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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

#281

Post by gitgudnubs »

DocSavage wrote: post #187
gitgudnubs wrote: post #96

Earlier quoted context omitted.

If the reproduction rate is 10, and you catch 70% of cases, then the effective reproduction rate will be closer to 3. Since even the highest estimates of the basic reproduction number are only about 4, a test that's 75% accurate means an effective reproduction rate closer to 1. Are you aware of the difference between 4^x and 1^x?

Since you are being snarky: Are you aware that the sensitivity quoted was mostly in symptomatic and hospitalized patients and not those in the very earliest stages who could also be shedding less virus? Are you aware that each false negative can infect N others, some of whom might have also been previously tested, and also be greenlit to deal with high-risk populations like nursing homes? Are you aware that your 4^x…

My favorite game.

Are you aware that the test can be improved by training medical personnel on sampling technique?

Are you aware that tests will, as a general rule, improve?

Are you aware that the majority of people understand the difference between 70% and 100% accurate?

Are you aware that public policy was affected by poor data on the spread?

Are you aware that it's far easier to successfully test [nearly] everyone in the chain when the number of cases is small, like it would have been when this test was initially available?

The _only_ way this can be contained is through massive lockdowns. If tests were performed _as soon as possible_, then there's a good chance we could have done a good job containing it through contact tracing. Even if that weren't the case, it would have given our medical system several extra weeks to prepare for the case load. It would have given our politicians better data to enact policies.

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

#282

Post by IggleSniggle »

MikeAmelung wrote: post #225
IggleSniggle wrote: post #215

The CDC is still instructing healthcare providers NOT to test UNLESS a person has either come into contact with a known COVID-19 carrier OR recently traveled abroad. Otherwise, the guideline is "do not test." I am married to a healthcare provider. Nevermind clinical judgement, context, or an abundance of available tests. If you don't meet the above guidelines, my spouse is being firmly instructed by the clinical prac…

Someone needs to update your clinical practice manager with the info from 2 weeks ago: https://emergency.cdc.gov/han/2020/han00429.asp

Thanks for that, I'll be sure to pass along.

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

#283

Post by IggleSniggle »

IggleSniggle wrote: post #213
panarky wrote: post #5

Does anyone know actual facts about testing in the US? Yes, the CDC's tests were flawed, but ... 1) Other countries don't have a problem testing millions of people, so why doesn't the US use the same tests they do? 2) 3.5 weeks ago the Trump admin promised 1 million tests that week with many more to follow soon thereafter. After all this time they still haven't materialized, so what happened to the million tests? 3)…

The CDC is still instructing healthcare providers NOT to test UNLESS a person has either come into contact with a known COVID-19 carrier OR recently traveled abroad. Otherwise, the guideline is "do not test." I am married to a healthcare provider. Nevermind clinical judgement, context, or an abundance of available tests. If you don't meet the above guidelines, my spouse is being firmly instructed to follow the CDC gu…

My spouse was being fed outdated information. Latest testing guideline is here:

https://emergency.cdc.gov/han/2020/han00429.asp

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

#284

Post by mentalpiracy »

someguydave wrote: post #255
belltaco wrote: post #179

Earlier quoted context omitted.

Whatever happened to American exceptionalism? >Did the administration cause every other countries problems with containing the virus too The American people did not elect and pay other countries to take care of them, they did for their government. The administration dismantled the pandemic team from the highest levels and along with their media cronies, actively minimized it for several weeks[1][2] and made it politi…

When you use the word “administration” are you thinking about a few hundred elected and directly appointed officials or the hundreds of thousands of government employees? Because it seems like the employees bungled the job.

Not for nothing, but we are 3 years into an administration that has done everything it could to push out career employees with lifetimes of expertise.

There have been failures from the top to the bottom. But let’s not pretend that there hasn’t been a systematic, intentional degradation of these agencies that has only served to exacerbate those failures.

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

#285

Post by atq2119 »

wutbrodo wrote: post #261
greedo wrote: post #245

Earlier quoted context omitted.

Most of my life I've been told that government is horrible, and that the most terrifying thing to hear is "I'm from the government, and I'm here to help." When an entire generation hears the demonization of civil service (though not military service), then it's no wonder that we end up with a government that can't serve us.

This is an odd conclusion to draw. You're saying that people call the government incompetent, and now they're demonstrating incompetence, and you're convinced that the causality flows from the former to the latter?

As an external observer, I think it's not so much about whether the current US government is incompetent or not, although of course that does play some role. The key point is that a large fraction of USians have a purely ideological belief that government cannot ever be good.

As a consequence, too large a fraction of the population and of political leadership don't even try to make government institutions better, and are instead actively standing in the way of people who do try. Instead, they end up dismantling institutions or making them worse when they fail to dismantle them. (Note that this is the semi-official policy of one of your major parties. They call it "starve the beast".)

And yes, this is genuinely different from other countries. Over here, while trust in institutions is often lower than it would ideally be, the vast majority consensus at least of political and media leadership is that government can and should be good. As a consequence there's a significant number of people over here genuinely trying to make better government happen, to at least some success.

