7 ms·

I've not been keeping up; what's the obstacle to getting tested? Insurance companies not covering? Hospitals not willing? Patients not going in?

by taborj 7y ago

dforrestwilson 7y ago
# of test kits. The US can currently test something like 7800 people per day as of yesterday. Some other system constraints to think about are: 1M hospital beds 70k ventilators
- hangonhn 7y ago
  I don't know if this is still true but according to an article I read a few days ago, the US has the lowest testing rate of any affected country. Experiences of other countries seem to suggest that high testing rate may mitigate the need for measures like lockdowns.
  - throwaway5752 7y ago
    By an order of magnitude: https://www.businessinsider.com/coronavirus-testing-covid-19-tests-per-capita-chart-us-behind-2020-3 https://www.businessinsider.com/coronavirus-testing-covid-19...
    - DyslexicAtheist 7y ago
      CDC also stopped reporting number of tests each day (last week iirc).
    - adventured 7y ago
      That's misleading. The Feds state that they've sent several hundred thousand tests to private labs and hospitals which do not report their figures directly to CDC. They don't know how many have been used at this point (which is bad, but not as bad as them not sending out hundreds of thousands of tests). "Earlier on Tuesday, Department of Health and Human Services Secretary Alex Azar said he couldn’t provide the figure. “We don’t know exactly how many because hundreds of thousands of our tests have gone out to private labs and hospitals that currently do not report in to CDC,” he said in a CNN appearance." https://news.yahoo.com/only-5000-americans-have-been-tested-for-the-coronavirus-so-far-151447195.html https://news.yahoo.com/only-5000-americans-have-been-tested-...
      - deleted 7y ago
        [deleted]
      - throwaway5752 7y ago
        As of 4pm ET today https://twitter.com/covid19tracking https://twitter.com/covid19tracking (aggregating known state testing results) shows about 5100 tests performed, or 15 tests per million people.
      - lootsauce 7y ago
        Seems like a lame argument, they are the CDC why can't they simply ask the labs to report back the findings its a global pandemic for goodness sake.
        danans 7y ago
        Not saying this as an defense to your observation, but it's possible that they just don't have the capacity to manage that information, given the disparate nature of our health care system. Others have pointed out that the entire pandemic response org chain was fired a while back under the premise of cost savings. Communicating that information back in a secure, consistent, and reliable way requires a "system" of some kind. It could be a secure website or even a phone war room ready to go and staffed with operators waiting for the test reports. If such a system was available, you'd think they'd use it in heartbeat, which kind of implies it doesn't exist. And it's not like systems of this sort - or more even more complex - don't exist. When my kids were born, we donated the umbilical cord blood to a stem cell bank. The organization sent me special bar-coded packaging with a refrigerated pack to be overnight posted back to them.
- alexandercrohde 7y ago
  Well, that's only the constraint because the FDA disallows importing foreign kits, and has prevented private companies from manufacturing them, no? So in a sense, the obstacle is (deliberately?) awful policy.
- rasz 7y ago
  Those are total NY numbers, right? considering recent article about "Washington state authorities sent an urgent request for 233,000 respirators .. to be released from the federal", not to mention the fact Italy has 30K, and they ran out a week ago.
smacktoward 7y ago
The CDC completely dropped the ball on providing test kits, so all the individual states and localities have had to source them themselves. Which, entirely predictably, they are not doing a great job at. It didn't help matters either that those test kits the CDC did provide early on turned out to have flaws that caused inaccurate readings (see https://www.nbcnews.com/health/health-news/after-missteps-cdc-says-its-coronavirus-test-kit-ready-primetime-n1145206 https://www.nbcnews.com/health/health-news/after-missteps-cd...).
- SkyPuncher 7y ago
  From my understanding, state and local labs HAVE been able to source them. The CDC has been refusing to authorize them for testing. Univ. of Washington seems to be an outlier as they were able to get approval under an existing research study they have.
  - alfiedotwtf 7y ago
    > The CDC has been refusing to authorize them for testing. This is new to me. Link?
    - claudeganon 7y ago
      See this reporting: https://www.nytimes.com/2020/03/02/health/coronavirus-testing-cdc.html https://www.nytimes.com/2020/03/02/health/coronavirus-testin... https://www.latimes.com/science/story/2020-03-06/chaos-at-hospitals-due-to-shortage-of-coronavirus-tests https://www.latimes.com/science/story/2020-03-06/chaos-at-ho...
  - chrisco255 7y ago
    I'm not sure where the lines break down between CDC and FDA, but the policy was changed on February 29th: https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-issues-new-policy-help-expedite-availability-diagnostics https://www.fda.gov/news-events/press-announcements/coronavi...
- throwaway5752 7y ago
SkyPuncher 7y ago
From my perspective, it's largely politics. CDC would not authorize state and local labs to test. That seems to be an order coming from the White House to avoid economic panic (which is happening anyways).
