23 ms·

A Third Solution

• tlb 6y ago
  You can rank people by the likely benefit of testing them. Interestingly, it goes up as the square of the number of people they interact with daily. (Because their risk of having it increases, and also the number they are likely to spread it to.) So you can allocate tests by sorting by (# of daily contacts in a closed space) ^ 2. But as PB says, it should be practical to test everyone every day.
  • saeranv 6y ago
    Curious to know how you are getting power of 2 exactly. Are you just saying it's some sort of power law growth and approximately 2, or is there an actual way of deriving it?
    • texasbigdata 6y ago
      Wouldn't it also vary by percent of population without immunity, perhaps demographics in the underlying population, and other environmental things (weather?). Seems like a (useful) aproximation.
    • tonyarkles 6y ago
      If you have N nodes and completely connect the nodes, there are O(N^2) edges. This comes from the formula for the sum(1...N). Edit: I’m not sure I interpreted the original statement correctly.
      • dr_zoidberg 6y ago
        That's what I was about to answer. That's where squaring comes from, in this case. However, as others have noted, you could just sort by # of people contacted, since squaring just gives you larger numbers for no benefit in analysis here.
    • scythe 6y ago
      If we assume (key) that the probability of becoming infected is directly proportional to the number of people you interact with, and consider that the probability of spreading infection given that you are infected is obviously directly proportional to the number of people you interact with, the product gives a quadratic function: [probability of becoming infected and spreading] = [probability of becoming infected] * [probability of spreading] ~ [people you meet]^2
      • saeranv 6y ago
        Okay so something like: probability of spreading = a * n probability of infected = b * n where: a,b = some blackbox function for spreading/infection ratio? n = number of people you meet Assuming both are independent events we get: p = a * b * n^2 I can see how we get n^2 with that. The way I'm using a, and b seems clumsy though, is there a better way?
        • scythe 6y ago
          In math and (especially) physics it is common to express "proportionality" laws usually with a symbol that looks like LaTeX \propto. So for instance the activity A of a radioactive sample is written A \propto e^(-t/T) where t is time and T is the mean lifetime of a single particle. For convenience \propto is often transliterated as ~ when typing. So that becomes p_catch ~ n p_spread ~ n p_relay = p_spread * p_catch ~ n^2.
          • saeranv 6y ago
            Thanks, that's a much clearer way to think of it.
      • deleted 6y ago
        [deleted]
      • argonaut 6y ago
        This isn't quite right. For one, the probability of being infected is not linear (it's capped at 1). If you do the math, the expected number of people you infect (given you are not infected) is roughly linear-ish.
  • tmoertel 6y ago
    Since squaring is a monotone transform over nonnegative numbers, why not just sort by (# of daily contacts in a closed space)?
• triyambakam 6y ago
  The article begins by stating that this is not like the flu, yet we know people die from complications or directly from the flu every year. And further, we're seeing more and more evidence of huge numbers of the population with antibodies, i.e. already infected and immune. We also have seen the damage that using ventilators have had due to misunderstanding how this virus starves the body of oxygen (through the blood, not like pneumonia). We should continue to focus on treatment and realize that treatment along with population immunity is the best way to handle it now. Waiting a year for a vaccine that may not work or rushing a poorly tested vaccine is not good.
  • roywiggins 6y ago
    It's not the flu because the infection fatality rate is almost certainly a lot higher, we have no vaccine, and no reliable treatments. Seasonal flu has (semi-reliable) vaccines and antivirals and is almost definitely significantly less deadly. Look at the excess death statistics. There's no question that it's deadlier than seasonal flu, because the seasonal flu doesn't kill a 9/11s worth of New Yorkers above the usual death rate over several weeks. If the current rate wasn't slowing we'd be looking at a death toll multiple times higher than the seasonal flu. About 20% of people in NYC showed a positive antibody test. That's not nearly enough for herd immunity and it's not enough to push the infection fatality rate as low as the flu's.
    • triyambakam 6y ago
      Is it actually excess deaths? So many deaths are being counted as covid-19 that it looks more like we have the same amount of total deaths by all causes and any other year
      • roywiggins 6y ago
        Sure looks that way to me. The spike is larger than 9/11. https://www.nytimes.com/interactive/2020/04/10/upshot/coronavirus-deaths-new-york-city.html https://www.nytimes.com/interactive/2020/04/10/upshot/corona...
• darkerside 6y ago
  Solutions like this give me hope that we can actually return to something resembling normal life in the future. I hope Paul's got everything he needs in funding and resources to pursue all three of his goals.
• uhnuhnuhn 6y ago
  Can we stop hyping blog posts by tech people writing about epidemiology and medicine? I'm shocked how much baseless speculation and misinformation is being shared on HN.
  • Ididntdothis 6y ago
    I tend to agree. Maybe medical people should start having opinions on software architecture after reading a few articles. They may have some fresh ideas. Or not?
    • dekhn 6y ago
      I've worked in both fields. Few people who are experts in one of those fields can be useful in the opposite field, but there are some exceptionally productive individuals who are. Reading through Bucheit's article, he seems to fall into the 'wow, biology is really easy, you just have to do <X> and the problem is fixed' camp. In my experience, that does not correlate with a good understanding of how to produce a successful medical diagnostic.
      • Ididntdothis 6y ago
        "you just have to do <X>" I have told a lot of people who said this "Just do it yourself. I don't know how to just do it". It's so disrespectful. "Just convert everything to micro services written in Go and all your problems will go away".
  • newacct583 6y ago
    He's not. He's hyping his biomedical startup which is trying to make a cheap plasmon covid test. Whether or not he's right, that's sort of right at the HN sweet spot for relevance. Will it work? God I hope so, but it doesn't seem prudent to bet on it. We know several existing technologies for covid testing that will work. We know they can scale. We know how expensive they are. And while they aren't cheap, we know can afford it at the federal level. That we still refuse to actually pull the trigger on mass testing and announce a program to fund and launch a universal covid testing regime is just infuriating. I mean, I desperately hope that a magic bullet like this will pop up to save us. But we know how to beat this. We just won't.
• marcell 6y ago
  > First of all, it’s not “just the flu”. It is something much more dangerous. Catching this virus is a bit like playing a round of Russian roulette. You’ll probably be fine, but you could end up dead I think this is mischaracterizing it. People have to die eventually. One year of existence has a mortality rate of 1%. For a 75-84 year old individual it is nearly 5%. Above 85 it's 14%. [1] The coronavirus infection fatality is likely around 0.5-1%, but it's heavily skewed towards older individuals. Younger people do die from it, but a very low rates. And young people die from other causes as well, the annual mortality rates for a 20-something is around 0.1%. Getting coronavirus for a 20-something or 30-something is roughly equivalent to the mortality rate of a few months of life. Death is sad and terrible, but we don't shut down society because people die. [1] https://www.mdch.state.mi.us/osr/deaths/ageadjdxARS.asp https://www.mdch.state.mi.us/osr/deaths/ageadjdxARS.asp
  • johnnyo 6y ago
    The things that generally kill Americans (heart disease, cancer, car crashes, diabetes, etc) aren’t contagious, so this is a bad analogy.
    • marcell 6y ago
      No analogy is perfect, but people need context to understand fatality rates, and see what risk is acceptable. Society doesn't have a goal of 0% death rates. We all accept some risk of death as a cost of continued existence. New data is showing that the fatality rate from covid-19 is more like existing risk we were all previously exposed to in the course of our existence, and not like a second version of smallpox.
      • johnnyo 6y ago
        As you said, you gotta die of something. If the covid rate equals the regular rate, then the US death rate would effectively double if we simply did nothing. That’s assuming no second order effects like a shortage of medical care making things worse.
• troughway 6y ago
  Another round of fear porn. I really wish HN would tone this down, because these articles/blog posts do not actually help or offer new insights in any way. This "Third Solution" has been offered all the way back in February. It suffers from the same lack of information around reinfection and spread rates as it did the first time around.
• jawns 6y ago
  > If we were able to identify and quarantine everyone who is contagious, including those who are asymptomatic, then we could let everyone else out of lockdown and resume ordinary social and economic activity. > Even with imperfect screening, if we are able to prevent 90% of disease transmission, then the virus’s reproductive number, or R0, will drop below one and the pandemic will quickly fade. There is no risk of reintroduction from the outside because any new outbreaks will quickly be caught and contained. If used consistently, there will be no second wave, ever. I'm not sure this "test and release" strategy works unless absolutely everybody gets tested simultaneously. Even if testing of the total population can be completed in a week (a highly ambitious timeframe), there's still time for people released on Day 1 to be reinfected by people who don't get tested until Day 6. Then you have to go through who knows how many follow-up rounds of testing absolutely everybody not in quarantine to identify those people. When responding to new outbreaks involves re-testing large populations of people, you're going to run into many problems. Notification, compliance, testing fatigue, etc. Sounds like a logistical nightmare.
  • pb 6y ago
    It's daily screening for exactly that reason. Is there something I should change to make that more clear?
    • jawns 6y ago
      But how realistic is daily screening on a wide scale? You're going to face major issues with compliance.
      • pb 6y ago
        That's why I think testing at the door is the more straightforward way to start. We can reopen factories, office buildings, even shopping malls, but no one gets in without passing the screen.
        • xyzzyz 6y ago
          What door? You mean my front door? I'm not letting anyone in, and I'm not leaving either. What are you going to do, call the cops to kick in the doors to test me?
• caymanjim 6y ago
  This isn't a unique idea. This is the mainstream view. Everyone knows we need more testing and that testing is the only way to effectively ease distancing rules. That was a pretty extensive writeup to say what we've been hearing from all rational information outlets for a month.
  • pb 6y ago
    I have not found any mainstream sources that advocate screening everyone every day (which is very different from simply doing "more testing"). Would love some pointers if I'm wrong.
    • scott_s 6y ago
      Paul Romer, an economist at NYU, has been advocating for testing millions of people a day for a few weeks. He is co-author of a piece in The Atlantic, "Without More Tests, America Can’t Reopen", https://www.theatlantic.com/ideas/archive/2020/04/were-testing-the-wrong-people/610234/ https://www.theatlantic.com/ideas/archive/2020/04/were-testi... Googling for "romer covid 19" should turn up a lot of news sources covering the notion of testing millions of people a day.
      • pb 6y ago
        Yes, he is the best I've found. This proposal is still at least an order of magnitude more testing though :) (on the order of 100 million tests/day, not 1 million tests/day)
        • scott_s 6y ago
          Romer has called for as much as 30 million tests a day, which I think was based on some simplistic modeling. I think he was targeting everyone in the US being tested every two weeks. I think the two approaches are similar: let's test lots of people all the time, however many X million tests a day that is, so that we can quickly isolate and treat them. People are spreading it before they know they have it, so let's just test everyone all the time and not wait until they have symptoms.
