairytrog wrote:
| It is now clear that Covid-19 is not as dangerous as was thought
| and hyped by media and governments worldwide, and that the
| prescribed shutdown cure has been and will be much worse than the
| disease itself. Please see (https://swprs.org/a-swiss-doctor-on-
| covid-19/) for a pretty clear summary or follow Aaron Ginn.
| Covid-19 vaccine development is nearly useless at this point.
| That said, we need countermeasures and resilience to such events
| in the future.
|
| The expectation is we may be well be in 50% to 100% infection
| rate if serology yield is 1/5. Pretty scary. This means the
| disease was extremely rapid, and we would've been absolutely
| trashed if it had been significantly more lethal. We need to
| invest massively on R&D against such potential threats. Covid-19
| shows that state control wouldn't have done much to prevent
| global devastation, and that state control can itself cause the
| devastation. We need technological countermeasures such as one
| week vaccine development and deployment or transition to more
| separate economic spheres with permanent and complete travel bans
| and highly controlled trade between countries or geographic
| regions.
| nostromo wrote:
| Just today I was reading that vaccinations in many countries
| were stopped to prevent Covid-19 transmission, and now children
| are starting to die.
|
| https://www.nytimes.com/2020/06/14/health/coronavirus-vaccin...
| shoyer wrote:
| This is actively dangerous misinformation.
|
| In places where the pandemic is not under control, there have
| been vast numbers of excess deaths:
| https://www.nytimes.com/interactive/2020/04/21/world/coronav...
|
| We are still far from the peak in most parts of the world.
|
| New York City has a population about 8 million, with 24,000 [1]
| excess deaths and an antibody positive rate of about 20% [2].
| Do you really think it would be acceptable to let another
| 50,000 people in New York die (0.6% of the population) to reach
| herd immunity?
|
| [1] https://www.bloomberg.com/news/articles/2020-05-11/new-
| york-... [2] https://www.cnbc.com/2020/05/20/antibody-testing-
| shows-coron...
| hairytrog wrote:
| Lots of downvotes on my comment. A somewhat hilarious denial
| of what is plainly visible. Did you people even read the
| linked summary? The economy was hijacked for a complete non-
| threat, driven by increasingly discredited studies, "experts"
| speaking in apocalyptic terms, and a media looking for
| crisis.
| [deleted]
| simonebrunozzi wrote:
| Hmm, sounds more like a PR statement rather than the usual
| (insightful) posts that Sam writes. Anyway...
|
| > Project Covalence's platform, powered by TrialSpark, is
| uniquely optimized to support COVID-19 trials, which are ideally
| run in community settings or at the patient's home to reduce the
| burden placed on hospitals and health systems.
|
| What's a "platform" in this case? I'd love to read simpler words.
| Is it a... piece of software to coordinate things? A physical
| machine? Else?
| sudhirj wrote:
| > supports trial execution, 21 CFR Part 11 compliant remote
| data collection, telemedicine, biostatistics, sample kits for
| at-home specimen collection, and protocol writing.
|
| Does that not make sense to people in this field?
| ryanseys wrote:
| Depends what you mean. I'm a software engineer working on
| clinical study software and it makes sense to me. Though, I'm
| sure there are plenty of problem spaces that I don't work in
| whose jargon wouldn't make sense to me.
|
| Here's a brief breakdown of the various terms though:
|
| > trial execution
|
| The act of running the clinical study.
|
| > 21 CFR Part 11 compliant remote data collection
|
| 21 CFR Part 11 compliance is a set of standards that must be
| adhered to when running clinical studies. To be compliant
| means you meet these standards and people or businesses that
| want to run studies can be sure that you're following the
| rules.
|
| > Telemedicine
|
| Medical visits typically done over video chat / phone calls
| or other digital means as opposed to going physically
| somewhere to be tested or evaluated.
|
| > Biostatistics
|
| Data science + medical data
|
| > Sample kits for at-home specimen collection
|
| Like 23&Me but for collecting other stuff from people at
| their homes. E.g. stool samples, COVID-19 swabs, etc. You
| mail the participant a kit, they collect their sample, mail
| it back to you, you process the sample, and that informs the
| data in your study.
|
| > Protocol writing
|
| Writing and codifying the procedure of how the clinical study
| will be run. Covers everything from enrollment, inclusion /
| exclusion criteria for the study, study running, and study
| closing and archiving.
| memexy wrote:
| Who and what field? If you mean programmers and regular HN
| visitors then no, those words have no meaning for me. What
| does each one mean and why is it important for running
| medical trials? Other than protocol writing, which sounds
| like a list of rules, I have no idea what the rest means or
| why it would be important in a trial.
| memexy wrote:
| I looked at the site
|
| > Participate in a clinical trial at no cost to you or your
| health insurance.
|
| Why would health insurance be involved when running medical
| trials and why would it cost anything? The pitch doesn't make
| sense to me. I always assumed medical trials were free for the
| participants. No idea who their target demographic is which
| makes me suspicious already.
| akiselev wrote:
| The FDA forbids charging for any medication or medical device
| that isn't approved so medical trials are free by definition,
| but the Affordable Care Act requires health insurers to cover
| routine cost of care incurred during qualified trials. In a
| Phase I trial under medical supervision, for example, might
| not cost the patient's insurance anything but a Phase 3 trial
| for chemotherapy might cost a ton just to deal with side
| effects and drug administration.
