20 ms·

What's the point of a Covid-19 test that takes 19 days for results?

224 points by finphil 6y ago

CyanLite4 6y ago
Thus the need for cheaper, quicker tests, even if the accuracy is t that great. TWIV Podcast episode #640 covers this. $1 per day test that quickly gives a result, but perhaps is only 50% accurate.
- watwut 6y ago
  The tests are quick. The delay is because labs are overwhelmed.
- stonogo 6y ago
  If that's the test you want, you can literally flip a coin.
  - dap 6y ago
    A coin flip won’t be nearly 50% accurate.
    - lostlogin 6y ago
      ELI5 - If the test has 50% accuracy and is producing equal false positives and false negatives, is the coin producing inferior results?
      - ls612 6y ago
        No because Pr(Infected) << Pr(Not Infected) even in the places with the most spread right now.
      - dap 6y ago
        Suppose you test a population of 100 people in which 10 are infected. The coin flip test reports 50 people infected on average. Among those positive tests, at least 40 have to be to be false positives Because there are only 10 infected to begin with. That’s a false positive rate at least 80%. Among negatives, we would expect 5 to be false (since 10 people are infected and each of them have a coin flip chance of testing negative) or 10%. I’m not sure that you can have a test that’s 50% accurate and errs equally in both directions. At least, I’m not sure what it would mean.
  - aquadrop 6y ago
    That's exactly was is talked about in the podcast by the doctor. It's not random 50% accuracy, it catches all the people it needs to catch, because accuracy depends on amount of viruses they shed. Accuracy on people who are transmitting decease is more than enough.
- acqq 6y ago
  My post with the summary, 7 days ago: https://news.ycombinator.com/item?id=23881080 https://news.ycombinator.com/item?id=23881080 "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." Thinking more about it, the most important point I'd add now is: We should learn not to think about "the test" but about (at least) two different kinds of tests for different purposes: 1) fast tests to reduce the chance of virus spreading. Anybody isolated before managing to spread the virus is better than not testing, so it doesn't have to be too precise. We just have to understand its limits. 2) more reliable tests for clinical purposes, whenever they are needed. Interestingly, even in such scenarios antibody tests could find their use and allow cheaper or faster results, something like this: https://www.clinisciences.com/en/read/newsletter-26/sars-cov-2-covid-19-diagnosis-by-2264.html https://www.clinisciences.com/en/read/newsletter-26/sars-cov... E.g. if somebody has symptoms and IgM (or IgM and IgG), that could be good enough of information to decide how somebody is to be treated. One more example where I'd guess nobody needs to wait for a PCR result.
- lern_too_spel 6y ago
  The current positive rate in the US is 8.5%. A test that always returns negative would be more than 90% accurate but completely useless.
- Stevvo 6y ago
  I've lost count of the amount of times I've been tested, and it never took more than 15 minutes. There are plenty of quick and cheap tests out there.
  - HaloZero 6y ago
    I think quick is more about getting the results back quicker. But in terms of taking the test, it takes time to get to a testing site. A take home test would be a huge boon.
  - jader201 6y ago
    Curious, if you can explain without going into any sensitive details: 1) Why are you getting tested so often? 2) Where/how are are you getting tested and getting quick results?
    - xenospn 6y ago
      Assuming they're a healthcare worker. My friend who works for a plastic surgeon gets tested all the time.
    - oneplane 6y ago
      I'm not the person you asked, but I also get tested often and quickly due to some work on physical access controls. Often being: once a week. Not considered often compared to physical contact workers, but considered often compared to work-from-home workers. Heck, even considered often compared to the entire continent of North America. Quickly being: drive-in test or walk-in test that is done in 5 minutes, results within 3 days, usually within 24h, either by SMS text message or phone call (depending on the test center). Test center appointments are generally divided based on proximity, there are 4 test centers nearby for me (4 kilometres to max 30 kilometres -- sadly the one closest is usually queued up full for 1 or 2 days). So far my experience has been that they are very efficient; a lot of open space, about 6 people physically there at the most, testing room is about the size of a shipping container, one person doing the tests, one person observing/checking/entering data. The most efficient one was actually in a parking lot next to the hospital that also has a lab where they do mass testing. There is space for about 30 cars, but they regulate the appointments in a way that even when some people come early only 4 cars are there. Half the spaces are blocked/crossed out, entry and exit are made using ramps and zigzags (if that makes sense) so they are very accessible but also naturally prompt people to keep their distance (aside from the stickers/billboards all over the place). Because it's a single-direction flow for both cars and people and the people flow exit ends where the car parking flow starts you never run in to anyone getting in or out.
sneak 6y ago
The point is that if they administered tests daily at the daily capacity for testing (24h result turnaround) then many people who want to be tested would be turned away, and become aware immediately of the testing bottlenecks. It’s a form of bufferbloat. I sometimes wonder how many fewer USians would have died in this pandemic had it occurred outside of an election year.
- maxerickson 6y ago
  Do you think the election being this year is the important parameter in how many people have died unnecessarily in the US?
  - enraged_camel 6y ago
    There should be zero doubt about it. Republicans are desperate to have the economy going again only because it is such a strong factor in elections. As Bill Clinton famously said, "it is the economy, stupid." (Indeed, the economy is the only issue/criteria in which Biden still trails Trump in polls, but even that margin has been decreasing.) This relentless push to reopen things has resulted in many, many more deaths.
    - deleted 6y ago
      [deleted]
    - SpicyLemonZest 6y ago
      If true, this would mean that Republican senators and governors who aren't up for reelection in 2020 should be strongly pro-shutdown. Is that the pattern we're seeing?
      - deleted 6y ago
        [deleted]
    - unnamed76ri 6y ago
      Considering that most of the deaths are among the elderly population who tend to vote republican, that doesn’t make much sense. Unless you want to get really cynical and say there was a political motive in Democrat governors for sending positive patients into nursing homes and causing most of those deaths...
ex3ndr 6y ago
Sorry but i didn't get claims about lack of public investing in healthcare. Why when i am already paying like 500$/mo for insurance and making one physical in a year at most. Also during this physical i asked about help with my panic attacks and was told "well we don't have capacity at all for this, you will wait for ~month for your visit and it won't be useful since they are not going to have enough time to look at you". And this visit would be paid. May be AHA shouldn't limit number of doctors educated to make it available to public? Money is clearly not an issue.
- leereeves 6y ago
  I'd also like to remove the artificial limits on the number of doctors, but I don't see how it would help in this case. This delay is in the labs, not the doctors' offices.
- acdha 6y ago