• 762236 6y ago
  One way to achieve ubiquitous screening is for people to perform regular VO2max tests (loosely speaking; you can do submaximal exercises for this). You quickly figure out if you have a stress on your immune system (by watching various metrics), and there are sports-science papers showing this (because they use it to avoid overtraining, which also appears as a stress on the immune system). This is of course not easy to achieve with our current culture. It used to be that physical achievement was valued. Only a small fraction of society pushes against their VO2max in a regular way that can be measured and tracked to detect the immune-system stress. If people were to pursue this approach, they'd become a lot healthier in general.
  • texasbigdata 6y ago
    Your "sick" vo2 might be above my "healthy" vo2. So you first need to get 300 Americans on a max treadmill test to baseline, then.....
  • tlb 6y ago
    Doesn't a VO2max test take 20 minutes, plus a shower afterwards? That sounds significantly more expensive than collecting vials of saliva. Also, you'd definitely need to do those VO2max tests in separate, sealed rooms because infected people would be huffing out maximum virus.
    • maxerickson 6y ago
      Exercise watches claim to estimate it accurately. I'll give my Garmin 645 credit for consistency day to day, though I have no idea how close it is to giving the correct value.
  • PeterisP 6y ago
    This seems like something that would detect symptomatic patients only, I haven't heard of any research showing that patients would see lowered oxygen saturation in the early stages of infection. So for people who are going to get sick it would trigger too late, letting them spread the infection for days until this test catches it; and all the many infected people who will never develop any symptoms (perhaps up to a half of infected according to the Iceland tests?) would never 'fail' this test, but still go on infecting other people.
• DrNuke 6y ago
  Cheap & working saliva test would be such a tracking game changer that I am really hoping it works, so good luck!
• temac 6y ago
  There are insanely high amount of speculation in there. To my knowledge no significant amount of non droplet or hand-to-face contamination as been demonstrated out of medical contexts where aerosolization is more a problem, because of technical gestures and cares. Even the linked page supposed to serve as a reference is completely speculative on the subject of the potential for the virus to be airborne: "In addition, it is possible that SARS-CoV might be spread more broadly through the air (airborne spread) or by other ways that are not now known." So yeah, it also has not been proven that airborne transmission does not happen. But there are no strong signs showing we should highly worry about that highly speculative subject. The main contamination paths are well-known: droplets, and hand-to-face. If you want to strongly reduce the rate, you must focus on that. > Even if we don’t avoid the virus 100%, reducing it by 80% could be the difference between something mild and something life-threatening. This could be a reason why so many otherwise young and healthy doctors and nurses have been killed by this virus. Yeah, no. This is also completely speculative at this point. There is no strong technical reason for why it should be the case, given how viruses work... So not completely impossible, but short of real reasoning and evidences and studies, this is not a theory to particularly to focus on... ANYWAY, it is a good idea to avoid spreading the virus on all surfaces, but simply because this will statistically reduce the contamination rate (maybe without any impact on the severity for those who will be contaminated) More generally, I'd like essays on that subject from people working in the medical field. And I'd probably not like essays on CS from virologists and epidemiologists...
  • dang 6y ago
    Can you please make your substantive points without swipes? Controversial threads tend to devolve into people swiping at each other, and emotions run especially high in a crisis. I don't think there's any reason to exclude an article on the basis of who wrote it. Articles should be excluded because they're off topic, bad, or uninteresting. Essays on CS from virologists would likely be of high interest to this community. Besides that generic argument, which has become a bit of a shallow dismissal lately, there's the fact that pb is writing about a project he's personally involved in and which hasn't been discussed here before. It's understandable if there's interest in that.
  • FrojoS 6y ago
• gowld 6y ago
  > (less than $1/test). How much less than $1? $6B/day is a lot of money.
  • baggy_trough 6y ago
    Not on the scale the world is blowing up wealth right now.
  • ak39 6y ago
    It's a lot of money in toal. But if the costs could be are borne by the customer or service provider or employer equally or proportionally, then it is a viable alternative to complete shutdown of businesses. (The total cost of 50c drinking straws or coffee cups daily is also in the billions but we don't see it that way.)
  • PanMan 6y ago
    The USA could pay 6B/day for over a year of the current stimulus package. And that would be paying for the whole world. For the Netherlands it’s a similar amount (for a year) as what we just put in one airline. So it’s peanuts. Employers could Easily pay this for staff, people could pay it for events, etc.
• downerending 6y ago
  This is a pleasant thought, but we can't even get most people to obey speed limits most days, even though it's far easier and we know it would save large numbers of lives.
  • jedberg 6y ago
    He's proposing scanning when you enter a public space. Public spaces generally comply with these types of things because of the fear of getting caught by random inspections and steep fines and penalties.
    • downerending 6y ago
      That actually does sound a lot like the situation with speeding on freeways, at least in flyover country.
  • clairity 6y ago
    strictly speaking, speed in and of itself isn’t the primary problem, it’s distracted driving in its many forms. speed only makes the severity of those accidents greater.
    • philwelch 6y ago
      That doesn’t really make sense. If you’re driving too fast, even with perfect focus you could hit someone or something before your normal reaction time could recognize and avoid it.
      • clairity 6y ago
        you’re missing the second half of the random chance argument. you could also have driven right past a collision that would have happened at a slower speed.
        • philwelch 6y ago
          That makes no sense. The “collision that would have happened at a slower speed” wouldn’t happen at a slower speed because you’d see it coming in time to react and avoid it.
• IdoRA 6y ago
  I’m having difficulty understanding why SPR would be more scalable than LFAs for this type of frequent screening? And what does the ROC look like for this startup’s SPR assay? Frankly, I don’t understand how this test is supposed to work, and I’ve used a Biacore! It might be helpful to have a technical explanation available, for domain experts to evaluate.
  • s0rce 6y ago
    There didn't seem to be any details at all. Is there some sort of functionalized surface that specifically binds the virus, if so what molecule/chemistry, how? edit: this is all I found about the company: https://www.sbir.gov/sbirsearch/detail/1564207 https://www.sbir.gov/sbirsearch/detail/1564207 https://innovation.medicine.umich.edu/portfolio_post/sepsis-risk-measurement-device/ https://innovation.medicine.umich.edu/portfolio_post/sepsis-...
    • deleted 6y ago
      [deleted]
    • predxionbio 6y ago
      Good sleuthing! As you suspect we functionalize the our sensor surface to specifically bind the virus. We've partnered with a therapeutics company developing highly specific monoclonal mAbs against SARS-CoV-2 which we leverage in our diagnostic platform.
• seafoam 6y ago
  Thank you Paul. Two questions : Does this approach bypass the reagent shortages ? What are the specificity / sensitivity metrics ?
  • predxionbio 6y ago
    Couple of things at play here. First is we are developing a non-PCR based viral detection test. Many of the molecular tests approved rely on many of the same ancillary components (RNA extraction kits, flocked nasal swabs, viral transport media) as well as instrument systems. What we are developing is a non-molecular based test to directly detect SARS-CoV-2 particles in fluids, specifically saliva. We've just begun our clinical testing so don't have specificity/sensitivity metrics yet, but will be sharing them when they're available.
• mehrdada 6y ago
  We should censor pb because it goes against ‘official WHO advice’ </SARCASM>
  • MiguelVieira 6y ago
    This is what the WHO has been saying for a while. From over a month ago: https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---16-march-2020 https://www.who.int/dg/speeches/detail/who-director-general-... "But we have not seen an urgent enough escalation in testing, isolation and contact tracing – which is the backbone of the response. Social distancing measures can help to reduce transmission and enable health systems to cope. Handwashing and coughing into your elbow can reduce the risk for yourself and others. But on their own, they are not enough to extinguish this pandemic. It’s the combination that makes the difference. As I keep saying, all countries must take a comprehensive approach. But the most effective way to prevent infections and save lives is breaking the chains of transmission. And to do that, you must test and isolate. You cannot fight a fire blindfolded. And we cannot stop this pandemic if we don’t know who is infected. We have a simple message for all countries: test, test, test. Test every suspected case. If they test positive, isolate them and find out who they have been in close contact with up to 2 days before they developed symptoms, and test those people too."
• davidwhodge 6y ago
  How can people help you succeed?
• buboard 6y ago
  This assumes that "economic activity will restart". Humans won't participate in dangerous activities. They may test the waters e.g. by ggoing to gyms, but as soon as a single case is found they 'll be scared back into their homes. It will happen even more so as the disease spreads and people learn about the death of someone they know. This will happen regardless of how much testing. If you 're doing contact tracing right, you should need to test very few people per million every day. If you need to do a lot of testing, you ve probably already lost and will be forced to shutdown again. The solution is probably the second: antivirals. OTOH i wonder what's the effectiveness of optical-based methods to detect viral particles: https://phys.org/news/2006-11-laser-nanotechnology-rapidly-viruses.html https://phys.org/news/2006-11-laser-nanotechnology-rapidly-v...
  • SpicyLemonZest 6y ago
    If humans were so extremely risk averse that a single case is unacceptable, wouldn't we have naturally isolated ourselves without requiring lockdown orders?
    • js8 6y ago
      No, because while many humans are risk averse, we also live in certain cultural circumstances that prevent us to make that decision unilaterally. For example, I cannot just tell my boss, I am working from home, even though in my case there is no problem. Even if he allows, the company policy might not. (Although I am lucky I live in a sane country and we have that policy now.) Or in Czechia, now everyone wears a mask (since it is mandatory). It became a norm in like 2 days, one day almost nobody had them (and people felt that wearing them makes you look sick), the next day they became mandatory in public transport, and the day after everybody had them. There are other examples like that, where the peer pressure plays an important role (in preventing humans to make rational decisions).
    • buboard 6y ago
      they did not know how dangerous it is. i think attitudes will change everywhere
• levpopov 6y ago
  Paul, is there anything HN readers can do to help with this?
• husein10 6y ago
  PB, can you elaborate on which other possible answers you've found for fast, easy, and abundant tests? I'm working with a team that has a test that detects proteins associated with covid. It works like a pregnancy test and does not need a special scanner. Would love to discuss further.
  • pb 6y ago
    I'd love to hear more! Part of the reason I put this out is to encourage other people with technology for fast, easy, cheap testing come forward. Is your protein test able to detect as soon as people become contagious? That's where a lot of ideas fail, but I think getting R0 < 1 likely requires it.
