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A Third Solution

paulbuchheit.blogspot.com

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Re: A Third Solution

#41

Post by vikramkr »

jawns wrote: post #11

> If we were able to identify and quarantine everyone who is contagious, including those who are asymptomatic, then we could let everyone else out of lockdown and resume ordinary social and economic activity. > Even with imperfect screening, if we are able to prevent 90% of disease transmission, then the virus’s reproductive number, or R0, will drop below one and the pandemic will quickly fade. There is no risk of re…

Compliance is tough. And my main concern would be false positives- if we are screening more people more frequently, we would have a lower expected percent of true positives, and even a small false positive rate could lead to significant overdiagnosis and disruption. The more often the test the more stringent that requirement. I dont know much about the testing method described in the article, but I wonder if it has unique characteristics beyond ease of administration to support that broad use case

Re: A Third Solution

#42

Post by johnnyo »

marcell wrote: post #30
JoeAltmaier wrote: post #17

Earlier quoted context omitted.

That's a terrible analysis, for reasons well-covered all over HN and elsewhere. This is a whole different thing from 'another flu'. We have to address it head-on. Throwing people (a million people?) under the bus is not going to fly, not politically and not morally.

Every year around 3 or 4 million people die in America from a variety of causes. This is sad, but at some point, everyone has to die. Data is showing that the infection fatality rate is around 0.5%-1%, and is concentrated in older people. [1] is one study, but there are many others. Given this data, it's clear that our current response is out of proportion with reality. [1] https://www.reddit.com/r/COVID19/comments/g…

So if all of America (330 million) gets infected, and we’ve got a 1% fatality rate, that means deaths (3.3 million) would be up there with all the other things that kill us combined!

Re: A Third Solution

#44

Post by astrophysician »

marcell wrote: post #6

> First of all, it’s not “just the flu”. It is something much more dangerous. Catching this virus is a bit like playing a round of Russian roulette. You’ll probably be fine, but you could end up dead I think this is mischaracterizing it. People have to die eventually. One year of existence has a mortality rate of 1%. For a 75-84 year old individual it is nearly 5%. Above 85 it's 14%. [1] The coronavirus infection fat…

> Death is sad and terrible, but we don't shut down society because people die.

Yea, but COVID has the potential to kill a lot of people, quickly -- are you suggesting it's a bad idea to "shut down society" to keep our hospitals functioning? I get the point that the economic cost is severe and also comes with its own share of human cost, but we're talking about saving ~1-2 million people in the US alone by doing this. Several trillion dollars is still worth it...

Re: A Third Solution

#45

Post by dang »

temac wrote: post #34

There are insanely high amount of speculation in there. To my knowledge no significant amount of non droplet or hand-to-face contamination as been demonstrated out of medical contexts where aerosolization is more a problem, because of technical gestures and cares. Even the linked page supposed to serve as a reference is completely speculative on the subject of the potential for the virus to be airborne: "In addition,…

Can you please make your substantive points without swipes? Controversial threads tend to devolve into people swiping at each other, and emotions run especially high in a crisis.

I don't think there's any reason to exclude an article on the basis of who wrote it. Articles should be excluded because they're off topic, bad, or uninteresting. Essays on CS from virologists would likely be of high interest to this community.

Besides that generic argument, which has become a bit of a shallow dismissal lately, there's the fact that pb is writing about a project he's personally involved in and which hasn't been discussed here before. It's understandable if there's interest in that.

Re: A Third Solution

#46

Post by vikramkr »

pb wrote: post #22
caymanjim wrote: post #13

This isn't a unique idea. This is the mainstream view. Everyone knows we need more testing and that testing is the only way to effectively ease distancing rules. That was a pretty extensive writeup to say what we've been hearing from all rational information outlets for a month.

I have not found any mainstream sources that advocate screening everyone every day (which is very different from simply doing "more testing"). Would love some pointers if I'm wrong.

I think governor Cuomo was saying he'd love to test every day if he could, but just doesn't have the capacity. Edit: as a side note he put out a call for companies that can help with testing saying that NY state might be willing to invest to bring things to scale. I believe he already wanted FDA approved tests but there's an opportunity there to work directly with a government to implement this sort of thing.

IIRC, mainstream objections tend to come from concerns of false positives, since that becomes a bigger problem with this frequent level of testing and could prove a huge disruption if you end up with too many quarantine still, or so many that testing positive becomes essentially meaningless in terms of telling you whether you have the disease or not if you test positive.

Re: A Third Solution

#47

Post by xyzzyz »

pb wrote: post #38
jawns wrote: post #24

Earlier quoted context omitted.

But how realistic is daily screening on a wide scale? You're going to face major issues with compliance.

That's why I think testing at the door is the more straightforward way to start. We can reopen factories, office buildings, even shopping malls, but no one gets in without passing the screen.

What door? You mean my front door? I'm not letting anyone in, and I'm not leaving either. What are you going to do, call the cops to kick in the doors to test me?

Re: A Third Solution

#48

Post by FrojoS »

temac wrote: post #34

There are insanely high amount of speculation in there. To my knowledge no significant amount of non droplet or hand-to-face contamination as been demonstrated out of medical contexts where aerosolization is more a problem, because of technical gestures and cares. Even the linked page supposed to serve as a reference is completely speculative on the subject of the potential for the virus to be airborne: "In addition,…

> Yeah, no. This is also completely speculative at this point. There is no strong technical reason for why it should be the case, given how viruses work...

Yes it is. If the initial amount of virus exposure is low, the immune system has more time to react.

Re: A Third Solution

#49

Post by roywiggins »

temac wrote: post #34

There are insanely high amount of speculation in there. To my knowledge no significant amount of non droplet or hand-to-face contamination as been demonstrated out of medical contexts where aerosolization is more a problem, because of technical gestures and cares. Even the linked page supposed to serve as a reference is completely speculative on the subject of the potential for the virus to be airborne: "In addition,…

I've heard from virologists that the amount of virus you're exposed to does matter. A gallonful of virus can quickly overwhelm the immune system, a small amount can take long enough to grow that your immune system can ramp up to deal with it before it overwhelms. It's like someone releasing one breeding pair of rats in your attic vs 100.

I don't have a cite, it was from the "This Week in Virology" podcast.

I also heard a number going around suggesting that an early group of people hospitalized and killed were Ear, Nose and Throat doctors, who obviously would have been exposed to an almost comically large amount of the virus.

Giving someone a little bit of smallpox was a known immunization method before modern methods were invented. You'd still get sick, but less sick, and you'd wind up immune.

https://en.m.wikipedia.org/wiki/Variolation

Re: A Third Solution

#50

Post by ak39 »

gowld wrote: post #35

> (less than $1/test). How much less than $1? $6B/day is a lot of money.

It's a lot of money in toal. But if the costs could be are borne by the customer or service provider or employer equally or proportionally, then it is a viable alternative to complete shutdown of businesses.

(The total cost of 50c drinking straws or coffee cups daily is also in the billions but we don't see it that way.)

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