6 ms·

An article terribly light on details - what's their testing strategy? If it's completely random statewide, then it's very alarming. If not... it's less alarming

An article terribly light on details - what's their testing strategy? If it's completely random statewide, then it's very alarming. If not... it's less alarming. I have to wonder if children a) are better at catching it (but not better at spreading it) than adults b) have a larger window in which they "test positive" or c) parents are the ones infecting children - that is to say that parents and children both test positive for the same duration of time, but parents get it and get over it first.

wtvanhest 6y ago
Another explanation, if I am sick, I will get tested first before making my kid go through that. If I test positive, only then will I test my child. If I test negative and we are both sick, I will presume we caught something else.
- saint_abroad 6y ago
  > I will get tested first before making my kid go through that. If I test positive, only then will I test my child. If I test negative and we are both sick, I will presume we caught something else. If you test positive, why make your kid go through that? If you test positive and you are both sick, you can presume you've caught the same thing.
  - wtvanhest 6y ago
    I haven't been there, (maybe someone who has can comment?), but I would expect you need the positive diagnosis for evaluating COVID19 treatment options for your kid. Or, at the minimum, I would expect the DR. to push you to have them tested. In any case, I would expect kids to be tested after adults in most cases during the shelter in place
    - catalogia 6y ago
      > I would expect you need the positive diagnosis for evaluating COVID19 treatment options for your kid. From what I understand, the overwhelming majority of kids with covid do not require any treatment whatsoever, with only a small handful of anecdotes of kids having bad symptoms. Just don't let junior visit grandma.
      - barkingcat 6y ago
        are you really willing to let your kid not receive treatment on a "anecdotal" evidence? if the kid turns out to be that small percentage that do need intensive care - you would be kicking yourself. kids have died from covid complications, they are not immune.
        catalogia 6y ago
        If the kid has symptoms, which is very unlikely, that's when you'd seek treatment. But if the kid has no symptoms, which is far more likely, what would there be to treat?
        deleted 6y ago
        [deleted]
        barkingcat 6y ago
        if the kid has no symptoms, and tests positive, it is a case to self isolate (the kid as well as the whole family) - so they don't transmit it to other kids and teachers who might be vulnerable. And in this case, it might very well be fatal to the teachers who are in close contact with the kid. Why is this so hard to grasp? Being a disease carrier is a problem even if the kid doesn't show symptoms, especially it's been established that covid is transmissible with no symptoms.
        catalogia 6y ago
        As I said, "Just don't let junior visit grandma."
        andi999 6y ago
        As far as I understand there is only symptomatic treatment. (apart from remdesivir, but not sure if I would give it a child before it really needs it (worried about sideeffects?))
        6y ago
    - mlyle 6y ago
      It's worth noting that most kids don't have symptoms, and it's considered less worthwhile to test kids. So I'd assume the cohort of kids who are tested for COVID-19 are a heck of a lot more symptomatic than the child population at large (and that this is more exaggerated than the selection bias for adults who want a test).
      - wtvanhest 6y ago
        I don’t think there is any evidence of that.
        mlyle 6y ago
        There tots is. :P e.g. Serosurveys of kids show significantly lower positivity rates than adults (fewer kids have had it); PCR testing of kids shows higher positivity rates than adults (a greater proportion of kids tested have it); other studies show seroconversion rates of kids are nearly as high as adults after infection. The only way to get this outcome is if negative kids are less likely to be PCR tested than negative adults, or if positive kids are more likely to be PCR tested than positive adults, or both.
  - barkingcat 6y ago
    if you want treatment from a disease that could lead to death, you need to have a diagnosis to access drugs and treatment .... if you know you are sick with covid, would you let your kid potentially die from the disease as well?
  - coding123 6y ago
    well, even so, at population scale, you're going to find people. Even if you're right that MOST people aren't going to test their kid...
  - toast0 6y ago
    > If you test positive, why make your kid go through that? If you test positive and you are both sick, you can presume you've caught the same thing. Most likely, you'd only get the kid(s) tested in that case if you were seeking medical care because it was pretty bad, or the tests were encouraged by a contact tracing regime. The first part would lead towards higher positivity results, and the second towards lower. With no details on who go tests / what their motive for testing was, we just don't know.
    - saint_abroad 6y ago
      > tested in that case if you were seeking medical care because it was pretty bad, or the tests were encouraged by a contact tracing regime. The first part would lead towards higher positivity results, and the second towards lower. That, in a nutshell, is the reason positivity rate matters. If a positivity rate is too high, that may indicate that the state is only testing the sickest patients who seek medical attention, and is not casting a wide enough net to know how much of the virus is spreading within its communities. A low rate of positivity in testing data can be seen as a sign that a state has sufficient testing capacity for the size of their outbreak and is testing enough of its population to make informed decisions about reopening. https://coronavirus.jhu.edu/testing/testing-positivity https://coronavirus.jhu.edu/testing/testing-positivity
