7 ms·

What I don’t understand is why the US still doesn’t have widespread testing. If the government lifted restrictions on testing and let people other than CDC and

What I don’t understand is why the US still doesn’t have widespread testing. If the government lifted restrictions on testing and let people other than CDC and health authorities test for it, most research hospitals and universities (and many other private labs) would be able to test for this disease very easily. The reagents are commercially available, and most other countries are rolling out (or have already rolled out) very widespread testing. I am not an expert in this, so if someone with more understanding wants to chime in I’d love to hear it. Edit: the FDA has reduced the restrictions on clia regulated labs https://www.fda.gov/media/135659/download https://www.fda.gov/media/135659/download

Anon84 7y ago
The number of cases doesn’t increase if you don’t test for it.
spectramax 7y ago
People are not getting to the bottom of this. Virus goes from one host to the other via the means of aerosol/droplet particulates. There is some evidence that it can stay "active" while on a surface such as a door knob. Everything else is external. So, whether you test or not, the fundamentals of aforementined mechanism most likely won't change. Cleaning public areas with disinfectant, educating the public of detailed ways of how this virus spreads (I mean really detailed information... not just what the media is doing currently) and doing everything to make sure there is no shortage of sanitizing supplies. I can't seem to find exact details of experiments or academic research on how this virus mechanically moves from one body to the other. No newspaper is publishing information about it. Turns out a lot of academic jargon can be explained to laymen if you have someone like Feynman write an article. So, if we can understand the precise mechanism of spread, we can bring down the R value close to 1 or below slowing down the exponential growth. If there is a probablistic aspect to the containment strategy, say for example, no matter what contingencies we put in place, no matter how clean the society gets, there is always some probability of propagation. That means we're not trying hard enough to understand the virus propagation and to enforce containment procedures. Ultimate goal would be to a get vaccine invented and distributed.
- dillonmckay 7y ago
  This is a paper about how coronaviruses can survive in water and wastewater systems. https://west.arizona.edu/sites/default/files/data/Gundy2008_Article_SurvivalOfCoronavirusesInWater.pdf https://west.arizona.edu/sites/default/files/data/Gundy2008_... Has anyone looked at the water supply as a method of transmission?
  - Symmetry 7y ago
    There was a case of the virus being transmitted that way but it shouldn't be a concern if the plumbing is up to code with things like s-curves in the pipes. There are a lot of viruses and bacteria like norovirus and cholera that are much better at traveling that way than a coronavirus and modern toilet and sewer systems should be designed with that in mind.
    - dillonmckay 7y ago
      I am not talking vent pipes... Larger scale, a decent size rain can upset a wastewater treatment plant, and that is also assuming nobody is dumping waste directly into the river, intentional or otherwise. Additionally, there have been multiple articles of detection via feces. The water treatment plant may be redistributing the virus from an upstream contamination.
      - Symmetry 7y ago
        In general feces from people infected with various varieties of Coronavirus aren't infectious. You can find segments of RNA in it but, though I'm not an expert on it, the good folks at This Week in Virology think that's just from mucus that's been swallowed. We had one instance of fecal transmission with the first SARS but it wasn't typical the way it is with other viruses and we haven't seen that with the new virus.
