OT: Article on why testing for COVID19 in the US has been a debacle (and other notes)
https://thedispatch.com/p/timeline-the-regulationsand-regulatorsthat
Here's a good article that explains why the US has tested so few (although that seems to be getting up to speed finally).
The FDA made it near impossible for labs to make testing kits BECAUSE of their emergency declaration. Then, they put all their eggs into one basket with a CDC test, which had a bunch of problems and was essentially unusable. And there's no good reason why they didn't just use the WHO tests.
Here's an update on the COVID19 mortality rate in Korea, which is likely the country closest to the true mortality rate because they've done the most testing.
https://twitter.com/iampaulkerry/status/1240811385660903431?s=20
After jumping up and down a bit in the beginning, it settled low but has been rising consistently and hasn't tapered off yet. It's at 1.1% as of now. The initial infected in Korea were largely young, so this is likely due to more elderly people getting infected and/or the disease running its course more fully. Reminder that the seasonal flu's mortality rate is about 0.1%.
And I'll just make a couple other remarks since I have the OP mic and you can't stop me, which you can TL;DR. It's still really early to tell how bad it can be and which countries have had the best response, besides obvious comparisons like Korea did a much better job than Italy (tracking is at least as important as testing). Italy probably got hammered with a mix of indifference until it was too late, the oldest median age population in the world, a lot of smokers, and pretty bad air pollution in northern Italy. Having said that, Japan is the 2nd oldest population and also has lots of smokers (you can still smoke in bars there! even some spots in restaurants), and also doesn't have the cleanest air in the world. While cases ramped up in Korea, testing languished in Japan and many Japanese were worried there was a coming disaster, but it hasn't materialized. Things are certainly going to get worse in the US, but urban sprawl, car ownership, and low smoking rates may help. I wonder how much is just plain luck as well. It's not entirely accurate to say China had a ton of cases. Wuhan and the surrounding provinces had a lot, but there are many provinces in China with tens of millions of people each that barely had any cases. As of a couple days ago, about 75% of all cases in Korea were in Daegu. This is largely because of a cult that had some super spreaders who had just come back from meetings in Wuhan and were very much uncooperative with authorities (avoiding testing, not telling about their contacts). New cases have dropped off dramatically since about a week ago.
The problem with that argument is that we all watched as he denied it was a problem...hell, that it even existed. Had he and his team been pro-active at the beginning of this, there's no telling where we'd be now, but probably not here.
I don't quite understand why people are so adamant about everyone getting tested. As long as we can test those with symptoms and people follow the rules then we are doing what needs to be done and tests will continue to get manufactured and processed. Because you get tested today and prove negative doesn't mean you can't get it tomorrow. Enough of the doomsday talk. I can get all of that I want from the major news channels. One of the best interviews I have seen was by the leader of FEDEX which deals with countries all around the world. I know we have a hard time believing what China is telling us but he stated that it is true that they are getting things ramped back up and that they do actually see this through the FEDEX activity at all of their plants. There is an end game folks. Think positive, wash your hands, and stay safe.
We can't test everyone with symptoms. There are many stories of people unable to get tests when they have been sick.
What’s the point in getting tested at all? There’s no magical medicine they’re gonna give you to feel better, they’re gonna tell you to stay your ass at home away from people until you feel better. This isn’t fucking rocket science.
edit: sorry shouldn’t have said at all, but the people experiencing no signs/symptoms currently that are using tests someone that actually has symptoms could use, if you feel fine follow the guidelines, if you have/start getting the symptoms then test
Besides, treatment? Data, data, data.
Treatment? Like the treatment that the poor person belows friend got? And the data that’s going to be wildly inaccurate around the globe because almost no one was in front of this?
sorry, I’m not against you on this. But We were fucked from day 1, we probably had cases hours after China across the world with the way travel is these days...
If you instituted an aggressive testing program very early, you could catch people with symptoms, isolate them and then track down and test their recent contacts. Only real chance of limiting spread without very large scale social isolation.
would it have worked, who knows. Wish we’d tried.
You answered your own question - "...they’re gonna tell you to stay your ass at home away from people until you feel better."
It tells us where the hotspots are so we can better isolate those groups. Targeted isolation beyond what the general public is doing will help contain outbreaks better than anything else.
