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A Third Solution

paulbuchheit.blogspot.com

271–280 of 535 posts

Re: A Third Solution

#271

Sounds like the start of a plan. My questions would be around those 10 minutes at the entry door. What do we do with people? How are they connected to the test? How do we keep separation between people? How do we grant access after the passed test? What happens to those around if someone is +ve?

Maybe it can be accompanied with an app which would send you test result so you don't have to literally queue. And then use the result to enter the building.

Re: A Third Solution

#272
post #162

An honest query by a non-medical professional as I'm sincerely curious... Paul advocates daily saliva-based testing, but as an intermediary imperfect, but "better than nothing" measure, what are the benefits and drawbacks of requiring people entering public shared spaces to have their body temperatures taken via handheld temperature guns or infrared monitors, a measure that's already taking place in much East Asia (G…

Thermometers are better than nothing, but unlikely to stop the spread because of asymptomatic transmission (easy to catch the virus from someone who doesn't have a fever). This is why I think directly detecting the virus is essential.

In a best-case scenario, what is the timeline for testing, widescale manufacture, and rollout including “last mile” education to end users for the saliva tests? Is it achievable within a quarter? 2020? Beyond?

What’s the costs/benefits versus the temperature gun method already being used in Asia?

I fear that “perfect” or “near-perfect” solutions such as daily saliva testing would be potentially unrealistic for widespread rollout in an effective amount of time. Could we perhaps consider prioritize the superior daily testing solutions for high-priority environments like first responders and hospitals and nurses while reserving the “less-than-perfect” solutions such as what’s being done in Asia for environments with other essential workers, at least until scale-up hurdles can be surmounted?

Re: A Third Solution

#273
post #266

Earlier quoted context omitted.

we're in the middle of a pandemic. at some point you've got to accept that dystopia is here, and the dystopian things that are happening are realistic ways of dealing with the situtuation. you can't reject solutions because they sound dystopian unless you've got better, non-dystopian solutions. and everybody has to stay in their homes at all times and all non-essential services are shut down is not a less dystopian s…

The flu comes every year, and it’s not even a order of magnitude less fatal. Maybe COVID will come back every year too. What “solution” are you looking for to solve this relatively small share of “death from natural causes” that we call COVID? How much damage should we inflict upon ourselves in this moral quandary? How many people should die because we’re willing to spend trillions of dollars due to our innate fear o…

Can you please stop posting in the flamewar style to HN? This sort of rhetoric and polemic destroys curious conversation, which is what the site exists for.

https://news.ycombinator.com/newsguidelines.html

Re: A Third Solution

#274

This is a solution that could work provided we have a rapid on the spot test. David States has recently proposed exactly such a test and apparently his company is woking on developing it [1]. The major problem with all self-testing and isolation strategies is getting population buy in and what to do about poor countries. It is difficult to get population buy in if the economic cost of being positive is high (which it…

I'm in a medium income country, Thailand and they do quite well testing people they think at risk and if you have it the government pays the costs of quarantine / treatment / some lost income. It works well. I don't see why similar won't work in poorer countries. They use regular PCR but a better test would just make things better I guess.

It's odd that there seems a negative correlation between country wealth and how well they are doing with covid eg. Vietnam zero deaths, UK & USA a mess.

Re: A Third Solution

#275
post #216

I was curious about the company that's being touted in this post so I did a little searching. The website doesn't seem to have much on it. I guess it's a YC17 company. The founders are Caroline Landau, Tim Cornell, Walker McHugh. From 2016: Landau was an MBA candidate, the other two founders have biomedical research/medical backgrounds: Walker McHugh, Co-Founder, PreDxion Bio / Biomedical engineering candidate, Unive…

Hi, Walker here, one of the PreDxion co-founders. Up until recently we've been focused on developing our technogy as a point of care biosensor for us in patients experiencing dysfunctional immune responses (e.g., sepsis, ARDS, and the immune responses induced by certain cancer immumotherapies). The technical implementation of a viral detection assay is much simiplier to implement than our quantitative, multiplexed sm…

What TRL are you at for the original POC test, and what TRL are you at for viral detection? Any published papers for viral detection?

