US admits 'failing' on testing, says Fauci • Hacker News Board

Re: US admits 'failing' on testing, says Fauci

#41

Post by Jtsummers » Thu, Mar 12, 2020, 5:43 PM UTC

chrisco255 wrote: post #14

MiroF wrote: post #11

Earlier quoted context omitted.

Absolutely. Was talking with a friend who was confused about why schools in remote areas are being shut down - testing needs to be done just so people realize that it's not just Washington or New York, this is pretty much everywhere or imminently about to be everywhere in the United States.

Anyone want guess at how difficult it is to ramp up testing to a population of 320 million for a disease that didn't exist 4 months ago?

It's not just one group that's doing it, though. This sort of testing (as addressed in other comments) can be done through university and hospital labs throughout the country, along with state and local health agencies and various private testing firms (mostly consolidated at this point).

Instead of going it alone, the focus could've (perhaps should've) been on early collaboration with those partners on establishing consistent testing procedures (whether they used precisely the same measures, validation that they were getting the same results) and a process to distribute the workload.

This wasn't done, that's the reason the scaling failed.

Re: US admits 'failing' on testing, says Fauci

#42

Post by chromatin » Thu, Mar 12, 2020, 5:46 PM UTC

pgrote wrote: post #5

Admitting and identifying the problem is the first step. The Cleveland Clinic just came out with an 8 hour test and hopefully this will help the situation if they share the process. https://www.vox.com/science-and-health/2020/3/12/21175034/co...

I mean, kudos to CCF, but take this for what it's worth (from another tier 1 University Hospital):

Most university hospitals' in house test results are / are going to be available in similar time frame, but they do not have the media budget of the Cleveland Clinic. Vox article links to a CCF press release fluff piece.

Re: US admits 'failing' on testing, says Fauci

#43

Post by Ir738urbb » Thu, Mar 12, 2020, 5:47 PM UTC

ajross wrote: post #7

drevil-v2 wrote: post #3

It’s so hard to trust the media to report on anything without trying to inflame the “orange man bad” narrative. In Australia almost no one with some or most of the symptoms is being tested. General Practitioners are basically telling people to fuck off, self isolate and call the hospital if symptoms worsen. https://apple.news/ASvoRONOWS9ijWX4RrGmiTQ “Currently we are not testing everyone, and whilst this may change i…

At what point does it become OK to point out that the "orange man" is, in fact, bad? Fox news and republican leaders spent weeks (weeks that we can't get back) trying to tell people that this wasn't a problem, that they shouldn't prepare, and that this was all a partisan argument against the president. And that was all wrong. It's real, it's happening, and we've lost critical time. That's bad, right? And it's bad in…

Guess what? They're all bad! Incompetence, perverse incentives, misinformation, exploitation: we're surrounded by it.

On Hacker News I expect a technical discussion and shared files how to build PCR kits at home to test for the virus. I want to see people sharing biohacks. Not this meaningless useless byllshit.

Re: US admits 'failing' on testing, says Fauci

#44

Post by surge » Thu, Mar 12, 2020, 5:48 PM UTC

snapetom wrote: post #25

I have a hard time faulting the CDC for the response overall, but I just don't understand why they decided to make their own test at the beginning. Was it bravado? Did they think the 70% accuracy of the WHO test wasn't good enough? If they didn't make their own test, they wouldn't have fubarred the manufacturing, which would have given us more tests. One of the CDC's main goals, if not the main goal in this, is to sp…

The test accuracy of the WHO test as far as I understood it was good if someone was already experiencing symptoms once viral load was high enough. The bigger issue was false negatives, people would get released from quarantine measures, then spread it (like the cruise ship). They recommended anyone within contact to self quarantine until symptoms had reached a point they could get a definitive test. At this point testing early and coming up negative doesn't mean anything, you should still stay quarantined and continuously get retested, since a lot of people who tested negative were found to have had it the whole time when symptoms present and were given the all clear before.

In summary, the testing early doesn't change the decision tree, which is stay quarantined for 14 days, until symptoms present or not, so little point was seen to testing until then.

Problem is now, we can't track it, so everyone ideally should self quarantine or limit as much as possible social interaction and get tested if they have good reason to believe they've been exposed. Early testing will catch a lot of people but not all, so it will slow the spread, so at this point the decision tree changes and we need to start testing more, if nothing else to get a sample to extrapolate the true spread of this thing.

Re: US admits 'failing' on testing, says Fauci

#45

Post by heyitsguay » Thu, Mar 12, 2020, 5:49 PM UTC

chromatin wrote: post #31

heyitsguay wrote: post #21

Earlier quoted context omitted.