blackearl 7y ago
This administration sticking their heads in the sand and the CDC also either not being prepared or executing their prep horrendously.
- smacktoward 7y ago
  It's actually worse than the administration just sticking their heads in the sand. The President has made multiple public statements where he's said his main objective in this is to keep the number of reported cases as low as possible. Every bureaucrat in the system is going to know exactly what that means: extensive testing will only surface more cases, so anyone who pushes for more testing will be performing what I heard described when I worked for the Air Force as "a career-limiting manuever." A head-in-the-sand approach would at least be neutral. The administration has gone beyond that to actively putting a thumb on the scale. (Ironically, this is the same type of "nobody ever prospered by upsetting The Boss" problem that lots of people were dunking on China for having a few weeks ago. The degree to which our supposedly open system has become vulnerable to it too should give us all a moment of pause.)
  - pbourke 7y ago
    He did a literal "just the flu" tweet yesterday ...
malandrew 7y ago
The CDC was restricting who could get tested up until a few days ago.
- agseward 7y ago
  They are still restricting who can get tested. My son who has a fever and cough can't get tested because he doesn't have shortness of breath (you have to exhibit all 3 symptoms at the same time to be eligible for a test).
  - malandrew 7y ago
    That's nuts. The federal government at this point has done far more harm than good. Organizations that provide testing (public or private) should have just coordinated directly with the WHO on how to do those tests and just busted their butts to keep up with demand, which doctors deciding directly who to test and when. We'd have far more testing being done if we have just let markets do their thing.
    - cmurf 7y ago
      It's not about markets vs government. It's about competency versus incompetency. South Korea has far more testing than about any country, it's not due to letting markets do their thing. It's due to competency: they had an imagination for this situation, from experience, and had a plan to deal with it, should it happen again. We have examples of authoritarian and democratic governments, some do the right thing, some do the wrong thing.
      - malandrew 7y ago
        With markets, you have an opportunity to discover and reward competency. With government, you have all your eggs in one basket and if that basket isn't competent, you're shit out of luck.
        cmurf 7y ago
vkou 7y ago
A laughable shortage of test kits. Combined with a CDC ban on third-party testing that was recently lifted. The retirement home in Kirkland that had 18 deaths from the virus over the last 2 weeks currently has ~30 patients in the ICU... Who still have not been tested for the virus.
- deleted 7y ago
  [deleted]
paulmd 7y ago
This board doesn't like politics but frankly it is the administration. They fired the CDC's pandemic response teams a couple years ago because they didn't want to fund it. They don't like admitting there's a crisis because it looks bad for them, they want to sweep the whole thing under the rug. That has translated into the administration stopping the CDC from doing their jobs, whether implicitly ("if you make this into a big deal, we'll find someone else who is more willing to align with the administrations positions") or explicitly (stuff like cutting the funding for the CDC pandemic response teams). It's basically the same thing as when Trump drew the hurricane on the map to an area where it wasn't going, and then fired all the people at the NWS who corrected him. Sticking your neck out and stating the emperor has no clothes is a fast track to getting replaced by someone who will play ball. Trump is exceptionally petty and has some paranoia that there is a “deep state” trying to undercut him. He doesn’t accept that these are professionals trying to do their jobs, because he is a moron who thinks he knows everything, better than the experts, and they are just trying to undermine him and make him look bad. Trump is a uniquely stupid and incurious president, and he has absolutely no interest in listening to experts. The only people he allows to be around him are yes-men. He doesn’t understand what’s going on, and he doesn’t particularly care insofar as it makes him look bad, and tanks the stock market (makes him look bad). Even Boris fucking Johnson is astonished by how bad the administration’s response has been. In short - we elected a narcissistic, incurious, anti-intellectual, paranoid con man to be president, he is now facing a real, serious crisis, and he’s busy purging the career professionals that we need to be solving this crisis. He is that boss who can’t stand not being “the smartest guy in the room” even when he has no idea what he’s talking about, and he’s in charge of managing our response to basically Spanish Flu 2: Electric Boogaloo.
- pjc50 7y ago
  This is all correct, and it's going to be downvoted because tribalism is more important than not getting a potentially fatal disease.
  - deleted 7y ago
    [deleted]
  - 7y ago
Gibbon1 7y ago
CDC blocking testing, refused to use existing tests developed outside the us. Feels like who ever they contracted to develop a test didn't deliver.

