How the CDC’s restrictive testing guidelines hid the coronavirus epidemic • Hacker News Board

Re: How the CDC’s restrictive testing guidelines hid the coronavirus epidemic

#131

Post by Symmetry » Sun, Mar 22, 2020, 4:02 PM UTC

Rather than just blaming the CDC, I think the real problem here has been the lack of coordination between the CDC and FDA?

CDC: Our test is going to be so much better than the WHO's, we'll test for SARS-CoV-2 in two samples and also test for other simultaneous infections in this third part!

FDA: Approved

Hospitals: Hey, we can't get that third part to work!

CDC: That's ok, just use the first two parts, that's all you really need to diagnose COVID-19. Though I'm sad I won't get any data on simultaneous infections, apparently that was a problem in Northeast China and we want to figure that out for our guidelines.

FDA: Only running the first two tests is not what we approved! Verboten!

*

Laboratory: Let's develop our own SARS-CoV-2 test!

FDA: Sure, just make sure to fill out these forms, be sure to send them to us by mail rather than email, and oh, make sure to test against the original SARS to make sure your test doesn't give a false SARS-CoV-2 reading if they patient just has that.

Laboratory: Uh, sure. Hey, CDC, can I have a sample of SARS to test against?

CDC: NO WHAT ARE YOU CRAZY I'M NOT GIVING YOU THAT! THAT'S SUPER DEADLY!

Re: How the CDC’s restrictive testing guidelines hid the coronavirus epidemic

#132

Post by mindslight » Sun, Mar 22, 2020, 4:03 PM UTC

ellius wrote: post #64

ceejayoz wrote: post #55

Earlier quoted context omitted.

My high school math teacher introduced exponential growth by asking the class if we'd take $1M now or $0.01 doubled daily for a month. We, as most people do, wanted the $1M, but the penny turns into more than $5M. Had to explain this to someone yesterday. They literally wouldn't believe me until I screenshotted an Excel spreadsheet of the daily doublings, despite a finance degree.

I think that's exactly the issue. People can't picture it. You can show them a curve on a graph, but that doesn't translate for people without a mathematical/scientific background into "a shitload of people will get ill very quickly." Our brains seem not to be very well wired to make the connection between mathematical abstractions and reality, and aside from the minority of people who seem to just "get it," people d…

We technology people don't just inherently "get it", but rather have experience traveling up and down in powers of two for things that are meaningful to us. A month has 30 days - that's easily recognizable as a giga (2^10 ~= 10^3). And a billion isn't even that large to us.

Re: How the CDC’s restrictive testing guidelines hid the coronavirus epidemic

#133

Post by ceejayoz » Sun, Mar 22, 2020, 4:03 PM UTC

catalogia wrote: post #128

ceejayoz wrote: post #114

Earlier quoted context omitted.

The government can, and should, guarantee they'll purchase as many as you can make right now. They could, in fact, order that production. https://en.wikipedia.org/wiki/Defense_Production_Act_of_1950 Trump's been hemming and hawing on invoking it for several days now. https://talkingpointsmemo.com/news/medical-orgs-urge-trump-t... > Health care professionals from the American Hospital Association (AHA), the American M…

That's not all the government is doing though. They are saying things that will convince people in the future, once this pandemic and supply problems are resolved, that they shouldn't bother buying masks to prepare for the next time. They're suppressing demand for masks not only in the present but in the future as well. In doing so, they make mask manufacturers less inclined to scale up production now or ever, since…

There are two issues you're mixing together.

1. The government should stop lying that masks aren't effective.

2. The government should ensure healthcare workers get sufficient supplies first.

"Masks work, but we need to get them where they're needed right the fuck now" is the message that should be sent right now.

Re: How the CDC’s restrictive testing guidelines hid the coronavirus epidemic

#134

Post by SpicyLemonZest » Sun, Mar 22, 2020, 4:04 PM UTC

MiroF wrote: post #111

nprz wrote: post #95

Earlier quoted context omitted.

Except that wasn't the actual message coming from the Surgeon General. The original message appears to intentionally obscure the fact that not only does the US not have enough masks for our civilians, we also don't have enough masks for our health care professionals.

In emergency situations, it's possible misleading the public might be somewhat necessary to reach optimal health outcomes. There is substantial literature on this question with regards to climate change messaging. The government already misleads the public when it exaggerates things like the actual threat of terrorism to the average American, at least this time it is lying with some sort of societal good in mind.

Even if we grant the premise, this is just such a dumb lie. It's universally obvious that masks work; you can look at pictures of everyone in other countries wearing masks, and the 1 second thought of "the virus has a hard time going through the mask" is substantially correct. How's anyone who realized that they lied about masks supposed to trust their other public health recommendations?

Re: How the CDC’s restrictive testing guidelines hid the coronavirus epidemic

#135

Post by dzdt » Sun, Mar 22, 2020, 4:05 PM UTC

ceejayoz wrote: post #13

tyingq wrote: post #5

The mask guidance is confusing as well. I get they are trying to preserve masks for medical staff. But, they also say it's mainly spread by coughing, sneezing, and resulting spray of bodily fluids. Surely even a scarf around your face would have some benefit? Yes, I get that the virus is small enough to pass through, but some deflection is better than none.

