Coronavirus protein treatment trial 'a breakthrough' | Hacker News Reader

Coronavirus protein treatment trial 'a breakthrough'

bbc.co.uk

157 pointsheadmelted70 comments

> The results have not been published in a peer-reviewed journal, nor has the full data been made available; so the BBC cannot confirm the claims made for the treatment.

How are these claims any different than the few other ones heard over the last few weeks? They always sound incredibly promising..... and then nothing!

Is this different?

edit: typos

What is worse this is a public traded company:

https://markets.ft.com/data/equities/tearsheet/summary?s=OMY...

Up more than 200% today!!!

Also mentioned in the article: "Stock market rules mean Synairgen is obliged to report the preliminary results of the trial."

Which rules exactly? Plenty of of publicly traded companies keep R&D projects secret...

There comes a time when you can no longer keep something secret even if you try. The next step in getting this approved requires that some people be told about this that you must assume will not keep it secret (ie a journal that goes to libraries for anyone to read). Thus at this point they have to tell everyone who might invest, that way they can't be accused of telling their friends.

We're specifically talking about clinical trials.

To be fair the stock wasn't worth much before today... It's far easier to get big sounding percentages with small numbers.

The price of a stock doesn't matter. A company with 100'000 shares that are worth $100 isn't worth more than a company that has 10 million shares that are worth $1.

But I a dollar stock is more likely to triple than a $100 stock.

As you say, it's the total market cap that matters in how much value a share is actually worth. But there is a floor to how much an individual share can be sold for before they de-list it entirely, resulting in a lot of volatility for very-low-priced stocks.

When a company on the brink gets a bit of good news, it's easier for it to triple in value than a company with an existing, stable business. Such things can suddenly turn into big, quick wins for the people who were there before the news. (People investing after the news are pretty much just suckers, though market irrationality still lets them sell at a profit to even further suckers.)

Well technically dmix says worth not price which to me is more akin to market cap than price.

That's also how I intended it.

What do you mean? The specific price per share doesn’t mean anything. It’s just a number calculated from value of the company and number of shares.

If I get my first sale today for $1 and then tomorrow make a sale for $3 I can say my daily revenue is up 200%.

The impressiveness of growth percentages drops off when your base is small.

The argument you’re looking for is that the market capitalization is small. The stock price itself is irrelevant and depends on units of stock extant.

If Apple does 1:100 split and their shares will have new price of $3.89, will that somehow make Apple stock more volatile?

The company was worth £50m yesterday, that's not chump change

Still, if you put 100k, you get 200k back.

And just as quickly the other direction, which is the risk with low value/penny stocks and high volatility without a strong base.

Still I'm not suggesting anything is atypical here (besides BBC declaring it a "breakthrough"). If anyone 'deserves' to be well capitalized it's companies doing research in this email to area with real clinical trials. It's hardly the last time people will gamble on preliminary results even beyond COVID, googling "preliminary results" will provide plenty of evidence.

"research in this email to area"

typos? voice transcription errors? no idea what you intended to convey here...

If you use leverage and take options you can put in 1k and get 200k back.

A large company is guaranteed to have been analyzed very carefully by skilled analysts. If you have a small sum to invest, a big risk appetite and you are willing to do your homework then you are better off trying your luck with understudied companies in inefficient markets.

It follows from the theory of comparative advantage. The big players can extract a lot more than you can from big companies but only a little more from the small ones.

Not really. On paper it works, but in practice your position is large enough relative to the whole that your activity is affecting the price. You won't be able to buy as much as you think for that price because there are not enough sellers, and even if you did, your act of selling drives the price down. Big players worry about this all the time. Small players can safely ignore it. The line between big and small depends on the company in question.

I realize that you were talking about options which have slightly different rules, but overall the same applies, in ways adjusted for the rules of options. (I don't know those rules well)

Options in such stock even if it exists will not be liquid enough you can do that easily . That is you won’t find counter parties for that kind of option for this type of stock easily .

This sounds just like a great Bitcoin opportunity I saw recently in a tweet from Elon!

Before tax, also the long train is past, time to short it for the week.

What?

https://en.wikipedia.org/wiki/Low_base_effect

> How are these claims any different than the few other ones heard over the last few weeks? They always sound incredibly promising..... and then nothing!

Cubans, and few other ex-Eastern Bloc countries were peddling interferons as miracle cures in the past.

The reality showed a big part of it being a cargo cult science, except for a few cases when it wasn't, and they actually worked.

The same thing was for the bacteriophage medicine from ex-USSR coutnries. It indeed works, and it is in deed very arcane to most of Western antibiotic researchers, but it's nowhere near the "miracle cure" they peddle it as.

Yea. Releasing such articles is irresponsible journalism, I'd put it in the same category as fear-mongering.

BBC is as much clickbait as any. The days of actual journalism at the BBC pretty much died off a number of years ago.

> Weeks

I'm sorry, but even with things getting rushed through by regulatory agencies, you cannot expect prelim results to convert to treatments in only a matter of weeks.

