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CDC coronavirus testing decision likely to haunt nation for months to come

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Re: CDC coronavirus testing decision likely to haunt nation for months to come

#71

Post by munk-a »

dominotw wrote: post #20
BoiledCabbage wrote: post #16

Earlier quoted context omitted.

> Meanwhile, the FDA did not allow anyone other than the CDC to test for coronavirus. true > there were multiple, compounding layers of fuck-ups. also true All of it is completely true. And the issue is that both of these were blatantly obvious to anyone paying attention to the situation. The CDC was struggling to develop the test, and the FDA regulates who can create tests under normal circumstances. The larger ques…

> FDA regulation only allowed the CDC to create a test wondering why this regulation exists and are there any guidelines for extreme situations.

Well, in extreme situations the best thing to do isn't to fire the pandemic response team three years prior cause "never gonna happen".

Those regulations (and most bureaucracy to be honest) is to provide guidance and constraint during normal times - these are extreme times and it's perfectly rationale to restrict burdensome regulations that hurt the public good right now.

Re: CDC coronavirus testing decision likely to haunt nation for months to come

#72

Post by DocSavage »

I'm also surprised that there isn't more talk about the sensitivity of the standard nasopharyngeal swab + RT-PCR. When the FDA approved it, they showed it's extremely accurate... if you use swabs saturated with the virus at various concentrations. Then I read about the poor (70-80%) sensitivity in the real-world, which isn't suprising considering you (1) have variably expert technique in positioning swabs into uncomfortable body spaces, and (2) apply it to people at various stages of the disease with low viral shedding initially and also at end stages. Apparently you can swab two different areas and may raise your sensitivity 10% to 85%.

So if you are "negative" with say a 80% sensitivity, that leaves a lot of room for actually infected people to think they are in the clear. There's a reason why screening tests need to be highly accurate. I'm all in favor of at least recognizing the positives and quarantining them, but with a high R0 disease, the false negatives could be a problem.

Re: CDC coronavirus testing decision likely to haunt nation for months to come

#73

Post by akiselev »

roenxi wrote: post #43
BoiledCabbage wrote: post #16

Earlier quoted context omitted.

> Meanwhile, the FDA did not allow anyone other than the CDC to test for coronavirus. true > there were multiple, compounding layers of fuck-ups. also true All of it is completely true. And the issue is that both of these were blatantly obvious to anyone paying attention to the situation. The CDC was struggling to develop the test, and the FDA regulates who can create tests under normal circumstances. The larger ques…

> Everyone saw the CDC couldn't scale up in time. Everyone knew the FDA regulation... No way that is possibly true. People realised they didn't have tests. A bunch of people of a liberterian bent or systems thinkers would have picked the FDA as the problem very quickly. But for most people diagnosing and rectifying that sort of snarl in a complex bureaucratic process would have taken about as long as it did. This hap…

You're underestimating how much more leeway the executive branch gets when given emergency power. In recent history alone state of emergencies have been used to: bypass Congressional war declaration powers in the form of at least one "war", ban entire countries from entering the United States with the recent travel ban, and bypass Congressional power of the purse with the border wall. Not to mention emergency powers were used to suspend habeus corpus for almost two years until Congress could meet during the Civil War and pass a bill making it official, in direct defiance of a circuit court ruling written by a Supreme court judge.

The act of declaring a national emergency is enough to give the President substantial powers that can be used immediately in the form of executive orders. Judges would be very hesitant to approve any injunctions in a real crisis.

Re: CDC coronavirus testing decision likely to haunt nation for months to come

#75

Post by dominotw »

BoiledCabbage wrote: post #58
roenxi wrote: post #43

Earlier quoted context omitted.