dillonmckay 7y ago
So, I really was not understanding what the delay was, either, but if you watch the CDC press conference with Trump from Friday, they make a distinction between ‘clinical’ lab testing and ‘public health’ lab testing. So, it seems the ‘public health’ labs are mired in some byzantine system of rules, where the local department defers to the state, and the state defers to the federal agencies. The ‘clinical’ labs are mostly for-profit and follow a different procurement process for obtaining the tests, and I believe they are different tests, as well. It is a mess.
s_y_n_t_a_x 7y ago
I believe they said the additional testing will be ready Monday, some places were ready Friday. LabCorp and Quest are two of those that are ready. The labs at the universities and private companies had to verify the results of the tests they created. It's important to note that no other country has widespread testing either. They simply take spit swabs and test a sample of them from a location. It's a much less precise method, but appropriate in the places where there is a widespread outbreak. The CDC is working with these countries, it's not one country having it together or not. Stop politicizing this.
- Symmetry 7y ago
  There are some pretty widespread differences in testing between countries. They had done over 140,000 tests on Friday compared to about 500 in the US and were getting the tests turned around much faster between application and result. I don't want to make this political either but US testing has until now been disastrous and we really need to revisit the ways in which CDC, HSS, and FDA policies and regulations interact to prevent this from happening in future crises.
  - s_y_n_t_a_x 7y ago
    Many of the regulations were from previous administrations and have already been rolled back. They have shipped 1.5 million tests out to universities and private labs w/ more being made. They have created a way for 3rd parties to create their own tests. LabCorp and Quest are already up and running. Many others will be ready Monday. I'm just happy the administration shut down traffic from China early on, even though the move was labeled as xenophobic, which is silly. Politicizing is evident when you ignore all the good things and highlight a minor mistake (initial CDC testing limits due to a bad ingredient) I just don't get what this gets you, especially when they are doing the thing you want them to do. I'm not sure what else you'd like to be done.
- MarkMc 7y ago
  > I believe they said the additional testing will be ready Monday, some places were ready Friday. For those places not ready by Friday, I wonder how much effort was put into being ready by Saturday or Sunday instead of Monday...
Symmetry 7y ago
Here's[1] a twitter thread from the former FDA commissioner from a month ago talking about some of the legal reasons that screening hasn't been so straightforward in the US as it has been in other countries, despite a screening being something a good sized hospital is capable of developing. Then there was a problem with one of the reagents in the official CDC test.[2] [1]https://twitter.com/ScottGottliebMD/status/1224042220665307137 https://twitter.com/ScottGottliebMD/status/12240422206653071... [2]https://www.sciencemag.org/news/2020/02/united-states-badly-bungled-coronavirus-testing-things-may-soon-improve https://www.sciencemag.org/news/2020/02/united-states-badly-...
dr_ 7y ago
As of this past weekend, both LabCorp and Quest can test for it, according to emails I’ve received from local hospitals. They will not collect samples in their own facilities, but will collect them from physicians offices etc for processing.
yread 7y ago
Apart from the bureaucracy there were apparently also some rather embarrassingly elementary technical reasons that the tests didn't work: https://tomeraltman.net/2020/03/03/technical-problems-COVID-primers.html https://tomeraltman.net/2020/03/03/technical-problems-COVID-...