Re: A Third Solution

#276

Earlier quoted context omitted.

> I was making the point that this disease is an issue for the young... [citation needed] > ... and it causes damage to the lungs even in the absence of symptoms. The data you provided did not back up your assertion. I have not seen any data the backs up your assertion. If you have some, please do share it. The data you provided suggested 73% of those folks were asymptomatic when in fact only 18% of them were upon fu…

I am not sure the relevance of flu in children for the problem of COVID-19. The flu rarely causes serious illness in children and thankfully SARS-CoV-2 also rarely causes serious illness in children.

Well, this was all born out of the line in the post saying that young and healthy healthcare workers were dying. The data indicates that occasionally, they have, but overwhelmingly, the data indicates the statement is false. This continued on to an evaluation of "even if they don't die, they may have permanent lung injuries -- even if they show no symptoms" and I responded that I have not seen any data to indicate this is the case. I'm certainly open to it being true (it was for SARS-COV-1) but I have not seen any supporting evidence.

Re: A Third Solution

#277

An honest query by a non-medical professional as I'm sincerely curious... Paul advocates daily saliva-based testing, but as an intermediary imperfect, but "better than nothing" measure, what are the benefits and drawbacks of requiring people entering public shared spaces to have their body temperatures taken via handheld temperature guns or infrared monitors, a measure that's already taking place in much East Asia (G…

The fast gun like IR thermometers are not very accurate. And can be fooled. In one case an infected person took fever reducing medicine specifically so that they would be allowed on a plane where the temperature was checked on boarding.

My assumption would be that high accuracy solutions such as PCR testing or even the saliva testing that Paul is suggesting would be ideal, but potentially difficult to effectively rollout in a widespread manner. While IR thermometers are not very accurate, are they on a whole accurate enough to effectively screen out a sufficient number of people to reduce the R-factor viral spread below 1.0? Again, I’m not a medical professional, but shouldn’t we be biasing towards processes already being used by the multiple regions that have seemed to have successfully managed to reduce the viral spread below 1.0 first before seeking new solutions?

Re: A Third Solution

#278
post #212

The post refers to an alternative method of testing for COVID-19 based on surface plasmon resonance that would have significant advantages, but unfortunately it provides absolutely no real substantiation that the test exists or works. The link about surface plasmon resonance goes to a generic Wikipedia page, the link about saliva is a small scale study that was conducted on RT-PCR not surface plasmon resonance, and t…

Hi, Walker here, one of the PreDxion Bio co-founders. Heres a some more information on the technology underlying the test we are developing: https://pubmed.ncbi.nlm.nih.gov/25790830/.

Unfortunately, up until about a month ago us like many folks, were blissfully minding our business developing a rapid point of care cytokine detection platform for use in monitoring patients experiencing certain immune responses following cancer immunothereapies, you can read more here: https://pubmed.ncbi.nlm.nih.gov/31597044/.

Currently, we are very much focused on techical/clinical validation. We will have many more details to share on our approach, the technology, as we continue to move things forward.

Re: A Third Solution

#279
post #212

The post refers to an alternative method of testing for COVID-19 based on surface plasmon resonance that would have significant advantages, but unfortunately it provides absolutely no real substantiation that the test exists or works. The link about surface plasmon resonance goes to a generic Wikipedia page, the link about saliva is a small scale study that was conducted on RT-PCR not surface plasmon resonance, and t…

And it's a public kiosk that you spit in?

I'm not so sure about this!

Re: A Third Solution

#280
post #274

This is a solution that could work provided we have a rapid on the spot test. David States has recently proposed exactly such a test and apparently his company is woking on developing it [1]. The major problem with all self-testing and isolation strategies is getting population buy in and what to do about poor countries. It is difficult to get population buy in if the economic cost of being positive is high (which it…

I'm in a medium income country, Thailand and they do quite well testing people they think at risk and if you have it the government pays the costs of quarantine / treatment / some lost income. It works well. I don't see why similar won't work in poorer countries. They use regular PCR but a better test would just make things better I guess. It's odd that there seems a negative correlation between country wealth and ho…

I not sure I believe that Vietnam has had zero deaths.

How many tests is Thailand doing per day?

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