> Everyone saw the CDC couldn't scale up in time. Everyone knew the FDA regulation... No way that is possibly true. People realised they didn't have tests. A bunch of people of a liberterian bent or systems thinkers would have picked the FDA as the problem very quickly. But for most people diagnosing and rectifying that sort of snarl in a complex bureaucratic process would have taken about as long as it did. This hap…

> No way that is possibly true. People realised they didn't have tests. A bunch of people of a liberterian bent or systems thinkers would have picked the FDA as the problem very quickly. You didn't need a "libertarian bent" or special"systems thinking" to figure that out. The CDC was testing at most 50 people a day IIRC. Can 50 tests across an entire country get you detailed info? No. You need labs to run tests, CDC…

> The administration let the country down enormously.

Is this a failing of current democratic system. Are there no check and balances for this sort of let down by the administration. How can we design a system that has nothing to check it if its making mistakes. Is that the job of the opposition or does opposition lack intelligence to find out in time.

Re: CDC coronavirus testing decision likely to haunt nation for months to come

#76

Post by robocat »

tosser0001 wrote: post #26

I just don't see what good is going to come out of worrying about this right now while the world is on fire. Everybody needs to be thinking about how to help in the coming weeks, anything else is a waste of time and mental energy. There will be plenty of time to analyze what went wrong with the initial response when things calm down. This is just raising the level of angst unnecessarily in my opinion.

Why not when you have time to spare?

I personally am trying to spread good information, and push back on misinformation as my part to help, but I feel I am seriously losing that battle at present.

Part of fixing “world on fire” is fixing your mistakes. And honestly, just because the US is on fire (due to lack of effective planning and mitigation), doesn’t mean Japan or other first world countries are on fire.

Re: CDC coronavirus testing decision likely to haunt nation for months to come

#77

Post by [deleted] »

robocat wrote: post #70
toomuchtodo wrote: post #33

Earlier quoted context omitted.

Yes! It’s overused, but very useful when communicating the idea.

The US response to Covid19 is nothing like the Swiss cheese model. The Swiss cheese model is a perfect storm of unlikely failures that leads to a negative outcome, a failure that slips through multiple safety nets and checks. A real “Swiss cheese failure” reads like a bizarre set of coincidences within a highly rational system of disaster prevention controls, with a unique outcome that never gets repeated again - lik…

[deleted]

Re: CDC coronavirus testing decision likely to haunt nation for months to come

#78

Post by munk-a »

jude- wrote: post #28
tosser0001 wrote: post #26

I just don't see what good is going to come out of worrying about this right now while the world is on fire. Everybody needs to be thinking about how to help in the coming weeks, anything else is a waste of time and mental energy. There will be plenty of time to analyze what went wrong with the initial response when things calm down. This is just raising the level of angst unnecessarily in my opinion.

If you want to come out of a lock-down without also causing the number of cases to spike again, we'll need to implement a widespread test-and-trace protocol similar to South Korea's. This requires _lots and lots_ of testing.

It also requires population participation in testing and that requires making the tests accessible including providing them for free or cheap[1] and without judgement[2].

1. This is currently not the case, Payers have widely agreed not to charge co-pays for tests, but deductibles may still apply and the uninsured will pay the full cost.

2. Hey Trump Administration - you know how you've eroded all the trust and faith of the immigrant community? Yea, that's not so great suddenly (I mean it wasn't great before, but now it'll effect you!). Even legal immigrants have expressed concerns over the census, the chances they'll go to a testing site where there will be LEOs (police certainly, maybe national guard) are slim to none.

Re: CDC coronavirus testing decision likely to haunt nation for months to come

#79

Post by mcculley »

rstupek wrote: post #34
acqq wrote: post #14

Earlier quoted context omitted.

> no country has tested 1 million people Well, the country prepared for epidemics just didn't have to test one million people, but still kept it under control: https://www.nbcnews.com/news/world/how-south-korea-flattened... They were indeed able to use their tests more efficiently than any other country, and to really do a lot of tests compared to any other country: https://www.cdc.go.kr/board/board.es?mid=a304020000…

Wouldn't it also help that South Korea is 1/7th the size of Texas so it's a little easier to test everyone? It also helped one company mass produced tests

The US benefits from economies of scale. We just choose not to implement public health infrastructure.
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