  Spending is not synonymous with investment. Around half of your money is going to middlemen - think about how many people have full time jobs deciding what to charge, coding it, shipping invoices around, etc. not to mention trying to figure out how to profit as much as possible? How much goes to emergency care because preventative care is not covered and healthy lifestyles are actively discouraged by public policy? None of that is going to medical professionals, infrastructure, or research. We pay considerably more than anyone else per-capita but that’s waste: as far as outcomes go we rank much lower than our peers. This is also interesting when you compare tax rates: Americans pay taxes + insurance at a combined rate around “expensive” countries like Denmark but we don’t get anywhere near as much for our money.
  - roughly 6y ago
    Is it just half?
  - learc83 6y ago
    You’re right! Only about 20% of healthcare spending goes to physicians and half of that does to practice expenses like malpractice insurance. So even forcing physicians to work for free wouldn’t do very much to lower healthcare prices.
tzs 6y ago
For the cases given as examples in the article, from Georgia and Texas, even if they got prompt test results both those states are doing badly at contact tracing which further exacerbates the situation. Georgia is currently tracing just 7% of contacts. They were in the 7-9% range from mid May to early June, then fell slowly to about 4%, then briefly in late June got up to 19%, and then immediately went into decline back down to 7%. Texas is doing 6%. They were at 19% in mid May, rising to 42% near the end of May, fell to 25% in early to mid June, jumped to 33% by June 11, and then have been on a decline down to the current 6%. Experts say this needs to be 90% withing 48 hours of infection. California peaked at 39% in mid May and has followed roughly a declining sawtooth since then, currently at 22%. Florida is just 3%. They peaked at 40% at the start of June and went steadily down hill since then. They curve looks like a capacitor discharge curve. The only states that currently either have enough contact tracers or have planned expansions that will get them enough are: Alaska, Hawaii, South Dakota, and everything north or east of Pennsylvania except for Rhode Island, . Of those, all but New Jersey, Massachusetts, Alaska, and Hawaii currently have sufficient contact tracers on hand. The remaining ~40 states do not have enough and do not plan to get enough. A state needs 5-15 tracers per daily positive test. Georgia has 0.33, Texas 0.31, California 1.07, and Florida 0.15. Compare to New York at 13.75. (Missouri and Alabama are tied for the worst here, at a paltry 0.08). Reading between the lines, I think that several states hired enough to handle the load near the end of lockdown, with perhaps some room to spare for a minor raise as they reopened. When the rise was faster than they anticipated, they failed to slow down reopening or to boost their budget for contract tracing. Above data from https://testandtrace.com/ https://testandtrace.com/ and https://covidactnow.org/ https://covidactnow.org/
- makomk 6y ago
  No amount of budget-boosting would be enough to keep up with exponential growth. If they hired enough people to cope with the contact tracing load near the end of lockdown plus a little bit of an increase, and then the increase was faster than expected, that sounds like a pretty clear sign that contact tracing is not a workable solution. (Which is, as I understand it, pretty much what we'd expect. Contact tracing has not conventionally been seen as even remotely viable for a respiratory disease like this one.)
threatripper 6y ago
There is _some_ value in knowing that you had it even after the fact. Having a positive PCR test is way better than a positive antibody test. This knowledge means that it is unlikely that you will get it again soon. (Though, we don't have very good data on that. It will take some time till we know how long immunity lasts and how well it works.) For test and trace to suppress the epidemic you'd want to have results before people become infectious to chase the infection chain quicker than it spreads. That means contact identification and test results in the order of 1-2 days (the faster the better but with peak about 3-8 days after infection you want to be on the lower end). Right now this strategy is not feasible since there are just too many cases coming in. Therefore this calls for a hard lockdown until the case rate is manageable again. Since the lockdown is not going to happen it will continue to spread till the hot zones burn out. Getting to herd immunity without overloading the hospitals is unlikely and would probably take years. Therefore overloading the hospitals is inevitable now. The difference between hospitals overloaded by a factor 3, 10, 100 does not seem so very big since you can't care for most patients anyways. Overloading heavily on the other hand has the advantage that it might be over soon and you are done with it (or maybe not, we don't know how long lasting immunity is and how many people will have serious health problems afterwards). So in summary: We are probably beyond the point of no return and whatever happens will happen. I wish you all and your loved ones good health and good luck.
- acqq 6y ago
  > Having a positive PCR test is way better than a positive antibody test. This knowledge means that it is unlikely that you will get it again soon. I believe positive “antibody” test could hint to some chance of faring better “next time”. But even that is still not clear.
abalaji 6y ago
Incremental improvement
kingkawn 6y ago
Delayed test results are a nightmare that will guaranteed plunge us exponentially deeper into the mess we’re in in the US
- 908087 6y ago
  Delayed test results, an administration actively spreading misinformation and telling people that the experts are lying to them, anti-vax/anti-mask/etc conspiracy theories spreading like wildfire, CDC suddenly telling people they can stop self-isolating without testing negative, public television broadcasters giving nation-wide air time to conspiracy "documentaries" telling people Dr. Fauci created the virus and vaccines will kill them, idiots pushing for schools and businesses to reopen regardless of the infection rate, etc. We're fucked. I fear that it's going to be a very long time before I'm able to travel outside of the US again, and I really can't blame the countries who don't want us within their borders right now.
dehrmann 6y ago
Without contact tracing, there's an argument that tests don't give you much actionable information. If you're sick, you'll (hopefully) self-quarentine anyway. If you're sick enough to go to the hospital, you'll go anyway and be presumed to have covid. If you feel healthy, unless you're being tested because of your job, you probably aren't going to get tested. The case that's somewhat interesting is the one in article where someone might have gotten people sick at a party.
- vharuck 6y ago
  The tests helped my wife make a decision. She and I slept through most of one weekend (very unusual) and had mild congestion and headaches. However, calling off work for two weeks would've been difficult for her. She works at a daycare where staff have been leaving one after another. And the daycare doesn't give paid sick days. (I still insisted she stay home until the results came in 2 days later). We had to go with likelihood of being a spreader instead of getting to play it safe.
- wonderwonder 6y ago
  positive test probably goes a long way towards allowing people at minimum wage / hourly style jobs to call in sick without risking their jobs. Although they are likely forced to go to work without telling anyone as they lack sick leave and cannot afford a missed paycheck.
jefftk 6y ago
If tests are much more useful if they come back quickly, then first come first served with huge queues is the exact wrong way to handle excessive demand. Instead you should test the newest round of specimens that you have ready, and catch up on older ones if you can when you have a lull.
- dmurray 6y ago
  That incentivizes gaming the system by getting multiple tests, though, and hoping one will be lucky to be the newest batch. If you can centralise test assignment enough to eliminate that, you can do something smarter, like prioritising health workers, at-risk demographics and those who are already asymptomatic. Assign any remaining capacity quasi-randomly to get the best possible statistical data for your epidemiologists: if your systems are that overwhelmed it's far too late for contact tracing to be useful, but the data scientists may learn something. Having inefficient assignment of test resources is a problem inherent to privatised distributed healthcare that doesn't just go away if you solve the financial side with Obamacare or the like.
