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Johns Hopkins CSSE Covid-19 Global Case Dashboard

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Re: Johns Hopkins CSSE Covid-19 Global Case Dashboard

#151

Post by davidw »

makomk wrote: post #145
hedora wrote: post #140

Earlier quoted context omitted.

Yesterday, I read the US had 100 confirmed cases, and had tested 500 people. Trump fired the a big part of the CDC that deals with pandemics back in 2018 and hasn’t replaced them. I don’t think the US government will make any serious effort to contain it, despite the recent theatrics from congress. Not testing sick people will inflate the official mortality rate. If the disease hits 70% of the population (projection…

I've seen comparisons like that doing the rounds. They're just plain wrong. The 500 number is the number of patients that had been tested by the CDC about a week ago, excluding state and local labs, whereas the 100 confirmed cases is a newer figure and a lot of those cases were diagnosed by the very state and local lab tests that aren't being counted. From looking at an old version of the CDC web page, at the point w…

The CDC stopped posting the numbers of tests they'd run a few days back. I don't know if they started again. It's not confidence inspiring.

I don't know if this has anything at all to do with firing the pandemic team, but you have to figure that didn't help, either.

Any administration has a lot of competent career professionals working for them. Events like this are the time to let them do their thing without hindrance, and without random commentary from uninformed leaders.

Re: Johns Hopkins CSSE Covid-19 Global Case Dashboard

#152

Post by wahern »

claudeganon wrote: post #144
wahern wrote: post #138

Earlier quoted context omitted.

The problem with wide scale testing is that it makes the CFR incomparable to seasonal flu or previous outbreaks. CFR is by definition deaths/confirmed cases. It's not a measure of infection lethality or mortality rate, even though that's what most of us think it is and what we're most curious about. For crisis management and planning, you want a CFR that is comparable to something like the seasonal flu or previous ou…

Nothing about what the CDC is doing is “understandable.” They’re stonewalling and delaying frontline responders testing puts the healthcare system more at risk of being overwhelmed and we’ve already seen cases of large numbers of nursing staff having to be quarantined once retroactive exposure was determined. There was also not a “temporary delay” with the kits, there is still nowhere near the necessary testing capac…

What value does knowing the total number of asymptomatic cases provide today? Such data is doubtlessly invaluable for studying the virus, but it's unnecessary today for managing the outbreak.

Yes, the data can help us more accurately estimate the rate of infections, but that'll take months or years to pin down to the precision that such fine-grained data promises. In the mean time, you can roughly determine the spread of impactful cases by the change in number of presentations of respiratory infections, just as we've done for decades.

You characterize what they're doing as stonewalling, but I'm charactering it as prioritizing. The biggest priority is collecting data on severe cases, and generally following established protocol to minimize unforced errors. The number of asymptomatic cases doesn't help you figure out how many ventilators you might need, at least not in a timely manner. The middle of an epidemic is not the time to revolutionize the practice and science of medicine. If you don't think things through carefully--i.e. the impact of false negatives and false positives of assay kits--you can easily fsck things up.

Researchers want data, but the primary concern right now is juggling medical resources and finding treatments. More data is not always helpful, especially data not directly relevant to the present task.

You're also assuming that hospitals and doctors are itching to run assay kits on every suspected case. Why, because some nurse's complaints went viral on social media? To out-do Singapore? Because "more data"? Doctors not interested in running millions of assay kits aren't going to be the ones complaining, not unless you forced them to run the tests. An assay result won't change the way you treat a patient with characteristic signs of a severe respiratory infection in the middle of a global SARS outbreak.

Re: Johns Hopkins CSSE Covid-19 Global Case Dashboard

#153

Post by claudeganon »

wahern wrote: post #152
claudeganon wrote: post #144

Earlier quoted context omitted.

Nothing about what the CDC is doing is “understandable.” They’re stonewalling and delaying frontline responders testing puts the healthcare system more at risk of being overwhelmed and we’ve already seen cases of large numbers of nursing staff having to be quarantined once retroactive exposure was determined. There was also not a “temporary delay” with the kits, there is still nowhere near the necessary testing capac…

What value does knowing the total number of asymptomatic cases provide today ? Such data is doubtlessly invaluable for studying the virus, but it's unnecessary today for managing the outbreak. Yes, the data can help us more accurately estimate the rate of infections, but that'll take months or years to pin down to the precision that such fine-grained data promises. In the mean time, you can roughly determine the spre…

This is just a series of counterfactuals to everything that’s been reported and said is necessary by frontline healthcare staff, epidemiologists, and even the WHO.

You can keep making these evidence-free, self-justifying claims, but that’s the sum total of what they are.