  - newacct583 6y ago
    You test the kid so that you can then warn all the kid's contacts! The ONLY reason we test is to control community spread. Covid doesn't really have any specific treatments, it gets managed the same way you manage a flu patient. There's near zero value in the individual information about an infection. In an idea situation (i.e. where the pandemic hasn't outstripped test bandwidth, which is true now in almost all of asia, most of europe, and some areas of the US like NYC) you test everyone who gets sick with covid-like symptoms, and for every positive you then go and test everyone who had meaningful contact with them. You absolutely don't skip tests because you can reasonably assume a positive. That's missing the point entirely.
    - graeme 6y ago
      > There's near zero value in the individual information about an infection. At present. There are lots of reports about lingering effects. And large portions of asymptomatics studied have penumonia. You don’t feel tis pneumonia as a symptoms, and if covid damages vascular or brain tissue, you won’t feel that directly either. But it could well be an issue down the road, and knowing if you or your kid had coronavirus could help future treatments.
    - vharuck 6y ago
      Exactly. This is why there's a goal for percentage of positive tests. We want to see a high proportion of negatives, because that means the virus is rarer but more likely to be caught in that population.
- swsieber 6y ago
  That's a great point! Interestingly enough, my daughter got sick and we thought it was strep. She ended up getting tested for strep and covid in one day.
gavman 6y ago
The article also does not mention the definition of "children". Under 10? Under 18? Under 21? If you count teenagers hanging out and spreading it as children, the number for very young children could still be as low as we thought and there are no new revelations here.
- lern_too_spel 6y ago
  It links to the report, which says "<18" at the top.
- cwhiz 6y ago
  Here is the actual report: http://ww11.doh.state.fl.us/comm/_partners/covid19_report_archive/pediatric_report_latest.pdf http://ww11.doh.state.fl.us/comm/_partners/covid19_report_ar... It is broken down by age group.
  - rurban 6y ago
    These are extreme percentages at these young age groups. Now to compare these numbers internationally we certainly need to know the cofactors. Are these all obese or diabetic, or are these healthy teenagers? If they were healthy, it points to a different virus strain. If obese, it points to the well-known national sugar problem. Also it could point to less exposure to common cold antibodies, this is the south. Common cold antibodies are believed to be the cause for the low IFR percentages worldwide.
newacct583 6y ago
People who get a test are those who have covid symptoms or those who have been exposed to known cases. There are a few exceptions around the edges, but that's the basic idea. The reason people track the "positive test rate" isn't to make deductions about the population directly, it's to provide data on how well testing and tracing is working. In NYC right now, positive tests are coming back at about 1%. That is, almost everyone who they think "might" have covid actually doesn't (they have the flu, or if they're a contact they didn't get infected). That's good, because it means the test and trace control is working and the probability of a person who does not get tested being infected is very low. In FL, things are out of control. Getting back a 30% positive rate means that you're really only catching the cases that come in the door. It means that there are probably a ton that you aren't catching, because you can't test enough to keep up.
formercoder 6y ago
One interesting thing about this global situation is it’s turned absolutely everyone into an armchair statistician. These are great points and I’ve never seen all of my friends so wrapped up in discussions of sampling bias.
- Bukhmanizer 6y ago
  It’s only sampling bias if it’s not the conclusion I want.
  - jschwartzi 6y ago
    Or if it's sampling bias.
- scruple 6y ago
  It's been this way for a while. Especially with politics. Everyone you know is a pundit today.
watwut 6y ago
It is alarming regardless. The 30% tested cases being positive means that the testing is much behind the reality. For contact tracing to work, the ratio of positive cases must be much lower. Basically, this means that they don't have enough testing capacity and are testing only when they must.
Vysero 6y ago
"health experts fear it can cause potential lifelong damage in children." Which health experts? Why do they fear this? "Alina Alonso, the health department director of Palm Beach County, reportedly told county commissioners on Tuesday that the long-term consequences of coronavirus in children are unknown." That doesn't sound like fear to me, and in some respects the article comes off on me as though the author is attempting to elicit fear where there should be none. I am not a parent myself, but if there's one thing I know about them it's that they tend to be VERY fearful when it comes to their children's safety. If the author is deliberately toying with that then the ought to be ashamed.
- pvaldes 6y ago
  > Why do they fear this? Modern medicine had seen before severe cardiovascular accidents and is aware of what a damage in young arteries or heart can produce. Some tissues can self-repair better than other. The origin is new, but the consequences of damage on any main organ are well studied.
  - Vysero 6y ago
    Right, but first we have to establish that they actual fear this. Then we have to establish who they are, and what their qualifications are. Then, as non-experts, if enough experts agree with the ones who are making the claim we can choose to worry or not to worry depending on circumstances.
- engineer_22 6y ago
  That's an interesting remark you've brought up here. COVID-19 is very obviously shaping up to be the defining issue of this election cycle. Mexico is very relieved. But as we are all aware - as the election goes, so goes the media.

