We’re Testing the Wrong People • Hacker News Board

Re: We’re Testing the Wrong People

#61

Post by leereeves » Thu, Apr 23, 2020, 5:24 PM UTC

jcranmer wrote: post #31

votepaunchy wrote: post #19

Earlier quoted context omitted.

The only thing stopping states from deficit spending (selling bonds to pay for general obligations) are the states’ own rules. As we have seen, constitutional requirements are not an impediment in a pandemic.

Which constitutional requirements do you think are being violated? And if you're going to say first amendment, be sure to explain precisely why they wouldn't survive strict scrutiny. (And if you're not aware of the legal meaning of "strict scrutiny," then you are probably ignorant of what the Constitution has actually been held to mean by the authority that has the power to interpret it.)

Controlling a pandemic is a compelling state interest, but it would be hard to argue that current lockdown restrictions are narrowly tailored and use the least restrictive means possible, when other states and other nations have controlled the outbreak without lockdowns.

Re: We’re Testing the Wrong People

#62

Post by theaeolist » Thu, Apr 23, 2020, 5:24 PM UTC

losvedir wrote: post #56

I appreciate the HN title ("We're Testing the Wrong People") in contrast to the article title ("Without More Tests, America Can't Reopen"), even though it's usually against policy to have them be different. But the HN title is actionable: if we can change our testing policy and deploy our tests more usefully, that's great to know and eminently achievable. But "not testing enough" isn't really actionable. There's a sh…

In tests/capita US is 42nd. https://www.worldometers.info/coronavirus/#countries

Re: We’re Testing the Wrong People

#63

Post by RandallBrown » Thu, Apr 23, 2020, 5:24 PM UTC

godtoldmetodoit wrote: post #44

RandallBrown wrote: post #25

I've been saying this since the beginning of this whole thing. I don't understand why we haven't focused all of our testing on people that aren't sick so we can catch the asymptomatic cases that are out in the world spreading it to everyone.

I've been wondering why there hasn't been more programs to test representative samples of individuals, just like a political poll. If I was in a Governor's or Mayor's shoes right now and I know there aren't enough resources to test everyone, I'd want some data like that to work with to make policy decisions. While you are in the process of opening things back up, you keep a close eye on your daily/weekly representati…

Seattle has been running a test like this. I believe they're allocating 300 tests per day.

https://scanpublichealth.org

Re: We’re Testing the Wrong People

#64

Post by uxp100 » Thu, Apr 23, 2020, 5:25 PM UTC

RandallBrown wrote: post #58

exhilaration wrote: post #35

Earlier quoted context omitted.

Because we don't have enough tests. We could reopen the country if we could test enough people, but we're stuck. Even in New York and New Jersey, tests are still limited to symptomatic people because there isn't enough testing capacity.

But what's the point of testing people that are already sick? We don't treat Covid patients any differently than any other patients that develop pneumonia

We often put covid and suspected covid in separate areas of the hospital from others, with a different staff.

Re: We’re Testing the Wrong People

#65

Post by ajross » Thu, Apr 23, 2020, 5:26 PM UTC

losvedir wrote: post #56

I appreciate the HN title ("We're Testing the Wrong People") in contrast to the article title ("Without More Tests, America Can't Reopen"), even though it's usually against policy to have them be different. But the HN title is actionable: if we can change our testing policy and deploy our tests more usefully, that's great to know and eminently achievable. But "not testing enough" isn't really actionable. There's a sh…

> The U.S. [...] is second only behind Italy in tests per capita

Where are you getting those numbers? I don't think that's correct. The Worldometer data may not be the best, but they have the US well down in the middle of the pack at ~13k tests/Mpop.

Lots of large developed nations have the US beat by quite a bit, in fact. And Iceland is literally a full order of magnitude higher!

In fact US testing policy has been largely a disaster. It's not the only disaster, but this is an area (large scale PCR laboratory work) where the US is supposed to be good at stuff. And yet there's been almost no attention paid to the problem at the highest levels of government.

Re: We’re Testing the Wrong People

#66

Post by elorant » Thu, Apr 23, 2020, 5:30 PM UTC

losvedir wrote: post #56

I appreciate the HN title ("We're Testing the Wrong People") in contrast to the article title ("Without More Tests, America Can't Reopen"), even though it's usually against policy to have them be different. But the HN title is actionable: if we can change our testing policy and deploy our tests more usefully, that's great to know and eminently achievable. But "not testing enough" isn't really actionable. There's a sh…

That's the title of the page. My guess is that HN's parser gives precedence to the title versus meta tags, so I didn't bother changing it after I submitted the story.

