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> To put this idea in perspective, there are ~56 million students in the US. To do this daily for an entire school year at $1/test would cost ~1% of the trillio

by xienze 6y ago

> To put this idea in perspective, there are ~56 million students in the US. To do this daily for an entire school year at $1/test would cost ~1% of the trillion dollars allocated spent in the first relief bill. Which $1 test currently in production would this be? And as a point of context, there’s been nowhere near the ~10B tests (I assume you’re talking about a 180 day school year) you’re proposing administered _worldwide_. Furthermore, what factory produces and ships 56 million of anything on a daily basis? I’ve said this before but I think HN readers suffer from thinking that everything in the world works like AWS in that you can just spin up unlimited “anything” on a moment’s notice.

acqq 6y ago
> Which $1 test currently in production would this be? It's not about what's "currently in production." It's about what should be a strategic goal to produce the bigger number of tests and use them frequently. 1) The current arguments against the speed tests is that they are not "sensitive" enough. But if one's goal is to do day to day testing and isolating from some environment those that can spread, there's no necessity to detect the RNA leftovers detected by the "sensitive" tests. Rather, the goal is to detect those that are the "powerful spreaders" who in fact have way more instances of virus present in their samples at the moment they are tested. Apparently even the "less sensitive" tests are in fact sensitive enough to catch these who produce a lot of virus. Those who produce a lot of virus have many orders of magnitude more virus RNA present in their samples than those who are in the phase of infection where they aren't so dangerously infective. Once one accepts that the "ultimate sensitivity" is not necessary, much cheaper tests than those currently used are possible. 2) Even if a single test is still e.g. 20 USD, just stating the goal of having very frequent and regular tests for the sole purpose of protecting a big group of people allows for "pooling" the tests, e.g. testing 20 people together using just one test. Running the numbers for a university of 1000 people: 1000 / 20 = 50 means only 50 tests per day allow for testing for protection of all 1000 people. Once one batch of 20 is positive, which should not happen every day, additional 20 tests allow for recognizing the one who is the actual carrier. Again, as those that are "dangerous" have many orders of magnitude more virus in the samples, pooling of 20 samples together should be still keep the result detectable enough. 3) Moreover, the test should be less complicated as the one used now: the idea is to test the spit, not to swab the deeps inside of the head. 4) Expensive and slow tests are simply not giving us the possibility to do these "detect early and often" strategies. The really sensitive PCR tests are indeed expensive and aren't as fast as the less expensive can be. How can the cheap test be made? For example, by designing them to be used the same way the diabetics test their blood sugar levels: https://www.diabetesaustralia.com.au/blood-glucose-monitoring https://www.diabetesaustralia.com.au/blood-glucose-monitorin... Or even the way the pregnancy tests work: https://www.123rf.com/photo_107386863_positive-pregnancy-test-result-with-two-strips-on-the-table-two-stripes-on-a-test-.html https://www.123rf.com/photo_107386863_positive-pregnancy-tes... In short, just new test strips. Moreover, there are already companies that did some development of such kinds of tests. It could be done, but it depends on the goals being set. China successfully used pooling to test the population of 11 million: https://www.bloomberg.com/news/articles/2020-05-29/how-china-tested-11-million-people-for-virus-in-just-two-weeks https://www.bloomberg.com/news/articles/2020-05-29/how-china...
pmoriarty 6y ago
"Which $1 test currently in production would this be?" The technology to make these tests currently exists, but the companies which own the technology have chosen not to put them in to production because the tests aren't sensitive enough to gain FDA approval under current regulations. If the regulations were relaxed to allow these less sensitive (but perfectly adequate) tests, then they could be put in to production. So what's necessary for us to get $1 tests is to convince the FDA that these less sensitive tests are adequate for use, which is what the This Week in Virology podcast and the NYT article linked to earlier argue for. "Furthermore, what factory produces and ships 56 million of anything on a daily basis?" From the TWiV podcast[1]: "Take every manufacturing company that knows how to print paper, adapt their tools to print monoclonal antibodies on to those sheets and just start slicing it up and shipping it out. It's as easy as that, I mean, you know, I'm simplifying it a bit, but..." [1] - from about 32'30" in to the podcast https://www.microbe.tv/twiv/twiv-640/ https://www.microbe.tv/twiv/twiv-640/
perl4ever 6y ago
>what factory produces and ships 56 million of anything on a daily basis Maybe more than one factory would be needed. The idea that 56 million a day of anything is outside the realm of anything but software might be exaggerated. Global production of microcontrollers, for instance, seems to be around 80 million per day. https://www.grandviewresearch.com/industry-analysis/microcontroller-market https://www.grandviewresearch.com/industry-analysis/microcon...

