16 ms·
With broad, random tests for antibodies, Germany seeks path out of lockdown
- chkaloon 7y agoShows what strong, competent leadership can do. And a society with fairly high trust in it.
- api 7y agoCompetent is by far the most important thing. Trust is given in response to consistent demonstration of competence and integrity. Germany is a democracy, so it ultimately comes down to the quality of the leadership decisions made by the populace.
- DasIch 7y ago> Germany is a democracy, so it ultimately comes down to the quality of the leadership decisions made by the populace. This is not entirely true. Democracy is a broad term and different democracies work very differently. In Germany for example political parties are quite powerful, politicians have to be elected by party members, there are no primaries like in the US. Being a politician in parliament or becoming chancellor in Germany requires a political career that takes quite some time. This excludes people in ways that are both good and bad. On the good side someone like Trump would have no chance at all because he lacks the political track record and relationships. On the bad side politicians in Germany are not a very diverse group. There is a strong bias towards older people, people who've been in politics for their entire life and people in professions that allow for spending time as a politician in parliament for a couple of years and continuing in their regular job afterwards. In practice this means teachers and lawyers, at least in Germany.
- Ididntdothis 7y agoGerman politicians seem to be younger than the ones in the US. It’s really sad to see that the best the US parties could come up with is people older than 70. I agree about the point with teachers and lawyers being predominant. Although it seems that worldwide politics is mainly run by lawyers which is a bad thing in my view.
- jakeogh 7y agoDo you know more now than you did ten years ago?
- Ididntdothis 7y agoI don't understand the question. Are you implying that the older people get the wiser they get?
- jakeogh 7y agoPerhaps you just dont want to answer it.
- toast0 7y agoYes, but if I'm honest, I'm also a lot less willing to consider new information.
- jakeogh 7y agoA lot? Why? My experience on new information summed up by the vid in my profile. I still find it astonishing.
- klenwell 7y agoThere was a clip of Angela Merkel that circulated on Twitter this week. Worth watching: https://twitter.com/BenjAlvarez1/status/1250563198081740800 https://twitter.com/BenjAlvarez1/status/1250563198081740800 Night and day when compared with the grandstanding and gaslighting that we're seeing from Trump. It's what burnt me about the Marc Andreessen article that generated a lot of discussion on HN yesterday and opened with this premise: Many of us would like to pin the cause on one political party or another, on one government or another. But the harsh reality is that it all failed — no Western country, or state, or city was prepared — and despite hard work and often extraordinary sacrifice by many people within these institutions. So the problem runs deeper than your favorite political opponent or your home nation. The assumption that a Clinton, Kasich, or Obama administration would not have managed this more competently is stupefying. We can just look at how H1N1 was handled by Obama in 2009: https://www.snopes.com/fact-check/obama-wait-swine-flu-n1h1/ https://www.snopes.com/fact-check/obama-wait-swine-flu-n1h1/ And here we have clear evidence of a Western country whose response to the present crisis has not been failure (ignoring all together South Korea, where the response appears to have been even more successful). How are we going to make radical systemic changes in society when we pretend like the people in charge make no difference?
- amelius 7y agoAngela Merkel has a Ph.D. in quantum physics, and an academic background is probably exactly what's needed in a situation like this (versus the more business oriented skills of e.g. Trump).
- deleted 7y ago[deleted]
- clairity 7y agotrump is terrible at business, very likely to have grossly underperformed against putting his inheritance and loans into an index fund. he’s good at grabbing attention and being a reality tv actor/celebrity however.
- Hoasi 7y ago> he’s good at grabbing attention and being a reality tv actor/celebrity however. He's good at marketing. Sadly he didn't put these skills to good use in the current crisis so far. Virology isn't his strongest suit. He performed a worse show than usual since it is not just about boasting about himself and branding other people with hilarious nicknames.
- clairity 7y agonot really. he’s good at self-promotion, which you might argue is an overlapping skillset with promotion, a component of marketing dealing with sales, advertising, and the like. but he’s most certainly not good at any other aspect of marketing (product, price, distribution, etc.), which is why he’s terrible at business and why he’s been losing credibility to state leaders.
- Hoasi 7y agoCompletely in agreement with you here. Replace marketing with marketing himself in my above comment.
