3 ms·

I think this article is getting things out of order. The question right now shouldn't be who to test, but rather how do we increase the volume of testing. The

I think this article is getting things out of order. The question right now shouldn't be who to test, but rather how do we increase the volume of testing. The article states that we should be running 500k tests a day, as if we're not simply because we choose not too. Right now we don't have the capacity and so we can't scale up at all. Why don't we have the capacity? Well the complete lack of coordination and leadership at the federal level means that each individual entity, whether it be state level government or a private entity, is having to do everything from scratch. That means developing SOPs, procuring supplies, and validating both the processes and reagents. This is being done on emergency orders as well, so some of the standards are relaxed to quickly get things up and running. There's also a shortage of reagents and kits because we didn't have or need this testing just a few months ago. There's also international competition for these resources, and because the US has decided it doesn't want to actually work with or coordinate with other countries, it's a free for all. Because everyone's frantically working on the same thing, but looking out for themselves it also means that true high throughput solutions are slow to develop as well. I could go on and on, but it's a clusterfuck and no one at the federal level either A) seems to care or B) thinks that it's their responsibility. Source: wife is currently in charge of starting up Covid testing

mjul 6y ago
The Danish Serum Institute published an alternative workflow for testing without using the scarce reagent. Instead, they use an old method of heating the samples like boiling an egg. See Fomsgaard and Rosenstierne’s preprint on medrxiv here: https://www.medrxiv.org/content/10.1101/2020.03.27.20044495v1 https://www.medrxiv.org/content/10.1101/2020.03.27.20044495v...
makomk 6y ago
There's, frankly, probably not enough reagents and consumables on the planet for the US to achieve 500k tests a day. As far as I know no country anywhere has managed this level of testing. Germany - who've been doing the best at testing lately - have been stuck at about 50,000 tests a day for a few weeks now, maybe even decreasing slightly. If you take into account the difference in population, that's only the equivalent of the US doing 200,000 tests a day - and of course scaling up to a larger population is harder. That doesn't stop the American press making it sound like not achieving those 500,000 tests a day is the result of some uniquely American political failing though.
- ahartmetz 6y ago
  There are even plans to increase testing to 4,5 million(!) tests per week in Germany, or ~650k per day. Currently there is unused testing capacity, so it looks like the old restrictive conditions for testing (basically: symptoms and (contact to infected person or stay in high risk area)) are still in place and should be updated ASAP.
- polygotdomain 6y ago
  100% there is a shortage of reagents and kits. There are certain countries that are not letting reagents and kits ship out, and we are in no position to call them out on that. >That doesn't stop the American press making it sound like not achieving those 500,000 tests a day is the result of some uniquely American political failing though. I don't think we're unique in where we are in comparison with other countries as far as testing, but we are in a unique position in regards to being able to put some strong leverage on getting other countries to work together to respond to this pandemic. We're not doing that and as a result, other countries are having to "roll their own" response to this pandemic just like we are. The lack of coordination within our country is putting us at a unique disadvantage, even if we had better coordination world wide. This pandemic is a exceptional global crisis in a way we've never seen before, and thus should've led to a addressing it at a global scale in a way we had never seen before. Instead the global response has been crippled in numerous ways at various different points in time. The American political failing is in not being the true world leaders, and the world is, IMHO, worse off for it.
adrianmonk 6y ago
I completely agree that increasing test capacity is the thing that blocks everything else, and we need to solve that first. But in order to try to generate the political will and get the backing to make this happen, it helps to get the word out about the big picture of exactly why having so many tests is important. New legislation is coming that provides some funding for testing, but out of $484 billion that it authorizes, only $25 billion in it for testing[0]. Meanwhile, a report from Harvard estimates that $50 to $300 billion will be needed[1]. So the amount of money made available so far is 1/2 to 1/12 of what one source has estimated that we need. --- [0] https://www.cnbc.com/2020/04/21/coronavirus-senate-passes-484-billion-small-business-relief-bill.html https://www.cnbc.com/2020/04/21/coronavirus-senate-passes-48... [1] See Appendix B starting on p. 42 of this PDF: https://ethics.harvard.edu/files/center-for-ethics/files/roadmaptopandemicresilience_updated_4.20.20.pdf https://ethics.harvard.edu/files/center-for-ethics/files/roa...
- polygotdomain 6y ago
  The political will should be fewer American lives lost. Politicians are framing this about the economy and states rights and other BS as a way to distract the public from the fact that people have died because we didn't act soon enough and decisively enough. I also don't think we need to get the word out about how testing is important. People are cooped up in their homes precisely because we don't know who has it and who doesn't. Testing could resolve that. I have little faith in the legislation from Washington for many reasons. The primary one being that before the crisis, during it, and at this very moment there is a lack of acknowledgment of the actual scale of this pandemic. Even worse a large part of the legislature fails to take this seriously, thus making the scale of the issue a secondary problem. What's been passed so far has already missed the mark as far as funding testing and properly ensuring that those who need the money get it. Instead, big business gets "relief" with little oversight, which given the past actions of this administration clearly isn't just by accident. The reality is that testing is still significantly behind and efforts to increase testing won't make the news cycles. I strongly doubt that we'd be able to scale up quickly enough to make a meaningful dent in this anymore than strictly following stay at home orders. Unfortunately even that is too much to ask us to do as a society it seems.
leereeves 6y ago
Are the numbers at https://www.realclearpolitics.com/coronavirus/ https://www.realclearpolitics.com/coronavirus/ accurate? Because according to that, adding up the number of tests done by Italy, Spain, France, the UK, and Germany (a combined population roughly the same as the US), they've done about 5.6 million tests vs the USA's 4.4 million tests. And we've done more tests per capita than South Korea. Which really doesn't sound like we're doing that badly.

