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The Doctor Who Helped Defeat Smallpox Explains What's Coming

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Re: The Doctor Who Helped Defeat Smallpox Explains What's Coming

#181

Post by DennisP »

tonetheman wrote: post #112
Amygaz wrote: post #45

Earlier quoted context omitted.

It's not a question of cost at this point. It's a question of availability of reagents and consumables, materials to make those, and time it takes to ramp up. The supply chain is like a supertanker. At first we didn't have enough test, but that ramped up quickly, then we didn't have enough RNA extraction reagent, now we don't have enough swabs, and soon is the collection media that will be missing. There has been a c…

We do not have tests. https://covidtracking.com/data/ We have tested 150K people. We have 327M people in the US, we have tested 0.00046% of the population. We do not have tests.

The FDA just approved an antibody test. One blood sample, results in fifteen minutes. The manufacturer thinks they can produce enough for 200K tests/day.

https://www.biospace.com/article/releases/20-20-bioresponse-...

Re: The Doctor Who Helped Defeat Smallpox Explains What's Coming

#182

Post by sp332 »

tonetheman wrote: post #112
Amygaz wrote: post #45

Earlier quoted context omitted.

It's not a question of cost at this point. It's a question of availability of reagents and consumables, materials to make those, and time it takes to ramp up. The supply chain is like a supertanker. At first we didn't have enough test, but that ramped up quickly, then we didn't have enough RNA extraction reagent, now we don't have enough swabs, and soon is the collection media that will be missing. There has been a c…

We do not have tests. https://covidtracking.com/data/ We have tested 150K people. We have 327M people in the US, we have tested 0.00046% of the population. We do not have tests.

Yeah but about HALF of those tests were done in the last TWO days! Capacity is coming online very rapidly now and while we are starting from behind, we will not be so short on tests for long. Roche alone is shipping 400,000 tests per week and Abbot Labs is on track to perform one million tests per week in the next couple of weeks. https://arstechnica.com/tech-policy/2020/03/america-is-final...

Re: The Doctor Who Helped Defeat Smallpox Explains What's Coming

#183

Post by DoreenMichele »

DennisP wrote: post #179
DoreenMichele wrote: post #175

Earlier quoted context omitted.

I think testing mostly matters to prove to people this is real, but tests don't actually stop the disease. They aren't a cure. I don't know how to get there from here, but I would like to see a great deal more focus on best practices and cultural change. That's how this pandemic will be stopped and prevented from recurring. Tests will only elucidate how bad it is, but aren't actual treatment. Stop touching your face.…

Testing helps a lot more than that, because it helps you catch infected people before they spread it further. This was a key factor in China and South Korea getting the disease under control.

If we have cultural practices in place that more universally reduce or halt the spread of disease, it matters less to know who has it.

Of course, then people will say "we were just lucky" or the threat was never real.

But in terms of actual germ control, I would like to see more focus on shifting the culture to one of higher levels of germ control permanently.

But I don't need convincing. I already know this stuff is serious and makes a difference because of my medical situation.

Re: The Doctor Who Helped Defeat Smallpox Explains What's Coming

#184

Post by mynegation »

no_gravity wrote: post #6

From what I read in this article and other sources, performing more tests seems to be a very promising approach to get this pandemic under control. The number of positive tests and death rates are published every day on all channels. I wish the number of performed tests would be also published daily. What gets measured gets managed. I wonder what limits the number of tests that can be performed. How much would it cos…

Ontario publishes this statistic and updates it twice daily [1]. It was just under 2% but started to creep up. To understand the numbers better it helps to know that currently there is about a 6 day wait on the test results. Until very recently criteria for testing were very stringent (2+ symptoms, recent travel), and even then only 2% were found to have it, which - in my understanding - disqualifies the idea that virus was already around for a while.

[1] https://www.ontario.ca/page/2019-novel-coronavirus

Re: The Doctor Who Helped Defeat Smallpox Explains What's Coming

#185

Post by xienze »

mynegation wrote: post #177
xienze wrote: post #73

Earlier quoted context omitted.

Yeah I’m not sure what people are expecting to happen here. This virus has been circulating in the US for months and testing was limited. There’s surely many multiples of infected people than currently reported, and that’s true for any country that isn’t doing blanket testing of entire population.

Even if that (EDIT: ‘that’ being an idea that virus has been circulating for months) were true (which almost certainly it is not), so what? The only logical explanation for this is that percentage of severe cases relative to totally susceptible and infected is orders of magnitude lower, and now the total number of infected is so large that number of severe cases is starting to get noticeable. But that is not the pict…

> Even if that were true (which almost certainly it is not)

What are you referring to? You don’t think the virus is already much more widespread in the US than currently reported numbers? I’m just making the observation that perhaps the large increases in US cases are more indicative of confirmation of already existing cases rather than necessarily being _new_ cases.