• stonogo 6y ago
  Not only is it completely unrealistic at scale, the specific approach in the blog post is wildly impossible at all. It requires screeners to directly manipulate saliva samples; this is dangerous in a pandemic. The assays referred to (lazily) in a Google Scholar search are almost overwhelmingly antibody assays; this does not allow the screener to differentiate between "has COVID-19" and "had COVID-19". Also, there is no evidence that the described test actually exists. Finally, maybe irrelevantly, there is no way in hell you're going to get people at large to stand around for two hours a week waiting for test results. Ten minutes for a screening whenever you try to enter a public building; that's ten minutes to get into work, and we'll say ten minutes to get into another place each day. "But wait," I hear you say, "you only need to be screened once per day, and the first place can share that data with the next place." This plan was constructed by someone who is unfamiliar with medical records laws. This is no "third solution." It's an engaging thought experiment, but it's just too far away from reality to get here from there.
  • vikramkr 6y ago
    I might be misreading your comment, but I don't think the blog is promoting antibody testing? It sounds like the blog is about a method of detecting viral particles directly, perhaps using an immunoassay based on the wiki for SPR, but not to test for antibodies directly. And in terms of medical records laws, the regulatory environment has loosened so quickly with the advent of this virus that I'm sure regulators and legislators will be favorable to making it easier for the company if the test demonstrates the appropriate sensitivity and specificity in clinical trials. People are getting reimbursed for sending emails to patients, health visits done over zoom, would have been impossible to imagine this level of regulatory flexibility just six months ago.
  • newacct583 6y ago
    Not to quibble too much with most of your criticism, but this one seems minor and trivially solved: > this does not allow the screener to differentiate between "has COVID-19" and "had COVID-19" As a policy matter, this doesn't rule out the use of the test in a pandemic management protocol at all, it just changes how it needs to be administered. For example it might require that people who are antibody-positive have a standardized note confirming recovery (in Contagion, this was a cute electronic bracelet). The critical requirement is that we detect unknown positives, and this test would do that.
• arcticbull 6y ago
  > First of all, it’s not “just the flu”. It is something much more dangerous. It is for some demographics, not all. It's safer than the flu for young folks, especially the under 10's which the flu hits pretty hard. For some it's worse, especially over 70s. > Catching this virus is a bit like playing a round of Russian roulette. You’ll probably be fine, but you could end up dead. Also true of the flu. Yes, even for the seemingly young and healthy. It's amazing how freaked out people are getting over this. All the data points to it being worse than the flu, but not drastically [1]. Certainly not "immunity checkpoints at all building entrances" worse, it's not ebola. [1] http://cebm.net/oxford-covid-19-evidence-service/ http://cebm.net/oxford-covid-19-evidence-service/
  • macintux 6y ago
    But unlike the flu there’s significant spread from asymptotic people, so the young are walking time bombs.
    • arcticbull 6y ago
      That doesn't really change anything. To the extent the vulnerable are holed up inside, everyone else is welcome to get it, display mild flu-like symptoms, and develop herd immunity.
      • jhayward 6y ago
        You repeat the fantasy that the more vulnerable population is separable from the less vulnerable. As well you omit the size of the vulnerable - everyone who is obese, diabetic, hypertensive, or cardiovascular diseased, or immunocompromised. The first is just a fantasy - no one has an actionable plan to do it. The second proves the size of the problem, which exacerbates the difficulty.
        • arcticbull 6y ago
          Again, as always, Sweden seems to be doing it just fine.
• epicureanideal 6y ago
  Let's hope this works, and if it does, that we use it for every other kind of disease as well. I'd sure like to never get the flu, or the common cold again, because we brought their R0 to near 0 also.
• fzeroracer 6y ago
  I don't think this tracks. What do you do if someone denies the test? You can deny them entry, but if they protest or decide to force the issue, then the police have to deal with it. Then if the police get sick, they have to self-quarantine, and what do you do when you don't have the power to enforce the test? Even if we managed to dress up our entire police force in hazmat suits to reduce the risk of infection, they can still infect people out and around the building. Turning away someone doesn't mean we're reducing the R0, we're just moving someone that's infected around. Given that there are asymptomatic people (and a certain number of people that would likely claim the test is a false positive or fake), all we're really doing is encouraging more people to gather in a single location as a potential infection vector. Let's assume next then that somehow we had an automated solution. All the doors to said buildings are locked unless you complete a saliva test to go through. Barring the huge logistical concerns, we're still dealing with potentially infected people spreading the virus on surfaces and areas that people are travelling to and from. Tech isn't going to save us from COVID-19.
• deleted 6y ago
  [deleted]
• gremlinsinc 6y ago
  I doubt people are going to want to do this everywhere they go. It's definitely good though to have more testing options. I've seen posts of using drones to detect 'sick' people... could they create a drone w/ some sort of scanner and microscope that could actually detect covid19 in the air? Imagine if it could spot it on surfaces, air, etc...might be a bit dystopian, but at least it'd have a further reach than voluntary testing enmasse.
• vikramkr 6y ago
  Really interesting read and sounds like it could be a game changer for testing - I know in NY we've been clamoring for increased testing for a while to help us reopen. I've got two questions I'm curious about: 0) Sensitivity/specificity: Any data yet on what the sensitivity and specificity of this form of test for SARS-COV-2 will be? And, is work in characterizing all of that far enough along that we can expect to see emergency authorization by the FDA and scale up happening sooner rather than later? 1) Reagent supply: The biggest problem with PCR tests and all seems to have been reagent shortages and supply chains dependent on manufacturers not able to scale. Assuming the test is approved, are there any operational advantages to this approach in terms of securing reagents to overcome that problem? Thanks for the fascinating read!
  • predxionbio 6y ago
    0) From a clinical perspective this is data we are generating on an on going basis. Analytically this is a largely a function of the characteristics of the affinity, specificity of the capture molecule used to capture the target (viral particle). As you point out EUA gives opportunities to launch sooner... But it's still critical to validate technogies both internally and externally probably to a greater extent than the de minimus EUA reqs 1) great question. Our approach is novel which allows us to tap into new supply chains that are inherently more scalable (think semi-conductor Fab) but the trade off is execution risk.
    • vikramkr 6y ago
      Thanks for your reply! Makes sense with regards to the specificity and sensitivity. Are those more scalable supply chains ones that expose you to risk with international suppliers? My understanding, at least from what we've been hearing from our governor's press conferences (so take it with a big political grain of salt obviously), is that while we have high throughput machines capable of large numbers of tests, the reagent supply chains all go back to china leaving domestic companires reliant on international trade negotiations to be able to get the inputs they need to scale. Is that a valid type of concern and are there concerns that even if it's technologically easily scalable, the political and operational logistics of relying on third parties with different incentives could negate that advantage? I don't knwo how valid a concern that is, but that's the narrative we keep hearing here.
• rossjudson 6y ago
  The latest on the COVID-19 R0 is a median of 5.7, up from the previously thought range of 2.2 - 2.7. https://wwwnc.cdc.gov/eid/article/26/7/20-0282_article https://wwwnc.cdc.gov/eid/article/26/7/20-0282_article This means herd immunity kicks in at 82% of the population. Antibody testing appears to be showing infection rates are a lot higher than previously thought as well. Both of those things together mean that 1) "there's no way to stop it" 2) "it might not be as dangerous as we thought". But who knows, right? There's a ton of science that needs to be done to find out what's really going on. Large-scale, accurate, randomized testing will hopefully fill out the data picture. Because the US has an awful medical system where access to care comes through your job, it seems to me that more people will die (from non-virus causes) than from the economic damage than from the virus itself. I guess we'll know more in a few years.
  • usaar333 6y ago
    > The latest on the COVID-19 R0 is a median of 5.7 Pet peeve of mine: R0 is not a property of a virus; it's a property of a virus in a certain environment. 5.7 is the estimate for covid-19 in Wuhan, a dense environment. It is nowhere close to that in the vast majority of the United States -- estimates are <3 in say Seattle or Norcal. > Antibody testing appears to be showing infection rates are a lot higher than previously thought as well. > 2) "it might not be as dangerous as we thought". The more reliable ones are about what we did think on both points, at least for those who rely on Imperial College's models (https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30243-7/fulltext https://www.thelancet.com/journals/laninf/article/PIIS1473-3...) > "there's no way to stop it" Contact tracing is enough to keep r < 1. If we keep this thing at under 20 cases/million/day for the next few years until there's a vaccine, I think we can go about our lives.
  • buboard 6y ago
    > infection rates are a lot higher in certain urban cores. herd immunity requires well mixed populations
• arcticbull 6y ago
  > This could be a reason why so many otherwise young and healthy doctors and nurses have been killed by this virus. This isn't well supported by data. In the sense that (a) young people just aren't particularly affected any more so than with the flu (old and sick people of course are much worse off) and (b) in Italy's data, no health professionals under the age of 49 died. There have been some deaths outside Italy but on average the trend mirrors the broader trend: if you're young and healthy, you're just fine. [1, 2] I get that there's wide-spread panic, but we should allow the data to guide us where it exists. This isn't the time to spout off unsubstantiated fear-inducing commentary. We need to keep our wits about us if we're going to tackle this effectively. [1] Oxford CEBM, cached since it appears down: http://webcache.googleusercontent.com/search?q=cache:6rohagxzQR4J:https://www.cebm.net/covid-19/global-covid-19-case-fatality-rates/&client=safari&hl=en&gl=us&strip=1&vwsrc=0 http://webcache.googleusercontent.com/search?q=cache:6rohagx... [2] Original data here in Italian: https://www.epicentro.iss.it/coronavirus/bollettino/Bollettino-sorveglianza-integrata-COVID-19_26-marzo%202020.pdf https://www.epicentro.iss.it/coronavirus/bollettino/Bolletti...
  • danieltillett 6y ago
    While the young might rarely die, this illness is not something you want even if young. It can be pretty brutal and there is some evidence that it causes damage to lung even in the absence of symptoms.
    • arcticbull 6y ago
      > While the young might rarely die, this illness is not something you want even if young. To begin of course, you don't want any disease at any age. Setting that aside it's pretty clear that you're less likely to die of COVID as a child than you are of the flu (which hits both young and old). Children are less likely to develop any meaningful symptoms in the first place, and if they do, they're less severe. Lots of ongoing research on this. “The fact is that we are not seeing preponderance of severe [COVID-19] disease in young children, which is distinct from influenza...” [1] > It can be pretty brutal... Yup. > ...and there is some evidence that it causes damage to lung even in the absence of symptoms. [citation needed], specifically for children. [1] https://time.com/5816239/children-coronavirus/ https://time.com/5816239/children-coronavirus/
• tmsh 6y ago
  If the proposed test takes 10 minutes, as Steve Jobs would say, that's not good enough. Try to make it work in 10 seconds. Like a breathalyzer. Add more liquid to the solution if necessary. I am not a doctor, but am just imagining TSA-style x-ray detectors that you walk through, while issued a disposable container to blow into, and put back into the large spinner machine. A quick search actually reveals something: https://www.nsmedicaldevices.com/news/astrotech-breathtest-1000-covid-19/ https://www.nsmedicaldevices.com/news/astrotech-breathtest-1...