|
| As all things healthcare, it's complicated.
| memexy wrote:
| Ah, I see. Thanks for the explanation. I had a narrow view
| of what "trial" meant. So it sounds like as soon as
| approved treatments are involved then insurance gets
| involved.
| type0 wrote:
| > Why would health insurance be involved when running medical
| trials and why would it cost anything?
|
| To cover for the possible adverse effects
| memexy wrote:
| Yes. That's not my question. Are you saying drug trials
| don't cover such costs and that this is standard? Because
| that's the pitch the company is making and it sounds odd
|
| > We put the patient in the driver's seat before, during,
| and after a trial. Because it's not just doctors who help
| build a healthier future. It's patients. And it's time to
| do right by them.
|
| It sounds like they're saying, "patients are treated very
| badly and we're here to fix that problem". How bad is it to
| be in a drug trial currently? Are trial participants really
| treated with neglect? I don't understand what actual
| problem they're addressing.
| curryst wrote:
| If they did, there's always going to be a debate over
| whether something was caused by the trial. You get a rash
| and have to go see a dermatologist, was it a result of
| the trial or unrelated? Or more seriously, you develop
| cancer. Was it from the trial, or from an unrelated
| issue? Other people might show symptoms, but it would
| still take time you don't have for them to sort out
| whether other participants have cancer, and whether
| that's a result of the trial or if they just had a higher
| than average number of people with risk factors.
| memexy wrote:
| So how is this company addressing all those issues?
| gumby wrote:
| Actually AEs, and especially SAEs, are more often than not
| handled by the clinical investigators or trial sponsor, for
| a variety of reasons.
|
| Insurance policies often don't cover you while you're
| enrolled in a trial ("you wouldn't have broken your leg if
| you hadn't been in that cholesterol drug trial so we don't
| cover that").
|
| The agency really cares a lot, especially about SAEs, and
| if someone is hit by a trolley while in a cholesterol drug
| study they will want the company to promptly determine that
| the drug didn't cause them to stumble, or lose vision, or
| be confused about where they were. We used to joke at one
| company, "but being hit by a meteor is not an SAE."
| jxramos wrote:
| I've actually been wondering as covid19 winds down and people's
| lived experiences no longer perceive it as the doom and gloom
| threat it once held sway with, if given that perception whether
| the market rewards will continue to stand and attract massive
| investments in pursuit of a vaccine where the rewards may not
| outweigh the risks.
|
| I would think that would be a pretty strong signal that covid is
| not as large a risk if big industries don't think it worthwhile
| to pursue any longer. Along those lines of thinking have any of
| the big pharmaceutical companies given serious pursuit of a
| vaccine or is it mainly smaller outfits?
| Shank wrote:
| > I've actually been wondering as covid19 winds down and
| people's lived experiences no longer perceive it as the doom
| and gloom threat it once held sway with, if given that
| perception whether the market rewards will continue to stand
| and attract massive investments in pursuit of a vaccine where
| the rewards may not outweigh the risks.
|
| This is an extremely long (56 word) and complex sentence. I
| fear that your point may be lost because of its length. Do you
| mind restating your thesis?
| cinntaile wrote:
| Most of the big pharma companies are developing a vaccine. [0]
| The ones that aren't specifically mentioned by name are
| probably funding some of the smaller biotech companies instead.
|
| [0] https://en.wikipedia.org/wiki/COVID-19_vaccine
| DiabloD3 wrote:
| Good luck with that, Sam.
| chintan wrote:
| Great initiative! There needs to be more effort towards
| streamlining these trials.
|
| At TrialX [1], we also launched Covid Labs Initiative to _Hack
| The Pandemic_ [2] by bringing together hackers in Clinical Trials
| informatics space - Drop us a note hackcovid@trialx.com if
| interested.
|
| We are seeing an unprecedented activity on-the-ground at various
| orgs[3,4,5] where we power the clinical trials recruitment. There
| is a huge interest in patient/volunteer community. Any effort to
| streamline and accelerate would be welcome.
|
| 1. https://trialx.com
|
| 2. https://trialx.com/covid-labs/
|
| 3.
| https://www.pennmedicine.org/coronavirus/covid-19-clinical-t...
|
| 4. https://www.centerwatch.com/covid-19-treatment-information
|
| 5.
| https://clinicaltrials.med.nyu.edu/clinicaltrials/?keyword=C...
| dzink wrote:
| Why set up a separate brand to funnel COVID trial business to
| TrialSpark? From their own site, TrialSpark is a VC-backed
| company which primarily runs trials for major drug companies to
| recruit more patients with painful chronic conditions (like
| Astma, COPD, Diabetes, inflammatory, skin problems etc, but not
| cancer)for drug studies. The highly profitable medical areas are
| clearly attractive for Pfizer, but the sales pitch of TrialSpark
| is to identify high cluster areas of a disease in small
| communities, recruit community doctors and incentivize them to
| attract patients to drug studies with 1.9x higher than usual
| conversion rate.
|
| So why the separate brand?
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(page generated 2020-06-16 23:00 UTC)