Which claims are these, could you give some examples, ones from reputable sources please.

https://www.nytimes.com/interactive/2020/science/coronavirus...

Not sure if I can give you sources, but have you followed the Oxford University vaccine story? It seems like they're working miracles while many other scientists are pretty skeptical if a vaccine can be found at all, or at least within such short time frames.

This is anecdotal, but I do agree with the OP, there is a lot of conflicting information available.

Several vaccine projects have reported good stimulation of antibody production in trials. The big problem is that we don't yet know what kind of immunity that may provide or how long it might last. But it seems getting people to produce antibodies without making them ill is extremely possible.

From the Moderna Phase I results published recently [1], I'd point out that most vaccine candidates are also performing antibody challenges and T-cell counting, to better characterize the effective immune response generated [2], beyond antibody production.

[1] https://www.nejm.org/doi/full/10.1056/NEJMoa2022483

[2] Via assessment methods in the above: "pseudotyped lentivirus reporter single-round-of-infection neutralization assay (PsVNA) and by live wild-type SARS-CoV-2 plaque-reduction neutralization testing (PRNT)" & "T-cell responses against the spike protein were assessed by an intracellular cytokine–staining assay, performed on specimens collected at days 1, 29, and 43"

There are many vaccine projects showing promising results.

> there is a lot of conflicting information available

That's the nature of science. There is conflicting information because it is unknown what works yet. There are many approaches that show promise.. until they don't.

We will find out eventually whether the Oxford University vaccine works or becomes an example of "and then nothing". But it is definitely not a "and then nothing" yet.

Sounds like this shouldn't even be a news story then.

One key component of getting peer review is by peers knowing about it.

I've never published a BBC (or any journal) article before publishing a paper. As far as I know, the reviewers at Springer Nature could not care less if there's a press release attached to your manuscript, and some reviewers in medicinal journals would prefer groups don't publicize on media like Twitter to avoid biased reviews.

I must have just missed the "mass press release" portion of peer review.

There are forums for that. Not internet forums, "forum" in the original sense of the word. A public broadcast to the masses (the B in BBC) is not the forum for notifying peers in a professional field.

and yet, it also notifies peers in a professional field.

Several new treatments have emerged. I just read ICU survival rates are are down nearly 20%.

Do you mean death rates? vs survival rates?

yes

Readers may find this brief statistical review useful:

https://zenodo.org/record/3952241

This is a big effect size at least, so less likely to be a fluke. Also many previous results indicate interferons (whatever they are, I don’t actually know!) are useful. I believe differences in interferon production between sexes also explain why men get worse Covid. So there is existing background information that makes it more likely to be true.

Could still be a flop of course...

Quote: "Interferon beta is commonly used in the treatment of multiple sclerosis."

Now here is my million dollar question. Is there any statistics/data available to view about COVID infections on those people who already receive Interferon beta for their sclerosis? Because that right there it would be the telling sign for this extraordinary claim.

Its use in MS involves injecting it into the muscle, whereas this trial was using nebulisers to deliver it directly to the lungs so I don't think looking at MS patients would tell us anything useful.

But, as a general point, this is exactly the sort of question people should be asking about proposed treatments, as we've done recently for inhaled corticosteroids: https://twitter.com/OpenSafely/status/1277989037446438912

I guess Ben Goldacre would be the person to ask given this study from a few months back

https://twitter.com/bengoldacre/status/1259074178952683520

For a quick synopsis of other treatments, NYTimes has a helpful page:

https://www.nytimes.com/interactive/2020/science/coronavirus...

I was curious about how administering a cytokine could improve survival, especially since there's evidence of cytokine storm in severe cases.

A cursory look on wikipedia[1]:

> Since there is evidence that insufficient production of interferon beta-1a in lung cells in older people can lead to their increased susceptibility to respiratory viral infections such as SARS-CoV-2 and MERS-CoV, replenishing the deficiency of this interferon can protect against the dire effects of these diseases. Company Synairgen began clinical tests of SNG001, a special inhalation formulation of interferon beta-1a in patients with COVID-19

So it sounds like this treatment (assuming it is effective) would only be especially effective in older people (or younger people with some kind of Interferon beta-1-a deficiency I guess), and only if administered relatively early in the course of the disease - i.e. before development of pneumonia.

1: https://en.wikipedia.org/wiki/Interferon_beta-1a#Clinical_tr...

Cytokine just means ‘cell signalling molecule’.

The word doesn’t tell us anything, or anything much at all, about what those cell signalling molecules do, where they came from, nor what their target / recipients are.

Source: studied a bit of anatomy and physiology & pathophysiology along the way.

From Wikipedia: The word comes from Greek: cyto, from Greek "κύτος" kytos "cavity, cell" + kines, from Greek "κίνησις" kinēsis "movement".

https://en.wikipedia.org/wiki/Cytokine

Link to company announcement: https://www.synairgen.com/wp-content/uploads/2020/07/200720-...

I don't really understand the requirement for public-traded companies to make the results of such preliminary tests "public" before publishing them in peer-reviewed journals.