mjul 6y ago

The Danish Serum Institute published an alternative workflow for testing without using the scarce reagent. Instead, they use an old method of heating the samples like boiling an egg. See Fomsgaard and Rosenstierne’s preprint on medrxiv here: https://www.medrxiv.org/content/10.1101/2020.03.27.20044495v1 https://www.medrxiv.org/content/10.1101/2020.03.27.20044495v...

makomk 6y ago

There's, frankly, probably not enough reagents and consumables on the planet for the US to achieve 500k tests a day. As far as I know no country anywhere has managed this level of testing. Germany - who've been doing the best at testing lately - have been stuck at about 50,000 tests a day for a few weeks now, maybe even decreasing slightly. If you take into account the difference in population, that's only the equivalent of the US doing 200,000 tests a day - and of course scaling up to a larger population is harder. That doesn't stop the American press making it sound like not achieving those 500,000 tests a day is the result of some uniquely American political failing though.

ahartmetz 6y ago
There are even plans to increase testing to 4,5 million(!) tests per week in Germany, or ~650k per day. Currently there is unused testing capacity, so it looks like the old restrictive conditions for testing (basically: symptoms and (contact to infected person or stay in high risk area)) are still in place and should be updated ASAP.
polygotdomain 6y ago
100% there is a shortage of reagents and kits. There are certain countries that are not letting reagents and kits ship out, and we are in no position to call them out on that. >That doesn't stop the American press making it sound like not achieving those 500,000 tests a day is the result of some uniquely American political failing though. I don't think we're unique in where we are in comparison with other countries as far as testing, but we are in a unique position in regards to being able to put some strong leverage on getting other countries to work together to respond to this pandemic. We're not doing that and as a result, other countries are having to "roll their own" response to this pandemic just like we are. The lack of coordination within our country is putting us at a unique disadvantage, even if we had better coordination world wide. This pandemic is a exceptional global crisis in a way we've never seen before, and thus should've led to a addressing it at a global scale in a way we had never seen before. Instead the global response has been crippled in numerous ways at various different points in time. The American political failing is in not being the true world leaders, and the world is, IMHO, worse off for it.

adrianmonk 6y ago

I completely agree that increasing test capacity is the thing that blocks everything else, and we need to solve that first. But in order to try to generate the political will and get the backing to make this happen, it helps to get the word out about the big picture of exactly why having so many tests is important. New legislation is coming that provides some funding for testing, but out of $484 billion that it authorizes, only $25 billion in it for testing[0]. Meanwhile, a report from Harvard estimates that $50 to $300 billion will be needed[1]. So the amount of money made available so far is 1/2 to 1/12 of what one source has estimated that we need. --- [0] https://www.cnbc.com/2020/04/21/coronavirus-senate-passes-484-billion-small-business-relief-bill.html https://www.cnbc.com/2020/04/21/coronavirus-senate-passes-48... [1] See Appendix B starting on p. 42 of this PDF: https://ethics.harvard.edu/files/center-for-ethics/files/roadmaptopandemicresilience_updated_4.20.20.pdf https://ethics.harvard.edu/files/center-for-ethics/files/roa...

polygotdomain 6y ago
The political will should be fewer American lives lost. Politicians are framing this about the economy and states rights and other BS as a way to distract the public from the fact that people have died because we didn't act soon enough and decisively enough. I also don't think we need to get the word out about how testing is important. People are cooped up in their homes precisely because we don't know who has it and who doesn't. Testing could resolve that. I have little faith in the legislation from Washington for many reasons. The primary one being that before the crisis, during it, and at this very moment there is a lack of acknowledgment of the actual scale of this pandemic. Even worse a large part of the legislature fails to take this seriously, thus making the scale of the issue a secondary problem. What's been passed so far has already missed the mark as far as funding testing and properly ensuring that those who need the money get it. Instead, big business gets "relief" with little oversight, which given the past actions of this administration clearly isn't just by accident. The reality is that testing is still significantly behind and efforts to increase testing won't make the news cycles. I strongly doubt that we'd be able to scale up quickly enough to make a meaningful dent in this anymore than strictly following stay at home orders. Unfortunately even that is too much to ask us to do as a society it seems.

leereeves 6y ago

Are the numbers at https://www.realclearpolitics.com/coronavirus/ https://www.realclearpolitics.com/coronavirus/ accurate? Because according to that, adding up the number of tests done by Italy, Spain, France, the UK, and Germany (a combined population roughly the same as the US), they've done about 5.6 million tests vs the USA's 4.4 million tests. And we've done more tests per capita than South Korea. Which really doesn't sound like we're doing that badly.