natrik 6y ago
I find it interesting how daily new deaths in Sweden seem to have levelled off to a low level. Of course there could be a second wave in the fall, but I think Sweden might have reached the low herd immunity threshold. https://www.worldometers.info/coronavirus/country/sweden/ https://www.worldometers.info/coronavirus/country/sweden/
- Marsymars 6y ago
  What I'm wondering is why it seems to have levelled off despite case numbers being wildly different in different regions of Sweden. Are people's habits different, leading to very different thresholds for herd immunity? Are reported case numbers off? Something else?
  - usaar333 6y ago
    In lower density areas, you'll have fewer contacts, so "herd immunity" numbers (with some interventions) are lower
- jschwartzi 6y ago
  They’ve leveled off here in Washington too, despite our daily new cases being double what they were before we locked down. I wonder why that is?
  - pgodzin 6y ago
    Well cases is the wrong measure as it's only identified cases -- we don't know how many new cases Washington was actually seeing before the lockdown
endymi0n 6y ago
It‘s so sad to watch, but compared to any other developed and affluent nation (and with equal time to prepare), the US is a complete shitshow at this point. The complete lack of leadership and resulting power vacuum resulted in valuable time lost bickering, blaming and thumb twiddling that could have gone towards preventing the second wave. This is a community spread at this stage and another hundred thousand people are all but guaranteed to die. It‘s mindblowing. Here in Germany, I‘m getting my test results within 3 days via SMS (usually same-day for positive results) and can enter it into an app to warn others. Everybody wears a mask indoors and nobody but a very small minority complains. Social distancing is enforced by usually friendly police which the people mostly trusts to do its job. It‘s just so sad to see how personal „freedom to choose“ turned into the achilles heel of one of the formerly greatest nations on Earth.
- deleted 6y ago
  [deleted]
- cnzxbT 6y ago
  > Everybody wears a mask indoors and nobody but a very small minority complains. This is true in supermarkets at least. > Social distancing is enforced by usually friendly police which the people mostly trusts to do its job. Sorry, hardly anyone still practices distancing outside. At a lake people were on a crowded beach 20cm apart.
  - microcolonel 6y ago
    > Sorry, hardly anyone still practices distancing outside. At a lake people were on a crowded beach 20cm apart. And the risks at these places are apparently pretty low, even with more lax physical distancing; 20cm does seem a bit close though.
- oezi 6y ago
  I am not so sure if Europe in general and Germany specifically could not be hit with similar situations again. - After the April lock down it is clear, that we cannot repeat this economically again. - Population becomes tired of maintaining the hygiene regiment. Improperly worn masks are on the rise. Dining out is increasing / bars/gyms/pools are reopening and are starting to get crowded. - Decision making is pushed down from Federal to State and local levels (at least in Germany) causing a lack of cohesion of plans and making it impossible for the public to understand what policy is enforced where and why. One good example of this is that the general mask wearing mandate is still in place but many states have allowed for employees (e.g. in stores) to forego masks. - Schools closed for summer have paused a likely source of many transmission routes. After going below 2000 infection per week, we are set to hit 4000 per week after the weekend in Germany.
dboreham 6y ago
Because the official government policy is "just deal with it" and proper testing isn't compatible with that policy. Essentially the test is a fobbing off measure.
birken 6y ago
If you want to be incredibly angry at the ineffectiveness of the current testing regime that we as a country are heavily investing in, listen to this episode of the This Week In Virology podcast: https://www.microbe.tv/twiv/twiv-640/ https://www.microbe.tv/twiv/twiv-640/ [TWiV 640: Test often, fast turnaround, with Michael Mina] The way to beat the pandemic is to have cheap, disposable instant tests that anybody can take in their homes, everyday, to see if they have a large amount of virus in their system. These instant tests will not have the sensitivity or specificity of the PCR style test, but it doesn't matter. The PCR style test can test for levels of virus that are billions or trillions times smaller than necessary, yet we disqualify other types of tests because they aren't as accurate as the PCR tests. So we set an impossible standard that all other tests, no matter how practically useful they could be, fail to reach. We all could have cheap, accurate enough instant tests, but do not because they aren't as accurate as a test that is ridiculously accurate but takes so long to get results at scale it becomes completely ineffective. It's complete madness.
- jacquesm 6y ago
  Is there such a thing as an instant test on the market?
  - microcolonel 6y ago
    A company here in Canada tried to bring one to market, but I think it was completely disapproved because it was not precise and specific enough, which baffled me since I don't really see the downside of it being available even if that's the case. Yes, accuracy is a nice thing to have, but if you aren't tested at all you are worse off. You can still follow precautions if you are negative on an inaccurate test, but we can't afford to have everyone take the precautions that those with positive tests should. If the test is highly sensitive but biased toward false positives, that would also be a useful form of test.
    - jacquesm 6y ago
      That it will lead to a lot of follow up tests and people that are ill thinking they are not.
deleted 6y ago
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saluki 6y ago
Not only the time frame but it seems like all the tests have significant false + and false - results. I don't see any benefit from being tested at this time. I definitely don't want to spread the virus if I'm positive or be around people who are positive and can spread it to me but the time frame and false +/- results, testing doesn't seem viable to provide any actionable knowledge. I think we'll see the limits of what testing can do to prevent the spread of the virus with the start of NFL training camp/season.
- aaronblohowiak 6y ago
  the roche antibody test has high specificity and sensitivity
  - adolph 6y ago
    Without knowing the base rate for a community isn’t specificity and sensitivity like a numerator without a denominator? “Roche’s SARS-CoV2 antibody test, which has a specificity greater than 99.8% and 100% sensitivity3 (14 Days post-PCR confirmation), can help assess patients’ immune response to the virus.” https://www.roche.com/media/releases/med-cor-2020-05-03.htm https://www.roche.com/media/releases/med-cor-2020-05-03.htm
    - nradov 6y ago
      Roche validated the test using stored blood samples from before the pandemic started, when the base rate was 0.
tammer 6y ago
I work for a big institution that includes a massively funded hospital network. I don’t actually work for the medical part of the institution. I am technically deemed an essential worker because we have servers on-site. Recently I had some minor symptoms and wanted to get a test. By going through my employer’s employee testing process I A) got a test scheduled for the same day I called B) got my negative result under 12 hours later This was a transformative moment for me in recognizing that there is an intentional, and centralized project to stress testing capacity in the United States. There is no shortage of materials or staff, just funding for lab capacity. This is an incredibly solvable problem that our leaders are choosing not to solve. I truly believe the future historical narrative of this moment will cast our elected leaders as the orchestrators of mass genocide. It’s hard to consider living, breathing, contemporary people who hold esteemed positions to be on the level of evil as historical Nazis. But as time passes and we consider the impact their choices are having, it will both become easier to cast them in such a light, and to question the passivity of a population that accepts their decisions. It has never been more clear to me how such atrocities can happen and at the same time become normalized.