It's really no surprise that US government is so dysfunctional, and it's entirely self-inflicted by bad culture.

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

#286

Post by im3w1l »

ganeshkrishnan wrote: post #279
Juxtapoz wrote: post #277

Earlier quoted context omitted.

According to your source > The coronavirus outbreak is more severe than the 2009 outbreak of H1N1, or swine flu. That illness infected between 700 million and 1.4 billion people worldwide but only had a mortality rate of 0.02%. 1.4 billion worldwide, not just in the United States. The mortality rate is much worse for coronavirus and it hasn't been around since 2009 so we've yet to see how many cases and deaths occur.

Just an FYI: the mortality rate of swine flu is based on estimate of total people infected (around 60 million cdc estimate) while the mortality rate of covid is from confirmed cases as we don't have estimates of total infection with some speculating that it's 10x of confirmed cases

We know from the cruise ships that mortality is in the 0.1% - 1% ballpark. With a broken down healthcare system it may go a bit beyond 1%, but not a lot. Data from Italy shows many people who get a ventilator die anyway, so running out of them wont make the figure jump.

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

#287

Post by mikeyouse »

throwaway122378 wrote: post #270
mikeyouse wrote: post #86

Earlier quoted context omitted.

WHO isn't faultless, but that's a fairly misrepresentative version of what that Tweet actually says.. "WHO said there's no human to human transmission" vs. > Preliminary investigations conducted by the Chinese authorities have found no clear evidence of human-to-human transmission of the novel #coronavirus (2019-nCoV) identified in #Wuhan, #China.

It was 1/23/20. Wuhan was under lockdown but there was no clear evidence of human to human transfer? Cmon

That tweet was from ten days before the lockdown, based on evidence gathered prior to that. The first death from the disease was 3 days prior to the WHO tweet and Chinese researchers had only identified the specific virus 6 days prior:

https://www.nytimes.com/2020/01/08/health/china-pneumonia-ou...

That very same day the WHO was recommending handwashing / avoiding close contact with anyone with flu-like symptoms / and avoiding wet markets and close contact with animals (since the largest known source of infection was the market in Wuhan):

https://twitter.com/WHO/status/1216754859292184577

It's hard to lay any blame on the WHO for not taking the virus seriously enough in the first days of the outbreak when major politicians were still dismissing it two months later.

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

#288

Post by roenxi »

AlexCoventry wrote: post #228
AlexCoventry wrote: post #105

Earlier quoted context omitted.

The Trump administration has responded quite slowly compared to the Obama administration's response to H1N1. The CDC commenced emergency operations a week after the first H1N1 case was detected, and advised school closings less than a week after that [0]. It seems likely that Trump's unfavorable comparison of the Obama H1N1 response to his COVID-19 response will come back to haunt him [1]. We'd be extremely lucky to…

I'm curious about why this is being downvoted.

You're comparing the Trump and Obama administrations handling of different diseases and it looks like you are making a partisan point.

This is the early phase of a crisis. Now is the time to call on leaders to do things; not to politic about whether something could have happened a bit earlier or not. Trump is still going to be held responsible for the administration's performance; but now isn't the time.

Nobody is going to bother going back to compare this to the Obama Administration's H1N1 response. The H1N1 response is not a useful guide for how to deal with the piles of dead bodies that are about to start appearing outside hospitals.

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

#289

Post by jMyles »

mennis16 wrote: post #275
jMyles wrote: post #253

Earlier quoted context omitted.

> If we want to know how lethal the virus is, we need sampling of who actually has contracted it, which is tough in the early stages of a pandemic. But several studies have done the best job possible, given different pieces of the dataset, to arrive at a more accurate IFR (see the links in the above content). I haven't seen anybody, in any published paper, defend the 3.4% as a likely indicator of the actual fatality…

Because it becomes 10x or so more deadly when proper care is not available, as is happening in areas where too many people have it at once. Letting this run wild would cripple hospitals. Many NYC area hospitals are already out of ventilators and that situation is just ramping up.

> Because it becomes 10x or so more deadly when proper care is not available

Source?

> Many NYC area hospitals are already out of ventilators

I don't think that's true. The governor predicted it last week, but it hasn't happened yet, right?

I can't find evidence of this happening in any hospital, much less many hospitals.

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

#290

Post by im3w1l »

ironmagma wrote: post #191
jonas21 wrote: post #166

Earlier quoted context omitted.

Have you considered that people are looking at you not because they want to shame you, but because they're trying to determine if you're sick and they should be extra careful around you, e.g. don't touch anything you've touched, etc? If the guidance so far has been to only wear a mask if you're sick, it seems reasonable to assume that someone wearing a mask is more likely to be sick than average.

Most of these people are passersby on the street who would have no opportunity to touch something I've touched. I heard from someone who wore a mask recently who was flat-out told, "You're overreacting." It's not just caution, there is some kind of social insistence that the masks are not necessary and even to be discouraged, which I even sense in myself when I'm out and about without a mask and see others wearing th…

I think it's because of cognitive dissonance. The combination of "I don't have a mask" and "masks are helpful" is painful.
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