  • deleted 6y ago
    [deleted]
• thaumaturgy 6y ago
  After the whole Theranos debacle, I'm most curious how due diligence was done on this team and their technology.
• danieltillett 6y ago
  This is a solution that could work provided we have a rapid on the spot test. David States has recently proposed exactly such a test and apparently his company is woking on developing it [1]. The major problem with all self-testing and isolation strategies is getting population buy in and what to do about poor countries. It is difficult to get population buy in if the economic cost of being positive is high (which it would be for many). If people have to isolate for weeks then it will be difficult to get the working poor to test and/or quarantine themselves if positive. This virus is so infectious that even a small percentage of people not voluntarily participating is a problem. It might be possible to overcome this issue via some rewards (say a cash payment), but this would need to be carefully structured to not encourage people to infect themselves and/or fraud. A daily test is unlikely to be viable for most poor countries in the world. I am not sure how we would overcome this problem outside of a cheap vaccine. 1. https://twitter.com/statesdj/status/1253794887062958081 https://twitter.com/statesdj/status/1253794887062958081
  • tim333 6y ago
    I'm in a medium income country, Thailand and they do quite well testing people they think at risk and if you have it the government pays the costs of quarantine / treatment / some lost income. It works well. I don't see why similar won't work in poorer countries. They use regular PCR but a better test would just make things better I guess. It's odd that there seems a negative correlation between country wealth and how well they are doing with covid eg. Vietnam zero deaths, UK & USA a mess.
    • danieltillett 6y ago
      I not sure I believe that Vietnam has had zero deaths. How many tests is Thailand doing per day?
    • rhino369 6y ago
      The correlation is between countries who were harder hit with SARS. They were better prepared for this outbreak. But it's also a good deal of luck. Test and tracing works until you miss enough people that you get controlled community spread.
• ggreer 6y ago
  I really hope this works. Without some new testing technology, I just don't see how we can stop the spread of this disease. A month ago, the US did about 100,000 tests per day. Yesterday, the US did about 200,000 tests. Growth in testing started off as exponential but now it looks linear.[1] Even if testing capability doubled every month, it would take 8 months before we could test every American once a week. (200,000 * 2^8 == 51,200,000, which is 15% of the population.) It only took a couple of months for 20% of New Yorkers to get infected.[2] If we assume that half the population will get this disease over the next two years, and we assume an infection fatality rate of 0.3%, that's around 500,000 deaths. (328,000,000 * 0.5 * 0.003 == 492,000). Those are optimistic projections. The IFR is likely higher and the R0 is somewhere between 3 and 9[3], so that means at somewhere between 60% and 90% of the population needs to be infected before we get herd immunity.[4] Unless there are radical improvements in testing and/or treatment, I think we'll end up with at least 500,000 deaths in the US. That would mean we're about 10% of the way through this catastrophe. So strap in, it's gonna be a long ride. 1. https://twitter.com/COVID19Tracking/status/1253807175945744391 https://twitter.com/COVID19Tracking/status/12538071759457443... 2. https://twitter.com/NYGovCuomo/status/1253353516803993600 https://twitter.com/NYGovCuomo/status/1253353516803993600 3. https://wwwnc.cdc.gov/eid/article/26/7/20-0282_article https://wwwnc.cdc.gov/eid/article/26/7/20-0282_article 4. For the relationship between R0 and herd immunity, see figure 2 of this paper: https://academic.oup.com/cid/article-pdf/52/7/911/847338/cir007.pdf https://academic.oup.com/cid/article-pdf/52/7/911/847338/cir...
  • Marsymars 6y ago
    > Even if testing capability doubled every month, it would take 8 months before we could test every American once a week. At this point, I'd consider that a success.
  • ChaseT 6y ago
    Making this worse, the final size of an epidemic can be estimated as not p=1-1/R0, but rather p=1-e^-R0 [1]. With this, those R0 estimates give a final infected population of 95%-~100%... we can't let herd immunity be the solution. [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3506030/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3506030/
• swang75 6y ago
  An honest query by a non-medical professional as I'm sincerely curious... Paul advocates daily saliva-based testing, but as an intermediary imperfect, but "better than nothing" measure, what are the benefits and drawbacks of requiring people entering public shared spaces to have their body temperatures taken via handheld temperature guns or infrared monitors, a measure that's already taking place in much East Asia (Greater China, Japan, Korea, etc.) in public shared spaces like malls, restaurants, office buildings? My understanding is that these methods are not as accurate as direct thermometers or Paul's saliva-based test; nonetheless, they would detect a good portion of mildly symptomatic people and also have the benefit of externally signaling to the populace to continue "sheltering-in-place" if they have a fever. Is there any issue with supply chains? Or is there scientific evidence disproving the effectiveness of this precautionary measure that's already in place in so many regions that have already seemed to have crested the first wave of the pandemic?
  • pb 6y ago
    Thermometers are better than nothing, but unlikely to stop the spread because of asymptomatic transmission (easy to catch the virus from someone who doesn't have a fever). This is why I think directly detecting the virus is essential.
    • swang75 6y ago
      In a best-case scenario, what is the timeline for testing, widescale manufacture, and rollout including “last mile” education to end users for the saliva tests? Is it achievable within a quarter? 2020? Beyond? What’s the costs/benefits versus the temperature gun method already being used in Asia? I fear that “perfect” or “near-perfect” solutions such as daily saliva testing would be potentially unrealistic for widespread rollout in an effective amount of time. Could we perhaps consider prioritize the superior daily testing solutions for high-priority environments like first responders and hospitals and nurses while reserving the “less-than-perfect” solutions such as what’s being done in Asia for environments with other essential workers, at least until scale-up hurdles can be surmounted?
  • hjuijjytt 6y ago
• not_a_moth 6y ago
  A fourth way: We throw as many resources as we can at sampling undiagnosed populations, like the recent NYC study that suggests 20% of the city (10% of the state) has antibodies already. We could get real confidence that it's safe enough to return to normal, acceping that COVID is a new disease that's just going to be around, the 5th coronavirus that we deal with seasonally.
  • maxerickson 6y ago
    The arithmetic on that is ~1 million early deaths in the US. The screening in the article would cost billions of dollars. If it worked, we could then reuse the infrastructure to kill the flu. And then start on the colds.
    • not_a_moth 6y ago
      > The arithmetic on that is ~1 million early deaths in the US. Sorry that's baseless histeria. We can easily think through how healthy people go back to normal (exponentially lower fatality rate than elderly/sick), while vulnerable take more precaution, how then getting to 60% of population gives us herd immunity which grinds R0 to a halt. Then a vaccine arrives in 18 months. Not to mention heat/humidity/summer is being shown to slow the disease from recent studies.
      • maxerickson 6y ago
        New York (state) deaths per infection assuming ~10% overall spread: 10000/(0.1 * (20 million)) = 0.005 Arithmetic to scale that to ~60% of the US: 0.005 * 0.6 * 330 million = 990000 Of course that is hugely sensitive to the assumptions about the overall infection rate in New York and the immunity factor, but like I said, the arithmetic on what you said leads to ~1 million early deaths.
        • not_a_moth 6y ago
          No, if elderly/vulnerable continue precaution, more like range(.001 - .0001) x .6 x 330 million = 20k - 200k deaths Add in supposed summer slow down and before we get a vaccine the numbers could be 10x less There are 12k cases in Singapore and 12 deaths because they almost exclusively tested foreign worker dormitories, healthy working people (and the 12 are all elderly).
• aaron695 6y ago
  This is badly written but very much in the correct direction. Screw Vaccines and Cures, if these could 'just' be found for Covid-19 then we wouldn't have any sickness in this world. Work on both cheap and quick tests while we wait for the long, if even possible, timeframes of Vaccines and Cures. So why aren't Bill Gates self swabs out yet? https://www.gatesfoundation.org/TheOptimist/Articles/coronavirus-interview-dan-wattendorf https://www.gatesfoundation.org/TheOptimist/Articles/coronav...
• danieltillett 6y ago
  I hope everyone has noticed that if this approach could wipe out COVID-19 it could wipe out influenza and even the common cold.
  • deleted 6y ago
    [deleted]
  • krrrh 6y ago
    Imagine how naive our immune systems would become. It could have unpredictable effects, like increasing the rate of novel zoonotic disease transmissions. Maybe something like this is what set the stage for the common cold wiping out the aliens in War of the Worlds.
    • danieltillett 6y ago
      We would still be exposed to a wide variety of diseases even if there were no more common cold viruses floating around. The common cold viruses haven’t helped us deal with COVID-19 :(
      • krrrh 6y ago
        > The common cold viruses haven’t helped us deal with COVID-19 We don’t actually know that yet.
• refurb 6y ago
  I think the ubiquitous testing is the right approach, but I don't think we need a new test. Any test that requires a machine is going to be a severe bottleneck in testing. Far better to use one of the antibody test strips. Prick your finger to get blood, or spit some saliva on a strip and you know in 5 minutes if you have antibodies. Just keep testing everyone on a regular basis, and once they test positive, they are quarantined for 14 days. After that, they are assumed to be immune.
  • philwelch 6y ago
    Someone would be infected and contagious for awhile before developing antibodies though.
    • refurb 6y ago
      True, but that's unavoidable with every test. Even PCR doesn't work until you're body has produced enough viruses to be detected.
      • philwelch 6y ago
        Yeah, I think there's value in minimizing the period that someone is contagious but still tests negative though.
  • tim333 6y ago
    I tried to order some of those off Alibaba in feb. The current ones never took off because they don't work very well, I think.
  • predxionbio 6y ago
    I agree that reliable antibody tests will be a help to policymakers in how they model the continued stay-at-home posture and begin to open things back up. I think the jury is still out on 1. The persistence of the antibody response post-infection and 2. the neutralization/protection afforded by these antibodies. The development of antibodies requires either a vaccine or you to be infected. The rate of antibody protection in populations is certainly rising, but to get to meaningful levels of herd-immunity it would require all of us to get infected, lets say ~70%+ (obviously problematic), or rapid and major strides to be made in vaccination. Anecdotally, significant therapeutic, vaccination and diagnostic approaches are required to effectively respond to COVID-19. Its been incredible to be a part of such a widespread, organized movement within both the healthcare and tech communities as we collectively mobilize to respond.