- Ididntdothis 7y ago
- s9w 7y ago> The generosity and solidarity [...] have been missing in Germany’s response to poorer European nations in the south, which were hit hardest by the virus. Germany gave away many hundreds of respirators, took in hundreds of patients from all neighboring countries (including Italy). Italy was offered money under the ESM which they didn't want. All while high ranking officials from Italy called Germans Nazis multiple times. All that although the Italian population has a higher median wealth, lower taxes, higher rate of home ownership and lower retirement age. And we're still the bad guys.
- zigzaggy 7y agoAmerican here. This is the first I’m hearing anything but good things about how Germany has handled this crisis. And I consider myself to be fairy tuned in. Don’t sweat the trolls, you’ll never make them happy.
- skrebbel 7y agoFYI you just called the majority of Italian media and politicians "trolls".
- plorkyeran 7y agoI'm fine with calling the majority of media and politicians from every country trolls.
- chasd00 7y agoI regret that I have but one upvote to give. This whole experience has further disillusioned me to the news media and the idea they contribute value in any way whatsoever. At this point, I trust Twitter more.
- kevin_thibedeau 7y agoHow do you think they generate revenue?
- 7y ago
- ttul 7y agoI would love to know how Germany has been able to discover a sufficiently accurate antibody assay before many excellent groups in other countries. Finding some antibodies is one thing; making it mean something is another. Does the presence of a particular antibody imply that someone is now no longer infectious to others? Are they themselves now immune to reinfection? These questions are unanswered AFAIK so I am curious as to what the Germans are actually learning.
- sarnowski 7y agoMy vague understanding is, that the tests can also test positive for antibodies from other similar viruses. They have a significant false-positive rate that you should not rely on a positive („you are immune“) result but overall they will provide a big picture approximation how many citizens might have already resistance. They are not good enough for a rumored „immune certification“.
- iso1210 7y agoCurrently we have no idea how many people have had covid. We have a good idea how many have died, but no country has managed to do the kind of testing that would give a good indication of how many people have been infected. Do 2% of people getting it die, or 0.2%, or 0.02%? Testing 1 million people at random across the country will give good results of not only how deadly it is, but also how likely it is to spread in different areas of the country.
- dboreham 7y agoWe have a pretty good idea it isn't 0.02% because there's an upper bound on the infection rate (around 75%) and the number of bodies is known and in all cases exceeds 0.3% of the maximum possible infections.
- quersive 7y agoHow did you come up with 0.3% number of bodies / maximum possible infections, aka total population? I'm trying to wrap my head around this whole mess... Take Lombardy, hardest hit region in Europe. 1130 deaths / million, or about 0.1% death rate. All German states are under 100 deaths per million, which is less than 0.01% death rate. Sanity check: Bayern, 1.2k deaths/13M people ~ 0.01%. Of course, this is a lower bound estimate assuming all people in a given region have got through the disease. Which is definitely not true. To figure out how bad is going to get we need the total number of infected people. Hopefully the random testing strategy will shed some light on that number. But at least we start [much] lower than 0.3%. https://covid19.quersive.com/chart?c=M&e=IT-Lombardy&e=DE-BW&e=DE-BY&e=DE-BE&e=DE-BB&e=DE-HB&e=DE-HH&e=DE-HE&e=DE-MV&e=DE-NI&e=DE-NW&e=DE-RP&e=DE-SL&e=DE-SN&e=DE-ST&e=DE-SH&e=DE-TH&f=DE-BY&t=D&tb=P&w=1 https://covid19.quersive.com/chart?c=M&e=IT-Lombardy&e=DE-BW...
- garraeth 7y agoAfter searching Google, I cannot find the results of the actual study. Are they available?
- Linus-Boehm 7y agoThey just started the study and will last at least a year. But here is the press release of the munich university. https://www.lmu-klinikum.de/aktuelles/pressemitteilungen/munchner-tropeninstitut-beginnt-stichprobenanalyse-zur-verbreitung-der-corona-pandemie-und-zur-wirksamkeit-von-gegenmassnahmen/6afa2c06cb6745a9 https://www.lmu-klinikum.de/aktuelles/pressemitteilungen/mun...