- asdf333 6y ago
  so you are saying that test results are intentionally being delayed? i am not a fan of this administration and feel there is plenty of blame to go around but i would love for more insight on why you think there is some intentional malice happening...
  - xenospn 6y ago
    Virus stats make the people at the top look bad. More testing - more accurate stats. More accurate stats - more outraged people. So they delay.
- mensetmanusman 6y ago
  Competence fluctuates around the country
pdog 6y ago
Did this pervasive level of criticism, animosity, and negativity exist a hundred years ago during the last serious pandemic? Every week there's some new crisis. It feels like the entire media is always trying to highlight the next systemic failure. "This is wrong." "This failed." "We don't have enough ventilators." "New York cases are surging." "California cases are surging." "We don't have enough PPE." "We don't have hand sanitizer." "We don't have masks." "We don't have enough tests." Are things actually this consistently bad, or does the media magnify the negative and ignore the positive developments (of which there are plenty)? It's like the difference between acute inflammation (which is good for the body when it's fighting an infection) and chronic inflammation (which causes a lot of problems).
- wittyreference 6y ago
  It also happens to be the case that Houston is the major processing center for all of the major lab groups for the south/southwest. They literally pointed at the single most congested part of the network, during a period of global supply shortages, and went "well, that's not working well." Well, yeah, it's not fucking working well. We're cranking out tests and running analyses at an unprecedented level. And we're doing a decent job of ramping up, actually, but not perfectly evenly across the board. My healthcare center is not particularly large or particularly well-connected. We've been getting our tests back in 3 days. At one point our partner started getting too heavily inundated, things were lagging to 5 days, so we switched to another that didn't require shipping to Houston for processing. We're back to 3 days. But we're lucky - we're small enough that we don't have to partner with a Houston-based center. Others aren't.
- mikeshank 6y ago
  > does the media magnify the negative and ignore the positive developments (of which there are plenty)? The media crafts its daily narrative with an eye on objectivity and plays right down the middle. Just the facts, always. To suggest otherwise is quite dangerous.
- jazzyjackson 6y ago
  I suppose ever since newspapers were invented they've done whatever they can to attract readership fact is the news needs their audience to feel that news is essential to their daily life, and if it was just good news I could make the choice to watch something a little more interesting, but by choosing stories that feel urgent and dramatic, they create the urgency to stay tuned to 'stay informed' No one needs to stay informed of the good news, although I do miss when the late night shows would make fun of light hearted news that was a once daily reminder that there's a lot going on in the world that's not american politics
mensetmanusman 6y ago
This will not get resolved because both major parties have decided America isn’t worth saving (because the other party exists).
at_a_remove 6y ago
Clearly, the reporter didn't really want the question answered because three points come to mind, immediately. 1) Testing of corpses and blood samples thereof. The CDC recently changed its guidelines for cause of death determination to be "if it looks like COVID, just mark it down as COVID." Being able to test corpses, who are in no rush, could help more accurately pin down mortality rates. 2) Knowing that you are not likely to catch it again, or, alternately, are still at risk. Yes, I know there's some debate as to whether or not you can catch it again due to declining antibodies. I am not believing that at current. 3) Being able to use antibodies cultivated from patients who have recovered in those who are currently quite ill. That's a common enough concept, cheaper than cultivating monoclonal antibodies. Boom, three right there. How hard was that?
tunesmith 6y ago
Even in a place like Oregon which seems fairly well managed, we have major test shortages. It just seems to me that the first benchmark should be if we have enough test availability (some combo of more tests and less infections) to be able to get results with 24 hours of symptoms, so we can effectively contact trace. If we don't have that, then all this Phase1 Phase2 stuff just means that you're increasing the epidemic. But here in Oregon, all the counties are in Phase1 or Phase2, none of them are in the "Baseline" lockdown phase. Shouldn't we all be in the Baseline phase until we have enough test availability? I'm betting there's a good answer, like maybe the amount of test availability Oregon has is dependent on the rest of the nation. Like, if our epidemic goes down 90%, maybe our test availability will go down 90% anyway because other states will get further prioritized. But anyway, it seems like that should be the basic standard nationwide. Lock it down until you can get test results within 24 hours, and then only slowly open it up while proving you can keep that test availability - if you can't, freeze or go back.
yalogin 6y ago
We are in this mess fully because of trump. It’s unfortunate we have a president that has no empathy for people and is constantly fanning the conspiracy theories as he also doesn’t believe in science. But finally he seems to have realize it’s bad for him so he might actually try to listen to his scientists for a day or two. Given people are already so predisposed to their theories not sure how many people actually will listen without a full lockdown. Also it’s highly unlikely the red states will lockdown ahead of the election and go against trump. We are in a real mess. The pessimist in me is thinking we will probably have to really solve it after the election it if trump wins probably never until we get a vaccine.
wyattpeak 6y ago
While a wait time of 19 days is much too long, the connection drawn by the article to the CDC recommended 2-week quarantine ("That’s five days longer than the quarantine period of two weeks recommended by the CDC") is spurious. That's the time in which the virus is expected to present, not the point at which it's okay to leave your home regardless. From the CDC article which they link right there, "[q]uarantine helps prevent spread of disease that can occur before a person knows they are sick or if they are infected with the virus without feeling symptoms."
Animats 6y ago
" So I said to my people, 'Slow the testing down, please.'". Mission accomplished.
vinniejames 6y ago
What percentage of the current population has already been infected? What is the latest death rate of confirmed cases?
flukus 6y ago
What's the point of testing at all in places that aren't taking steps to reduce the spread? Testing isn't the goal, it's data to use for an informed response. If the response isn't going to come it's just a morbid and useless statistic.
- SpicyLemonZest 6y ago
  Even in places that are willing to accept some amount of spread, testing allows people to make informed decisions before doing particularly risky things. I have friends who for example take a test just before visiting their grandparents - if we lived in an area with week-long turnarounds, they wouldn't be able to do that, and would have to choose between a significant risk of infecting them or leaving them isolated for months on end.