• xivzgrev 6y ago
  The article proposes daily broad testing. I thought that is what governments were shooting for?
• stickhandle 6y ago
  Sounds like the start of a plan. My questions would be around those 10 minutes at the entry door. What do we do with people? How are they connected to the test? How do we keep separation between people? How do we grant access after the passed test? What happens to those around if someone is +ve?
  • korantu 6y ago
    Maybe it can be accompanied with an app which would send you test result so you don't have to literally queue. And then use the result to enter the building.
• mastermojo 6y ago
  We have Trump claiming things like "we don't have a shortage of tests" and "everybody who needs a test gets a test" and "the US is testing more people than every other country combined". These are daily press conferences broadcast on a national level. Unfortunately, rational information outlets are covering this too. Trump would rather pretend that we don't need more tests than admit to something the administration could do slightly better. I'm sure if we took the pulse of all Americans there would be a shockingly large number of people who didn't think testing was a big deal.
• zmmmmm 6y ago
  The post refers to an alternative method of testing for COVID-19 based on surface plasmon resonance that would have significant advantages, but unfortunately it provides absolutely no real substantiation that the test exists or works. The link about surface plasmon resonance goes to a generic Wikipedia page, the link about saliva is a small scale study that was conducted on RT-PCR not surface plasmon resonance, and the actual link to the team goes to a nothing more than splash screen with the company logo on it. If there is substance to this then it would be massively in Paul's (and the company's) interest to better link to that in both the post and the company web site. At the moment, it looks like at worst vaporware or at best, something so early stage it's years out from viability.
  • dekhn 6y ago
    He should also disclose any personal interest in it more clearly at the top of the article.
    • m3kw9 6y ago
      Yeah he def have skin in there
    • kordlessagain 6y ago
      At this point all our personal interests are to stay virus free as long as possible, given what we don't know might kill us. I really don't care why he's speculating about the things he is. Many of the things we postulate may be proven wrong simply by waiting long enough to get more data - i.e. it's not always necessary to formulate a test for disproving an idea, sometimes they evaporate on their own. (Software features for example frequently meet their ends this way). I just found out about Covid Toes. What will come tomorrow? And now, a shameless plug for a next-day delivered PPE from Amazon built from a full faced snorkel, a vacuum filter and a 3D printed adapter I designed: https://3dprint.nih.gov/discover/3dpx-013899 https://3dprint.nih.gov/discover/3dpx-013899. There's a video too, which shows a bit cheaper version's assembly: https://www.youtube.com/watch?v=wydRpFpQD4I https://www.youtube.com/watch?v=wydRpFpQD4I I haven't been into an indoor shared space without it on for almost 3 weeks. You probably shouldn't use Gorilla Tape on it, because it might off gas something. Try surgical tape.
• dekhn 6y ago
  I was curious about the company that's being touted in this post so I did a little searching. The website doesn't seem to have much on it. I guess it's a YC17 company. The founders are Caroline Landau, Tim Cornell, Walker McHugh. From 2016: Landau was an MBA candidate, the other two founders have biomedical research/medical backgrounds: Walker McHugh, Co-Founder, PreDxion Bio / Biomedical engineering candidate, University of Michigan Dr. Tim Cornell, Co-Founder, PreDxion Bio / Pediatric Critical Care Physician, University of Michigan (https://www.hbs.edu/openforum/openforum.hbs.org/goto/challenge/health-acceleration-challenge-2016/predxion-bio-faster-results-saving-lives.html https://www.hbs.edu/openforum/openforum.hbs.org/goto/challen...) At least until recently, the company focused on making diagnostics for immune disorders (microkine) for CAR-T patients which I can't find much detail on. I don't know if it's related to the SPR-based tests mentioned in the pb post. They received a government business grant (SBIR) in 2018 and have some VC funding. It looks like this post demonstrates their pivot to a specific infectious disease, and from a hospital provider setting to a public setting. As an ex-advisor to a successful (in bio) VC fund, this is not something I would really spend a lot of time considering. There are too many non-technical hurdles that would need to be jumped before this was widespread, popular, effective, and profitable.
  • new299 6y ago
    Right, I think we’ve probably missed boat on developing new diagnostic methods for Sars-CoV2. In particular, this method appears to be antibody based? (Which has accuracy issues) and uses SPR, which may involve some technical risk. However, I think there’s mileage in developing methods now for the next pandemic. My personal interest is in developing programmable qPCR-like systems [1]. So that kits can be deployed ahead of time, and then programmed to a specific target as required. If anyone is interested in discussing diagnostic approaches, please get in touch. [1] http://41j.com/blog/2020/03/thoughts-on-a-new-approach-to-viral-testing/ http://41j.com/blog/2020/03/thoughts-on-a-new-approach-to-vi...
    • predxionbio 6y ago
      I'm not familiar with the acronym PSM. Can you expand? Are you familiar with the work of Dr. Chui at UCSF? His group has done some really cool work using mNGS to detect/diagnose emerging/rare infections in critically-ill patients with refractory encephalopathy
• distantaidenn 6y ago
  This is essentially what South Korea did. Granted it was done in a different way but everyone was “tested.” I was there just as covid-19 was on the rise and every shop, every station, and every high traffic area had people set up with thermal guns. Shop staff were having their temps checked before their shifts started. Everyone was gloved and masked. And once they had a proper test in place it was made easily accessible — even set up drive through testing. And now they are pretty much back to normal while much of the world is still at a standstill.
  • jhwang5 6y ago
    But of course you need to package it as an unique, never seen before, game changing solution and write a blog post about it. He’s shilling his startup
  • toyg 6y ago
    They learnt from the previous SARS bout, reportedly thanks to a number of political factors aligning properly. The sad thing is that basically nobody else did, among major players. Even other countries in the area (i.e. Japan and China) just went “phew!” after SARS and didn’t substantially review their response strategies. Which is how China was caught napping, Japan is still fundamentally in denial, and everyone else got their asses handed to them by covid19.
    • user5994461 6y ago
      China had dispatched detachments of specialists to evaluate the unknown disease in mid December. They knew they were facing a new coronavirus ala SARS end of December and started closing Wuhan then other provinces in January. Not the chill lockdown like Europe, real lockdown where they close all transports, scan all citizens at checkpoints and have the police beatup people going out without masks. Napping is not the word for that.
• human 6y ago
  “It is my belief that the best cure for any disease is to avoid the disease.” https://m.imgur.com/dL807yM https://m.imgur.com/dL807yM
• ajarmst 6y ago
  I don't particularly disagree with any of this, but as a society, we have a bad habit of assuming that people with an impressive record of innovation and expertise in one field should be treated as authoritative in others. At the very least, they should take their idea to people with sufficient expertise to evaluate it before using their notoriety to take it to the public. I think Elon Musk, Steve Jobs, Linus Pauling and any number of failed unicorn startups should have taught us some caution. I don't want to know what a famed early architect of social media thinks about this topic, at least not before a famed virologist, immunologist or public health practitioner comments on it first.
• mastermojo 6y ago
  Why are there so many armchair quarterbacks in this thread spouting dismissive criticism? Paul already acknowledges that "success is far from guaranteed." If this works, great! If it doesn't, I don't think any of us are worse off... This seems like a heavy application of The Copenhagen Interpretation of Ethics https://blog.jaibot.com/the-copenhagen-interpretation-of-ethics/ https://blog.jaibot.com/the-copenhagen-interpretation-of-eth...
  • zaroth 6y ago
    I’d be less inclined to offer negative opinions on someone making a product that helped manage COVID and financially benefiting from that product, if it; 1) Actually helped solve a problem we face with COVID without doing more harm than good, and 2) Did so in a way that didn’t trample civil liberties with invasive daily tests before allowing someone to leave their house.
    • mrfusion 6y ago
      I wonder why we always jump to the China approach of forcing people to do things. Why not use an incentive system instead? You’d need a lot of work to design a good system but for example pay $100 for a positive test and proof that you isolated that day. (For proof of isolation maybe a system texts you at random times and asks for a picture of something in your house. Eg. 10:13am you get a text asking for a picture of a pillow.) Please don’t critique the plan, I’m only offering it as an example of an alternative to having the national guard show up on your doorstep.
      • tim333 6y ago
        You don't really need to pay. At the infectious disease place in Marseille they offered free tests, hundreds lined up to get tested and the the number of infections in community dropped dramatically.
        • mrfusion 6y ago
          Great point. I guess my thinking was to make sure folks could afford to isolate and increase compliance even more.
• zaroth 6y ago
  Dr. Fauci explained very clearly and simply the problem with daily testing. Fauci’s background is in AIDS. It’s what he’s worked on his entire career. With AIDS, you can take a test, come back negative, and a year later if you haven’t done any at risk activities, you can be assured you are still negative. Not so with SARS-CoV-2. With a virus as transmissible and prevalent as corona, you can test negative on Monday, and be shedding virus on Tuesday. A negative test gives you some confidence that you weren’t infected yesterday. It gives you no confidence that you weren’t exposed this morning. The final nail in the proverbial Daily Testing coffin, even aside from the absurd logistical challenges, even aside from the civil rights issues of baring someone from leaving their home unless they wear a special colored armband, the biggest problem is that it just doesn’t work. The false positive rates on a test like this will be high enough that daily repeated testing will give the average uninfected person a 50% chance of testing positive by the end of the week. Don’t forget that we now have evidence that even a 14-day quarantine is insufficient, and that totally asymptomatic people can shed virus. Ignoring that TFA is a sales pitch, which makes the whole thing rather nauseating, I hope that people will start taking a hard look at the absurdity of such a response, and perhaps not usher in a totalitarian regime with such open arms. There’s certainly some sick irony involved in this post’s title. Gives me shivers.
• justnotworthit 6y ago
  > With early detection, we can get the best known treatments From WHO: What is the treatment for the coronavirus disease? No pharmaceutical products have yet been shown to be safe and effective for the treatment of COVID-19. What is the author referring to?
  • agentdrtran 6y ago
    Assuming he's speaking in the more general sense, but who knows? he's an engineer and not an epidemiologist or a doctor.
  • pb 6y ago
    The best known treatment at the time the infection is detected. That can be as basic as rest and hydration, but hopefully we'll have something better down the line.
• esahione 6y ago
  A fourth solution: force the boomers and vulnerable to retire. Let's bail them out. Let the young take control of the economy. Everybody wins.
  • mkl 6y ago
    Younger people get it too, and some die. Not only that but many older or vulnerable people live with or depend on younger people. Separation like you suggest is simply impossible, and your misbelief that young people are invulnerable is dangerous.