wtvanhest 6y ago

Another explanation, if I am sick, I will get tested first before making my kid go through that. If I test positive, only then will I test my child. If I test negative and we are both sick, I will presume we caught something else.

saint_abroad 6y ago
> I will get tested first before making my kid go through that. If I test positive, only then will I test my child. If I test negative and we are both sick, I will presume we caught something else. If you test positive, why make your kid go through that? If you test positive and you are both sick, you can presume you've caught the same thing.
- wtvanhest 6y ago
  I haven't been there, (maybe someone who has can comment?), but I would expect you need the positive diagnosis for evaluating COVID19 treatment options for your kid. Or, at the minimum, I would expect the DR. to push you to have them tested. In any case, I would expect kids to be tested after adults in most cases during the shelter in place
  - catalogia 6y ago
    > I would expect you need the positive diagnosis for evaluating COVID19 treatment options for your kid. From what I understand, the overwhelming majority of kids with covid do not require any treatment whatsoever, with only a small handful of anecdotes of kids having bad symptoms. Just don't let junior visit grandma.
    - barkingcat 6y ago
      are you really willing to let your kid not receive treatment on a "anecdotal" evidence? if the kid turns out to be that small percentage that do need intensive care - you would be kicking yourself. kids have died from covid complications, they are not immune.
      - catalogia 6y ago
        If the kid has symptoms, which is very unlikely, that's when you'd seek treatment. But if the kid has no symptoms, which is far more likely, what would there be to treat?
        deleted 6y ago
        [deleted]
        barkingcat 6y ago
        if the kid has no symptoms, and tests positive, it is a case to self isolate (the kid as well as the whole family) - so they don't transmit it to other kids and teachers who might be vulnerable. And in this case, it might very well be fatal to the teachers who are in close contact with the kid. Why is this so hard to grasp? Being a disease carrier is a problem even if the kid doesn't show symptoms, especially it's been established that covid is transmissible with no symptoms.
        catalogia 6y ago
        As I said, "Just don't let junior visit grandma."
      - andi999 6y ago
        As far as I understand there is only symptomatic treatment. (apart from remdesivir, but not sure if I would give it a child before it really needs it (worried about sideeffects?))
        6y ago
  - mlyle 6y ago
    It's worth noting that most kids don't have symptoms, and it's considered less worthwhile to test kids. So I'd assume the cohort of kids who are tested for COVID-19 are a heck of a lot more symptomatic than the child population at large (and that this is more exaggerated than the selection bias for adults who want a test).
    - wtvanhest 6y ago
      I don’t think there is any evidence of that.
      - mlyle 6y ago
        There tots is. :P e.g. Serosurveys of kids show significantly lower positivity rates than adults (fewer kids have had it); PCR testing of kids shows higher positivity rates than adults (a greater proportion of kids tested have it); other studies show seroconversion rates of kids are nearly as high as adults after infection. The only way to get this outcome is if negative kids are less likely to be PCR tested than negative adults, or if positive kids are more likely to be PCR tested than positive adults, or both.
- barkingcat 6y ago
  if you want treatment from a disease that could lead to death, you need to have a diagnosis to access drugs and treatment .... if you know you are sick with covid, would you let your kid potentially die from the disease as well?
- coding123 6y ago
  well, even so, at population scale, you're going to find people. Even if you're right that MOST people aren't going to test their kid...
- toast0 6y ago
  > If you test positive, why make your kid go through that? If you test positive and you are both sick, you can presume you've caught the same thing. Most likely, you'd only get the kid(s) tested in that case if you were seeking medical care because it was pretty bad, or the tests were encouraged by a contact tracing regime. The first part would lead towards higher positivity results, and the second towards lower. With no details on who go tests / what their motive for testing was, we just don't know.
  - saint_abroad 6y ago
    > tested in that case if you were seeking medical care because it was pretty bad, or the tests were encouraged by a contact tracing regime. The first part would lead towards higher positivity results, and the second towards lower. That, in a nutshell, is the reason positivity rate matters. If a positivity rate is too high, that may indicate that the state is only testing the sickest patients who seek medical attention, and is not casting a wide enough net to know how much of the virus is spreading within its communities. A low rate of positivity in testing data can be seen as a sign that a state has sufficient testing capacity for the size of their outbreak and is testing enough of its population to make informed decisions about reopening. https://coronavirus.jhu.edu/testing/testing-positivity https://coronavirus.jhu.edu/testing/testing-positivity
- newacct583 6y ago
  You test the kid so that you can then warn all the kid's contacts! The ONLY reason we test is to control community spread. Covid doesn't really have any specific treatments, it gets managed the same way you manage a flu patient. There's near zero value in the individual information about an infection. In an idea situation (i.e. where the pandemic hasn't outstripped test bandwidth, which is true now in almost all of asia, most of europe, and some areas of the US like NYC) you test everyone who gets sick with covid-like symptoms, and for every positive you then go and test everyone who had meaningful contact with them. You absolutely don't skip tests because you can reasonably assume a positive. That's missing the point entirely.
  - graeme 6y ago
    > There's near zero value in the individual information about an infection. At present. There are lots of reports about lingering effects. And large portions of asymptomatics studied have penumonia. You don’t feel tis pneumonia as a symptoms, and if covid damages vascular or brain tissue, you won’t feel that directly either. But it could well be an issue down the road, and knowing if you or your kid had coronavirus could help future treatments.
  - vharuck 6y ago
    Exactly. This is why there's a goal for percentage of positive tests. We want to see a high proportion of negatives, because that means the virus is rarer but more likely to be caught in that population.
swsieber 6y ago
That's a great point! Interestingly enough, my daughter got sick and we thought it was strep. She ended up getting tested for strep and covid in one day.