I've not been keeping up; what's the obstacle to getting tested? Insurance companies not covering? Hospitals not willing? Patients not going in?

by taborj 7y ago

I've not been keeping up; what's the obstacle to getting tested? Insurance companies not covering? Hospitals not willing? Patients not going in?

dforrestwilson 7y ago

# of test kits. The US can currently test something like 7800 people per day as of yesterday. Some other system constraints to think about are: 1M hospital beds 70k ventilators

hangonhn 7y ago
I don't know if this is still true but according to an article I read a few days ago, the US has the lowest testing rate of any affected country. Experiences of other countries seem to suggest that high testing rate may mitigate the need for measures like lockdowns.
- throwaway5752 7y ago
  By an order of magnitude: https://www.businessinsider.com/coronavirus-testing-covid-19-tests-per-capita-chart-us-behind-2020-3 https://www.businessinsider.com/coronavirus-testing-covid-19...
  - DyslexicAtheist 7y ago
    CDC also stopped reporting number of tests each day (last week iirc).
  - adventured 7y ago
    That's misleading. The Feds state that they've sent several hundred thousand tests to private labs and hospitals which do not report their figures directly to CDC. They don't know how many have been used at this point (which is bad, but not as bad as them not sending out hundreds of thousands of tests). "Earlier on Tuesday, Department of Health and Human Services Secretary Alex Azar said he couldn’t provide the figure. “We don’t know exactly how many because hundreds of thousands of our tests have gone out to private labs and hospitals that currently do not report in to CDC,” he said in a CNN appearance." https://news.yahoo.com/only-5000-americans-have-been-tested-for-the-coronavirus-so-far-151447195.html https://news.yahoo.com/only-5000-americans-have-been-tested-...
    - deleted 7y ago
      [deleted]
    - throwaway5752 7y ago
      As of 4pm ET today https://twitter.com/covid19tracking https://twitter.com/covid19tracking (aggregating known state testing results) shows about 5100 tests performed, or 15 tests per million people.
    - lootsauce 7y ago
      Seems like a lame argument, they are the CDC why can't they simply ask the labs to report back the findings its a global pandemic for goodness sake.
      - danans 7y ago
        Not saying this as an defense to your observation, but it's possible that they just don't have the capacity to manage that information, given the disparate nature of our health care system. Others have pointed out that the entire pandemic response org chain was fired a while back under the premise of cost savings. Communicating that information back in a secure, consistent, and reliable way requires a "system" of some kind. It could be a secure website or even a phone war room ready to go and staffed with operators waiting for the test reports. If such a system was available, you'd think they'd use it in heartbeat, which kind of implies it doesn't exist. And it's not like systems of this sort - or more even more complex - don't exist. When my kids were born, we donated the umbilical cord blood to a stem cell bank. The organization sent me special bar-coded packaging with a refrigerated pack to be overnight posted back to them.
alexandercrohde 7y ago
Well, that's only the constraint because the FDA disallows importing foreign kits, and has prevented private companies from manufacturing them, no? So in a sense, the obstacle is (deliberately?) awful policy.
rasz 7y ago
Those are total NY numbers, right? considering recent article about "Washington state authorities sent an urgent request for 233,000 respirators .. to be released from the federal", not to mention the fact Italy has 30K, and they ran out a week ago.

smacktoward 7y ago

The CDC completely dropped the ball on providing test kits, so all the individual states and localities have had to source them themselves. Which, entirely predictably, they are not doing a great job at. It didn't help matters either that those test kits the CDC did provide early on turned out to have flaws that caused inaccurate readings (see https://www.nbcnews.com/health/health-news/after-missteps-cdc-says-its-coronavirus-test-kit-ready-primetime-n1145206 https://www.nbcnews.com/health/health-news/after-missteps-cd...).

SkyPuncher 7y ago
From my understanding, state and local labs HAVE been able to source them. The CDC has been refusing to authorize them for testing. Univ. of Washington seems to be an outlier as they were able to get approval under an existing research study they have.
- alfiedotwtf 7y ago
  > The CDC has been refusing to authorize them for testing. This is new to me. Link?
  - claudeganon 7y ago
    See this reporting: https://www.nytimes.com/2020/03/02/health/coronavirus-testing-cdc.html https://www.nytimes.com/2020/03/02/health/coronavirus-testin... https://www.latimes.com/science/story/2020-03-06/chaos-at-hospitals-due-to-shortage-of-coronavirus-tests https://www.latimes.com/science/story/2020-03-06/chaos-at-ho...
- chrisco255 7y ago
  I'm not sure where the lines break down between CDC and FDA, but the policy was changed on February 29th: https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-issues-new-policy-help-expedite-availability-diagnostics https://www.fda.gov/news-events/press-announcements/coronavi...
throwaway5752 7y ago