    • esahione 6y ago
      It's like the cold for young people. Stop being a pussy. Everything can kill including driving. We are all going to die.
• mrfusion 6y ago
  It’s a cool solution but I don’t like the fear mongering at the beginning. Reminds me of this (0) If you’re a numerate person you’ll know it’s very unlikely you’ll lose a leg to corona virus. People argue that the fear is needed to keep people accepting quarantine but I’d submit that honesty is the best policy. We need to find a way to make honesty work. The alternative is people losing trust in science the more they’re misled. In the event his solution isn’t a available soon, What do you think of a solution like this? (1) (0) https://mobile.twitter.com/billmaher/status/1251350310045413377?s=20 https://mobile.twitter.com/billmaher/status/1251350310045413... (1) https://thehill.com/opinion/healthcare/494034-the-data-are-in-stop-the-panic-and-end-the-total-isolation https://thehill.com/opinion/healthcare/494034-the-data-are-i...
• agentdrtran 6y ago
  > Ctrl+f theranos no results have we learned nothing?
• projektfu 6y ago
  Paul, have you partnered with an epidemiologist to produce a paper on the method?
  • projektfu 6y ago
    I guess the answer, as usual on these things, is no.
• nickysielicki 6y ago
  > It appears that the virus travels through the air, so whenever possible, it’s important to avoid crowds of people or indoor spaces with shared air. The virus is about the same size as the particles in cigarette smoke (though it would usually be part of a larger droplet), so I find it helpful to imagine a smoker exhaling smoke, and what it would take to avoid inhaling too much of that second-hand smoke. I just got back from a bike ride and I went through an area where a lot of homeless hang out. I could strongly smell urine and smoke while I was waiting at a stop light under a bridge. Do I need to be concerned that I just exposed myself?
  • paxys 6y ago
    The virus can travel through droplets and other large particles, so you definitely have to watch out for people sneezing etc. around you. There isn't any consensus, however, for whether it is airborne or not, i.e. whether it can be in regular exhaled air. Of course you should take precautions regardless.
  • eyeball 6y ago
    Yes
• flaque 6y ago
  I may have missed this, but how physically is this test done? Is it “spit in a tube” or “swab the back of the throat”?
  • predxionbio 6y ago
    Hi there. We are developing a saliva (e.g., spit in tube) type test. There are a couple of reasons for this including: - supply chain issues with flocked nasal swabs and viral transport media - enable self-sampling limiting healthcare workers SARS-CoV-2 exposures and PPE utilization
    • flaque 6y ago
      Gotcha! Thank you!
• m3kw9 6y ago
  You need a test in real time. Ten minutes for millions is gonna be hard to enforce them to sit and wait every day. I’m assuming you need to test them every day. You need a real time scanner and even that may or may not work depending the speed and invasivness of collecting before the actual scan.
• sitkack 6y ago
  We need micro PCR machines built into our phones. They could basically test for everything all the time.
  • savrajsingh 6y ago
    That would be sweet. Lead-time on this one is likely too long, however.
  • sitkack 6y ago
    Also a FLIR selfie camera could monitor our temperature at random points throughout the day.
• tolmasky 6y ago
  There is an episode of Sliders (Fever, Season 1, Episode 3), where they slide into a world affected by an infection with no cure, and scanners have been placed at the entrance to every store to detect if you have it. In the show the disease is used as a classist thing or something. Anyways, its bacterial not viral, and they discover than antibiotics were never discovered so the Professor scrapes some fungus off some trash and takes it and is cured.
  • johnedwards 6y ago
    I remember that episode! Love the Sliders reference. I might stream that all weekend.
• Animats 6y ago
  They're in a "startup incubator" for bio firms in South San Francisco.[1][2] The incubator is run by a unit of Johnson and Johnson. Multiple companies (51 are listed, but some may no longer be there) share 30,000 square feet of workspace there. "We welcome new resident companies with the infrastructure and tools they need to get up and running on day one. This capital efficient model takes time and investment out of the equation—eliminating the normal setup typically required of a startup." [1] https://businesssearch.sos.ca.gov/Document/RetrievePDF?Id=04265673-26160052 https://businesssearch.sos.ca.gov/Document/RetrievePDF?Id=04... [2] https://jlabs.jnjinnovation.com/locations/jlabs-ssf https://jlabs.jnjinnovation.com/locations/jlabs-ssf [3] https://jlabs.jnjinnovation.com/JLABSNavigator#/location/Bay%20Area%20-%20SSF https://jlabs.jnjinnovation.com/JLABSNavigator#/location/Bay...
• vadym909 6y ago
  An inadvertant Masterclass on how to convince a non-technical audience to invest in a tech startup. - Take a huge and important problem - Show the current challenges/lack of solutions - Propose a 'radical' alternative - Lend credence to the competency of the team - 'How world can be saved' - Imply the resultant victory
  • lvs 6y ago
    And critically, ensure there aren't really enough details to evaluate the proposal. ... Profit
• vanniv 6y ago
  No, we definitely don't want a world in which government officials have little kiosks outside every business where they get to decide who has to be removed from society with no due process.
• cryptonector 6y ago
  > It is my belief that the best cure for any disease is to avoid the disease. > Again, the best cure for any disease is to avoid the disease. Sure, if we're talking about HIV or HSV (any variant), then yes, the best cure is to avoid getting it in the first place. Some diseases you don't really get a choice. When 21% of NYC has had a disease that has been spreading for only a few weeks in spite of extreme public safety measures (social distancing, shutdowns), you have to wonder if you can avoid getting it, for how long, and at what cost. If you don't get it now, how do you keep from getting it later? Eradication is typically a decades-long project. Vaccination is anywhere from a months-long project if you don't care about establishing vaccine safety to a multi-year effort -- enough to eradicate if you're serious about it and have a vaccine that can cope with mutation rate (probably not). > Catching this virus is a bit like playing a round of Russian roulette. You’ll probably be fine, but you could end up dead. But that's not really the case. Risk factors for covid-19 are fairly well understood at this point: old age, past history of pneumonia, obesity, and diabetes. That's not not-a-big-deal, but it's in the realm of the manageable: isolate those at risk. But stopping the progression of this virus through the population is clearly not an option at this point -- we long ago passed the point where that was feasible. We can only slow down the progression, and definitely not long enough to obtain a tested vaccine because that's well over a year away and might be closer to two years if anything goes wrong with the current candidates. In terms of morbidity rates, this thing is not that bad as it has not overwhelmed the U.S. healthcare system (a few hospitals, yes, but the vast majority are far from capacity), and some treatments are available. So it's not clear that we need to slow covid-19's progression further, or that we could if we really wanted to. Transmission rates are just extremely high. > With this test, we can screen for the virus at the entrances to buildings and other areas, much like we currently use metal detectors to screen for weapons. [...] Longer term, it can be used to safely reopen more crowded areas such as festivals, sporting events, and even Disneyland. With... a test that... takes 10 minutes to run? Color me skeptical. By the time amusement parks get the go-ahead to reopen, covid-19 will have worked its way through well over 50% of the population. The way things are going, that's not too long from now, maybe two more months and NYC will be at 50% -- by the end of the year maybe most of the U.S. will be past 50%. Covid-19 is just too infectious. We can't stop it.
• nopinsight 6y ago
  A very recent Yale study suggests promises for saliva-based detection: “While saliva has shown promise for SARS-CoV-2 detection, very few studies have directly compared it to the current gold standard, nasopharyngeal (NP) swab. So, we compared NP and saliva samples from COVID-19 patients and self-collected samples from asymptomatic healthcare workers” “COVID-19 patients: SARS-CoV-2 detection from saliva is comparable to (or better than!) NP swabs and more consistent over time ...” “Plus, the detection of SARS-CoV-2 from the saliva of two asymptomatic healthcare workers (...and counting!) who tested negative from their NP swabs suggests that saliva could be a viable alternative for identifying mild or subclinical infections.” https://twitter.com/awyllie13/status/1252996627217801218?s=20 https://twitter.com/awyllie13/status/1252996627217801218?s=2...
• deleted 6y ago
  [deleted]
• gorgoiler 6y ago
  If I test positive, do I need to go straight to hospital as a precaution? I’d like something constructive to happen to happen to me (and by Golden Rule extension, anyone else who shows up as a carrier) while everyone else is running away in fear and revulsion. What happens when I reach the front of the line at Disneyworld, enter the testing booth, and the big red light flashes? Will Disney Corporation have a record of my identity at this point as well? It’s all very challenging. There are chilling warnings from history of both the havoc caused by mass viral illness, and also of discrimination and ostracizing based on fear. Ideally I’d want the test to be anonymous, private, and administered by me. Like taking my temperature or feeling for swollen neck glands. Hopefully we’ll get to that point in my lifetime.
• redis_mlc 6y ago
  > However, there is a third solution that could be implemented this year: Ubiquitous daily screening. And I want a pony. Wishing doesn't make it true. The correct solution is to treat it like "just another flu" because we don't have a vaccine or adequate testing.
• capitalbreeze 6y ago
  Of course we are going to get another TSA agency. This one comes right after you finish walking through TSA, FSA checks for viruses in your system.
• fsh 6y ago
  Grandiose statements with zero technical details make this sound a lot like "Theranos for Viruses".
• lrpublic 6y ago
  Quotes from the article: “It’s easy to fall into dystopian visions of the future — a world shut down by one virus after another” “It doesn’t have to be that way. ..... Ubiquitous screening is the key.” The approach is interesting and the possibility of eliminating large scale spread of covid, flu and others is attractive. However the idea of requiring a saliva swab from every visitor to an office or event has the potential to create an equally terrifying dystopian future where those samples are used to collect and use other data (DNA for example). How long before screening companies offers to provide free screening and access control systems in return for anonymised data? This kind of solution needs to have very well thought out privacy rules supported by strong and enforceable legislation to protect the individuals rights.
  • manmal 6y ago
    An easy fix would be to require that all saliva samples are disposed of into the same container, mixing all samples of all tested persons.
    • lrpublic 6y ago
      Perhaps, but if you think about how systems like this work today, for example scanning ID at the entrance to a nightclub or bar. One way something like this is likely to be implemented is by validating a ticket or access card/token with a saliva swab. This is just too easy and attractive an opportunity for data collection to be passed up by some operators with business models that monetise the data as a revenue source.
    • londons_explore 6y ago
      Or you do the test yourself, and just show the already-completed test to the guy at the office door, and keep the test hardware, just like you currently show but keep an ID badge. Sure, some people could fake the test, but for this approach to work, all that matters is that most people don't fake it.
