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A Third Solution

paulbuchheit.blogspot.com

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Re: A Third Solution

#81

Post by philwelch »

jedberg wrote: post #64
LiquidSky wrote: post #57

Earlier quoted context omitted.

But that just moves the compliance and logistics problem back one step. Who's doing this massive amount of testing? If it's the government, you'd need armies of workers spread out everywhere. If it's the owners of these buildings, who checks to ensure compliance? Imagine trying to enforce this on every non-residential building in, say, NYC. It would be practically impossible.

> If it's the owners of these buildings, who checks to ensure compliance? Who checks to make sure every restaurant follows the standards of cleanliness? They have inspectors who (theoretically) show up randomly, so it ensures most places comply voluntarily, because the cost of getting caught is very high. A combination of random inspections and steep fines would solve the compliance problem. Edit: I just had another…

To your point, many businesses and facilities implement safety measures because they fear civil liability for preventable damages. I don’t think that’s likely in this case but if you can get most businesses and facilities to be mostly compliant most of the time, that might be enough.

Re: A Third Solution

#82

Post by clairity »

downerending wrote: post #59

This is a pleasant thought, but we can't even get most people to obey speed limits most days, even though it's far easier and we know it would save large numbers of lives.

strictly speaking, speed in and of itself isn’t the primary problem, it’s distracted driving in its many forms. speed only makes the severity of those accidents greater.

Re: A Third Solution

#83

Post by philwelch »

chatmasta wrote: post #78
LiquidSky wrote: post #57

Earlier quoted context omitted.

But that just moves the compliance and logistics problem back one step. Who's doing this massive amount of testing? If it's the government, you'd need armies of workers spread out everywhere. If it's the owners of these buildings, who checks to ensure compliance? Imagine trying to enforce this on every non-residential building in, say, NYC. It would be practically impossible.

Now imagine going out shopping, you’re stopped at the door, and you test positive. What happens then? The government puts you in a car and sends you... back to your apartment? Sounds like a dystopian nightmare, to be honest.

The store does not permit you to enter and you are asked to go home and self-quarantine.

Re: A Third Solution

#84

Post by PeterisP »

762236 wrote: post #15

One way to achieve ubiquitous screening is for people to perform regular VO2max tests (loosely speaking; you can do submaximal exercises for this). You quickly figure out if you have a stress on your immune system (by watching various metrics), and there are sports-science papers showing this (because they use it to avoid overtraining, which also appears as a stress on the immune system). This is of course not easy t…

This seems like something that would detect symptomatic patients only, I haven't heard of any research showing that patients would see lowered oxygen saturation in the early stages of infection.

So for people who are going to get sick it would trigger too late, letting them spread the infection for days until this test catches it; and all the many infected people who will never develop any symptoms (perhaps up to a half of infected according to the Iceland tests?) would never 'fail' this test, but still go on infecting other people.

Re: A Third Solution

#85

Post by sfkdjf9j3j »

jedberg wrote: post #64
LiquidSky wrote: post #57

Earlier quoted context omitted.

But that just moves the compliance and logistics problem back one step. Who's doing this massive amount of testing? If it's the government, you'd need armies of workers spread out everywhere. If it's the owners of these buildings, who checks to ensure compliance? Imagine trying to enforce this on every non-residential building in, say, NYC. It would be practically impossible.

> If it's the owners of these buildings, who checks to ensure compliance? Who checks to make sure every restaurant follows the standards of cleanliness? They have inspectors who (theoretically) show up randomly, so it ensures most places comply voluntarily, because the cost of getting caught is very high. A combination of random inspections and steep fines would solve the compliance problem. Edit: I just had another…

For this to work I think you would need a much stricter compliance than what is enforced in restaurant cleanliness.

Re: A Third Solution

#86

Post by SpicyLemonZest »

buboard wrote: post #73

This assumes that "economic activity will restart". Humans won't participate in dangerous activities. They may test the waters e.g. by ggoing to gyms, but as soon as a single case is found they 'll be scared back into their homes. It will happen even more so as the disease spreads and people learn about the death of someone they know. This will happen regardless of how much testing. If you 're doing contact tracing r…

If humans were so extremely risk averse that a single case is unacceptable, wouldn't we have naturally isolated ourselves without requiring lockdown orders?

Re: A Third Solution

#87

Post by tempestn »

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 think the main point is that he's pointing toward a specific test being developed that is intended to facilitate greatly increased degrees of testing. It is of course generally understood that if we could test everyone daily (or even a large section of people regularly), it could allow the virus to be contained without such widespread distancing and shutdown measures.

> This test gives results in ten minutes using a small amount of saliva which is taken into a disposable tube and then run through a scanner.

> We’re planning to start operating the first scanner within a month. If all goes well, there will be millions of scanners deployed by this fall, ensuring that every school and essential business can reopen while remaining safe and virus-free.

Re: A Third Solution

#88

Post by stonogo »

Not only is it completely unrealistic at scale, the specific approach in the blog post is wildly impossible at all.

It requires screeners to directly manipulate saliva samples; this is dangerous in a pandemic. The assays referred to (lazily) in a Google Scholar search are almost overwhelmingly antibody assays; this does not allow the screener to differentiate between "has COVID-19" and "had COVID-19". Also, there is no evidence that the described test actually exists.

Finally, maybe irrelevantly, there is no way in hell you're going to get people at large to stand around for two hours a week waiting for test results. Ten minutes for a screening whenever you try to enter a public building; that's ten minutes to get into work, and we'll say ten minutes to get into another place each day. "But wait," I hear you say, "you only need to be screened once per day, and the first place can share that data with the next place." This plan was constructed by someone who is unfamiliar with medical records laws.

This is no "third solution." It's an engaging thought experiment, but it's just too far away from reality to get here from there.

Re: A Third Solution

#89

Post by floatingatoll »

chatmasta wrote: post #78
LiquidSky wrote: post #57

Earlier quoted context omitted.

But that just moves the compliance and logistics problem back one step. Who's doing this massive amount of testing? If it's the government, you'd need armies of workers spread out everywhere. If it's the owners of these buildings, who checks to ensure compliance? Imagine trying to enforce this on every non-residential building in, say, NYC. It would be practically impossible.

Now imagine going out shopping, you’re stopped at the door, and you test positive. What happens then? The government puts you in a car and sends you... back to your apartment? Sounds like a dystopian nightmare, to be honest.

You are handed a free mask that serves as warning people to give you space, and you are simultaneously logged as being infected with the CDC.

Re: A Third Solution

#90

Post by mcherm »

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 have not found any mainstream sources that advocate screening everyone every day

That's because we currently aren't capable of testing everyone who is obviously sick just once. If we got there, we wouldn't even be close to being capable of testing key personnel (like health care workers). If we got there we wouldn't even be close to being able to test everyone once. If we got there we wouldn't even be close to being able to test everyone every day.

You haven't heard any advocating for OR against it because it is so far from achievable that it isn't worth considering.

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