"Why Telling People They Don’t Need Masks Backfired: To help manage the shortage, the authorities sent a message that made them untrustworthy." https://www.nytimes.com/2020/03/17/opinion/coronavirus-face-... And some data back from SARS: "Always wearing a mask when going out was associated with a 70% reduction in risk compared with never wearing a mask. Wearing a mask intermittently was associated with a smaller yet…

Yes the truth is masks help, but officials decided to lie about this to prevent panic over lack of masks. But this is damaging not only to official credibility but also to the response. A big demand for masks in January could have forced new supply chains to develop in the west. That would have averted some of the current disaster happening where hospitals can't get masks.

Re: How the CDC’s restrictive testing guidelines hid the coronavirus epidemic

#136

Post by seanwilson » Sun, Mar 22, 2020, 4:06 PM UTC

Thriptic wrote: post #27

tyingq wrote: post #5

The mask guidance is confusing as well. I get they are trying to preserve masks for medical staff. But, they also say it's mainly spread by coughing, sneezing, and resulting spray of bodily fluids. Surely even a scarf around your face would have some benefit? Yes, I get that the virus is small enough to pass through, but some deflection is better than none.

It's very irritating because people don't understand the concept of defense in depth. Are surgical masks going to give you total protection? Of course not, but as you say they provide SOME benefit. Saying "masks don't work because they don't fully stop the virus and users misuse them" is basically equivalent to saying "code review is a waste of time because it won't catch every bug and because devs don't do it correc…

> Are surgical masks going to give you total protection? Of course not, but as you say they provide SOME benefit

Face protection must surely have the side-benefit as well that it signals to others to keep your distance and that this is a serious situation.

Re: How the CDC’s restrictive testing guidelines hid the coronavirus epidemic

#137

Post by susanhi » Sun, Mar 22, 2020, 4:06 PM UTC

Jare wrote: post #69

erentz wrote: post #16

Earlier quoted context omitted.

The whole blaming people for hoarding masks and then the "masks don't work" things have been incredibly frustrating. It is almost like authorities didn't want anyone to start asking why the public couldn't get masks, as they can in say Taiwan. Most (if not all) distributors and manufacturers of masks has been prioritizing health care systems and governments over retailers since January. Just as they should do. Were t…

- If you tell the public that masks are great protection, and the public can't find then to buy, that is a huge source of unrest. - The messaging (in Spain but looks similar everywhere) has been that you should wear one if you are sick or, more importantly here, if you are at risk. This is a clear indication that they do help protect against being infected. This should have prevented everyone from harassing anyone we…

“You should wear one if you are sick”

Asymptomatic carriers are showing as a large contributor of spread. We should have a mandate for masks for everyone (since we don’t know who is a carrier or not) and government should contract manufacturers to ramp production ASAP to meet the demand.

China and South Korea has ramped productions and is allocating 2 masks per week per resident.

US has 330 million people. 2 per person is 660 million face masks.

China is currently producing 200 millions masks a day. If we ramp production to even half of that, 100 million masks a day, we can have 2 masks for everyone in less than a week.

Re: How the CDC’s restrictive testing guidelines hid the coronavirus epidemic

#138

Post by en-us » Sun, Mar 22, 2020, 4:06 PM UTC

simonh wrote: post #91

en-us wrote: post #12

Earlier quoted context omitted.

Agreed. The US surgeon general lied to the population about the efficacy of masks to try to preserve them for healthcare workers. It would have been better to ask people to preserve N95 for healthcare workers and instead improvise their own. Any reduction in droplet transmission is going to drop the R0 of this and help flatten the curve. As an alternative see Hong Kong, where they are encouraging the population to im…

Improvised masks commonly provide little protection, but obstruct breathing so people suck in more air with more force, increasing their risk of exposure.

What you say is directly contradicted by the researchers at University of Hong Kong-Shenzhen Hospital, as detailed in my link above.

Can you cite a study that supports your claim?

Re: How the CDC’s restrictive testing guidelines hid the coronavirus epidemic

#139

Post by MiroF » Sun, Mar 22, 2020, 4:07 PM UTC

SpicyLemonZest wrote: post #134

MiroF wrote: post #111

Earlier quoted context omitted.

In emergency situations, it's possible misleading the public might be somewhat necessary to reach optimal health outcomes. There is substantial literature on this question with regards to climate change messaging. The government already misleads the public when it exaggerates things like the actual threat of terrorism to the average American, at least this time it is lying with some sort of societal good in mind.

Even if we grant the premise, this is just such a dumb lie. It's universally obvious that masks work; you can look at pictures of everyone in other countries wearing masks, and the 1 second thought of "the virus has a hard time going through the mask" is substantially correct. How's anyone who realized that they lied about masks supposed to trust their other public health recommendations?

I suspect that there is substantial overlap between gullible people and panic buyers.

Re: How the CDC’s restrictive testing guidelines hid the coronavirus epidemic

#140

Post by catalogia » Sun, Mar 22, 2020, 4:08 PM UTC

MiroF wrote: post #92

OJFord wrote: post #72

Earlier quoted context omitted.

> Now since I’m shopping and cooking for them, I am trying really hard not to get sick so I wear a mask to the stores and I’m getting looks from people like I stole them from a hospital. I have an N99 (actually FFP3, a pretty much equivalent European standard I gather) from some DIY work a year or so ago; I haven't been out in some time, but when I did I didn't wear it for the same reason. It will be interesting to s…

This will probably hit us culturally the way SARS hit east Asia in the early aughts. The good news is that we likely won't be caught completely flat footed against a pandemic again.

Unfortunately many authorities are trying to stamp out public mask culture in the west before it even has a chance to properly develop. I think this is penny wise, pound foolish. It's short term thinking that optimizes for the present at the expense of the future.