224 points by finphil 6y ago

Thus the need for cheaper, quicker tests, even if the accuracy is t that great. TWIV Podcast episode #640 covers this. $1 per day test that quickly gives a result, but perhaps is only 50% accurate.

watwut 6y ago
The tests are quick. The delay is because labs are overwhelmed.
stonogo 6y ago
If that's the test you want, you can literally flip a coin.
- dap 6y ago
  A coin flip won’t be nearly 50% accurate.
  - lostlogin 6y ago
    ELI5 - If the test has 50% accuracy and is producing equal false positives and false negatives, is the coin producing inferior results?
    - ls612 6y ago
      No because Pr(Infected) << Pr(Not Infected) even in the places with the most spread right now.
    - dap 6y ago
      Suppose you test a population of 100 people in which 10 are infected. The coin flip test reports 50 people infected on average. Among those positive tests, at least 40 have to be to be false positives Because there are only 10 infected to begin with. That’s a false positive rate at least 80%. Among negatives, we would expect 5 to be false (since 10 people are infected and each of them have a coin flip chance of testing negative) or 10%. I’m not sure that you can have a test that’s 50% accurate and errs equally in both directions. At least, I’m not sure what it would mean.
- aquadrop 6y ago
  That's exactly was is talked about in the podcast by the doctor. It's not random 50% accuracy, it catches all the people it needs to catch, because accuracy depends on amount of viruses they shed. Accuracy on people who are transmitting decease is more than enough.
acqq 6y ago
My post with the summary, 7 days ago: https://news.ycombinator.com/item?id=23881080 https://news.ycombinator.com/item?id=23881080 "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." Thinking more about it, the most important point I'd add now is: We should learn not to think about "the test" but about (at least) two different kinds of tests for different purposes: 1) fast tests to reduce the chance of virus spreading. Anybody isolated before managing to spread the virus is better than not testing, so it doesn't have to be too precise. We just have to understand its limits. 2) more reliable tests for clinical purposes, whenever they are needed. Interestingly, even in such scenarios antibody tests could find their use and allow cheaper or faster results, something like this: https://www.clinisciences.com/en/read/newsletter-26/sars-cov-2-covid-19-diagnosis-by-2264.html https://www.clinisciences.com/en/read/newsletter-26/sars-cov... E.g. if somebody has symptoms and IgM (or IgM and IgG), that could be good enough of information to decide how somebody is to be treated. One more example where I'd guess nobody needs to wait for a PCR result.
lern_too_spel 6y ago
The current positive rate in the US is 8.5%. A test that always returns negative would be more than 90% accurate but completely useless.
Stevvo 6y ago
I've lost count of the amount of times I've been tested, and it never took more than 15 minutes. There are plenty of quick and cheap tests out there.
- HaloZero 6y ago
  I think quick is more about getting the results back quicker. But in terms of taking the test, it takes time to get to a testing site. A take home test would be a huge boon.
- jader201 6y ago
  Curious, if you can explain without going into any sensitive details: 1) Why are you getting tested so often? 2) Where/how are are you getting tested and getting quick results?
  - xenospn 6y ago
    Assuming they're a healthcare worker. My friend who works for a plastic surgeon gets tested all the time.
  - oneplane 6y ago
    I'm not the person you asked, but I also get tested often and quickly due to some work on physical access controls. Often being: once a week. Not considered often compared to physical contact workers, but considered often compared to work-from-home workers. Heck, even considered often compared to the entire continent of North America. Quickly being: drive-in test or walk-in test that is done in 5 minutes, results within 3 days, usually within 24h, either by SMS text message or phone call (depending on the test center). Test center appointments are generally divided based on proximity, there are 4 test centers nearby for me (4 kilometres to max 30 kilometres -- sadly the one closest is usually queued up full for 1 or 2 days). So far my experience has been that they are very efficient; a lot of open space, about 6 people physically there at the most, testing room is about the size of a shipping container, one person doing the tests, one person observing/checking/entering data. The most efficient one was actually in a parking lot next to the hospital that also has a lab where they do mass testing. There is space for about 30 cars, but they regulate the appointments in a way that even when some people come early only 4 cars are there. Half the spaces are blocked/crossed out, entry and exit are made using ramps and zigzags (if that makes sense) so they are very accessible but also naturally prompt people to keep their distance (aside from the stickers/billboards all over the place). Because it's a single-direction flow for both cars and people and the people flow exit ends where the car parking flow starts you never run in to anyone getting in or out.

sneak 6y ago

The point is that if they administered tests daily at the daily capacity for testing (24h result turnaround) then many people who want to be tested would be turned away, and become aware immediately of the testing bottlenecks. It’s a form of bufferbloat. I sometimes wonder how many fewer USians would have died in this pandemic had it occurred outside of an election year.

maxerickson 6y ago
Do you think the election being this year is the important parameter in how many people have died unnecessarily in the US?
- enraged_camel 6y ago
  There should be zero doubt about it. Republicans are desperate to have the economy going again only because it is such a strong factor in elections. As Bill Clinton famously said, "it is the economy, stupid." (Indeed, the economy is the only issue/criteria in which Biden still trails Trump in polls, but even that margin has been decreasing.) This relentless push to reopen things has resulted in many, many more deaths.
  - deleted 6y ago
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  - SpicyLemonZest 6y ago
    If true, this would mean that Republican senators and governors who aren't up for reelection in 2020 should be strongly pro-shutdown. Is that the pattern we're seeing?
    - deleted 6y ago
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  - unnamed76ri 6y ago
    Considering that most of the deaths are among the elderly population who tend to vote republican, that doesn’t make much sense. Unless you want to get really cynical and say there was a political motive in Democrat governors for sending positive patients into nursing homes and causing most of those deaths...

ex3ndr 6y ago

Sorry but i didn't get claims about lack of public investing in healthcare. Why when i am already paying like 500$/mo for insurance and making one physical in a year at most. Also during this physical i asked about help with my panic attacks and was told "well we don't have capacity at all for this, you will wait for ~month for your visit and it won't be useful since they are not going to have enough time to look at you". And this visit would be paid. May be AHA shouldn't limit number of doctors educated to make it available to public? Money is clearly not an issue.

