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Daily Briefing Covid-19 [4th April 2020]

Nǐ hǎo, - I am waiting for this sudden mist to burn off so I can do my walk in better visibility. In other news, my bread is getting better. Incrementally. After 3 weeks of living in one another's pockets, Mrs S and I have been rather techy with one another this morning. To be expected. Imagine our planned walk together will be a solo affair! ----- MS News ----- Not Covid-19 related but interesting about ocrelizumab. Despite how the headline appears it is not a new trial but further data analysis of the two big trials that got the licence called OPERA1 and, rather unsurprisingly, OPERA2. The upshot is that the further analysis of these ginormous data sets has made it clear that for better evidence still further specific trials need to be run. The issue for us patients with pharma companies is that if they feel that the extremely high cost of running these trials outweighs potential gains in revenue then they are unlikely to fund them. This leaves us in the hands of people like Prof G, Prof Schmierer etc at the Blizzard Institute at Barts and other global research teams to run such trials. - http://tiny.cc/OcOutcomes - Reality Bites - an interesting post about going forward and what losing our focus regarding distancing etc the Covid-19 pandemic will mean to everyone, including pwMS. https://multiple-sclerosis-research.org/2020/04/a-mscovid19-reality-check/ - Here is some more work comparing the success rates of easing in gently (Escalation) with hitting MS hard and fast upon diagnosis (Induction). It is with mitotraxone as these studies take a long time to do so this started a while ago before the newer therapies were in widespread use. It is still interesting as even with this slightly cnstrained viewpoint it is looking less likely that the default position should be escalate. Obviously there are different circumstances for everyone, this is contributing to the ongoing debate about the initiation approaches. https://multiple-sclerosis-research.org/2020/04/induction-verse-escalation/ and for the actual paper with no commentary though you need library access to read the entire thing and quite a few people here do http://tiny.cc/IvsE ------- Social stuff ------- It seems @vixen is not so keen on bbq brisket ;) It wasn't a meat vs veggies thing. I eat more veggie than meat these days for cost and health reasons. If I am going to eat a slice of signature meat before I kark it I want that brisket though and also some really good Kobe beef. - However, to go with them I'd need a very well cooked aubergine parmigiana like so https://www.youtube.com/watch?v=rq1EUwiLa6M

Thanks again for a great post with some valuable links. Regarding the persistence of Covid-19 in other countries after they have "peaked" I can confirm that while the news reports are that the virus is basically over in China and Taiwan there are still pockets and communities that report infection. We hosted a 4H international exchange visitor from Taiwan last summer and I stay in contact with her. She described what they did in the past (they didn't return to the University after winter break for one and take temperatures constantly before entering mass transit or public buildings, observations centers, testing, etc.) and what is still going on now. For example her family was hoping to visit relatives this next week in a local community (not far from New Taipei where she lives) but decided they had better not as there was an active Covid-19 case with a friend there. So it is not like it is totally gone and not affecting that country/community now. I think it is just at a more manageable level. We also hosted a student exchange visitor for an entire school year from east of Paris. They are basically under house arrest and need to show paperwork if they want to drive anywhere...a note to show through their window to the police that are patrolling and stopping people. You can go out to walk or bike but not in groups and adequately spaced. So major impact there but I think it is just peaking in that area. In the US we have areas, typically the large cities such as New York that are especially troubled right now but also pockets throughout the country that are having issues. In my state Milwaukee is in trouble as well as our capital Madison. The rest of us are mostly bunkered in our homes with businesses shut down. But we are in a agricultural area and farms and animals need to be tended to in order to maintain our current and future food supply so many people are "essential" workers and many of them have lowered risk as they work pretty independently in many cases. Love the escalation theory models vs the "hit it hard" model now that we actually have DMT options more effective than the initial DMTs that were available back when I was diagnosed in 2005! Neuro's need to decide what path is right for each patient and the patients need to be aware of the difference in the approaches and what path they want to take.