Doesn't that sound a bit backward ? As in, the company is incentivized to disclose very optimistic preliminary results, so that it appears in the BBC newssite, and make it's share price go up ; and then, much later, to submit an article in much more obscure academic journal where all the buzz will be toned down, hopping that Joe-The-Trader does not notice ?

(Honestly curious, I'm not familiar with the legislation here.)

If you submit something for peer review, by definition it has to go to a wider audience, it has to go to people who may share it with others, it has to leave the companies control etc. You generally don't even get to know who it goes to, let alone force NDAs on them. At that point you cannot hope to keep it private. So what you're doing is releasing price-sensitive information, but only to a select few (reviewers, their teams, journal admin staff, printers etc). That's unfair as they may well trade on the information defrauding others.

So you have to release it to everyone to be fair.

But you put a disclaimer on it to say its "not peer reviewed, preliminary etc".

Then if an expert wants to trade on it, they can and they're not left out just for not being part of the peer review circuit. And if an idiot doesn't read the disclaimer, that's his problem.

I agree that we get 1000s of dumb articles from hacks based on a non-peer-reviewed, "we're only releasing this statement because we're required to" data. But the issue there is journalists being lazy, editors refusing to do their jobs and readers rewarding them IMHO, not too much transparency. At least that's what I thought before people started drinking pool cleaner...

Oh, thanks, of course, I forgot about the insider's knowledge fraud. That makes sense.

No worries, it is a bit obscure...

The issue is the people (and the computer systems) it passes through for peer review.

There's a small number of publishers who put out most journals and not that many peer reviewing scientists per subfield. If you didn't publish preliminary results like this, those systems would be high value bottlenecks through which market sensitive data would flow all the time and a lot of effort would be put into breaking into them.

(edit: I do think it would be better to put out a preprint on Medrxiv at the same time though)

There was another RCT about six weeks ago released that showed that a combination of Lopinavir/Ritonavir, Ribavirin, and Interferon Beta 1a beat just Lopinavir/Ritonavir in time to PCR negative (7 days vs. 12 days). Presumably this was either due to the Interferon or the Ribavirin.

https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

Original press release:

https://www.londonstockexchange.com/news-article/tidm/headli...

(Has more details/statistics etc)

It is so strange to see covid19 news coming from stock exchange websites.

Da, welcome to kapitalism, komrade. :/ There is a not-insignificant number of people who view such developments primarily or exclusively through the prism of financial returns.

Stats sound promising. Let’s hope they hold up to scrutiny

I learned last night that the US has been buying up all the worlds supply of various promising medicines in an historic effort to fast track a cure for the US population, at the expense of everyone else.

It now looks like there’s a decent chance a vaccine could be available to Americans before the election. Very surprised I haven’t heard more about that as the lack of coverage could help make it into a real silver bullet for Trump’s re-election if it happens.

Edit: this effort is called “OWS”

That is Operation Warp Speed[1] and it is a very large investment by the US Government to find a vaccine. You should be thankful that the United States has the money to invest in this global research, instead of spreading FUD that the USA is blocking others from getting treatment. In fact, the Oxford trial that was announced today was heavily funded by this program, with the NHS being some of the first to be vaccinated if the treatment is approved. How dare the USA help the NHS, amirite?

Seriously, would you rather the USA didn't make this investment? What is your optimal outcome here?

[1] https://en.wikipedia.org/wiki/Operation_Warp_Speed

I assume you’re responding to “at the expense of”. My understanding is that the US bought almost the whole global supply of remdesivir, among other things, which will make it harder for other entities searching for a vaccine/treatment to operate. OWS is targeting producing 300 million vaccines as quickly as possible, which seems very “America first”.

I don’t really place a value judgement on it, but I stand by the statement. I find it strange I haven’t heard more about this, only that trump is “ignoring” COVID. I was pointing out that this narrative will really backfire if OWS produces a viable vaccine before the election.

To be fair, Remdesivir is an under-patent medicine designed by an American company, it isn't all that outlandish that the USA would procure as much as possible. The "among other things" is doing a _lot_ of heavy lifting in your statement. I do not see any evidence that the USA bought anything that would limit the ability for other countries to develop a vaccine. Only to use Remdesivir as a treatment. Which, I can see both sides of that really.

I also don't have a problem with the USA targeting 300 mil doses through OWS. They simply mean they will buy that many, not that other countries can't buy more etc. As I said, the leading vaccine right now is from a British university and a Swedish/British company funded by the USA (in part). I think it is totally fair for the USA to make a large investment and "pre-order" 300 million doses. If they were ordering 600 million doses and demanding that the patent be transferred to a US company, that would be shady.

But yeah, OWS is certainly part of Trump's re-election campaign. I despise Trump, and I hope OWS is successful well before November. If it gets him re-elected so be it. People are dying.

Not complaining about OWS here; but for context it's worth noting that this vaccine was started on jan 10, months before OWS existed. Of course, that was the cheap bit: the research. The clinical trials and scaling unusually quickly will likely be much more expensive; and where that billion will hopefully turn into something useful.

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