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The goal isn’t to arguably not be failing worse than some other countries are failing. The NYT piece isn’t about comparing the US to other countries anyway—tha

by jmull 6y ago

The goal isn’t to arguably not be failing worse than some other countries are failing. The NYT piece isn’t about comparing the US to other countries anyway—that’s your narrative, in this context. The question is whether is makes sense right now in the US to curtail testing of asymptomatic people who have had a high-risk exposure event, as the CDC is recommending now. That’s hard to understand from a health policy perspective. Meanwhile the ultimate boss of the CDC has explicitly stated he’d like to see less testing so we’d have fewer cases, so it’s not that wild a conspiracy theory to wonder if this isn’t a partisan political recommendation not a scientific one.

makomk 6y ago
The article uses the testing of asymptomatic people who've potentially been exposed as a jumping-off point to push the authors' proposal for testing asymptomatic people regardless of known exposure. These are of course completely unrelated in terms of actual benefits, practicality, etc but it treats one as though it were an extension of the other. It can even make sense to test selected high-risk or high-danger people without known exposure whilst not testing people known to be exposed in general; I know the UK is doing this to a certain extent for example. As for testing of potentially exposed people without symptoms, it has its issues as the CDC pointed out. The test just can't reliably detect people who're infected but still in the incubation period of the disease, so testing them will tell a bunch of them that they're negative and some of them will think they're in the clear and go about their normal business. I think New Zealand had a incident recently where a health worker in a city they were hoping to stop the disease spreading to tested negative, went back to work, and then tested positive again later after developing symptoms and working for a while whilst infectious, though that one was probably hard to avoid. It's also not terribly commonplace, especially as a companion to mass testing everyone with symptoms rather than an alternative - I know the UK in particular, which is the other country with a big mass testing program and probably the only one with relatively working contact tracing too, doesn't do this as a matter of policy. It also consumes a bunch of tests that would be more usefully used dealing with the test backlog - finding potentially exposed people should work a lot better if you find out they're potentially exposed sooner, and the main tactic is getting them to self isolate.
- jmull 6y ago
  Well, the Times article acknowledges that testing is limited and suggests we "make well-informed predictions about those who should be given priority". That seems pretty much compatible with your comments.
thu2111 6y ago
Everything about COVID is hard to understand from a health policy perspective. Motivated reasoning is everywhere. See this: the CDC was a beacon of technocratic science right up until it stopped arguing for mass government action, now suddenly it's politically motivated. Maybe, but you'd have to demonstrate that with some evidence. Here's an easy demonstration of the opposite: scientists were in agreement that masks were of no use, right up until political lobbying caused a total reversal of position as confirmed by the BBC [1]. Yet on HN we can read all the time that the new consensus is totally scientific, and it was the previous position that was unscientific. Lockdowns weren't recommended by the WHO or CDC, right up until they suddenly became the only responsible scientific thing to do. There's a clear pattern here - when an agency is recommending massive government action, a certain segment of the population praises them as 'scientific'. When an agency says maybe there's less for governments to do, they are damned as political and partisan. It's quite obviously ideological reasoning. Mass testing has to end at some point. That means at some point the CDC has to make such a recommendation. Or do you believe it should never end? [1] https://twitter.com/ClarkeMicah/status/1282987860090593280 https://twitter.com/ClarkeMicah/status/1282987860090593280

by jmull 6y ago

makomk 6y ago

The article uses the testing of asymptomatic people who've potentially been exposed as a jumping-off point to push the authors' proposal for testing asymptomatic people regardless of known exposure. These are of course completely unrelated in terms of actual benefits, practicality, etc but it treats one as though it were an extension of the other. It can even make sense to test selected high-risk or high-danger people without known exposure whilst not testing people known to be exposed in general; I know the UK is doing this to a certain extent for example. As for testing of potentially exposed people without symptoms, it has its issues as the CDC pointed out. The test just can't reliably detect people who're infected but still in the incubation period of the disease, so testing them will tell a bunch of them that they're negative and some of them will think they're in the clear and go about their normal business. I think New Zealand had a incident recently where a health worker in a city they were hoping to stop the disease spreading to tested negative, went back to work, and then tested positive again later after developing symptoms and working for a while whilst infectious, though that one was probably hard to avoid. It's also not terribly commonplace, especially as a companion to mass testing everyone with symptoms rather than an alternative - I know the UK in particular, which is the other country with a big mass testing program and probably the only one with relatively working contact tracing too, doesn't do this as a matter of policy. It also consumes a bunch of tests that would be more usefully used dealing with the test backlog - finding potentially exposed people should work a lot better if you find out they're potentially exposed sooner, and the main tactic is getting them to self isolate.

jmull 6y ago
Well, the Times article acknowledges that testing is limited and suggests we "make well-informed predictions about those who should be given priority". That seems pretty much compatible with your comments.

thu2111 6y ago

Everything about COVID is hard to understand from a health policy perspective. Motivated reasoning is everywhere. See this: the CDC was a beacon of technocratic science right up until it stopped arguing for mass government action, now suddenly it's politically motivated. Maybe, but you'd have to demonstrate that with some evidence. Here's an easy demonstration of the opposite: scientists were in agreement that masks were of no use, right up until political lobbying caused a total reversal of position as confirmed by the BBC [1]. Yet on HN we can read all the time that the new consensus is totally scientific, and it was the previous position that was unscientific. Lockdowns weren't recommended by the WHO or CDC, right up until they suddenly became the only responsible scientific thing to do. There's a clear pattern here - when an agency is recommending massive government action, a certain segment of the population praises them as 'scientific'. When an agency says maybe there's less for governments to do, they are damned as political and partisan. It's quite obviously ideological reasoning. Mass testing has to end at some point. That means at some point the CDC has to make such a recommendation. Or do you believe it should never end? [1] https://twitter.com/ClarkeMicah/status/1282987860090593280 https://twitter.com/ClarkeMicah/status/1282987860090593280