Because that’s gonna stop people from being stupid? Like one of my employees who decided last weekend they needed to fly out to Seattle to see their friend for the weekend even tho they’re in a high risk category (as am I and several of their co-workers)? And their significant other that is also an employee, in a high risk group, that had to rush over and see them immediately upon getting home? Thereby putting entire communities at risk that so far have 0 reported cases (knowing they’ve probably had several anyhow)
March 21st, 2020 at 11:43 AM ^
I never said you can fix stupid! Just reiterating the need for testing, and why its important. Stupid people continuing to do stupid things will affect us all this time...
March 21st, 2020 at 12:19 PM ^
Agree 100% on the stupid people part...
and I’m not advocating for testing being unimportant. I do believe until testing supplies are in large supply that the people rushing out en masse and sitting in lines that are hours long while not having symptoms shouldn’t be. The world is way behind on this, we’ll have a lot of data at the end of this, but would doubt how legitimate it is at the end of the day just like many other illnesses...
March 21st, 2020 at 11:43 AM ^
The point of testing en masse is to identify the hotspots, so your country can properly allocate resources to them. Like if we start manufacturing ventilators, we'll know precisely where they are needed.
And in general, the more people you identify and send into quarantine, the lower the chances are for others of getting infected.
And knowing how many people are walking around as super spreaders helps too. The more data you have, the better your models.
Yep. I have a VERY sick friend in northern Michigan who just got released from the hospital. Fever, heavy difficulty breathing, etc. They refused to test her because she is only 34 years old and not in an "at risk" group. They just don't have enough tests. They sent her home, told her to self-isolate for 2 weeks.
Interesting. As is being demonstrated on this thread, there are a significant number of followers of the religion of "Ignorance is Bliss". One thing we do know is that this virus loves females in their 20s and 30s-they are the highest vector group.
Can you provide a cite to that? Had not heard it and am confused as to how it could be determined with limited testing.
not saying you are wrong and genuinely curious. I couldn’t find anything with admittedly quick google search.
Umm ... Do you mind telling us where in northern Michigan?
Yes. China is getting things ramped back up. Italy absolutely is not. They're still climbing. The end is not in sight. We don't even know how bad it is there yet, and it's already terrible.
You seem to be thinking about testing just as a way to find who to treat, which makes sense for most diseases most of the time. The real value now is knowing where the cases are, isolating those people so they don't infect others, and keeping quarantines as individual or local as possible without putting the whole country in a lockdown.
I'm here in Korea. I go to restaurants sometimes. I go grocery shopping. I go hiking. I went surfing last week. I meet my friends sometimes. I went to get a massage. No one is hoarding toilet paper. There were never the chaotic runs on grocery stores you see in America. Not testing means probably tens of thousands of people dying unnecessarily and not being able to go to a restaurant and unemployment for most people.
I don’t think testing would have solved any of that in the US sadly, we’re by and large just obviously not that intelligent. 1/3 of us are out hoarding shit tickets for some reason, 1/3 of us are/were out at beaches/bars/restaurants like nothing is wrong, and 1/3 of us are being sensible and doing what we can to help
The longer this goes the harder it will be for things to return to normal for most people. If you have enough money you will probably be fine but most of us regular folks could lose our houses and be totally screwed.
Yup. Kind of my nightmare scenario. And I work for a hospital. We had a bunch of bills over the past few years and we’re just getting back even. Now this. Nothing I can do about it.
fit what it’s worth, my dog doesn’t know what a pandemic is but she hates to be alone and so far thinks they are the best thing ever.
This lack of testing has been my major complaint from the beginning. Here, you cannot make good decisions without good information-and our medical community was denied a fighting chance. And here, the federal government holds virtually all the blame. That the politicians held sway here should put them in the firing squad line. This was a conscious choice that they made and it will likely, among many other (bad) things, cause many thousands of deaths that could have otherwise been avoided. That major healthcare systems have been able to develop their own tests in a matter of weeks since the feds despicable, willful ineptness became crystal clear puts the character of this matter on full display.