leereeves 6y ago
I'd also like to remove the artificial limits on the number of doctors, but I don't see how it would help in this case. This delay is in the labs, not the doctors' offices.
acdha 6y ago
Spending is not synonymous with investment. Around half of your money is going to middlemen - think about how many people have full time jobs deciding what to charge, coding it, shipping invoices around, etc. not to mention trying to figure out how to profit as much as possible? How much goes to emergency care because preventative care is not covered and healthy lifestyles are actively discouraged by public policy? None of that is going to medical professionals, infrastructure, or research. We pay considerably more than anyone else per-capita but that’s waste: as far as outcomes go we rank much lower than our peers. This is also interesting when you compare tax rates: Americans pay taxes + insurance at a combined rate around “expensive” countries like Denmark but we don’t get anywhere near as much for our money.
- roughly 6y ago
  Is it just half?
- learc83 6y ago
  You’re right! Only about 20% of healthcare spending goes to physicians and half of that does to practice expenses like malpractice insurance. So even forcing physicians to work for free wouldn’t do very much to lower healthcare prices.

tzs 6y ago

For the cases given as examples in the article, from Georgia and Texas, even if they got prompt test results both those states are doing badly at contact tracing which further exacerbates the situation. Georgia is currently tracing just 7% of contacts. They were in the 7-9% range from mid May to early June, then fell slowly to about 4%, then briefly in late June got up to 19%, and then immediately went into decline back down to 7%. Texas is doing 6%. They were at 19% in mid May, rising to 42% near the end of May, fell to 25% in early to mid June, jumped to 33% by June 11, and then have been on a decline down to the current 6%. Experts say this needs to be 90% withing 48 hours of infection. California peaked at 39% in mid May and has followed roughly a declining sawtooth since then, currently at 22%. Florida is just 3%. They peaked at 40% at the start of June and went steadily down hill since then. They curve looks like a capacitor discharge curve. The only states that currently either have enough contact tracers or have planned expansions that will get them enough are: Alaska, Hawaii, South Dakota, and everything north or east of Pennsylvania except for Rhode Island, . Of those, all but New Jersey, Massachusetts, Alaska, and Hawaii currently have sufficient contact tracers on hand. The remaining ~40 states do not have enough and do not plan to get enough. A state needs 5-15 tracers per daily positive test. Georgia has 0.33, Texas 0.31, California 1.07, and Florida 0.15. Compare to New York at 13.75. (Missouri and Alabama are tied for the worst here, at a paltry 0.08). Reading between the lines, I think that several states hired enough to handle the load near the end of lockdown, with perhaps some room to spare for a minor raise as they reopened. When the rise was faster than they anticipated, they failed to slow down reopening or to boost their budget for contract tracing. Above data from https://testandtrace.com/ https://testandtrace.com/ and https://covidactnow.org/ https://covidactnow.org/

makomk 6y ago
No amount of budget-boosting would be enough to keep up with exponential growth. If they hired enough people to cope with the contact tracing load near the end of lockdown plus a little bit of an increase, and then the increase was faster than expected, that sounds like a pretty clear sign that contact tracing is not a workable solution. (Which is, as I understand it, pretty much what we'd expect. Contact tracing has not conventionally been seen as even remotely viable for a respiratory disease like this one.)

threatripper 6y ago

There is _some_ value in knowing that you had it even after the fact. Having a positive PCR test is way better than a positive antibody test. This knowledge means that it is unlikely that you will get it again soon. (Though, we don't have very good data on that. It will take some time till we know how long immunity lasts and how well it works.) For test and trace to suppress the epidemic you'd want to have results before people become infectious to chase the infection chain quicker than it spreads. That means contact identification and test results in the order of 1-2 days (the faster the better but with peak about 3-8 days after infection you want to be on the lower end). Right now this strategy is not feasible since there are just too many cases coming in. Therefore this calls for a hard lockdown until the case rate is manageable again. Since the lockdown is not going to happen it will continue to spread till the hot zones burn out. Getting to herd immunity without overloading the hospitals is unlikely and would probably take years. Therefore overloading the hospitals is inevitable now. The difference between hospitals overloaded by a factor 3, 10, 100 does not seem so very big since you can't care for most patients anyways. Overloading heavily on the other hand has the advantage that it might be over soon and you are done with it (or maybe not, we don't know how long lasting immunity is and how many people will have serious health problems afterwards). So in summary: We are probably beyond the point of no return and whatever happens will happen. I wish you all and your loved ones good health and good luck.

acqq 6y ago
> Having a positive PCR test is way better than a positive antibody test. This knowledge means that it is unlikely that you will get it again soon. I believe positive “antibody” test could hint to some chance of faring better “next time”. But even that is still not clear.

abalaji 6y ago

Incremental improvement

kingkawn 6y ago

Delayed test results are a nightmare that will guaranteed plunge us exponentially deeper into the mess we’re in in the US

908087 6y ago
Delayed test results, an administration actively spreading misinformation and telling people that the experts are lying to them, anti-vax/anti-mask/etc conspiracy theories spreading like wildfire, CDC suddenly telling people they can stop self-isolating without testing negative, public television broadcasters giving nation-wide air time to conspiracy "documentaries" telling people Dr. Fauci created the virus and vaccines will kill them, idiots pushing for schools and businesses to reopen regardless of the infection rate, etc. We're fucked. I fear that it's going to be a very long time before I'm able to travel outside of the US again, and I really can't blame the countries who don't want us within their borders right now.

dehrmann 6y ago

Without contact tracing, there's an argument that tests don't give you much actionable information. If you're sick, you'll (hopefully) self-quarentine anyway. If you're sick enough to go to the hospital, you'll go anyway and be presumed to have covid. If you feel healthy, unless you're being tested because of your job, you probably aren't going to get tested. The case that's somewhat interesting is the one in article where someone might have gotten people sick at a party.

vharuck 6y ago
The tests helped my wife make a decision. She and I slept through most of one weekend (very unusual) and had mild congestion and headaches. However, calling off work for two weeks would've been difficult for her. She works at a daycare where staff have been leaving one after another. And the daycare doesn't give paid sick days. (I still insisted she stay home until the results came in 2 days later). We had to go with likelihood of being a spreader instead of getting to play it safe.
wonderwonder 6y ago
positive test probably goes a long way towards allowing people at minimum wage / hourly style jobs to call in sick without risking their jobs. Although they are likely forced to go to work without telling anyone as they lack sick leave and cannot afford a missed paycheck.

jefftk 6y ago

If tests are much more useful if they come back quickly, then first come first served with huge queues is the exact wrong way to handle excessive demand. Instead you should test the newest round of specimens that you have ready, and catch up on older ones if you can when you have a lull.