  • arendtio 6y ago
    Reminds me of that access control system in the movie Gattaca, where you had to give a blood sample ;-) https://i.pinimg.com/736x/ac/aa/b0/acaab01e6647159309f6808443314ffb--film-culte-ethan-hawke.jpg https://i.pinimg.com/736x/ac/aa/b0/acaab01e6647159309f680844...
• pugworthy 6y ago
  “Ubiquitous daily screening” has this William Gibsonesque edge to it. Add the idea that anyone who has already had it gets a pass and it sounds worse.
• JungleGymSam 6y ago
  This person has a lot of fear in them. Sad. This person's third solution is a horrible authoritarian nightmare. Someone get him some help. Worst part is he think this is perfectly sane. "What we need is a leper colony for all the lepers so that I don't get sick. It sounds so scary to me!"
• JungleGymSam 6y ago
  See a therapist.
• auston 6y ago
  Not sure if I'm missing something, isn't Saliva based testing almost/basically here? 1. https://finance.yahoo.com/news/orasure-technologies-receives-barda-contract-100010049.html https://finance.yahoo.com/news/orasure-technologies-receives... 2. https://www.politico.com/states/new-jersey/story/2020/04/23/rutgers-saliva-based-covid-test-could-be-key-to-unlocking-new-jerseys-economy-1279421 https://www.politico.com/states/new-jersey/story/2020/04/23/...
• bsaul 6y ago
  I can't help feeling a bit uneased reading about computer science people doing salespitch for solving a world epidemic. If a famous medical doctor was trying to convince me that his database product was really the best, while making grandiose statement, i think i'd be very very harsh with them.
  • lend000 6y ago
    This appeal to authority always bothers me. Polymaths are capable of making bigger contributions in any field they involve themselves in than the average phD can in their own field of expertise. Look at Musk, Tesla, Von Neumann, Hughes, Da Vinci, Edison, Ben Franklin. However, I wouldn't limit this to being a "genius" thing -- there may actually be something significant to being able to apply knowledge and patterns in one or more field to a seemingly unrelated field, and people who tend to be interested enough to learn and think about a lot of different fields in depth have a better base of mental abstractions for inventing in a new field, even if they don't score ridiculously high on an IQ test. Note that this is just a general rant -- re: the article, I don't think the pitch is particularly interesting or noteworthy.
    • CPLX 6y ago
      Citing Elon Musk in this context is definitely not making the point you think it’s making.
      • lend000 6y ago
        Name one aeronautical engineer phD who deserves more credit for giving America the ability to put humans in space next month than Musk. He's quite involved with technical decisions. His social media behavior is irrelevant here -- this is about the ability to innovate outside of physics or economics, which is what he learned about in college.
        • pjc50 6y ago
          > putting humans back on the moon next month Wait what? Despite the pandemic?
• alex_young 6y ago
  > Even with imperfect screening, if we are able to prevent 90% of disease transmission, then the virus’s reproductive number, or R0, will drop below one and the pandemic will quickly fade. There is no risk of reintroduction from the outside because any new outbreaks will quickly be caught and contained. If used consistently, there will be no second wave, ever. This is dangerously wrong. If you reduce R0 below 1, you may stop community spread. You will not eradicate it however, unless this is done globally for a prolonged period of time with no error. This cannot be done with the proposed solution. We can (probably) stop this from hurting the vulnerable population while we find a long term solution like an inoculation, but we cannot just skip that and call everything good after some period of low / no new cases in a region.
  • __blockcipher__ 6y ago
    Also remember this is literally a virus that emerged from animals in the first place (zoonotic transmission). There will always be animal reservoirs of this. For that reason, and those you outlined, we could achieve the flawless techno-totalitarian state that so many well-intentioned citizens are practically begging for, and we would still be screwed. The only stable long-term solution is widespread exposure; ie how humanity has dealt with pretty much every other global pandemic we’ve been encountered with. Thus why those who are trying to demonize the concept of “herd immunity” and make it a dirty word are playing a very dangerous game.
    • RonanTheGrey 6y ago
      I really feel like we're spitting into the wind. There are very few who agree with this position.
• smhg 6y ago
  I think it is a good idea to keep some interpretation of the stages of grief [0] in the back of your head while reading posts like these (especially now, related to SARS-CoV-2). I don't want to say they are all wrong, but you tend to see the type of responses evolve as countries are further down the whole lockdown-process. [0] https://en.wikipedia.org/wiki/K%C3%BCbler-Ross_model https://en.wikipedia.org/wiki/K%C3%BCbler-Ross_model
• known 6y ago
  You may get a negative result if you’ve only had the coronavirus a short time. And it’s possible to get exposed and not develop antibodies. You may also get a “false positive” i.e. you have antibodies but had a different kind of virus e.g Hepatatis-B archive.vn/NzNRO
• known 6y ago
  TL;DR Test, Test and Test
• celticninja 6y ago
  major issue I have here is that once you put these turnstiles in they aren't coming back out. then they start scanning for other stuff and there goes your medical privacy.
• Kiro 6y ago
  > Unfortunately, I’m still seeing people at the supermarket with their mouths uncovered In Sweden masks are so uncommon that you react when you see one.
• sub7 6y ago
  A) Does he have any financial interest in PreDxion Bio? This sounds like another smaller startup claiming bullshit. B) Testing for O2 levels using already cheap + widely available pulse oximeters is probably an insufficient but necessary measure.
• stefankeys 6y ago
  A blogspot/google blogger blog how quaint
• ezoe 6y ago
  Unless we have a fool-proof self test kit that is so cheap to mass produce and distribute so everyone can use it every morning by simply dropping saliva and the result is available within 5 minutes while the probability of false-negative/false-positive are practically zero, A Third Solution the linked article suggested never happens. There are 7 billion humans in the world. Even the very low probability of false-negative lead to millions of infected people go outside, or millions of healthy people rushed to the hospital for detailed test every day.
• transfire 6y ago
  Or we could just have a mandatory global quarantine for two weeks. Not only Covid, but all transmittable diseases would plummet.
• dustinmoris 6y ago
  > It is my belief that the best cure for any disease is to avoid the disease. That's not a cure. That is prevention. > As such, I want to avoid ever catching this virus. I’m optimistic that we will eventually have a good vaccine, but until then I need to avoid those who are contagious. Completely unrealistic. Same person would have said in 1918 that they want to avoid ever catching the flu. Maybe back then some HN users would think it sounds smart, but today we know it sounds just silly, because it's unrealistic, unnatural, against how life works and simply unnecessary. Try your best to stay healthy, but please stop compromising life in ways which are completely unnatural because there is a possibility that your immune system has to do a bit of work. Our immune system has to work all the time, we are exposed to viruses all the time. This is how nature works. If there's a vaccine then yes let's all get it, like we should with other vaccines. Only a fool wouldn't get vaccinations, but until we have a vaccine let's just respect nature and how nature works and please live life like animals like us are meant to live. Freely.
  • apatters 6y ago
    The author doesn't understand the virus and makes many dubious statements about it. > Catching this virus is a bit like playing a round of Russian roulette. You’ll probably be fine, but you could end up dead. This is a poor analogy. In Russian roulette you have a 1 in 6 chance of getting a bullet in the head. The overall infection fatality rate of COVID-19 is under 1%, and the vast majority of fatalities are people with comorbidities. It's more accurate to say that catching the virus is like Russian roulette only if you have a serious pre-existing condition. > It is my belief that the best cure for any disease is to avoid the disease. Avoiding the disease is not a cure. The only cure we have at this time is in fact the opposite: exposure and resulting immunity. This is the population level cure too; as immunity in the population grows, the reproduction rate of the virus declines. There are still valid reasons for encouraging people to isolate and avoid infection. Like keeping the hospitals running, and minimizing the exposure of vulnerable individuals while the rest of us develop immunity. But curing the disease isn't a reason. And it also postpones the only true cure we have, which is the thing dying off due to herd immunity. > The great challenge with avoiding this virus is that people with minimal symptoms are responsible for much, if not most, of the disease transmission. This is true simply because people with minimal symptoms are most of the people who have it. So of course they represent the largest number of transmissions; they are the largest number of cases. Again, getting COVID-19 is not the same as Russian roulette, unless you're already sick. > It appears that the virus travels through the air, so whenever possible, it’s important to avoid crowds of people or indoor spaces with shared air. One authority after another has said that the main way this virus is transmitted is through respiratory droplets. Can it aerosolize? Yes. Can someone get sick from inhaling it in that aerosolized state? Probably yes. Is this a common form of transmission? Despite endless media coverage of studies in which the virus was deliberately aerosolized or found to be aerosolized, the answer is no. It is not. Neither the WHO nor the CDC has changed their view on this. Most transmission occurs at home or in tightly packed public transport. There's no evidence that we need to avoid indoor spaces with shared air. There's an abundance of evidence that we should stay six feet away from each other and wear masks, wherever we are. (Since day one, all health authorities have acknowledged that wearing a mask reduces your risk of spreading the disease to other people.)
• lorsting 6y ago
  Most of the statements in this article are false or exaggerated. There are no studies to back them up. These are just personal believes born out of fear. Computer engineers like him should be shamed in public for speaking so confident about things they have not been trained. We, as society, should point the finger at such frauds.
  • IAmEveryone 6y ago
    Any examples? It really reads like common sense to me.
  • febeling 6y ago
    Why can't we reflexively refute things if they are wrong? Why does it have to be shaming so often these days? We need fringe opinion, we need new ideas. And new ideas on average means: bad ideas. Still need the process for the one brilliant one among all the bad. We should encourage people thinking out loud, and accept that this is a process. Including people with bigger-than-life personality, including lunatics who might hit onto something by accident, including amateurs. Please allow creativity again, especially in times of need. Sharing your thinking isn't misinformation. We don't need other grownups protected from mistaken thinking, because you yourself aren't the only one who can spot it.
  • manmal 6y ago
    I think it’s worth a shot. Around the world, countries will use different strategies long-term, and the best strategies will be employed by all others, eventually. If cheap and extensive testing works as a means of reducing infections, then the world will be better off for it. Rest assured, studies will be done, but before they can be done, funding has to be ensured. And that‘s what I see this article try to do. I think condemning professionals for looking into other domains is not conducive to scientific discourse. The silo-ing of domains that has developed in recent decades IMO leads to local optima.
• deleted 6y ago
  [deleted]
• jacquesm 6y ago
  If a test doesn't give a result in a few seconds the queues at the testing stations will become a perfect venue for spreading the virus.
• alkonaut 6y ago
  Prediction: no test development will be faster than the spread of the disease so when tests are easily available many or most densely populated areas will be at over 50% immunity.