There are 13 of us in the eldest 2 generations of my immediate family who are on the frontlines of this-taking direct fire in this regard. President Trump and his band of idiots, including all those who mindlessly defend the indefensible, can all go to hell. Because, the chances are that somewhere along the line we (our family) are going to take a hit. My wife is directly, in-the-face exposed to several hundred people 4 times a week who are in a very high risk category.
Inexcusable.
Lots of journalists pouring through data to come up with ratios and projections. It is bothersome in its speculation. Statisticians and epidemiologists are sitting around genuinely disputing each other over the severity and spread of the disease, but some journalist or marketing guy has one stat that is true and important.
The reality is we don't know. Even the guy who posted the SKorea mortality rate admits it is crude and other flaws in his twitter feed.
People seem to ignore all the caveats and just have a reaction. I get it. That is how journalism works. It is just troubling when everyone who is intelligent is saying we just don't know yet.
But, lets go ahead and.... jump to a conclusion.
"It is just troubling when everyone who is intelligent is saying we just don't know yet."
I'm not sure who you are listening to that says we don't know... Pretty much every doctor, epidemioligist, and statistician I've seen say the same things - that's its going to get bad. Only the sycophants around government 'leadership' says anything different.
March 21st, 2020 at 10:02 AM ^
Too many examples to post
Start with this Nobel prize winning Stanford professor Michael Levitt. Take a look at epidemiologist John ionnidis also from Stanford. Clinicians just finished a study that shows that the death rate in Wuhan, which was completely unprepared for all of this was at 1.4%, etc.
Lots of science coming out from all corners.
Take a look at any modeling done by other experts and the caveats are always huge. They are warnings of the potential based on what we are trying to figure out.
The resounding chorus is that we don't know much.
As a politician, you have to make decisions based on worst case. I get it. But, we don't have to pretend those variables are going to go the worst way possible.
The misinformation and fear that will be leftover from this is going to cause so much harm.
March 21st, 2020 at 11:52 AM ^
I think I'm picking up on what you're trying to get across, so let me summarize differently... If you mean that the media reports are only talking about worst case, then yes, I'll agree. They never mention that part of it, the part where its a reflection of 'worst case' prediction. They also don't talk about the small dataset for analysis within the US. It's small because of the lack of testing, though, and that goes to the heart of the problem.
This is a common problem with news media of all sorts. Another point to fact - the Senate relief package, we're told, will provide us with 'up to $2500 for a family of three'. This is mostly not true, as the amount we'd get is tied to tax returns from 2018. Families with income below a few thousand, or zero, will get nothing. Families above $99K (joint filers above $198) will also get nothing. Most of the relief goes to businesses, not people. Note that I'm not judging this either way - merely pointing out the fact that all media outlets are not relaying that news, only that checks will go out to people.
March 21st, 2020 at 12:08 PM ^
Just out of curiosity, where did you get that joint filers figure? Because I haven't seen it mentioned anywhere.
March 21st, 2020 at 10:47 AM ^
Exactly right. Highly educated clinicians on one side saying this going to bad and last a while.
People who only get news from Fox on the other.
I'm a conservative Republican and even I can figure out which side is likely correct.
March 21st, 2020 at 11:18 AM ^
Those are not Fox News guys. I have never watched it either.
It's just science. Accept it. Look at the data. Everyone says we are still trying to figure it out. Just because you are on one side of the aisle doesn't mean you can ignore science and the basis of the modeling.
This study (which I posted about yesterday) gets at your point. It surveyed 18 experts and as you pointed out, it found a wide range of opinion
‘Experts believe COVID-19 will be responsible for around 195,000 deaths (approximate 80%
uncertainty interval: 19,000-1,200,000) in the US by the end of 2020. As a comparison, a typical influenza season is estimated by the CDC to cause between 11,000 and 95,000 deaths in a typical influenza season.”
while you can be comforted by the low end estimates, I’d be worried about the fact that it suggests a 64% probability of more than 100,000 US deaths by the end of 2020 and a slightly better chance (38% vs 36%) of more than 300,000 deaths vs less than 100,000.
https://works.bepress.com/mcandrew/2/download/
as someone said “It's just science. Accept it. Look at the data. Everyone says we are still trying to figure it out. Just because you are on one side of the aisle doesn't mean you can ignore science and the basis of the modeling.”