dmurray 6y ago
That incentivizes gaming the system by getting multiple tests, though, and hoping one will be lucky to be the newest batch. If you can centralise test assignment enough to eliminate that, you can do something smarter, like prioritising health workers, at-risk demographics and those who are already asymptomatic. Assign any remaining capacity quasi-randomly to get the best possible statistical data for your epidemiologists: if your systems are that overwhelmed it's far too late for contact tracing to be useful, but the data scientists may learn something. Having inefficient assignment of test resources is a problem inherent to privatised distributed healthcare that doesn't just go away if you solve the financial side with Obamacare or the like.

natrik 6y ago

I find it interesting how daily new deaths in Sweden seem to have levelled off to a low level. Of course there could be a second wave in the fall, but I think Sweden might have reached the low herd immunity threshold. https://www.worldometers.info/coronavirus/country/sweden/ https://www.worldometers.info/coronavirus/country/sweden/

Marsymars 6y ago
What I'm wondering is why it seems to have levelled off despite case numbers being wildly different in different regions of Sweden. Are people's habits different, leading to very different thresholds for herd immunity? Are reported case numbers off? Something else?
- usaar333 6y ago
  In lower density areas, you'll have fewer contacts, so "herd immunity" numbers (with some interventions) are lower
jschwartzi 6y ago
They’ve leveled off here in Washington too, despite our daily new cases being double what they were before we locked down. I wonder why that is?
- pgodzin 6y ago
  Well cases is the wrong measure as it's only identified cases -- we don't know how many new cases Washington was actually seeing before the lockdown

endymi0n 6y ago

It‘s so sad to watch, but compared to any other developed and affluent nation (and with equal time to prepare), the US is a complete shitshow at this point. The complete lack of leadership and resulting power vacuum resulted in valuable time lost bickering, blaming and thumb twiddling that could have gone towards preventing the second wave. This is a community spread at this stage and another hundred thousand people are all but guaranteed to die. It‘s mindblowing. Here in Germany, I‘m getting my test results within 3 days via SMS (usually same-day for positive results) and can enter it into an app to warn others. Everybody wears a mask indoors and nobody but a very small minority complains. Social distancing is enforced by usually friendly police which the people mostly trusts to do its job. It‘s just so sad to see how personal „freedom to choose“ turned into the achilles heel of one of the formerly greatest nations on Earth.

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cnzxbT 6y ago
> Everybody wears a mask indoors and nobody but a very small minority complains. This is true in supermarkets at least. > Social distancing is enforced by usually friendly police which the people mostly trusts to do its job. Sorry, hardly anyone still practices distancing outside. At a lake people were on a crowded beach 20cm apart.
- microcolonel 6y ago
  > Sorry, hardly anyone still practices distancing outside. At a lake people were on a crowded beach 20cm apart. And the risks at these places are apparently pretty low, even with more lax physical distancing; 20cm does seem a bit close though.
oezi 6y ago
I am not so sure if Europe in general and Germany specifically could not be hit with similar situations again. - After the April lock down it is clear, that we cannot repeat this economically again. - Population becomes tired of maintaining the hygiene regiment. Improperly worn masks are on the rise. Dining out is increasing / bars/gyms/pools are reopening and are starting to get crowded. - Decision making is pushed down from Federal to State and local levels (at least in Germany) causing a lack of cohesion of plans and making it impossible for the public to understand what policy is enforced where and why. One good example of this is that the general mask wearing mandate is still in place but many states have allowed for employees (e.g. in stores) to forego masks. - Schools closed for summer have paused a likely source of many transmission routes. After going below 2000 infection per week, we are set to hit 4000 per week after the weekend in Germany.

dboreham 6y ago

Because the official government policy is "just deal with it" and proper testing isn't compatible with that policy. Essentially the test is a fobbing off measure.

birken 6y ago

If you want to be incredibly angry at the ineffectiveness of the current testing regime that we as a country are heavily investing in, listen to this episode of the This Week In Virology podcast: https://www.microbe.tv/twiv/twiv-640/ https://www.microbe.tv/twiv/twiv-640/ [TWiV 640: Test often, fast turnaround, with Michael Mina] The way to beat the pandemic is to have cheap, disposable instant tests that anybody can take in their homes, everyday, to see if they have a large amount of virus in their system. These instant tests will not have the sensitivity or specificity of the PCR style test, but it doesn't matter. The PCR style test can test for levels of virus that are billions or trillions times smaller than necessary, yet we disqualify other types of tests because they aren't as accurate as the PCR tests. So we set an impossible standard that all other tests, no matter how practically useful they could be, fail to reach. We all could have cheap, accurate enough instant tests, but do not because they aren't as accurate as a test that is ridiculously accurate but takes so long to get results at scale it becomes completely ineffective. It's complete madness.

jacquesm 6y ago
Is there such a thing as an instant test on the market?
- microcolonel 6y ago
  A company here in Canada tried to bring one to market, but I think it was completely disapproved because it was not precise and specific enough, which baffled me since I don't really see the downside of it being available even if that's the case. Yes, accuracy is a nice thing to have, but if you aren't tested at all you are worse off. You can still follow precautions if you are negative on an inaccurate test, but we can't afford to have everyone take the precautions that those with positive tests should. If the test is highly sensitive but biased toward false positives, that would also be a useful form of test.
  - jacquesm 6y ago
    That it will lead to a lot of follow up tests and people that are ill thinking they are not.

deleted 6y ago

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saluki 6y ago

Not only the time frame but it seems like all the tests have significant false + and false - results. I don't see any benefit from being tested at this time. I definitely don't want to spread the virus if I'm positive or be around people who are positive and can spread it to me but the time frame and false +/- results, testing doesn't seem viable to provide any actionable knowledge. I think we'll see the limits of what testing can do to prevent the spread of the virus with the start of NFL training camp/season.

aaronblohowiak 6y ago
the roche antibody test has high specificity and sensitivity
- adolph 6y ago
  Without knowing the base rate for a community isn’t specificity and sensitivity like a numerator without a denominator? “Roche’s SARS-CoV2 antibody test, which has a specificity greater than 99.8% and 100% sensitivity3 (14 Days post-PCR confirmation), can help assess patients’ immune response to the virus.” https://www.roche.com/media/releases/med-cor-2020-05-03.htm https://www.roche.com/media/releases/med-cor-2020-05-03.htm
  - nradov 6y ago
    Roche validated the test using stored blood samples from before the pandemic started, when the base rate was 0.