by xienze 6y ago

acqq 6y ago

> Which $1 test currently in production would this be? It's not about what's "currently in production." It's about what should be a strategic goal to produce the bigger number of tests and use them frequently. 1) The current arguments against the speed tests is that they are not "sensitive" enough. But if one's goal is to do day to day testing and isolating from some environment those that can spread, there's no necessity to detect the RNA leftovers detected by the "sensitive" tests. Rather, the goal is to detect those that are the "powerful spreaders" who in fact have way more instances of virus present in their samples at the moment they are tested. Apparently even the "less sensitive" tests are in fact sensitive enough to catch these who produce a lot of virus. Those who produce a lot of virus have many orders of magnitude more virus RNA present in their samples than those who are in the phase of infection where they aren't so dangerously infective. Once one accepts that the "ultimate sensitivity" is not necessary, much cheaper tests than those currently used are possible. 2) Even if a single test is still e.g. 20 USD, just stating the goal of having very frequent and regular tests for the sole purpose of protecting a big group of people allows for "pooling" the tests, e.g. testing 20 people together using just one test. Running the numbers for a university of 1000 people: 1000 / 20 = 50 means only 50 tests per day allow for testing for protection of all 1000 people. Once one batch of 20 is positive, which should not happen every day, additional 20 tests allow for recognizing the one who is the actual carrier. Again, as those that are "dangerous" have many orders of magnitude more virus in the samples, pooling of 20 samples together should be still keep the result detectable enough. 3) Moreover, the test should be less complicated as the one used now: the idea is to test the spit, not to swab the deeps inside of the head. 4) Expensive and slow tests are simply not giving us the possibility to do these "detect early and often" strategies. The really sensitive PCR tests are indeed expensive and aren't as fast as the less expensive can be. How can the cheap test be made? For example, by designing them to be used the same way the diabetics test their blood sugar levels: https://www.diabetesaustralia.com.au/blood-glucose-monitoring https://www.diabetesaustralia.com.au/blood-glucose-monitorin... Or even the way the pregnancy tests work: https://www.123rf.com/photo_107386863_positive-pregnancy-test-result-with-two-strips-on-the-table-two-stripes-on-a-test-.html https://www.123rf.com/photo_107386863_positive-pregnancy-tes... In short, just new test strips. Moreover, there are already companies that did some development of such kinds of tests. It could be done, but it depends on the goals being set. China successfully used pooling to test the population of 11 million: https://www.bloomberg.com/news/articles/2020-05-29/how-china-tested-11-million-people-for-virus-in-just-two-weeks https://www.bloomberg.com/news/articles/2020-05-29/how-china...

pmoriarty 6y ago

"Which $1 test currently in production would this be?" The technology to make these tests currently exists, but the companies which own the technology have chosen not to put them in to production because the tests aren't sensitive enough to gain FDA approval under current regulations. If the regulations were relaxed to allow these less sensitive (but perfectly adequate) tests, then they could be put in to production. So what's necessary for us to get $1 tests is to convince the FDA that these less sensitive tests are adequate for use, which is what the This Week in Virology podcast and the NYT article linked to earlier argue for. "Furthermore, what factory produces and ships 56 million of anything on a daily basis?" From the TWiV podcast[1]: "Take every manufacturing company that knows how to print paper, adapt their tools to print monoclonal antibodies on to those sheets and just start slicing it up and shipping it out. It's as easy as that, I mean, you know, I'm simplifying it a bit, but..." [1] - from about 32'30" in to the podcast https://www.microbe.tv/twiv/twiv-640/ https://www.microbe.tv/twiv/twiv-640/

perl4ever 6y ago

>what factory produces and ships 56 million of anything on a daily basis Maybe more than one factory would be needed. The idea that 56 million a day of anything is outside the realm of anything but software might be exaggerated. Global production of microcontrollers, for instance, seems to be around 80 million per day. https://www.grandviewresearch.com/industry-analysis/microcontroller-market https://www.grandviewresearch.com/industry-analysis/microcon...