Re: The Doctor Who Helped Defeat Smallpox Explains What's Coming

#186

Post by mynegation »

DoreenMichele wrote: post #175
no_gravity wrote: post #6

From what I read in this article and other sources, performing more tests seems to be a very promising approach to get this pandemic under control. The number of positive tests and death rates are published every day on all channels. I wish the number of performed tests would be also published daily. What gets measured gets managed. I wonder what limits the number of tests that can be performed. How much would it cos…

I think testing mostly matters to prove to people this is real, but tests don't actually stop the disease. They aren't a cure. I don't know how to get there from here, but I would like to see a great deal more focus on best practices and cultural change. That's how this pandemic will be stopped and prevented from recurring. Tests will only elucidate how bad it is, but aren't actual treatment. Stop touching your face.…

I agree with you on almost all points, but testing does help to stop the disease. They are not a cure but an ability to test infected and recovered people en masse would help immensely to (a) isolate contagious people as soon as possible (b) confirm that the virus is cleared and the person can go back to the productive work with at least some assurance of immunity.

Re: The Doctor Who Helped Defeat Smallpox Explains What's Coming

#187

Post by fragmede »

andrepd wrote: post #69
throwaway_pdp09 wrote: post #3

This is bad. I've been graphing the exp curve for Italy, UK and USA and the USA curve is fearsomely steep. Italy has more cases now but the USA is growing fastest and looks like it will match Italy's on ~March 28th (looking at the most recent 10 points, see below) The rate of growth in the USA, extrapolated, is just huge. Looking at the whole curve it does not match an exponential well, I think the early part is skew…

>I've been graphing the exp curve As you can imagine, there's more to epidemiology than this. I'm a big fan of letting the qualified people do their work, while we do ours: shut up and do not spread misinformation. In fact, at the risk of being rude ill even go so far and say that it's quite arrogant to pretend to pontificate about this when your knowledge about this issue is 0, and also when one major problem in com…

Epidemiologist are working, and they are saying the same as throwaway_pdp09 - that this is bad. If throwaway_pdp09 were claiming otherwise then it would be a different story. No country is going to change their country's healthcare response plan based on some random conjecturing on HN, and regardless of any numbers that pop out here, the instructions are the same - self-isolate until mid-April, at the soonest.

throwaway_pdp09 isn't spreading unnecessary panic and their attitude has been anything but arrogant, pompous, or dogmatic. They are very open in admitting that they are not an epidemiologist. Saying f(x) = 9 and asking why their 'f' is wrong, and wanting to understanding its shortcomings and how to improve it, seems entirely fine to me. You are going to have to be far more specific on the harm caused by a lay-person projecting that we are fucked in 9 days, vs an expert's opinion that we are going to be fucked in 11.

If it helps, pretend this question is being presented and asked at TA office hours during Epidemiology 101 at university by someone who is considering going into epidemiology.

We are all here to learn.

Meanwhile, there's actual, harmful nonsense out there to rail against. Half-remembered gossip misinformation that spreads like an infectious disease with an R0 of 5. Complete crap, like holding your breath for 10 seconds will test for Covid-19, or that essential oils cure Covid-19 or that its eventual vaccine will cause autism. Fight that misinformation, not people who's latent interest in epidemiology has been awakened. Who knows, a reader here could be deciding to get a degree in epidemiology because of an interest sparked because an exp curve is too simple.

Re: The Doctor Who Helped Defeat Smallpox Explains What's Coming

#188

Post by mynegation »

xienze wrote: post #185
mynegation wrote: post #177

Earlier quoted context omitted.

Even if that (EDIT: ‘that’ being an idea that virus has been circulating for months) were true (which almost certainly it is not), so what? The only logical explanation for this is that percentage of severe cases relative to totally susceptible and infected is orders of magnitude lower, and now the total number of infected is so large that number of severe cases is starting to get noticeable. But that is not the pict…

> Even if that were true (which almost certainly it is not) What are you referring to? You don’t think the virus is already much more widespread in the US than currently reported numbers? I’m just making the observation that perhaps the large increases in US cases are more indicative of confirmation of already existing cases rather than necessarily being _new_ cases.

I am not arguing that virus is more widespread than the reported numbers, that much is obvious. I was replying to the idea that virus has been circulating “for months” undetected. With a doubling time of 5 days or so, with “for months” circulation we would be in a totally different territory right now.

Re: The Doctor Who Helped Defeat Smallpox Explains What's Coming

#190

Post by DoreenMichele »

mynegation wrote: post #186
DoreenMichele wrote: post #175

Earlier quoted context omitted.

I think testing mostly matters to prove to people this is real, but tests don't actually stop the disease. They aren't a cure. I don't know how to get there from here, but I would like to see a great deal more focus on best practices and cultural change. That's how this pandemic will be stopped and prevented from recurring. Tests will only elucidate how bad it is, but aren't actual treatment. Stop touching your face.…

I agree with you on almost all points, but testing does help to stop the disease. They are not a cure but an ability to test infected and recovered people en masse would help immensely to (a) isolate contagious people as soon as possible (b) confirm that the virus is cleared and the person can go back to the productive work with at least some assurance of immunity.

Let me try to put that another way:

Tests are information. I think we have enough information to try to err on the side of "Let's just assume everyone is a danger. Let's just globally reduce our cavalier, casual exposure to germs as a matter of course."

To me, it's crazy to insist we need to keep testing and we need to know who has it to protect people.

Social distancing and good hygiene are effective whether the person has been identified or not. I wish we would just go with that and stop acting like "a return to normal" is the goal and just around the corner for most people, if only we can identify the parties guilty of being infected and Target them.

It kind of doesn't matter. Just stop touching your face, among other things.

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