You can’t even respond to an epidemiologist saying they’re necessary to put in place appropriate mitigating strategies without espousing straw men like “outdoing Singapore” or “one nurse going viral.”

I guess all these other doctors and nurses, describing chaos in California because of the lack of testing, are just trying to “go viral” too?

https://www.latimes.com/science/story/2020-03-06/chaos-at-ho...

Re: Johns Hopkins CSSE Covid-19 Global Case Dashboard

#155

Post by lhorie »

claudeganon wrote: post #148
lhorie wrote: post #133

Earlier quoted context omitted.

It's not a straw man, the spectrum goes from no testing to testing everyone, and _measuring_ "actual cases" accurately (especially after community transmission stage) requires one to be on the latter end of the spectrum. I did say that it's unrealistic to go that far, and you're right that more aggressive testing will obviously lead to better visibility. My point merely was that the rationale for not ramping up testi…

What is this evidence of this “risk/cost analysis” you keep alluding to? Frontline staff are describing dangerous, chaotic circumstances in hospitals because testing is being delayed: https://www.latimes.com/science/story/2020-03-06/chaos-at-ho... If the US isn’t deploying anywhere near the response of countries with demonstrably curbed spreads in places like Seattle and California, what do you think, explicitly, jus…

I'm not comparing what one country is doing in relation to others. I'm saying that the CDC has their own criteria of what cases qualify for tests. They're not going just wake up one morning and say "yep let's ramp up to 300M test kits because people in the web are up in arms", that's not how it works. They look at the data they have then decide what to do. That's what risk/cost analysis is.

What you seem to be missing from my point is that things take time to do and larger bureaucratic institutions move slower. While the CDC hasn't formally stated the reasons for delays in test ramp up, it's entirely plausible that they're slow to update their analyses, recommendations and action plans because of broken telephones/bureaucracy/politics/etc. If, as the rumors go, the CDC arm needs money to make test kits but the president says "nah can't be that bad", then yeah you can bet things are gonna move very slow.

With all this said, I'm not sure why you are using the word "justify", as if the involved parties are naughty kids to be spanked. I'm not very interested in armchair judgment.

Re: Johns Hopkins CSSE Covid-19 Global Case Dashboard

#156

Post by creaghpatr »

davidw wrote: post #146
creaghpatr wrote: post #143

Earlier quoted context omitted.

And yet that's not what you insinuated. There were no cuts no matter how you characterize it-your source confirms that. Certainly no "reaping" what was "sowed".

You're responding to me, not the author of the 'reaping' comment.

I'm responding to both, the cuts you mention never took place so it's a bad faith accusation.

Re: Johns Hopkins CSSE Covid-19 Global Case Dashboard

#157

Post by davidw »

davidw wrote: post #150
ethbro wrote: post #120

Earlier quoted context omitted.

Georgia ran 50 tests yesterday. And that's after only 3 positive results so far. All states not equally dysfunctional.

Let's do some numbers: Georgia, with 50 tests/day and 10,000,000 people is at 0.005 per 1K people. Oregon, with 40 tests/day and 4,200,000 people, is at 0.0095 per 1K people. Italy, with about 2500 tests/day and about 60,000,000 people, is doing around 0.04 per thousand people. It's about an order of magnitude more. The point isn't a pissing match between states, it's that the entire US has not responded well so far.…

Oh, and Italy went back to a higher number. Today they ran almost 4,000 tests.

https://lab24.ilsole24ore.com/coronavirus/

Re: Johns Hopkins CSSE Covid-19 Global Case Dashboard

#159

Post by ethbro »

davidw wrote: post #150
ethbro wrote: post #120

Earlier quoted context omitted.

Georgia ran 50 tests yesterday. And that's after only 3 positive results so far. All states not equally dysfunctional.

Let's do some numbers: Georgia, with 50 tests/day and 10,000,000 people is at 0.005 per 1K people. Oregon, with 40 tests/day and 4,200,000 people, is at 0.0095 per 1K people. Italy, with about 2500 tests/day and about 60,000,000 people, is doing around 0.04 per thousand people. It's about an order of magnitude more. The point isn't a pissing match between states, it's that the entire US has not responded well so far.…

More testing != useful testing.

The fact that Georgia and Oregon are testing at virtually equivalent rates is what's wrong.

I feel like ~50/day is an appropriate number for GA. I feel like ~50/day is not an appropriate number for Oregon (sandwiched in-between Washington and California).

The federal goverent should be doing a stronger job of quarterbacking this to allocate scarce resources.

If Oregon needs surge capacity of testing labs across the Midwest, then by god make that happen.

Some amount of testing likely needs to happen in every state in order to prevent panic, but the most resources should flow towards the places with the most known infections.

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