- anotheryou 7y agoBut it hasn't ramped up yet and they loosen the lockdown already by monday. The got R down to .7 at best and that only on average, not in the hotspots. I bet in 2 weeks (I hope it's not even more delay) they will notice that (partially) opening schools and shops was a mistake and will have to row back. I just hope they will be as lucky as with the initial curve-flattening. Germany has flattened the curve, but that still means they are roughly on it's summit. There are still more infected than ever and every misstep might be costly. Here are the different regions, just recovered/dead are not included in the graph I think: https://preview.redd.it/x7g0xnlblds41.png?width=894&format=png&auto=webp&s=b104f985de617b4f55e0585a3da32fa63778403d https://preview.redd.it/x7g0xnlblds41.png?width=894&format=p... Generally it peaked at 70k infected and is back at 50k https://studylib.net/coronavirus#country-de https://studylib.net/coronavirus#country-de
- KarlKemp 7y agoI believe it’s very much expected to see some resurgence and to adjust measures accordingly. Over time, it might become easier to measure which interventions are most effective and to focus on those. Schools are certainly a risky gamble, but their closing is also among the most expensive measures. Many people are staying at home because they have no options for their children, including many doctors and nurses.
- anotheryou 7y agoYou might be right. I wished they'd publish what exactly they aim for and what the plan for different outcomes of this experiment is. For now they seem to aim at R = 1, which means waiting for the vaccine with whatever is possible to keep it at 1. (Probably not much more than barbers and very few school classes.)
- lowdose 7y agoIsn't more important to take decisions instead of holding everyone upfront accountable for any mistake?
- johnohara 7y agoIt's unrealistic to use RT-PCR testing on the entire U.S. population to derive what is essentially a binary result. RT-PCR tests are too time consuming, too sensitive, and too reliant on specialized laboratory equipment for that. Right now however, they are all we have to achieve results accurate enough for some form of certification. Immunoassays are simpler, faster, localized, and less expensive, but may also yield positive results for other coronaviruses such as 229E, NL63, OC43, HKU1, SARS-CoV, and MERS-CoV. Germany may be isolating potential COVID-19 positives by using immunoassays, then using RT-PCR to be certain. I don't know. But it doesn't mean those "negatives" will always remain so.
- beagle3 7y agoPlease correct me if I'm wrong, but rt-PCR can only detect active SARS-Cov-2 shedding - meaning active disease, whereas immuno-assays check for the existence of antibodies. A SARS-Cov-2 naive person will be negative to both; early on, rt-PCR will be positive[0] and immunoassay will be negative; then (if and when the immune system manages to synthesize the right antibodies) they will both be positive; then the virus is eradicated so rt-PCR will go negative, but the immunoassay will stay positive (for a while; unknown yet if for life) [0] Assuming perfect accuracy and specificity.
- johnohara 7y agoI agree with your reply. Thank you for it. The recent seroprevalence study performed in Santa Clara County [0] [1] used an immunoassay manufactured by Premier BioTech, Minneapolis, MN. Their page entitled "PCR And Serology Based Testing Explained" does a very good job explaining what we both understand [2]. I stand by my opinion that it is unrealistic to use RT-PCR testing on the entire U.S. population. It is too sensitive and too time-consuming given the time constraints we are under. This Wash Post article (printed by MSN) describes why the CDC had to recall its initial testing kits. [3] [0] https://www.medrxiv.org/content/10.1101/2020.04.14.20062463v1 https://www.medrxiv.org/content/10.1101/2020.04.14.20062463v... [1] https://news.ycombinator.com/item?id=22899272 https://news.ycombinator.com/item?id=22899272 [2] https://premierbiotech.com/innovation/pcr-and-serology-based-testing-explained/ https://premierbiotech.com/innovation/pcr-and-serology-based... [3] https://www.msn.com/en-us/news/us/contamination-at-cdc-lab-delayed-rollout-of-coronavirus-tests/ar-BB12Q90W https://www.msn.com/en-us/news/us/contamination-at-cdc-lab-d...
