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This worries me. South Korea's mass testing alone was not enough to contain the coronavirus outbreak; they relied on social distancing measures too: https://www

by makomk 7y ago

This worries me. South Korea's mass testing alone was not enough to contain the coronavirus outbreak; they relied on social distancing measures too: https://www.reuters.com/article/us-health-coronavirus-southkorea/south-korea-extends-intensive-social-distancing-to-reach-50-daily-coronavirus-cases-idUSKBN21M02P https://www.reuters.com/article/us-health-coronavirus-southk...

ajross 7y ago
Yes, but once the outbreak is at a low enough level, and you have sufficient test bandwidth, you can manage it via testing and tracing. Everyone who gets sick, with anything, gets tested (in some variants of the plan every everywhere gets tested every N days). If you find a positive, quarantine them and test everyone they came in contact with. Repeat. This reduces the rate of spread by catching community transmission before the end of its cycle. And it's worked with other outbreaks in the past. But it depends on having a very large available pool of rapid testing, so you can't do it when you have thousands of cases per day. But a few dozen... probably. It definitely seems to be working in Korea. But again, it only works once the outbreak is well contained. Stay home.
- makomk 7y ago
  The trouble is, reducing the size of the outbreak doesn't affect the number of tests needed to do this much at all, and the number of people South Korea has been testing doesn't seem to have increased in quite a while. In fact, it seems to have actually decreased compared to back in March. Like, as far as I can tell, they're still using the same contact tracing and testing strategy that failed to contain it before without additional strong social distancing, and the social distancing is weakening.
- api 7y ago
  That is very labor intensive and isn't sustainable. People will get complacent fast.
  - jeremyjh 7y ago
    It is a lot more sustainable than the alternatives.
  - deleted 7y ago
    [deleted]
- usaar333 7y ago
  > But it depends on having a very large available pool of rapid testing Not necessarily. You can just aggressively quarantine - basically the strategy in China. > so you can't do it when you have thousands of cases per day At what scale? Iceland was able to do it with ~200 new cases per day per million. The majority of US states haven't had spikes this high - nowhere in CA has even come close to that. For some reason, we've only recently started building up the volunteer armies needed to do this (https://www.sfgate.com/bayarea/article/San-Francisco-coronavirus-contact-tracing-case-15199505.php https://www.sfgate.com/bayarea/article/San-Francisco-coronav...) - this should have been done on day 1.
  - ajross 7y ago
    > Iceland was able to do it Iceland's per capita new infection rate peaked higher than basically any nation in the world, and while it's dropping comparatively rapidly it hasn't reached a stable baseline yet. I don't think this is a good example at all. While it's clear their lockdown "worked" (in the sense of recovering them from a disastrous peak), I think it's still very much an open question as to whether their testing capacity will sustain this success.
    - usaar333 7y ago
      case rate, not infection rate. They are one of the few nations in the world that are credibly even close to catching half their infections. The US is probably missing 90% (https://www.medrxiv.org/content/10.1101/2020.04.06.20055582v1 https://www.medrxiv.org/content/10.1101/2020.04.06.20055582v...) To that point, their death rate is lower than the Bay Area. To a second point, Iceland is under a very weak lockdown, if you can even call it that. Their elementary schools remain open.
      - cma 7y ago
        Through mass testing they already avoided one nursing home hit, and haven’t had a single hit. If they do, their fatality rate could quadruple because of how small the numbers are we are looking at there.
narrator 7y ago
South Korea: 234 deaths 8042 recovered. China: 4632 deaths, 77k recovered[1]. Their treatment protocol is an order of magnitude better than every other country. What are they doing that we're not? This is a huge glaring discrepancy. What's the difference between their treatment protocols and everyone else's? [1]https://www.worldometers.info/coronavirus/ https://www.worldometers.info/coronavirus/
- usaar333 7y ago
  https://www.wolframalpha.com/input/?i=china+population+%2F+south+korea+population https://www.wolframalpha.com/input/?i=china+population+%2F+s... Actually worse than China by that metric, though given credibility issues of Chinese data, let's just say about the same.
- rhino369 7y ago
  The "recovered" numbers in other countries aren't even close to accurate. Countries with large outbreaks are only testing people with severe symptoms. Korea is testing anyone who comes near someone with the virus. So are catching close to everyone who has it.
- yfzhou 7y ago
  Western countries most likely still aren't testing mild patients. SK and China went for full containment: every single positive case is hospitalized and close contacts are quarantined in hotels so few cases are missed. While in New York, hospitals are focused on saving critical patients. If you test positive but have mild symptoms, you are usually let home anyway so it doesn't really make sense to test most people who would be taken very seriously in Asia.
- varjag 7y ago
  > China: 4632 deaths, 77k recovered There are zero deaths and zero cases in Turkmenistan, must have gotten their treatment protocols tight.
- joe_the_user 7y ago
  What's the difference between their treatment protocols and everyone else's? It's mind boggling anyone has to ask now this has been going on so long but here goes. 1) They had an approach plan beforehand because they had observed the previous SARS epidemic and took the danger seriously. 2) They had "quarantine hotels" freely available for those who were positive to prevent them from infecting others. (Seattle has a few of these, I've heard but they aren't widespread in the US. The idea of housing people freely is anethema to the US.) 3) They did testing early and often. 4) Their doctors and nurses worked with full PPEs, full anti-contamination suits, so they didn't themselves massively spread the illness. 5) They reserved hospitals specifically for the epidemic and had protocols for sending people to these hotel. 6) They had drive through testing and other testing easily and freely available (the US plan of profiting from testing is just so "I can't even"). 7) They did systematic contact tracing with an app for people to discover where infectious people had been. 8) They did social distancing with mask from the start. -- The US had literally done NONE of this. What the US has done is last-ditch efforts by states after the ostensibly responsible parties (the CDC etc) failed massively. And the Federal government is now literally sabotaging the states.