gavman 6y ago

The article also does not mention the definition of "children". Under 10? Under 18? Under 21? If you count teenagers hanging out and spreading it as children, the number for very young children could still be as low as we thought and there are no new revelations here.

lern_too_spel 6y ago
It links to the report, which says "<18" at the top.
cwhiz 6y ago
Here is the actual report: http://ww11.doh.state.fl.us/comm/_partners/covid19_report_archive/pediatric_report_latest.pdf http://ww11.doh.state.fl.us/comm/_partners/covid19_report_ar... It is broken down by age group.
- rurban 6y ago
  These are extreme percentages at these young age groups. Now to compare these numbers internationally we certainly need to know the cofactors. Are these all obese or diabetic, or are these healthy teenagers? If they were healthy, it points to a different virus strain. If obese, it points to the well-known national sugar problem. Also it could point to less exposure to common cold antibodies, this is the south. Common cold antibodies are believed to be the cause for the low IFR percentages worldwide.

newacct583 6y ago

People who get a test are those who have covid symptoms or those who have been exposed to known cases. There are a few exceptions around the edges, but that's the basic idea. The reason people track the "positive test rate" isn't to make deductions about the population directly, it's to provide data on how well testing and tracing is working. In NYC right now, positive tests are coming back at about 1%. That is, almost everyone who they think "might" have covid actually doesn't (they have the flu, or if they're a contact they didn't get infected). That's good, because it means the test and trace control is working and the probability of a person who does not get tested being infected is very low. In FL, things are out of control. Getting back a 30% positive rate means that you're really only catching the cases that come in the door. It means that there are probably a ton that you aren't catching, because you can't test enough to keep up.

formercoder 6y ago

One interesting thing about this global situation is it’s turned absolutely everyone into an armchair statistician. These are great points and I’ve never seen all of my friends so wrapped up in discussions of sampling bias.

Bukhmanizer 6y ago
It’s only sampling bias if it’s not the conclusion I want.
- jschwartzi 6y ago
  Or if it's sampling bias.
scruple 6y ago
It's been this way for a while. Especially with politics. Everyone you know is a pundit today.

watwut 6y ago

It is alarming regardless. The 30% tested cases being positive means that the testing is much behind the reality. For contact tracing to work, the ratio of positive cases must be much lower. Basically, this means that they don't have enough testing capacity and are testing only when they must.

Vysero 6y ago

"health experts fear it can cause potential lifelong damage in children." Which health experts? Why do they fear this? "Alina Alonso, the health department director of Palm Beach County, reportedly told county commissioners on Tuesday that the long-term consequences of coronavirus in children are unknown." That doesn't sound like fear to me, and in some respects the article comes off on me as though the author is attempting to elicit fear where there should be none. I am not a parent myself, but if there's one thing I know about them it's that they tend to be VERY fearful when it comes to their children's safety. If the author is deliberately toying with that then the ought to be ashamed.

pvaldes 6y ago
> Why do they fear this? Modern medicine had seen before severe cardiovascular accidents and is aware of what a damage in young arteries or heart can produce. Some tissues can self-repair better than other. The origin is new, but the consequences of damage on any main organ are well studied.
- Vysero 6y ago
  Right, but first we have to establish that they actual fear this. Then we have to establish who they are, and what their qualifications are. Then, as non-experts, if enough experts agree with the ones who are making the claim we can choose to worry or not to worry depending on circumstances.
engineer_22 6y ago
That's an interesting remark you've brought up here. COVID-19 is very obviously shaping up to be the defining issue of this election cycle. Mexico is very relieved. But as we are all aware - as the election goes, so goes the media.