- neonate 7y agohttps://archive.md/L6abQ https://archive.md/L6abQ
- dustinmoris 7y agoWhat's the goal with all this testing? The simple reality is that unless you have a large proportion of your population immune (either due to infection or vaccine) you will NOT be able to reverse the lockdown successfully without seeing a surge in infections and deaths shortly after. So you can test as much as you want, but this whole pandemic started from ONE person in China so as long as there is 1 or 5 or more likely 100s or 1000s of cases in any country then as soon as restrictions are loosened the infection rate will exponentially go up again. You can play the game of opening/closing schools/shops every couple weeks for about 2 years until everyone either got eventually infected or we might see a vaccine hitting the public. Even if a vaccine might be available at the end of 2020, it won't be available to the public across the globe for yet another year if not longer. That is just simple maths on manufacturing and distribution, anyone who thinks differently is completely dillusional. So my question remains, what is the end goal with all of the testing? Calling testing as a way out of the lockdown is either a dumb assertion, because more testing won't stop the spread (contact tracing and isolation will only slow the exponential outbreak by days or couple weeks), or it is a lie to give the public false hope. There is only two ways out: - Now, by lifting all lockdown restrictions, target, shield and isolate the most vulnerable in our society (old & fragile, people with diabetes, cancer, HIV, etc.), ramp up hospital capacity and let the virus rage through the remaining population, hoping that everyone else will mostly experience mild or no symptoms and only very few people who need hospitalisation and who will die given that the most vulnerable remain in isolation... or - stay in lockdown for 24 months at a minimum until there's the capacity to manufacture and supply a vaccine to roughly 60% of the population with a pointless ping pong exercise of easing and tightening the restrictions I'm honestly not sure which one is better, but there is literally NO OTHER OPTION. Most of Europe is currently going down the second option and Sweden is mostly leading on the first option. I predict that if in ~ 6 months time countries will see that there's little difference in the death rate between countries with tright restrictinos and those with lax restrictions (because tight restrictions only delay the deaths, but don't prevent) then everyone will change to a more Swedish model probably. Only time will tell the truth.
- kaybe 7y agoI don't think option 1 as you wrote is is any good. There appear to be strong signs that even with very mild symptoms patients can have significant lung damage, and also damage to other organs. It is not clear yet how far that will heal. Only time will tell, but from the extend, I've seen discussions that the people affected might be patients for the rest of their lives. (eg. https://www.rainews.it/tgr/tagesschau/articoli/2020/04/tag-Coronavirus-Lungeschaden-Forschung-Uniklinik-Innsbruck-6708e11e-28dc-4843-a760-e7f926ace61c.html https://www.rainews.it/tgr/tagesschau/articoli/2020/04/tag-C... in German)
- travisgriggs 7y ago“Of course I said yes... I want to help. This is a collective crisis. The government is doing what it can. Everyone needs to do their bit.” I live in the wrong country. Can I come live with you Germany?
- KCUOJJQJ 7y agoAccording to a diagram [1] of the Robert Koch Institute the effective reproduction number was already down to 1 two days before the measurements of March 23. It also didn't go down further in this diagram. [1] https://www.rki.de/DE/Content/Infekt/EpidBull/Archiv/2020/17/Art_02.html https://www.rki.de/DE/Content/Infekt/EpidBull/Archiv/2020/17... https://www.rki.de/DE/Content/Infekt/EpidBull/Archiv/2020/Ausgaben/17_20_SARS-CoV2_vorab.pdf?__blob=publicationFile https://www.rki.de/DE/Content/Infekt/EpidBull/Archiv/2020/Au... --> Page 14, "Abb. 4"
- anotheryou 7y agoI looked into that a bit. Basically everyone was already self-quarantining. I looked at mobility on sundays (because that isolates it to the private lockdown as ordered on the 23rd and excludes school, shops and work quite a bit): 14.3.: -10% Mobility 21.3.: -46% Mobility 23.3.: ----- official Lockdown ----- 29.3.: -55% Mobility So the bulk of it happened in advance, because people where already isolating themselves during the initial "panic". Data from here http://rocs.hu-berlin.de/covid-19-mobility/mobility-monitor/ http://rocs.hu-berlin.de/covid-19-mobility/mobility-monitor/ (I wonder why there is no Sunday dip for the 5th of April though)
- LatteLazy 7y agoStop testing individuals and start testing populations. That's the only way to know what is happening. That is the only way to start controlling the epidemic instead of just guessing.