Re: We’re Testing the Wrong People

#67

Post by cm2187 » Thu, Apr 23, 2020, 5:31 PM UTC

yason wrote: post #41

alex_young wrote: post #3

The only data that is somewhat reliable in this pandemic is COVID deaths. Testing the population that is very sick / dying is crucial to understanding the baseline for the worst part of the problem. Once you have that under control, and we are not nearly there yet, you have to get every first responder tested regularly so you can prevent them from spreading the disease and give them some assurance that coming to work…

Deaths can lie too. What does it take for a death to be labelled as covid-19 death? That the person who died was merely tested positive, or do they do autopsies for all those who tested positive? How about covid-19 deaths that aren't counted as covid-19 deaths, for a reason or another? How about people dying less of regular influenza this year because of covid-19 and lockdowns? Even looking back at monthly 2020 death…

In the US, if the person tested positive, it is classified as covid19 death.

Also it seems that 98% of covid19 deaths have at least one comorbidity, 75% at least two. So I would expect that in many cases the virus may have just accelerated something that would have happened within a few months anyway. So you kind of need to look at how the full year death rate evolved to have an idea of the net impact of the virus.

Re: We’re Testing the Wrong People

#68

Post by kick » Thu, Apr 23, 2020, 5:31 PM UTC

losvedir wrote: post #56

I appreciate the HN title ("We're Testing the Wrong People") in contrast to the article title ("Without More Tests, America Can't Reopen"), even though it's usually against policy to have them be different. But the HN title is actionable: if we can change our testing policy and deploy our tests more usefully, that's great to know and eminently achievable. But "not testing enough" isn't really actionable. There's a sh…

The HN title is both the title in the URL and the HTML title, so it's likely that the title on the site is new.

Re: We’re Testing the Wrong People

#69

Post by jellicle » Thu, Apr 23, 2020, 5:36 PM UTC

ctoth wrote: post #57

heraclius wrote: post #49

Earlier quoted context omitted.

The target is to ensure that each case infects no more than one additional person (‘R Each infected person will come into contact with some other people. Testing allows three things— - first, we can tell this person to stay at home and so stop them from infecting more people; - second, we can tell the people they have seen to stay at home with good contact-tracing, so that even if they get it they don’t spread it fur…

So I guess I'm still not seeing this. Can you give me a concrete idea of what this looks like? Let's assume that it is the middle of August and the food situation is still somehow stable, I install my contact tracing app, I get a clean test. Then what? If we miss one person, that one person can still infect an entire office building by coughing in an elevator. Because of the two week incubation period, those people w…

Since this is infectious before symptoms show up, it's basically impossible to eliminate it entirely.

But suppose A starts showing symptoms, tests positive. We can immediately notify B1, B2 and B3 that they need to quarantine, immediately. Before they start showing symptoms. And therefore we're cutting down on the time that they were infectious and spreading. Therefore generation C is only a couple of people instead of dozens. We can notify C generation as well, immediately if we wish. This causes a large quarantine - there are a lot of false positives who are quarantining without being infected - but it would massively reduce the spread. If you can immediately test all of generation B and C, you can perhaps avoid some of the quarantining (assuming a negative is reliable).

Maybe contact tracing misses some, maybe some new infected come from other countries, maybe some people don't quarantine when told. All these things keep the infection going. But it can be held down to a manageable level.

Re: We’re Testing the Wrong People

#70

Post by ajross » Thu, Apr 23, 2020, 5:37 PM UTC

cm2187 wrote: post #67

yason wrote: post #41

Earlier quoted context omitted.

Deaths can lie too. What does it take for a death to be labelled as covid-19 death? That the person who died was merely tested positive, or do they do autopsies for all those who tested positive? How about covid-19 deaths that aren't counted as covid-19 deaths, for a reason or another? How about people dying less of regular influenza this year because of covid-19 and lockdowns? Even looking back at monthly 2020 death…

In the US, if the person tested positive, it is classified as covid19 death. Also it seems that 98% of covid19 deaths have at least one comorbidity, 75% at least two. So I would expect that in many cases the virus may have just accelerated something that would have happened within a few months anyway. So you kind of need to look at how the full year death rate evolved to have an idea of the net impact of the virus.

That's a misunderstanding of how death works. Everything is a comorbidity on some level.

> just accelerated something that would have happened within a few months anyway

That's absolutely not what this means. Asthma is a comorbidity. Are asthmatics just a few months from death? I have hypertension, am I about to kick the bucket? Sixty percent of the US population (no doubt including many of the posters on this very thread) are overweight, yet somehow we keep coming back.

Almost nothing kills "by itself". Everything adds up, and eventually the body stops working. Other diseases work this way too, yet you don't complain that yearly influenza deaths are inflated. Would you have argued that AIDS deaths were "really" due to the final infection and not HIV?