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We’re Testing the Wrong People

theatlantic.com

151–155 of 155 posts

Re: We’re Testing the Wrong People

#151
If the goal is to stop deaths and prevent economic damage, then what is the alternative to testing (both for antibodies and for active presence of the virus), assuming that testing everyone in the US multiple times in the near term is not possible? Without testing a lot of people will not willingly return to work, which is already hurting the economy. Without testing we don't know the new places where the virus is spreading until a week or two later, so reactionary measures like contact tracing don't work as well. Total lockdown reduces deaths, but destroys the economy and reduces the scope of life.

Maybe we need to use the tools we already have, such as flu surveillance and data from hospitals, to detect excess non-flu infections. We seem to be able to do flu tests, are they more scalable so that at least flu can be ruled out in many cases?

If widespread testing can not happen because we can't build factories to make reagents/swabs/tubes/PCR array machines/etc. fast enough, we need to start thinking of alternatives. We don't actually seem to understand yet how the virus spreads, too many clinicians trained in handling infectious disease are getting sick despite PPE. If the new small antibody test results are right, then the virus is spreading much faster than can be accounted for via droplet spread as the main mechanism; we may have to consider birds, mosquitoes, surfaces, skin touching, and other methods as possible common spreading mechanisms. If we understood transmission better then it might be possible to tell people how to truly protect themselves, and then they could go back to work. So understanding transmission better is something that could be used in addition to whatever testing is available in order to prevent deaths and economic damage. But people may not follow the new rules based on that understanding, so get the social scientists involved to get the message across. Get OSHA involved to set best practices for workplaces. It seems like there is probably a lot that can be done, even without testing, and at present we may have to assume testing will not be sufficient in the near term (3-6 months).

But someone has to start thinking about these things and doing them, and I'm not seeing any evidence of this in the news. Given that contact tracing is not already ramping up (I've seen only Massachusetts as having a plan to scale it up but I tend to only see East Coast news) I have to wonder if anyone is even thinking about alternatives to testing if testing at scale is not possible.

Re: We’re Testing the Wrong People

#152
post #42

Maybe someone here can explain to me how this is supposed to work. Let's assume we have enough tests in the US to test every single person in the country every 3 days, and are contact tracing everyone with a smartphone, and providing smartphones to everyone without. Now, with all this in place, isn't the best we can do to alert people after they have already been exposed to the virus? It feels a bit like the safe sex…

> Now, with all this in place, isn't the best we can do to alert people after they have already been exposed to the virus? No, the best we can do in that case is treat COVID-19 like a dangerous communicable disease that isn't too widespread for surveillance and do specific quarantines of the infected and exposed, which then vastly limits the possibility that anyone else gets exposed, while not requiring shelter-in-pl…

You and I are often in disagreement on here, but not on this!

Re: We’re Testing the Wrong People

#153
post #94

Earlier quoted context omitted.

Sometimes, I feel like concepts such as these need to be translated into terms the average hackernews reader will understand. Let's say your key metric you're trying to maintain or improve is P50 request latency. Its relatively easy to exhibit an acceptable P50 to 10 users, from 1 VM. Its actually harder to deliver the same P50 to 100 users, from 10 VMs. Even harder for 1000 users and 100 VMs, snd so on. You run into…

> average hackernews reader > P50 request latency I for one don't even know what P50 means.

It seems to be jargon for "median". 50th percentile.

Re: We’re Testing the Wrong People

#154

Earlier quoted context omitted.

You are projecting that citizens are willing to throw their rights out the window. A more neutral perspective would be that people are willing to make sacrifices when they feel it's worth it. Also, people aren't "throwing their rights out the window" -- it's more like people are chilling them in the fridge for a small window of time. To prevent their friends, families, and countrymen from death. (Also, it's not clear…

It’s good idea to accept that the risk analysis of someone making 6 figures here is absolutely different than that of someone who is living paycheck to paycheck. This is why it’s been so frustrating to see “YOU’RE TRYING TO MURDER PEOPLE” from one side and “muh freedom” from the other. There is nuance of course. I think it’s super interesting how differently this all looks to different people. But I can’t think even…

The 1918 flu pandemic is not a good baseline, except for identifying where we fell short in science, public policy, and action. Remember, 50M+ people died (>500K Americans) at a time when there were maybe 1.5B people around.

People weren't quarantined. The death toll was much higher. Not saying those two are directly correlated -- many other factors -- but there's not a good comparison on the "rights" front because of that death toll.

Re: We’re Testing the Wrong People

#155

Earlier quoted context omitted.

You are projecting that citizens are willing to throw their rights out the window. A more neutral perspective would be that people are willing to make sacrifices when they feel it's worth it. Also, people aren't "throwing their rights out the window" -- it's more like people are chilling them in the fridge for a small window of time. To prevent their friends, families, and countrymen from death. (Also, it's not clear…

It’s good idea to accept that the risk analysis of someone making 6 figures here is absolutely different than that of someone who is living paycheck to paycheck. This is why it’s been so frustrating to see “YOU’RE TRYING TO MURDER PEOPLE” from one side and “muh freedom” from the other. There is nuance of course. I think it’s super interesting how differently this all looks to different people. But I can’t think even…

News media was actually heavily censored in 1918 due to the Sedition Act. It was literally "fake news".
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