• Oil prices turned negative. Hundreds of US oil companies could go bankrupt - CNN

    The American oil industry is facing a doomsday scenario.

    The coronavirus pandemic has caused oil demand to drop so rapidly that the world is running out of room to store barrels. At the same time, Russia and Saudi Arabia flooded the world with excess supply.
    That double black swan has caused oil prices to collapse to levels that make it impossible for US shale oil companies to make money. US crude for May delivery turned negative on Monday — something that has never happened since NYMEX oil futures began trading in 1983. It was easily the oil market’s worst day on record.
    US crude for June delivery is still trading above $20 a barrel — but even that’s disastrous.

    $30 is already quite bad, but once you get to $20 or even $10, it’s a complete nightmare,” said Artem Abramov, head of shale research at Rystad Energy.

    Many oil companies took on too much debt during the good times. Some of them won’t be able to survive this historic downturn.
    In a $20 oil environment, 533 US oil exploration and production companies will file for bankruptcy by the end of 2021, according to Rystad Energy. At $10, there would be more than 1,100 bankruptcies, Rystad estimates.

    At $10, almost every US E&P company that has debt will have to file Chapter 11 or consider strategic opportunities,” Abramov said.

    The most stunning part of the record low in oil prices is that it comes after Russia and Saudi Arabia agreed to end their epic price war after President Donald Trump intervened. OPEC+ agreed to cut oil production by a record amount.
    Trump said the OPEC+ agreement would save countless jobs and much-needed stability to the oil patch.
    This will save hundreds of thousands of energy jobs in the United States,” Trump tweeted on April 12. “I would like to thank and congratulate President Putin of Russia and King Salman of Saudi Arabia.

  • Contrairement aux affirmations à l’emporte-pièce de...

    ....la CNN...
    Remdesivir : Covid-19 patients recovering quickly after getting experimental drug - CNN

    ... et Bret Stephens (New York times)...
    Opinion | The Story of Remdesivir - The New York Times

    ...les résultats partiels d’une étude en cours (connus grâce à une « fuite »- qui a fait bondir la valeur en bourse de la compagnie pharmaceutique mère...) ne prouvent nullement l’efficacité du #remdesivir, comme expliqué ci-dessous :

    What’s Happening With Remdesivir ? | In the Pipeline

    But now that it’s out there, let’s talk about what’s in the leak. Gilead stock jumped like a spawning salmon in after-market trading on this, and one of the reasons was that that 113 of the 125 patients were classed as having “severe disease”. People ran with the idea that these must have been people on ventilators who were walking out of the hospital, but that is not the case. As AndyBiotech pointed out on Twitter, all you had to do was read the trial’s exclusion criteria: patients were not even admitted into the trial if they were on mechanical ventilation. Some will have moved on to ventilation during the trial, but we don’t know how many (the trial protocol has these in a separate group).

    Note also that this trial is open-label ; both doctors and patients know who is getting what, and note the really key point: there is no control arm . This is one of the trials mentioned in this post on small-molecule therapies as being the most likely to read out first, but it’s always been clear that the tradeoff for that speed is rigor. The observational paper that was published on remdesivir in the NEJM had no controls either, of course, and that made it hard to interpret. Scratch that, it made it impossible to interpret. It will likely be the same with this trial – the comparison is between a five-day course of remdesivir and a ten-day course, and the primary endpoint is the odds ratio for improvement between the two groups.

    Et ce d’autant plus que la « fuite » survient juste après l’annonce de l’arrêt avant-terme de deux études chinoises sur le remdesivir (ce qui avait eu un mauvais effet sur la cotation en bourse...)

    More Small Molecule Clinical Data Against Covid-19, As of April 16 | In the Pipeline

    I refer to trials of Gilead’s remdesivir in China, one for moderate cases and one for severe ones, both of which were updated yesterday to “suspended” on ClinicalTrials.gov. That took people by surprise, and Gilead’s stock dropped in response.