Anon84 7y ago

The number of cases doesn’t increase if you don’t test for it.

spectramax 7y ago

People are not getting to the bottom of this. Virus goes from one host to the other via the means of aerosol/droplet particulates. There is some evidence that it can stay "active" while on a surface such as a door knob. Everything else is external. So, whether you test or not, the fundamentals of aforementined mechanism most likely won't change. Cleaning public areas with disinfectant, educating the public of detailed ways of how this virus spreads (I mean really detailed information... not just what the media is doing currently) and doing everything to make sure there is no shortage of sanitizing supplies. I can't seem to find exact details of experiments or academic research on how this virus mechanically moves from one body to the other. No newspaper is publishing information about it. Turns out a lot of academic jargon can be explained to laymen if you have someone like Feynman write an article. So, if we can understand the precise mechanism of spread, we can bring down the R value close to 1 or below slowing down the exponential growth. If there is a probablistic aspect to the containment strategy, say for example, no matter what contingencies we put in place, no matter how clean the society gets, there is always some probability of propagation. That means we're not trying hard enough to understand the virus propagation and to enforce containment procedures. Ultimate goal would be to a get vaccine invented and distributed.

dillonmckay 7y ago
This is a paper about how coronaviruses can survive in water and wastewater systems. https://west.arizona.edu/sites/default/files/data/Gundy2008_Article_SurvivalOfCoronavirusesInWater.pdf https://west.arizona.edu/sites/default/files/data/Gundy2008_... Has anyone looked at the water supply as a method of transmission?
- Symmetry 7y ago
  There was a case of the virus being transmitted that way but it shouldn't be a concern if the plumbing is up to code with things like s-curves in the pipes. There are a lot of viruses and bacteria like norovirus and cholera that are much better at traveling that way than a coronavirus and modern toilet and sewer systems should be designed with that in mind.
  - dillonmckay 7y ago
    I am not talking vent pipes... Larger scale, a decent size rain can upset a wastewater treatment plant, and that is also assuming nobody is dumping waste directly into the river, intentional or otherwise. Additionally, there have been multiple articles of detection via feces. The water treatment plant may be redistributing the virus from an upstream contamination.
    - Symmetry 7y ago
      In general feces from people infected with various varieties of Coronavirus aren't infectious. You can find segments of RNA in it but, though I'm not an expert on it, the good folks at This Week in Virology think that's just from mucus that's been swallowed. We had one instance of fecal transmission with the first SARS but it wasn't typical the way it is with other viruses and we haven't seen that with the new virus.

dillonmckay 7y ago

So, I really was not understanding what the delay was, either, but if you watch the CDC press conference with Trump from Friday, they make a distinction between ‘clinical’ lab testing and ‘public health’ lab testing. So, it seems the ‘public health’ labs are mired in some byzantine system of rules, where the local department defers to the state, and the state defers to the federal agencies. The ‘clinical’ labs are mostly for-profit and follow a different procurement process for obtaining the tests, and I believe they are different tests, as well. It is a mess.

s_y_n_t_a_x 7y ago

I believe they said the additional testing will be ready Monday, some places were ready Friday. LabCorp and Quest are two of those that are ready. The labs at the universities and private companies had to verify the results of the tests they created. It's important to note that no other country has widespread testing either. They simply take spit swabs and test a sample of them from a location. It's a much less precise method, but appropriate in the places where there is a widespread outbreak. The CDC is working with these countries, it's not one country having it together or not. Stop politicizing this.

Symmetry 7y ago
There are some pretty widespread differences in testing between countries. They had done over 140,000 tests on Friday compared to about 500 in the US and were getting the tests turned around much faster between application and result. I don't want to make this political either but US testing has until now been disastrous and we really need to revisit the ways in which CDC, HSS, and FDA policies and regulations interact to prevent this from happening in future crises.
- s_y_n_t_a_x 7y ago
  Many of the regulations were from previous administrations and have already been rolled back. They have shipped 1.5 million tests out to universities and private labs w/ more being made. They have created a way for 3rd parties to create their own tests. LabCorp and Quest are already up and running. Many others will be ready Monday. I'm just happy the administration shut down traffic from China early on, even though the move was labeled as xenophobic, which is silly. Politicizing is evident when you ignore all the good things and highlight a minor mistake (initial CDC testing limits due to a bad ingredient) I just don't get what this gets you, especially when they are doing the thing you want them to do. I'm not sure what else you'd like to be done.
MarkMc 7y ago
> I believe they said the additional testing will be ready Monday, some places were ready Friday. For those places not ready by Friday, I wonder how much effort was put into being ready by Saturday or Sunday instead of Monday...

Symmetry 7y ago

Here's[1] a twitter thread from the former FDA commissioner from a month ago talking about some of the legal reasons that screening hasn't been so straightforward in the US as it has been in other countries, despite a screening being something a good sized hospital is capable of developing. Then there was a problem with one of the reagents in the official CDC test.[2] [1]https://twitter.com/ScottGottliebMD/status/1224042220665307137 https://twitter.com/ScottGottliebMD/status/12240422206653071... [2]https://www.sciencemag.org/news/2020/02/united-states-badly-bungled-coronavirus-testing-things-may-soon-improve https://www.sciencemag.org/news/2020/02/united-states-badly-...

dr_ 7y ago

As of this past weekend, both LabCorp and Quest can test for it, according to emails I’ve received from local hospitals. They will not collect samples in their own facilities, but will collect them from physicians offices etc for processing.

yread 7y ago

Apart from the bureaucracy there were apparently also some rather embarrassingly elementary technical reasons that the tests didn't work: https://tomeraltman.net/2020/03/03/technical-problems-COVID-primers.html https://tomeraltman.net/2020/03/03/technical-problems-COVID-...