SkyPuncher 7y ago

From my perspective, it's largely politics. CDC would not authorize state and local labs to test. That seems to be an order coming from the White House to avoid economic panic (which is happening anyways).

blackearl 7y ago

This administration sticking their heads in the sand and the CDC also either not being prepared or executing their prep horrendously.

smacktoward 7y ago
It's actually worse than the administration just sticking their heads in the sand. The President has made multiple public statements where he's said his main objective in this is to keep the number of reported cases as low as possible. Every bureaucrat in the system is going to know exactly what that means: extensive testing will only surface more cases, so anyone who pushes for more testing will be performing what I heard described when I worked for the Air Force as "a career-limiting manuever." A head-in-the-sand approach would at least be neutral. The administration has gone beyond that to actively putting a thumb on the scale. (Ironically, this is the same type of "nobody ever prospered by upsetting The Boss" problem that lots of people were dunking on China for having a few weeks ago. The degree to which our supposedly open system has become vulnerable to it too should give us all a moment of pause.)
- pbourke 7y ago
  He did a literal "just the flu" tweet yesterday ...

malandrew 7y ago

The CDC was restricting who could get tested up until a few days ago.

agseward 7y ago
They are still restricting who can get tested. My son who has a fever and cough can't get tested because he doesn't have shortness of breath (you have to exhibit all 3 symptoms at the same time to be eligible for a test).
- malandrew 7y ago
  That's nuts. The federal government at this point has done far more harm than good. Organizations that provide testing (public or private) should have just coordinated directly with the WHO on how to do those tests and just busted their butts to keep up with demand, which doctors deciding directly who to test and when. We'd have far more testing being done if we have just let markets do their thing.
  - cmurf 7y ago
    It's not about markets vs government. It's about competency versus incompetency. South Korea has far more testing than about any country, it's not due to letting markets do their thing. It's due to competency: they had an imagination for this situation, from experience, and had a plan to deal with it, should it happen again. We have examples of authoritarian and democratic governments, some do the right thing, some do the wrong thing.
    - malandrew 7y ago
      With markets, you have an opportunity to discover and reward competency. With government, you have all your eggs in one basket and if that basket isn't competent, you're shit out of luck.
      - cmurf 7y ago

vkou 7y ago

A laughable shortage of test kits. Combined with a CDC ban on third-party testing that was recently lifted. The retirement home in Kirkland that had 18 deaths from the virus over the last 2 weeks currently has ~30 patients in the ICU... Who still have not been tested for the virus.

deleted 7y ago
[deleted]

paulmd 7y ago

This board doesn't like politics but frankly it is the administration. They fired the CDC's pandemic response teams a couple years ago because they didn't want to fund it. They don't like admitting there's a crisis because it looks bad for them, they want to sweep the whole thing under the rug. That has translated into the administration stopping the CDC from doing their jobs, whether implicitly ("if you make this into a big deal, we'll find someone else who is more willing to align with the administrations positions") or explicitly (stuff like cutting the funding for the CDC pandemic response teams). It's basically the same thing as when Trump drew the hurricane on the map to an area where it wasn't going, and then fired all the people at the NWS who corrected him. Sticking your neck out and stating the emperor has no clothes is a fast track to getting replaced by someone who will play ball. Trump is exceptionally petty and has some paranoia that there is a “deep state” trying to undercut him. He doesn’t accept that these are professionals trying to do their jobs, because he is a moron who thinks he knows everything, better than the experts, and they are just trying to undermine him and make him look bad. Trump is a uniquely stupid and incurious president, and he has absolutely no interest in listening to experts. The only people he allows to be around him are yes-men. He doesn’t understand what’s going on, and he doesn’t particularly care insofar as it makes him look bad, and tanks the stock market (makes him look bad). Even Boris fucking Johnson is astonished by how bad the administration’s response has been. In short - we elected a narcissistic, incurious, anti-intellectual, paranoid con man to be president, he is now facing a real, serious crisis, and he’s busy purging the career professionals that we need to be solving this crisis. He is that boss who can’t stand not being “the smartest guy in the room” even when he has no idea what he’s talking about, and he’s in charge of managing our response to basically Spanish Flu 2: Electric Boogaloo.

pjc50 7y ago
This is all correct, and it's going to be downvoted because tribalism is more important than not getting a potentially fatal disease.
- deleted 7y ago
  [deleted]
- 7y ago

Gibbon1 7y ago

CDC blocking testing, refused to use existing tests developed outside the us. Feels like who ever they contracted to develop a test didn't deliver.