    #mic-mac #manipulations # #sars-cov-2 #coronavirus #covid-19 #pharma

    • Data on Gilead’s #remdesivir show no benefit for #coronavirus patients

      Étude chinoise prématurément interrompue dont une mouture a été confiée à l’OMS qui l’a accidentellement rendu public (voir ci-dessous) avant d’être retirée,

      According to the abstract, 158 patients received remdesivir and 79 patients were in the control arm; one patient in the control arm withdrew before receiving treatment. The abstract said that for time to clinical improvement, the hazard ratio was 1.23, which would normally mean the patients on remdesivir improved more slowly than those in the control group.

      However, in a previous note to investors preparing them for the data, Umer Raffat, a biotech analyst at Evercore ISI, had said to expect the opposite arrangement: that a hazard ratio of 1.2 would show patients were doing better. It is not certain how the hazard ratio is being described in the abstract.

      Whether or not the drug benefit is trending in a positive or negative direction, the difference described in the abstract is not statistically significant, meaning that the study failed.

    • Le remdesivir accélère nettement la guérison des patients Covid-19, annoncent les Etats-Unis - Heidi.news

      Folle journée pour le remdesivir, cet antiviral évalué dans plusieurs essais cliniques de par le monde. L’immunologiste Anthony Fauci, directeur du National Institute of Allergy and Infectious Diseases (Niaid) et membre éminent de la task force Covid-19 américaine, a annoncé mercredi 29 avril la réussite du principal essai contrôlé randomisé américain. Le traitement expérimental aurait permis de réduire d’un tiers le temps de récupération des patients Covid-19 sévères, et les résultats suggèrent fortement un bénéfice en survie.


    • Remdesivir for the Treatment of Covid-19 — Preliminary Report | NEJM

      Étude randomisée en double aveugle, resultats préliminaires : n’est clairement utile à ce stade des résultats que dans le groupe modérément oxygéno-requérant,

      The benefit was most apparent in patients with a baseline ordinal score of 5 (requiring oxygen), a finding most likely due to the larger sample size in this category (since the interaction test of treatment by baseline score on the ordinal scale was not significant). Confidence intervals for baseline ordinal scores of 4 (not receiving oxygen), 6 (receiving high-flow oxygen), and 7 (receiving ECMO or mechanical ventilation) are wide. We note that the median recovery time for patients in category 7 could not be estimated, which suggests that the follow-up time may have been too short to evaluate this subgroup. Additional analyses of outcomes such as the time to a one- or two-point improvement on the ordinal scale score will be conducted after the full cohort has completed 28 days of follow-up and may provide additional insight into the treatment of this critical subgroup. Our findings highlight the need to identify Covid-19 cases and start antiviral treatment before the pulmonary disease progresses to require mechanical ventilation.

    • Covid-19 : remdésivir (Veklury°) autorisé dans l’Union européenne, avec beaucoup d’incertitudes et d’inconnues

      Quelle efficacité pour les patients gravement atteints ? À partir de cette analyse intermédiaire, la mortalité à 14 jours a été estimée à 7 % dans le groupe remdésivir, versus 12 % dans le groupe placebo. La différence n’est pas statistiquement significative (p = 0,06), autrement dit il y a une probabilité non négligeable que la différence soit due au hasard. La durée médiane avant amélioration clinique (définie surtout par la fin de l’hospitalisation ou l’arrêt de l’apport en oxygène) a été de 11 jours dans le groupe remdésivir versus 15 jours dans le groupe placebo (différence statistiquement significative, p < 0,001). La différence sur ce critère a été rapportée uniquement chez les patients dont l’état à l’inclusion justifiait au moins un apport en oxygène (12 jours versus 18 jours), mais pas chez ceux moins gravement atteints (5 jours, sans différence entre les deux traitements). D’autres analyses n’ont pas montré d’efficacité du remdésivir chez les patients les plus gravement atteints qui, au moment de leur inclusion dans l’essai, recevaient une ventilation, invasive ou non. Chez les patients sous ventilation invasive à l’inclusion, une augmentation de la mortalité avec le remdésivir a même été évoquée.

