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We’re Testing the Wrong People

theatlantic.com

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Re: We’re Testing the Wrong People

#71

Post by polygotdomain »

I think this article is getting things out of order. The question right now shouldn't be who to test, but rather how do we increase the volume of testing. The article states that we should be running 500k tests a day, as if we're not simply because we choose not too. Right now we don't have the capacity and so we can't scale up at all.

Why don't we have the capacity? Well the complete lack of coordination and leadership at the federal level means that each individual entity, whether it be state level government or a private entity, is having to do everything from scratch. That means developing SOPs, procuring supplies, and validating both the processes and reagents. This is being done on emergency orders as well, so some of the standards are relaxed to quickly get things up and running.

There's also a shortage of reagents and kits because we didn't have or need this testing just a few months ago. There's also international competition for these resources, and because the US has decided it doesn't want to actually work with or coordinate with other countries, it's a free for all.

Because everyone's frantically working on the same thing, but looking out for themselves it also means that true high throughput solutions are slow to develop as well.

I could go on and on, but it's a clusterfuck and no one at the federal level either A) seems to care or B) thinks that it's their responsibility.

Source: wife is currently in charge of starting up Covid testing

Re: We’re Testing the Wrong People

#72

Post by pmiller2 »

munificent wrote: post #32

> Another promising pathway is to pool many tests and run them together. If a pooled sample tests negative, everyone in the pool is negative. If it is positive, the members of the pool can be tested individually. Well, it took a global pandemic, but we finally found a use for bloom filters!

It's also the solution to a fun puzzle/brain teaser: https://www.geeksforgeeks.org/puzzle-19-poison-and-rat/

Re: We’re Testing the Wrong People

#73

Post by [deleted] »

ajross wrote: post #65
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 l…

[deleted]

Re: We’re Testing the Wrong People

#74

Post by pirocks »

awinter-py wrote: post #34

sampling bias debate reminds me of this stats legend from ww2: the USAF wanted to armor planes where the bullet holes were. statistician abe wald recommended armoring where the bullet holes weren't on the theory that those were the non-survivable hits can't interpret a statistic until you think about what's excluded from the sample

When I first heard this story it was the RAF not the USAF. I somewhat doubt how true it was.

Re: We’re Testing the Wrong People

#75

Post by adventured »

theaeolist wrote: post #62
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

> In tests/capita US is 42nd

That requires that you compare the US to Iceland, Faeroe Islands, Falkland Islands, UAE, Malta, Gibraltar, Luxembourg, Bahrain, Estonia, San Marino, Cyprus, Isle of Man, Lithuania, Brunei, Qatar, Liechtenstein, Ireland, Latvia, Andorra, Channel Islands, Bermuda, Aruba.

Nice try.

Back on planet earth, here's the list of actual sane comparables that are in front of the US, in order:

Italy, Germany, Spain, Australia, Russia, Canada

And Russia is fake. They haven't tested much at all.

The US has tested at a higher rate than South Korea (which is behind all of those tiny nations also).

The US testing rate is just behind Belgium, a nation 1/29th the size of the US. And it's not very far behind Singapore at this point, either.

Re: We’re Testing the Wrong People

#76

Post by user5994461 »

_Anken wrote: post #37
gumby wrote: post #12

Earlier quoted context omitted.

> The only data that is somewhat reliable in this pandemic is COVID deaths. I agree,, especially as you included the word “somewhat”. We have pretty good numbers on people who died in hospitals, but people who died at home appear to be seriously under counted. Additionally, consequential deaths are currently invisible. These are people who died, say, ecause the coronavirus crowded out their access to hospitals. There…

Most nursing home deaths are not getting tested either.

France started testing systematically in EHPAD (nursing home for retired fully dependent elders). That's why they have the most dramatic fatality rate out of every country now.

Not sure it was a good idea to test and attribute all the deaths to COVID.

Re: We’re Testing the Wrong People

#77

Post by ajross »

beamatronic wrote: post #39
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.

Keep in mind, we've learned so much. At the beginning there were some authorities (China, WHO) claiming there was no human-to-human transmission. It's too bad they would have ever made that statement, because I think people latched onto that and didn't let go of the idea.

> At the beginning there were some authorities (China, WHO) claiming there was no human-to-human transmission.

I don't understand how this misconception persists. That is not what the WHO statement said.

The statement was that the outbreak was not being sustained by community transmission, and that they believed (this was very early on) that the cases from the Wuhan market were all due to exposure to a single case or pathogen.

This was, obviously, wrong. But at the time it wasn't unreasonable to believe. That's the way most outbreaks work when you catch them early.

At no point did anyone say that a respiratory coronavirus was not contagious, which is how people insist on treating that statement. Of course these things are contagious, that's how they spread.

Re: We’re Testing the Wrong People

#78

Post by cm2187 »

ajross wrote: post #70
cm2187 wrote: post #67

Earlier quoted context omitted.

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 t…

The study I got these numbers from doesn't seem to classify asthma or obesity as a comorbidity. The largest ones are hypertension, diabetes, ischemic heart disease, atrial fibrilation, active cancer in past 5y, heart failure, COPD, dementia, stroke and chronic liver disease. Not familiar with all items in this list but some seem pretty serious.

Re: We’re Testing the Wrong People

#79

Post by ajross »

cm2187 wrote: post #78
ajross wrote: post #70

Earlier quoted context omitted.

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 t…

The study I got these numbers from doesn't seem to classify asthma or obesity as a comorbidity. The largest ones are hypertension, diabetes, ischemic heart disease, atrial fibrilation, active cancer in past 5y, heart failure, COPD, dementia, stroke and chronic liver disease. Not familiar with all items in this list but some seem pretty serious.

So you think that stroke victims and retirees with dementia are just months from the grave? FWIW: I've personally been living with diagnosed atrial fibrilation for almost three decades. Diabetes is, literally, a lifelong illness for its sufferers.

In fact, please cite me any of those factors which will reasonable by expected to kill you in months. Even heart failure and cancer patients tend to live years to decades with treatment.

Re: We’re Testing the Wrong People

#80

Post by autokad »

markrages wrote: post #26
gumby wrote: post #12

Earlier quoted context omitted.

> The only data that is somewhat reliable in this pandemic is COVID deaths. I agree,, especially as you included the word “somewhat”. We have pretty good numbers on people who died in hospitals, but people who died at home appear to be seriously under counted. Additionally, consequential deaths are currently invisible. These are people who died, say, ecause the coronavirus crowded out their access to hospitals. There…

You can get part of that with excess death rates. From the weeks overall deaths subtract the average death rate for this week in past years. That should give both people who died at home and consequential deaths.

this is not easy, as death rates are going down because people are not out and about.
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