5 ms·

I don't understand the need or upside to mass testing? We know the spread is inevitable. It doesn't change the course of treatment right now, or the recommended

I don't understand the need or upside to mass testing? We know the spread is inevitable. It doesn't change the course of treatment right now, or the recommended precautionary measures.

claudeganon 7y ago
Mass testing is the only way to gauge the appropriate response for things like level of quarantine and directing additional resources where case clusters will overwhelm healthcare infrastructure.
BryantD 7y ago
It's still beneficial to slow the spread. It will be easier for a health care system to handle X cases over the course of six months than X cases over the course of three months. Mass testing has the potential to get infected individuals out of the population more quickly, and thus create a slower spread.
- edmundsauto 7y ago
  How sensitive is the test? You might end up flooding ERs with false positives, or people from not-at-risk populations.
  - claudeganon 7y ago
    In the Korean and Chinese tests, there was no evidence of false positives, only false negatives, and they still ratcheted up testing because it’s still better to catch all the cases one can.
  - rpearl 7y ago
    You wouldn't go to ER, even as a positive test, unless you needed intensive care. Most cases could be isolated at home.
    - refurb 7y ago
      This is the big reason why you don't need to test everyone - the results of the test change nothing. If you have a mild case of Coronavirus and are able to self-isolate, then just do it. Testing and confirming you have it doesn't change things, you'd still be asked to self-isolate. I can see the value in people who are very sick - confirming they have the virus can inform the need for isolation in the hospital.
      - noodlenotes 7y ago
        But how does anyone know they have a mild case of Coronavirus? It looks just like the cold or flu. Now that there's community spread, you can't assume that you only have Coronavirus if you've recently traveled or had contact with someone with confirmed Coronavirus. People who think they just have the cold or flu are going to maybe stay home a day or two, not self-quarantine for 2 weeks.
      - elihu 7y ago
        A positive test result would indicate to a person that they should remain in isolation for a week or so (or whatever the current recommendation is) after they get better, and not return to work immediately. It might also be useful to have a diagnosis to present to an impatient boss who wants you back at work.
        refurb 7y ago
        I think the point is, if it becomes endemic, people should self-quarantine even in the absence of a positive test. That's what my employer is doing now. If you're sick, work from home for 2 weeks. Don't come in.
      - rpearl 7y ago
        the results of the test indicate whether quarantine and contact tracing are useful.
      - dsq 7y ago
        Deciding whether to visit elderly relatives?
- Cacti 7y ago
  There aren't enough tests to do that. All that would happen is you'd run out testing, largely on unlikely cases as people flock to their doctors for tests, and when someone with clearer symptoms presents themselves you won't be able to test them. You really don't think tens of thousands of medical doctors and experts haven't already thought this one through? They're not limiting tests because they're utter morons, they're limiting them because they are limited and they are trying to do the best with what they have.
  - claudeganon 7y ago
    The only reason the tests are limited is because the US rejected the WHO standard test, tried to make their own, screwed it up, and now are stonewalling frontline doctors (who are absolutely demanding more testing). We could import foreign tests from Korea, where some facilities are capable of producing 10K per day. The absence of testing is absolutely an unnecessary, dangerous scandal, and everyone credible on this is saying as much. https://www.nytimes.com/2020/03/02/health/coronavirus-testing-cdc.html https://www.nytimes.com/2020/03/02/health/coronavirus-testin...
    - divbzero 7y ago
      If true, this should be a huge scandal. People, myself included, criticized China early on for being slow to recognize the crisis. It would be tragic and embarrassing if we’ve made the same mistake here in the States.
      - claudeganon 7y ago
        It’s true. Read the article and watch the clip linked at the top of this thread. It’s Li Wenliang all over again: https://www.cnbc.com/video/2020/03/02/coronavirus-testing-emergency-room-doctor-cdc-department-health-squawk-box.html https://www.cnbc.com/video/2020/03/02/coronavirus-testing-em... The CDC even deleted the testing counts from the data off their site to try and cover up the absence of testing.
- elihu 7y ago
  Also, it would be better for COVID-19 patients to be showing up en mass when the flu season has abated in a couple months. Right now, hospitals don't have a lot of spare capacity. That's my understanding, anyways. I'm not a health care expert.
rpearl 7y ago
if we knew the identities of all or most of the current cases, we could isolate them, trace their contacts, and thus slow the spread giving our systems more time to prepare by letting us allocate resources more effectively instead of reacting to critical cases only. here is an analysis of the percentage of contacts we would have to trace (paramerized on R0), to stop the spread entirely. https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(20)30074-7/fulltext https://www.thelancet.com/journals/langlo/article/PIIS2214-1... (We're probably past that point now, though)
dillondoyle 7y ago
is there value in at least testing a small sample randomly in all major population centers, to gauge where resources and potentially reduced movement rules should be put in place?
- gizmo686 7y ago
  For random testing to find anything, you would need a large portion of the given population to be infected. By that point, you would already have detected the outbreak by targeted testing at hospitals (or even without any direct testing, based on the surge of patients with COVID-19 symptoms). Once the dust settles, random testing for anti-bodies will probably be useful to work out exactly what happened to better inform planning on future epidemics.