  • pbhjpbhj 6y ago
    >over 50% immunity. // As you say "the" disease I assume you mean Covid19, not just a future disease. AFAIAA is not been shown that recovered (or long-term asymptomatic) cases are immune and there's some suggestion that at least a few people don't have immunity after recovery. I think I'd stick with "at 50% infection rate". But then if at 50% infection rate you've had 0.2% death rate (seems to be about the right order for confirmed deaths+anticipated numbers of not confirmed {ie excess deaths during the period of the diseases spread}, in UK) then testing might save huge numbers of deaths. The death rate in the second half of the population I'd expect to be higher, they include those with pre-existing conditions (including the more elderly) who isolated early, testing of the caregivers and families will be very important.
    • alkonaut 6y ago
      Yes - I’m only talking a about Covid. This can definitely be interesting for Covid-31 though. Testing and contact tracing will indeed save lots of lives, I’m just not optimistic about <$1 “daily tests for everyone” within the relevant time frame of this pandemic.
• _ph_ 6y ago
  The most important thing was mentioned at the top of that article: there is a very effective thing everyone can do right now and does not require any technology: keep your distance. Stay at home, if you can, and in the public, keep distances. Face masks are an important help in this distancing, as there are always situations, where you can't quite maintain the "safe" 2m distance. If we all kept perfect distancing, the virus would be erradicated in 4-8 weeks. As this isn't always possible and mistakes are made, testing is indeed the other important part of fighting any spreadable disease. The comparison of the Covid-19 infections across different countries show clearly, how effective strict testing is. Any technology, which allows for frequent, wide-range testing is a big help in fighting diseases. If you could run a test when you are like feeling like getting a cold, the common cold and the flu would become much rarer diseases. (Especially if the west picks up the asian habit on wearing face masks, when you have the flu or a cold). HIV could be erradicated quickly, if there was even a yearly test of the whole population and anyone tested positive would get treated with the antiviral medicine which already exists for quite a while. Once treated, the virus count decreases rapidly and there is very little risk of spreading the virus, especially when taking minimal precautions. All above of course require for the tests to be available to literally everyone. So this should be a state run function, where you can get tested without any question asked about possible health insurance and also certain treatments should be given free of any charge.
• _pmf_ 6y ago
  > t’s confusing to me that we’ve implemented harsh and expensive lockdown measures, but have been slow to implement a basic mask mandate. That's what baffles me the most.
• noobermin 6y ago
  The issue with testing particularly in the US is not at all about the availability of tests or their expense, it is almost entirely political. Political discussions can often be fraught but when it almost the sole reason we don't have adequate testing in the US. It has almost nothing to do with the lack of a technical solution.
• schnischna 6y ago
  I wonder if it could be possible to mix test samples to test several people at once? Like maybe take 10 or even 100 samples, mix them together, and the test shows positive if any of the 100 has the disease? In that case, the samples could be tested individually. Also I don't think the consensus is that only a vaccine can end the thread, or that it is necessarily much more dangerous than the flu. I know three people who died from the flu. And there are also cases of younger, healthy people dying from the flu, or people getting permanent health issues like inflammation of the heart.
• martini333 6y ago
  This is not a third solution... It's the first ever thought of. But impractical, very expensive, and therefore, unrealistic.
• inglor 6y ago
  This really reminds me of the old Newgrounds stuff and the old Room game https://www.newgrounds.com/portal/view/547307 https://www.newgrounds.com/portal/view/547307 Tom Fulp had a bigger impact on my childhood than most - <3 newgrounds. Good Times.
• repied 6y ago
  > Catching this virus is a bit like playing a round of Russian roulette. Well, the comparison is a bit unfair, recent studies [1] give : P(death | infected) = 0.05% overall which is order of magnitude less than Russian's roulette where P(death | play) = 16% [1] https://death-proba-website.appspot.com/ https://death-proba-website.appspot.com/
  • evross 6y ago
    Russian roulette might be an unfair comparison, but it may only be one order of magnitude different to this virus IFR. With probability a number between 0 and 1, percentage is between 0 and 100. From the study in your source [1] the P(death|infected) = 0.005 And Russian roulette P(death | play) = 0.16 In percentages: Covid19 - IFR = 0.5%, Russian roulette = 16% From this calculation based on the recent New York antibody study [2] the average IFR across all age groups is 1.31%. (0 + 0.017 + 0.067 + 0.13 + 0.45 + 1.26 + 3.16 + 5.4)/8 = 1.31% This is a much higher IFR than flu or H1N1 (IFR was 0.02% in 2009, 65 times less). [1] https://hal-pasteur.archives-ouvertes.fr/pasteur-02548181 https://hal-pasteur.archives-ouvertes.fr/pasteur-02548181 "We find 2.6% of infected individuals are hospitalized and 0.53% die" [2] https://www.reddit.com/r/COVID19/comments/g6pqsr/nysnyc_antibody_study_updates/foc1cbf/ https://www.reddit.com/r/COVID19/comments/g6pqsr/nysnyc_anti... 0-19 ~= 0%; 20-29 = 0.017%; 30-39 = 0.067%.; 40-49 = 0.13%; 50-59 = 0.45%; 60-69 = 1.26%; 70-79 = 3.16%; 80+ = 5.4%;
    • repied 6y ago
      > Covid19 - IFR = 0.5%, Russian roulette = 16% Thanks for the correction and the new study link.
• jl2718 6y ago
  There’s not enough consumable tests, and there is currently no installed base of surface plasmon resonance machines, nor any of the other myriad types of constant-monitoring systems that have actually been proven to work for many years now in high-risk facilities (I developed some for the government 15 years ago and it wasn’t new). If you want my opinion, the right way to approach this is using the consumable tests to maximum effect for mass viral surveillance by contact group hierarchies. For instance, pool an entire school district on a single test, and then hunt down positives by school then class etc. There won’t be enough tests to find every case. That’s okay; others in contact are suspect anyway even if their test would have been negative at that time. The contact group discovery is simple too: cell tower data (civil liberties notwithstanding). This is pretty obvious, but it doesn’t work because our medical system is set up to charge individuals, and the highest priority will always be hospital admittances. This does little for the patient, but does protect others in the hospital.
• danielovichdk 6y ago
  Soon you will realize, that the cost of keeping people alive times the growing number of new people on earth will be the thing that will kill us all. Fuck your third solution. No one has been promised a long life nor a happy life. The gift of life is imminent, and you should aim for being well and in a good state until you cannot. Nature is the only religion than you really need to respect and obey. The rest is just for fun. Let the virus go. Let people go. We cannot act as god, it's unfair for everyone.
• known 6y ago
  Is it possible to create an artificial antibody in lab that can stimulate the immune system?
• bagacrap 6y ago
  "First of all, it’s not “just the flu”. It is something much more dangerous. Catching this virus is a bit like playing a round of Russian roulette. You’ll probably be fine, but you could end up dead." Whether this virus is more or less dangerous than the flu depends on who you are. For a child it's much less dangerous. This virus is not like Russian Roulette, the outcome of which is random and impossible to predict. It has a much greater likelihood of affecting certain groups than others. Flu is much more random. Like covid and most other respiratory illnesses, the flu is also transmitted by asymptomatic individuals. Most of the motivating factoids presented in this article are false or misleading. Since the author's stated goal is to never become infected he should hide in a closet until the vaccine is ready.
• patcon 6y ago
  Ah, of course. We create a new type of [patentable] ubiquitous technology and sell our way out of this. Leave it to the entrepreneurial mind... Sorry for being cynical -- I just feel suspicious of this particular tired mindset to addressing complex public health and social issues, ones that intersect with (and aggravate) many other pre-existing social dilemmas. There are a thousand other ways to look at this that don't involve a small cornered market, I just doubt the entrepreneurial mind knows how to parse for it on its own. When you have a hammer... Wake me up when someone's talking about this sort of thing amongst members of a consortium building open patents, not from some guy with plain-as-day zero-to-one ambitions. I'll root for someone who sees the interlocking opportunities, not someone who speaks about personal aspirations to "wipe out COVID-19" in 2020
• nickthemagicman 6y ago
  A lot of fear mongering and FUD in this article. They say COVID is like Russian roulette. LIFE is Russian roulette. In the under 54 crowd Covid is no more deadly than the flu. So any time you go outside during flu season you're playing Russian roulette? The only people who need fear this bug are the over 54 crowd. They need to remain quarantined until the vaccine is released or herd immunity is built up.
• Eric_WVGG 6y ago
  I’m sure this is the last of their concerns, but the word “disposable” and “daily” immediately made me think, “great, more garbage.” It would be nice if they could figure out a recycling system — or at least make sure the vials are made of somewhat environmentally neutral glass — out of the gate, rather than have another problem to solve after there are millions of these out there
• DominikD 6y ago
  I'm tired of reading that it spreads through the air and so we should avoid indoor spaces where we share air. It spreads through droplets large enough for the gravity to pull them down relatively fast. It's not measles, you can't contract it by breathing the same air someone infected did unless you're in a medical setting and AGP is performed on someone who's infected. If it was airborne, masks that aren't fitted wouldn't protect anyone: they wouldn't prevent absorbing nor would they prevent spreading.
  • buboard 6y ago
    How sure are we? https://www.sciencedirect.com/science/article/pii/S016041202031254X https://www.sciencedirect.com/science/article/pii/S016041202...
    • DominikD 6y ago
      All studies that point to it being airborne are from medical setting or are misrepresented in the media. For example there's a new one that circulates abbreviated to "air conditioned restaurants make SARS-CoV-19 airborne". Comment + source: https://twitter.com/alicesim/status/1254057546333241346 https://twitter.com/alicesim/status/1254057546333241346 As for your source: it misrepresents SARS as airborne in the same way most other publications of this ilk do: by taking examples from medical setting and extrapolating from that. It even admits the setting but keeps the general "airborne" label for the sake of argument. > SARS-CoV-1, did spread in the air. This was reported in several studies and retrospectively explained the pathway of transmission in Hong Kong’s Prince of Wales Hospital Yes, this virus can become airborne if aerosol generating procedure is performed on an infected patient. But 1) you don't intubate people in restaurants, and 2) that's why PPE is so important for medical staff, because they do operate in conditions in which this virus can become airborne. That's also why you can't visit people in hospitals any more. You can't do contact tracing of airborne infection that is this contagious. Measles hover in the room for hours after spraying and you can't trace down everyone who was doing groceries across 5h in your local market (I'm glad we have vaccine for measles). But you can do tracking and isolation of SARS-CoV-19 patients. Why? Because droplets are pulled down to surfaces and are no longer dangerous within seconds to minutes after spraying. But they do stay on surfaces, that's why hand hygiene is so important.
• SomeoneFromCA 6y ago
  I absolutely agree with the point, and it goes 100% against to Sweden is doing.