tammer 6y ago

I work for a big institution that includes a massively funded hospital network. I don’t actually work for the medical part of the institution. I am technically deemed an essential worker because we have servers on-site. Recently I had some minor symptoms and wanted to get a test. By going through my employer’s employee testing process I A) got a test scheduled for the same day I called B) got my negative result under 12 hours later This was a transformative moment for me in recognizing that there is an intentional, and centralized project to stress testing capacity in the United States. There is no shortage of materials or staff, just funding for lab capacity. This is an incredibly solvable problem that our leaders are choosing not to solve. I truly believe the future historical narrative of this moment will cast our elected leaders as the orchestrators of mass genocide. It’s hard to consider living, breathing, contemporary people who hold esteemed positions to be on the level of evil as historical Nazis. But as time passes and we consider the impact their choices are having, it will both become easier to cast them in such a light, and to question the passivity of a population that accepts their decisions. It has never been more clear to me how such atrocities can happen and at the same time become normalized.

asdf333 6y ago
so you are saying that test results are intentionally being delayed? i am not a fan of this administration and feel there is plenty of blame to go around but i would love for more insight on why you think there is some intentional malice happening...
- xenospn 6y ago
  Virus stats make the people at the top look bad. More testing - more accurate stats. More accurate stats - more outraged people. So they delay.
mensetmanusman 6y ago
Competence fluctuates around the country

pdog 6y ago

Did this pervasive level of criticism, animosity, and negativity exist a hundred years ago during the last serious pandemic? Every week there's some new crisis. It feels like the entire media is always trying to highlight the next systemic failure. "This is wrong." "This failed." "We don't have enough ventilators." "New York cases are surging." "California cases are surging." "We don't have enough PPE." "We don't have hand sanitizer." "We don't have masks." "We don't have enough tests." Are things actually this consistently bad, or does the media magnify the negative and ignore the positive developments (of which there are plenty)? It's like the difference between acute inflammation (which is good for the body when it's fighting an infection) and chronic inflammation (which causes a lot of problems).

wittyreference 6y ago
It also happens to be the case that Houston is the major processing center for all of the major lab groups for the south/southwest. They literally pointed at the single most congested part of the network, during a period of global supply shortages, and went "well, that's not working well." Well, yeah, it's not fucking working well. We're cranking out tests and running analyses at an unprecedented level. And we're doing a decent job of ramping up, actually, but not perfectly evenly across the board. My healthcare center is not particularly large or particularly well-connected. We've been getting our tests back in 3 days. At one point our partner started getting too heavily inundated, things were lagging to 5 days, so we switched to another that didn't require shipping to Houston for processing. We're back to 3 days. But we're lucky - we're small enough that we don't have to partner with a Houston-based center. Others aren't.
mikeshank 6y ago
> does the media magnify the negative and ignore the positive developments (of which there are plenty)? The media crafts its daily narrative with an eye on objectivity and plays right down the middle. Just the facts, always. To suggest otherwise is quite dangerous.
jazzyjackson 6y ago
I suppose ever since newspapers were invented they've done whatever they can to attract readership fact is the news needs their audience to feel that news is essential to their daily life, and if it was just good news I could make the choice to watch something a little more interesting, but by choosing stories that feel urgent and dramatic, they create the urgency to stay tuned to 'stay informed' No one needs to stay informed of the good news, although I do miss when the late night shows would make fun of light hearted news that was a once daily reminder that there's a lot going on in the world that's not american politics

mensetmanusman 6y ago

This will not get resolved because both major parties have decided America isn’t worth saving (because the other party exists).

at_a_remove 6y ago

Clearly, the reporter didn't really want the question answered because three points come to mind, immediately. 1) Testing of corpses and blood samples thereof. The CDC recently changed its guidelines for cause of death determination to be "if it looks like COVID, just mark it down as COVID." Being able to test corpses, who are in no rush, could help more accurately pin down mortality rates. 2) Knowing that you are not likely to catch it again, or, alternately, are still at risk. Yes, I know there's some debate as to whether or not you can catch it again due to declining antibodies. I am not believing that at current. 3) Being able to use antibodies cultivated from patients who have recovered in those who are currently quite ill. That's a common enough concept, cheaper than cultivating monoclonal antibodies. Boom, three right there. How hard was that?

tunesmith 6y ago

Even in a place like Oregon which seems fairly well managed, we have major test shortages. It just seems to me that the first benchmark should be if we have enough test availability (some combo of more tests and less infections) to be able to get results with 24 hours of symptoms, so we can effectively contact trace. If we don't have that, then all this Phase1 Phase2 stuff just means that you're increasing the epidemic. But here in Oregon, all the counties are in Phase1 or Phase2, none of them are in the "Baseline" lockdown phase. Shouldn't we all be in the Baseline phase until we have enough test availability? I'm betting there's a good answer, like maybe the amount of test availability Oregon has is dependent on the rest of the nation. Like, if our epidemic goes down 90%, maybe our test availability will go down 90% anyway because other states will get further prioritized. But anyway, it seems like that should be the basic standard nationwide. Lock it down until you can get test results within 24 hours, and then only slowly open it up while proving you can keep that test availability - if you can't, freeze or go back.

yalogin 6y ago

We are in this mess fully because of trump. It’s unfortunate we have a president that has no empathy for people and is constantly fanning the conspiracy theories as he also doesn’t believe in science. But finally he seems to have realize it’s bad for him so he might actually try to listen to his scientists for a day or two. Given people are already so predisposed to their theories not sure how many people actually will listen without a full lockdown. Also it’s highly unlikely the red states will lockdown ahead of the election and go against trump. We are in a real mess. The pessimist in me is thinking we will probably have to really solve it after the election it if trump wins probably never until we get a vaccine.

wyattpeak 6y ago

While a wait time of 19 days is much too long, the connection drawn by the article to the CDC recommended 2-week quarantine ("That’s five days longer than the quarantine period of two weeks recommended by the CDC") is spurious. That's the time in which the virus is expected to present, not the point at which it's okay to leave your home regardless. From the CDC article which they link right there, "[q]uarantine helps prevent spread of disease that can occur before a person knows they are sick or if they are infected with the virus without feeling symptoms."

Animats 6y ago

" So I said to my people, 'Slow the testing down, please.'". Mission accomplished.

vinniejames 6y ago

What percentage of the current population has already been infected? What is the latest death rate of confirmed cases?

flukus 6y ago

What's the point of testing at all in places that aren't taking steps to reduce the spread? Testing isn't the goal, it's data to use for an informed response. If the response isn't going to come it's just a morbid and useless statistic.

SpicyLemonZest 6y ago
Even in places that are willing to accept some amount of spread, testing allows people to make informed decisions before doing particularly risky things. I have friends who for example take a test just before visiting their grandparents - if we lived in an area with week-long turnarounds, they wouldn't be able to do that, and would have to choose between a significant risk of infecting them or leaving them isolated for months on end.