Are there any differences for Covid-19 samples versus any of the other samples such labs would be routinely testing though?

Yes, it is RNA virus so it is an extra step that is not necessary in many other PCR based clinical tests.

Sure, I meant for the non-technical aspects that the previous poster mentioned - chain of custody, sample integrity.

Re: US admits 'failing' on testing, says Fauci

#46

Post by Lewton » Thu, Mar 12, 2020, 5:52 PM UTC

chrisco255 wrote: post #14

MiroF wrote: post #11

Earlier quoted context omitted.

Absolutely. Was talking with a friend who was confused about why schools in remote areas are being shut down - testing needs to be done just so people realize that it's not just Washington or New York, this is pretty much everywhere or imminently about to be everywhere in the United States.

Anyone want guess at how difficult it is to ramp up testing to a population of 320 million for a disease that didn't exist 4 months ago?

The ability to test for this scales linearly with number of people...

Re: US admits 'failing' on testing, says Fauci

#47

Post by fbourque » Thu, Mar 12, 2020, 5:52 PM UTC

pgrote wrote: post #5

Admitting and identifying the problem is the first step. The Cleveland Clinic just came out with an 8 hour test and hopefully this will help the situation if they share the process. https://www.vox.com/science-and-health/2020/3/12/21175034/co...

Not exactly a breakthrough as testing take 3-5 hours in other countries... and in the US.

https://www.sciencemag.org/news/2020/03/were-behind-curve-us... Q: What's the turnaround time when you have a sample on hand? How long does it take to extract RNA from the sample, put it into a polymerase chain reaction machine, etc.?

A: About 2 to 3 hours to do the testing, but because the process requires us to batch samples, you can't really just test the sample as they come in. In order to conserve reagents and labor, you' wait until you have a certain bolus of samples and then test them together. So you do testing once or twice a day.

Re: US admits 'failing' on testing, says Fauci

#48

Post by Lewton » Thu, Mar 12, 2020, 5:54 PM UTC

drevil-v2 wrote: post #20

deminature wrote: post #10

Earlier quoted context omitted.

>In Australia almost no one with some or most of the symptoms is being tested. General Practitioners are basically telling people to fuck off, self isolate and call the hospital if symptoms worsen. This is simply false: >Here, testing is free and widely available, thanks to early and coordinated planning for a pandemic. On Thursday, Mr. Hanks said he and his wife had seen the efforts firsthand, as they tested positiv…

It’s not false because I went through this myself yesterday. Was told over the phone “don’t come in, its probably a common cold, stay at home and if symptoms worsen called the health hotline” Community forums are full others reporting similar stories https://apple.news/ASvoRONOWS9ijWX4RrGmiTQ “Currently we are not testing everyone, and whilst this may change in the future, at the moment this isn’t feasible. The press…

if you have the symptoms for the cold, and don't have the symptoms for covid-19, then why would they test you?

Re: US admits 'failing' on testing, says Fauci

#49

Post by MisterBastahrd » Thu, Mar 12, 2020, 6:00 PM UTC

jfengel wrote: post #23

ajross wrote: post #7

Earlier quoted context omitted.

At what point does it become OK to point out that the "orange man" is, in fact, bad? Fox news and republican leaders spent weeks (weeks that we can't get back) trying to tell people that this wasn't a problem, that they shouldn't prepare, and that this was all a partisan argument against the president. And that was all wrong. It's real, it's happening, and we've lost critical time. That's bad, right? And it's bad in…

Especially since the article isn't about him. It mentions him twice, once citing the travel ban, another time quoting him as saying that we have good testing infrastructure (but noting that he did not elaborate). It does not describe him as "bad" or say anything directly negative. The article is about a high-level bureaucrat who says only "we". The OP's comment is, unfortunately, indicative. The OP reads it as negati…

The idea is that anything that any article that does not go out of its way to praise him must be negative by definition, because that's how his mind works. The US's response to this current situation is a direct response by Trump to how he is being perceived.

Re: US admits 'failing' on testing, says Fauci

#50

Post by rstupek » Thu, Mar 12, 2020, 6:07 PM UTC

stevenwoo wrote: post #39

chrisco255 wrote: post #14

Earlier quoted context omitted.

Anyone want guess at how difficult it is to ramp up testing to a population of 320 million for a disease that didn't exist 4 months ago?

Italy and South Korea managed to scale up widespread testing and their economies are proportionately much smaller than the USA for their population.

Italy is geographically half the size of Texas and South Korea is 1/7 the size of Texas. It's considerably easier to do widespread testing when everyone practically lives next to everyone else.