March 21st, 2020 at 12:27 PM ^
“It’s only 3.6 roentgen!” - Comrade Dyatlov
“When you have 15 people, and the 15 within a couple of days is going to be down to close to zero,” - Donald J. Trump
What are you talking about? Did anyone say the mortality rate is 1.1% the end? No. It's an update in the data, and there will be more updates in the future. It's like you're trying to prove a point but you don't have one.
March 21st, 2020 at 10:04 AM ^
It is not newsworthy. Just more reporting.
EDIT: This journalist is posting this as a reason to be concerned. It is raw data from moment in time, with no context. He is using it as an alarm bell.
Lets not spread fear mongering. Take it seriously, but don't ring alarm bells for every little stat we get a glimpse of....
March 21st, 2020 at 11:53 AM ^
People also seem to forget the other major component in the death rate (CFR), which is the capacity of the healthcare system (and, indirectly, measures out in place to minimize contagion since it is responsible for the capacity challenges). I’ve seen a number of people commenting that the ‘death rate is only 1 or 2% and so even if everyone got infected it wouldn’t be THAT bad’ (even if that were the case I’d argue that’s pretty bad), but if millions (let alone tens of millions or hundreds of millions) of people get this the death rate will be MUCH higher than 1-2% as a very small percentage of the people who need treatment will get it.
March 21st, 2020 at 10:29 AM ^
Are you related to Petr Klima? If so could you get me an autographed Jofa bucket?
Whoever decided we should not take the WHO tests is a complete A-hole and should be fired immediately.
A mind boggling decision, but less so than that percentage of Americans who will rationalize and legitimize the reasoning.
March 21st, 2020 at 10:55 AM ^
You mean like Snopes and Anthony Fauci?
https://www.snopes.com/fact-check/us-coronavirus-test/
It's true we didn't use WHO tests. But neither were we ever offered them. We didn't "turn them down" because you can't turn down something that was never offered.
March 21st, 2020 at 11:06 AM ^
maybe not offered, but perhaps they could have asked for the WHO test. but CDC always wants to create their own tests. and they failed miserably. why re-invent the wheel, if it's already out there. that said, WHO should share a lot of this blame too.
If memory serves there were reports of those early tests giving a lot of false positives and negatives.....maybe that's why the CDC decided to run their own tests.
i believe those were the CDC designed tests that failed. so they spent a few more weeks trying to develop new ones. it appears those took too long to process. then they finally went to the private sector, who have only recently been preparing better tests. just today i heard another private company is preparing a test that can give almost immediate results be the patient themself.
the CDC was a complete failure, imo.
False. It's the CDC tests that sucked. That's in the article I posted. That's a big part of why testing has been a failure.
March 21st, 2020 at 10:00 AM ^
We didn’t even need the who kits. We just needed to unleash state labs, research hospitals and the private sector much earlier. These groups are the reason are test capacity is finally getting up to speed.
Wait till the 2nd wave hits, then you'll see some shit
March 21st, 2020 at 10:07 AM ^
Hmmmmm……… Why the US government response to a crisis is a debacle...….hmmmmmm….. yes let us ponder this for a bit.
March 21st, 2020 at 10:26 AM ^
They even ran a pandemic simulation in 2017 showing the shortcomings of our response to a pandemic and this is what we’ve come up with!
https://www.theatlantic.com/politics/archive/2020/03/pandemic-coronavirus-united-states-trump-cdc/608215/
March 21st, 2020 at 12:01 PM ^
Why is everyone so hell bent on politicizing this? Should this have been handled differently from the get go and the message different? Yes. Would it have changed the outcome significantly? I don’t think so, the message has been out for a while and people are doing what they want still and to this day reluctant to change that, on both sides.
Guess what, viruses spread by human interaction. Knowing that base knowledge did anyone alter their normal lifestyle from the moment this started? If they did I didn’t see it...
Everyone has some degree of accountability in these, even all of us. The only way to have truly gotten ahead of this would’ve been immediately shut everything down...Guess how that would’ve went over...
Why do “we” politicize?
Maybe because the guy whose completely dismissive attitude (amplified by his completely submissive media supporters) contributed greatly to the problem. Now he’s busy gaslighting us, accepts no responsibility, and yet remains in charge.
Thanks for proving my point.
Can you elaborate on what point he proved?