      5 jours ou 10 jours ? Dans un autre essai randomisé, mais non aveugle, deux durées de traitement par remdésivir ont été comparées : 5 jours versus 10 jours, chez 402 patients hospitalisés à cause d’un covid-19 grave, justifiant pour la plupart au moins un apport en oxygène, et âgés en moyenne de 62 ans. Seulement 43 % du groupe « 10 jours » ont reçu réellement 10 jours de traitement et 27 % des patients de ce groupe n’ont reçu que 5 jours ou moins de traitement. La mortalité à 14 jours a été de 8 % dans le groupe « 5 jours » versus 11 % dans le groupe « 10 jours ». Ces résultats sont difficiles à interpréter car malgré la répartition par tirage au sort, les patients du groupe « 5 jours » étaient moins fréquemment atteints d’une forme grave de covid-19 que ceux du groupe « 10 jours », avec, à l’inclusion, 26 % des patients sous ventilation invasive ou non dans le groupe 5 jours, versus 35 % dans le groupe « 10 jours ». Cependant, il n’est pas exclu qu’un traitement prolongé par remdésivir ait eu un effet délétère. Selon le RCP, le traitement doit durer au minimum 5 jours et au maximum 10 jours.

      À suivre. En somme, comme pour tout nouveau médicament et encore plus ceux autorisés par AMM conditionnelle, il y a de nombreuses inconnues autour du remdésivir. Elles concernent à la fois ses effets indésirables et son efficacité au-delà de celle d’un placebo, ce qui incite à la prudence. Des résultats incomplets et fragiles d’un seul essai ont montré une amélioration clinique un peu plus rapide avec le remdésivir, mais uniquement chez des patients dont l’état justifie un apport en oxygène, et sans effet démontré sur la mortalité. En l’état actuel des connaissances, et en dehors du cadre de la recherche clinique, un traitement par remdésivir n’est pas justifié chez les patients dont l’état ne justifie pas un apport en oxygène, ni chez les patients les plus gravement atteints, dont l’état justifie une ventilation invasive.
      ©Prescrire 13 juillet 2020

    • Covid-19 : comment Gilead a vendu son remdésivir à l’Europe

      Testé sans grand succès contre Ebola, le remdésivir a été opportunément repositionné au début de l’épidémie de Covid-19, sur la base d’études antérieures avec d’autres coronavirus (SARS-CoV-1 et MERS-CoV). Gilead n’a pas grand-chose à perdre : il ne sait que faire des doses qu’il n’a pas utilisées lors des essais cliniques menés en Afrique.

      Le 6 février, un petit essai est lancé avec 237 patients recrutés dans les hôpitaux de Wuhan, foyer chinois de l’épidémie. L’espoir est immense, alors que la ville est déjà confinée depuis deux semaines, mais les résultats sont loin d’être à la hauteur : publiés en avril dans la prestigieuse revue scientifique The Lancet, ils ne montrent aucune efficacité sur la mortalité.

      Le cours de Gilead perd quelques points sur les indices boursiers, mais le laboratoire américain ne se décourage pas. Un essai de plus grande ampleur − un millier de patients − a été lancé en février aux Etats-Unis : Gilead compte dessus pour convaincre la FDA, l’agence américaine du médicament. Un peu ébranlé par les résultats chinois, le laboratoire modifie cependant son critère d’efficacité principal : ce ne sera plus la mortalité, mais la « durée de récupération ».

  • UK may have to rethink its relationship with migrant workers due to coronavirus - CNN

    London (CNN)Coronavirus travel restrictions have led to a labor crisis for British agricultural sectors that traditionally rely on seasonal migrant workers from Europe, forcing some employers to bring workers in on charter flights.

  • Beijing tightens grip over coronavirus research amid US-China row on virus origin - CNN

    Hong Kong (CNN)China has imposed restrictions on the publication of academic research on the origins of the novel coronavirus, according to a central government directive and online notices published by two Chinese universities, that have since been removed from the web.

