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A Third Solution

paulbuchheit.blogspot.com

191–200 of 535 posts

Re: A Third Solution

#191
I think the ubiquitous testing is the right approach, but I don't think we need a new test. Any test that requires a machine is going to be a severe bottleneck in testing.

Far better to use one of the antibody test strips. Prick your finger to get blood, or spit some saliva on a strip and you know in 5 minutes if you have antibodies.

Just keep testing everyone on a regular basis, and once they test positive, they are quarantined for 14 days. After that, they are assumed to be immune.

Re: A Third Solution

#192

Earlier quoted context omitted.

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, m…

Gov Cuomo should call up Gov Pritzger. Illinois recognized the challenge of testing supplies and asked the state universities to solve the problem. They have. Illinois is reporting a lot more positive cases in the past week because they keep increasing the number of daily tests. I believe that today was well over 12000 tests in Illinois. Anyone who feels like getting tested is now allowed to get a test.

New York has done more tests and more tests per capita than any other state per latest numbers - the reason for more tests isn't just to test people who want it, it's to run large random tests, require tests before visiting nursing homes, get an accurate picture of the infection rate, etc. We're testing more per capita than most countries in the world and it's still not enough. We've tested approximately 4 times as many people with only about a 50% higher population than Illinois and it's still not enough.

https://www.politico.com/interactives/2020/coronavirus-testi...

Re: A Third Solution

#193

Earlier quoted context omitted.

"Test and release" only works in science fiction. In the real world there is no absolute test that would enable practical test/catch-and-release processing of infected persons. From an epidemiological perspective, when applied to an entire population even tiny false negative rates will let countless infections slip through. False positive rates will see some people doomed to perpetual lockdown as, for whatever reason…

Can you be sure it's not an existential threat? Can you guarantee that a healthy person who gets this 3 times doesn't have a 100% fatality rate (i.e. it gets worse each time?) Can you guarantee asymptomatic people don't become sterile? (Not saying they do, but if they did this would be an existential crisis and lead to our extinction after a generation). Can you guarantee asymptomatic people still won't have lung dam…

These are part of worst case scenarios that are not published openly. We need more data, and until then the responsible actions are taken by almost all govs.

Re: A Third Solution

#194

Earlier quoted context omitted.

While the young might rarely die, this illness is not something you want even if young. It can be pretty brutal and there is some evidence that it causes damage to lung even in the absence of symptoms.

> While the young might rarely die, this illness is not something you want even if young. To begin of course, you don't want any disease at any age. Setting that aside it's pretty clear that you're less likely to die of COVID as a child than you are of the flu (which hits both young and old). Children are less likely to develop any meaningful symptoms in the first place, and if they do, they're less severe. Lots of o…

This paper found more than half of the asymptomatic patients had lung damage [1].

1. https://pubs.rsna.org/doi/10.1148/ryct.2020200110

Re: A Third Solution

#195
post #88

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…

> antibody assays; this does not allow the screener to differentiate between "has COVID-19" and "had COVID-19"

It does if it's an IgM test - IgM is only around during the illness. However, it takes a while to come up, so it can't tell you if someone is presymptomatic, at which point they are highly infectious.

Re: A Third Solution

#196

> This could be a reason why so many otherwise young and healthy doctors and nurses have been killed by this virus. This isn't well supported by data. In the sense that (a) young people just aren't particularly affected any more so than with the flu (old and sick people of course are much worse off) and (b) in Italy's data, no health professionals under the age of 49 died. There have been some deaths outside Italy bu…

"Just fine" is really misleading.

The 45 - 64 age group accounts for 23% of deaths currently [1]. There are widespread reports of high hospitalization rates for people under the age of 50 [2][3][4][5]. Unfortunately, most of the statistics being collected are focusing on official mortality rates, which leads people to see much higher numbers for "old" people and assume there's no impact for younger groups, which isn't true. ICU hospitalization is still a serious health care event, even if the probable outcome is much better.

Finally, please stop referring to what's going on as "panic". All things considered, most people have been remarkably calm. The only ones panicking seem to be the crazy attention-seekers blocking traffic.

[1]: https://www.worldometers.info/coronavirus/coronavirus-age-se...

[2]: https://old.reddit.com/r/Coronavirus/comments/fj1owh/over_ha...

[3]: https://old.reddit.com/r/Coronavirus/comments/fip9t9/france_...

[4]: https://old.reddit.com/r/Coronavirus/comments/fipavk/more_th...

[5]: https://www.businessinsider.com/new-york-city-coronavirus-ca...

Re: A Third Solution

#198

Earlier quoted context omitted.

> While the young might rarely die, this illness is not something you want even if young. To begin of course, you don't want any disease at any age. Setting that aside it's pretty clear that you're less likely to die of COVID as a child than you are of the flu (which hits both young and old). Children are less likely to develop any meaningful symptoms in the first place, and if they do, they're less severe. Lots of o…

This paper found more than half of the asymptomatic patients had lung damage [1]. 1. https://pubs.rsna.org/doi/10.1148/ryct.2020200110

The Diamond Princess averaged (mean age, 62 years ± 16, range 25-93) years old. That's not the demographic we're discussing. We know they're way, way worse off than younger folks. I was also informed that the "73% asymptomatic" rate they quote in this article dwindled down to below 18%.

Your study also appears to indicate that the amount of damage is correlated to severity of the disease ("The CT severity score was higher in symptomatic cases than asymptomatic cases, particularly in the lower lobes"), which is demonstrably much lower in children.

It's also not clear this damage won't go away.

Re: A Third Solution

#199
post #55

Earlier quoted context omitted.

A reasonable policy is to go home when the machine at the door to your office gives a positive result. Then get a more specific PCR test, and maybe come back to work. So the cost of a false positive can be one lost day. The false positive rate of lockdowns is 100%.

Exactly. While this plan would certainly result in some disruption, it would be a lot less than the current status quo. And you can't really compare it to simply "opening back up" without a plan like this, because the simple fact is that even without government-enforced lockdowns, many (perhaps most) people won't return to a normal level of activity if they don't feel safe doing so.

> “...because the simple fact is that even without government-enforced lockdowns, many (perhaps most) people won't return to a normal level of activity if they don't feel safe doing so.“

you’re underestimating the pain that many americans are feeling after just a few weeks of (soft) lockdown. it’s not that people want to be unsafe, it’s that their livelihoods are in grave danger if the lockdowns last for months. many people are willing to take some risk now that the pandemic hasn’t turned out to be plague-levels of badness that some initially feared. few people are economically secure enough to say ‘no’ to opening back up sooner rather than later.

Re: A Third Solution

#200
post #181

Earlier quoted context omitted.

Perhaps you should contact these medical residents to remind them that they'll be "just fine": https://www.aamc.org/news-insights/terrifying-privilege-resi... I also see a fair number of younger people on this list: https://www.medscape.com/viewarticle/927976

Again, I suggest you look at the data instead of responding emotionally. We need to allow the data to guide us. I'm skeptical of the Medscape list, since it appears to be the product of a Google form. I'm not saying it's wrong, but I chose not to use it as my primary source because unlike the government data I provided, it's unclear how or if it's being verified.

I agree that data is good, but the data you linked to seems to be for Italy only. Perhaps they had adequate PPE?

I'm kind of skeptical of the idea that the doctors and nurses in the United States are simply reacting out of irrational fear.

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