by makomk 7y ago

ajross 7y ago

Yes, but once the outbreak is at a low enough level, and you have sufficient test bandwidth, you can manage it via testing and tracing. Everyone who gets sick, with anything, gets tested (in some variants of the plan every everywhere gets tested every N days). If you find a positive, quarantine them and test everyone they came in contact with. Repeat. This reduces the rate of spread by catching community transmission before the end of its cycle. And it's worked with other outbreaks in the past. But it depends on having a very large available pool of rapid testing, so you can't do it when you have thousands of cases per day. But a few dozen... probably. It definitely seems to be working in Korea. But again, it only works once the outbreak is well contained. Stay home.

makomk 7y ago
The trouble is, reducing the size of the outbreak doesn't affect the number of tests needed to do this much at all, and the number of people South Korea has been testing doesn't seem to have increased in quite a while. In fact, it seems to have actually decreased compared to back in March. Like, as far as I can tell, they're still using the same contact tracing and testing strategy that failed to contain it before without additional strong social distancing, and the social distancing is weakening.
api 7y ago
That is very labor intensive and isn't sustainable. People will get complacent fast.
- jeremyjh 7y ago
  It is a lot more sustainable than the alternatives.
- deleted 7y ago
  [deleted]
usaar333 7y ago
> But it depends on having a very large available pool of rapid testing Not necessarily. You can just aggressively quarantine - basically the strategy in China. > so you can't do it when you have thousands of cases per day At what scale? Iceland was able to do it with ~200 new cases per day per million. The majority of US states haven't had spikes this high - nowhere in CA has even come close to that. For some reason, we've only recently started building up the volunteer armies needed to do this (https://www.sfgate.com/bayarea/article/San-Francisco-coronavirus-contact-tracing-case-15199505.php https://www.sfgate.com/bayarea/article/San-Francisco-coronav...) - this should have been done on day 1.
- ajross 7y ago
  > Iceland was able to do it Iceland's per capita new infection rate peaked higher than basically any nation in the world, and while it's dropping comparatively rapidly it hasn't reached a stable baseline yet. I don't think this is a good example at all. While it's clear their lockdown "worked" (in the sense of recovering them from a disastrous peak), I think it's still very much an open question as to whether their testing capacity will sustain this success.
  - usaar333 7y ago
    case rate, not infection rate. They are one of the few nations in the world that are credibly even close to catching half their infections. The US is probably missing 90% (https://www.medrxiv.org/content/10.1101/2020.04.06.20055582v1 https://www.medrxiv.org/content/10.1101/2020.04.06.20055582v...) To that point, their death rate is lower than the Bay Area. To a second point, Iceland is under a very weak lockdown, if you can even call it that. Their elementary schools remain open.
    - cma 7y ago
      Through mass testing they already avoided one nursing home hit, and haven’t had a single hit. If they do, their fatality rate could quadruple because of how small the numbers are we are looking at there.

narrator 7y ago

South Korea: 234 deaths 8042 recovered. China: 4632 deaths, 77k recovered[1]. Their treatment protocol is an order of magnitude better than every other country. What are they doing that we're not? This is a huge glaring discrepancy. What's the difference between their treatment protocols and everyone else's? [1]https://www.worldometers.info/coronavirus/ https://www.worldometers.info/coronavirus/

usaar333 7y ago
https://www.wolframalpha.com/input/?i=china+population+%2F+south+korea+population https://www.wolframalpha.com/input/?i=china+population+%2F+s... Actually worse than China by that metric, though given credibility issues of Chinese data, let's just say about the same.
rhino369 7y ago
The "recovered" numbers in other countries aren't even close to accurate. Countries with large outbreaks are only testing people with severe symptoms. Korea is testing anyone who comes near someone with the virus. So are catching close to everyone who has it.
yfzhou 7y ago
Western countries most likely still aren't testing mild patients. SK and China went for full containment: every single positive case is hospitalized and close contacts are quarantined in hotels so few cases are missed. While in New York, hospitals are focused on saving critical patients. If you test positive but have mild symptoms, you are usually let home anyway so it doesn't really make sense to test most people who would be taken very seriously in Asia.
varjag 7y ago
> China: 4632 deaths, 77k recovered There are zero deaths and zero cases in Turkmenistan, must have gotten their treatment protocols tight.
joe_the_user 7y ago
What's the difference between their treatment protocols and everyone else's? It's mind boggling anyone has to ask now this has been going on so long but here goes. 1) They had an approach plan beforehand because they had observed the previous SARS epidemic and took the danger seriously. 2) They had "quarantine hotels" freely available for those who were positive to prevent them from infecting others. (Seattle has a few of these, I've heard but they aren't widespread in the US. The idea of housing people freely is anethema to the US.) 3) They did testing early and often. 4) Their doctors and nurses worked with full PPEs, full anti-contamination suits, so they didn't themselves massively spread the illness. 5) They reserved hospitals specifically for the epidemic and had protocols for sending people to these hotel. 6) They had drive through testing and other testing easily and freely available (the US plan of profiting from testing is just so "I can't even"). 7) They did systematic contact tracing with an app for people to discover where infectious people had been. 8) They did social distancing with mask from the start. -- The US had literally done NONE of this. What the US has done is last-ditch efforts by states after the ostensibly responsible parties (the CDC etc) failed massively. And the Federal government is now literally sabotaging the states.