    Under the new policy, all academic papers on Covid-19 will be subject to extra vetting before being submitted for publication. Studies on the origin of the virus will receive extra scrutiny and must be approved by central government officials, according to the now-deleted posts.
    A medical expert in Hong Kong who collaborated with mainland researchers to publish a clinical analysis of Covid-19 cases in an international medical journal said his work did not undergo such vetting in February.

    The increased scrutiny appears to be the latest effort by the Chinese government to control the narrative on the origins of the coronavirus pandemic, which has claimed more than 100,000 lives and sickened 1.7 million people worldwide since it first broke out in the Chinese city of Wuhan in December.
    Since late January, Chinese researchers have published a series of Covid-19 studies in influential international medical journals. Some findings about early coronavirus cases — such as when human-to-human transition first appeared — have raised questions over the official government account of the outbreak and sparked controversy on Chinese social media.
    And now, Chinese authorities appear to be tightening their grip on the publication of Covid-19 research.

    A Chinese researcher who spoke on condition of anonymity due to fear of retaliation said the move was a worrying development that would likely obstruct important scientific research.
    “I think it is a coordinated effort from (the) Chinese government to control (the) narrative, and paint it as if the outbreak did not originate in China,” the researcher told CNN. “And I don’t think they will really tolerate any objective study to investigate the origination of this disease.”
    CNN has reached out to China’s foreign ministry for comment.(...)

    However, parts of Chinese social media and even the country’s government appear to have launched a concerted campaign to question the origin of the virus.
    Chinese officials and state media have repeatedly stressed that there has been no conclusion on the exact origin of the virus. Last month, Zhao Lijian, a spokesperson of the Chinese Foreign Ministry, promoted a conspiracy on Twitter that the virus had originated in the US and was brought to China by the US military.
    In China, research papers on the coronavirus are already subjected to layers of vetting after they are submitted to Chinese academic journals, according to an editor at a Chinese medical journal.
    Wang Lan, the editorial director of the Chinese Journal of Epidemiology, said all Covid-19 papers have to go through an approval process for “major topics” after being submitted to her journal.
    “It has always been the case,” she told CNN. “They have to be approved by three levels of organizations. It’s a long process.”
    The Chinese researcher who requested anonymity said under the new restrictions, however, coronavirus research that contradicted the official narrative could be suppressed by Beijing.
    “I think the importance is that the international scientific community must realize that any journal or manuscripts from (a) Chinese research institution has kind of been double-checked by the government,” said the researcher. “It is important for them to know there are extra steps between independent scientific research and final publication.”
    CNN’s Steven Jiang and Alexandra Lin contributed reporting.

    #recherche #story_telling

  • Fact check: Trump falsely claims he ’inherited’ the faulty coronavirus test. It was developed this year - CNNPolitics

    In March, Trump initially made a debatable claim that he had inherited a flawed testing “system.” By the final days of March and the first days of April, however, he was making a demonstrably inaccurate claim about inheriting the actual tests.
    – “We inherited a broken test — the whole thing was broken,” Trump said on the Fox News morning show “Fox and Friends” on March 30.
    – “And remember this: We inherited — the word is we inherited bad tests. We really inherited bad tests. These are horrible tests. And it was broken. It was all broken. And we fixed it,” Trump said at the White House briefing on April 1.
    – “The original test — the ones we inherited, Jim, as an example, they were — they were broken. They were obsolete. They were not good tests. And that’s what we got stuck with,” he said at the April 3 briefing.
    – “Initially speaking, the tests were old, obsolete, and not really prepared,” he said at the April 6 briefing.

    Trump’s clear suggestion was that the flawed test had been left to him by President Barack Obama’s administration.

    Facts First: The faulty initial test for the coronavirus was created during Trump’s administration, in early 2020, by the Centers for Disease Control and Prevention. Since this is a new virus that was first identified this year, the tests couldn’t possibly be “old” or “obsolete.”