I don't understand the need or upside to mass testing? We know the spread is inevitable. It doesn't change the course of treatment right now, or the recommended precautionary measures.

claudeganon 7y ago

Mass testing is the only way to gauge the appropriate response for things like level of quarantine and directing additional resources where case clusters will overwhelm healthcare infrastructure.

BryantD 7y ago

It's still beneficial to slow the spread. It will be easier for a health care system to handle X cases over the course of six months than X cases over the course of three months. Mass testing has the potential to get infected individuals out of the population more quickly, and thus create a slower spread.

edmundsauto 7y ago
How sensitive is the test? You might end up flooding ERs with false positives, or people from not-at-risk populations.
- claudeganon 7y ago
  In the Korean and Chinese tests, there was no evidence of false positives, only false negatives, and they still ratcheted up testing because it’s still better to catch all the cases one can.
- rpearl 7y ago
  You wouldn't go to ER, even as a positive test, unless you needed intensive care. Most cases could be isolated at home.
  - refurb 7y ago
    This is the big reason why you don't need to test everyone - the results of the test change nothing. If you have a mild case of Coronavirus and are able to self-isolate, then just do it. Testing and confirming you have it doesn't change things, you'd still be asked to self-isolate. I can see the value in people who are very sick - confirming they have the virus can inform the need for isolation in the hospital.
    - noodlenotes 7y ago
      But how does anyone know they have a mild case of Coronavirus? It looks just like the cold or flu. Now that there's community spread, you can't assume that you only have Coronavirus if you've recently traveled or had contact with someone with confirmed Coronavirus. People who think they just have the cold or flu are going to maybe stay home a day or two, not self-quarantine for 2 weeks.
    - elihu 7y ago
      A positive test result would indicate to a person that they should remain in isolation for a week or so (or whatever the current recommendation is) after they get better, and not return to work immediately. It might also be useful to have a diagnosis to present to an impatient boss who wants you back at work.
      - refurb 7y ago
        I think the point is, if it becomes endemic, people should self-quarantine even in the absence of a positive test. That's what my employer is doing now. If you're sick, work from home for 2 weeks. Don't come in.
    - rpearl 7y ago
      the results of the test indicate whether quarantine and contact tracing are useful.
    - dsq 7y ago
      Deciding whether to visit elderly relatives?
Cacti 7y ago
There aren't enough tests to do that. All that would happen is you'd run out testing, largely on unlikely cases as people flock to their doctors for tests, and when someone with clearer symptoms presents themselves you won't be able to test them. You really don't think tens of thousands of medical doctors and experts haven't already thought this one through? They're not limiting tests because they're utter morons, they're limiting them because they are limited and they are trying to do the best with what they have.
- claudeganon 7y ago
  The only reason the tests are limited is because the US rejected the WHO standard test, tried to make their own, screwed it up, and now are stonewalling frontline doctors (who are absolutely demanding more testing). We could import foreign tests from Korea, where some facilities are capable of producing 10K per day. The absence of testing is absolutely an unnecessary, dangerous scandal, and everyone credible on this is saying as much. https://www.nytimes.com/2020/03/02/health/coronavirus-testing-cdc.html https://www.nytimes.com/2020/03/02/health/coronavirus-testin...
  - divbzero 7y ago
    If true, this should be a huge scandal. People, myself included, criticized China early on for being slow to recognize the crisis. It would be tragic and embarrassing if we’ve made the same mistake here in the States.
    - claudeganon 7y ago
      It’s true. Read the article and watch the clip linked at the top of this thread. It’s Li Wenliang all over again: https://www.cnbc.com/video/2020/03/02/coronavirus-testing-emergency-room-doctor-cdc-department-health-squawk-box.html https://www.cnbc.com/video/2020/03/02/coronavirus-testing-em... The CDC even deleted the testing counts from the data off their site to try and cover up the absence of testing.
elihu 7y ago
Also, it would be better for COVID-19 patients to be showing up en mass when the flu season has abated in a couple months. Right now, hospitals don't have a lot of spare capacity. That's my understanding, anyways. I'm not a health care expert.

rpearl 7y ago

if we knew the identities of all or most of the current cases, we could isolate them, trace their contacts, and thus slow the spread giving our systems more time to prepare by letting us allocate resources more effectively instead of reacting to critical cases only. here is an analysis of the percentage of contacts we would have to trace (paramerized on R0), to stop the spread entirely. https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(20)30074-7/fulltext https://www.thelancet.com/journals/langlo/article/PIIS2214-1... (We're probably past that point now, though)

dillondoyle 7y ago

is there value in at least testing a small sample randomly in all major population centers, to gauge where resources and potentially reduced movement rules should be put in place?

gizmo686 7y ago
For random testing to find anything, you would need a large portion of the given population to be infected. By that point, you would already have detected the outbreak by targeted testing at hospitals (or even without any direct testing, based on the surge of patients with COVID-19 symptoms). Once the dust settles, random testing for anti-bodies will probably be useful to work out exactly what happened to better inform planning on future epidemics.