Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Covid-19 at a homeless shelter in Boston: Implications for universal testing

medrxiv.org

Post reply on HN
Print view View original

181–190 of 208 posts

Re: Covid-19 at a homeless shelter in Boston: Implications for universal testing

#181

Post by draw_down »

coliveira wrote: post #167
marvin wrote: post #132

Earlier quoted context omitted.

That's a much more reasonable interpretation of the available data, although there are still plenty of unknowns here, as sibling comments are pointing out. My interpretations the last week are converging on the same ballpark figures. I'd just like to point out that this is still a far cry from the wishful thinking a lot of people are putting forth, claiming an IFR of These interpretations seem less likely to be true…

There is a very economical way to figure out this: test the majority of the US population. Sure, the government will have to spend a few billion dollars, but that would possibly save a few trillion dollars in GDP losses. The fact that people and businesses are not requiring this right now from the government makes my head explode!

Testing, why didn’t we think of that

Re: Covid-19 at a homeless shelter in Boston: Implications for universal testing

#182

Post by ben_w »

bgorman wrote: post #144
ben_w wrote: post #41

Earlier quoted context omitted.

Another explanation is that the exact infection level isn’t important when the observed all-causes fatality rate is double [0] its seasonal average and everyone is therefore busy firefighting the immediate and obvious problems. [0] varies by region, but see for example this graph of London: https://pbs.twimg.com/media/EVlO-28XQAA30xu?format=jpg&name=...

Don't take my word for it. Here is an article by a Stanford epidemiologist calling for random testing a month ago: https://www.statnews.com/2020/03/17/a-fiasco-in-the-making-a... We need data to act objectively. As far as I can tell US state governments are doing all they can to prevent random data from being released.

A month ago I would’ve agreed with the article you linked to. I’m suggesting that right now there’s probably enough information in merely the death count to say “we need to do something! Argh, panic!” — and governments, regional and national, are doing just that worldwide.

Re: Covid-19 at a homeless shelter in Boston: Implications for universal testing

#183

Post by rrrrrrrrrrrryan »

microtherion wrote: post #160
makomk wrote: post #140

Earlier quoted context omitted.

The US is doing a significant amount of testing compared to what's available almost anywhere else on the planet. I think Germany is still beating them, but they're basically the only large country that is at this point. Journalists here in the UK have actually been pointing to the US as one of the examples that proves we're the ones failing at testing for a while now.

It depends on where you draw the line for "large", but the US is really not doing all that great (though it has caught up significantly over the last month): https://www.worldometers.info/coronavirus/ Drawing the line at ~5M inhabitants, the following countries/territories have conducted more tests per million population than the US: The UAE, Norway, Switzerland, Germany, Portugal, Italy, Ireland, Austria, Hong Kong,…

The U.S. has more resources per capita at its disposal, but if everyone is starting at zero tests, I'd still expect smaller countries to be able to ramp faster relative to their population, and all the countries you've listed are indeed smaller than the U.S.

There's the old adage "nine women can't make a baby in a month". Sometimes there are real-world limits to scaling, and the U.S. does have an incredible amount of tests to create.

Re: Covid-19 at a homeless shelter in Boston: Implications for universal testing

#184

Post by pm_me_ur_fullz »

sjg007 wrote: post #175
pm_me_ur_fullz wrote: post #161

Earlier quoted context omitted.

> We would have seen a higher death rate if the virus was here earlier. > What if this is already the "second wave". Something with lower symptoms wouldn't have warranted checking for a new strain, complications and deaths would fit into the normal distribution of last fall's flu season with no outlier spikes. I think you are misunderstanding what wave means here. It means an earlier not as deadly strain/conditions h…

We know this is not true because the mutation rate is too low.

I specifically wrote "/conditions" to predict that specific rebuttal.

The virus could be the same, the opportunistic additional virus/bacteria could be different.

just like HIV causes no symptoms, until your immune system is down and a different infection (caused by bacteria or virus) kills you. Maybe even a normal "gut" bacteria, or something in your body usually present, is what kills you.

There is research pointing to Sars-Cov-2 attacking T cells directly. Instant AIDS.

In the fall and early winter, there could have been different variables that made it less debilitating and deadly than the spring variables. And in that case the fall and early winter deaths and pneumonia would have blended in to normal distribution.

Re: Covid-19 at a homeless shelter in Boston: Implications for universal testing

#185

Post by Erlich_Bachman »

bgorman wrote: post #29
smallgovt wrote: post #17

Earlier quoted context omitted.

> We need more studies to gather data on these asymptomatic cases if we want to reopen the economy soon. I don't understand what's so hard about measuring population infection rate. Assuming the population infection rate is between 1-10%, we would only need to do around ~500 randomized tests to achieve a 95% confidence interval of +/- 1%. For example, let's say we tested 500 random NYC residents for COVID and found t…

The thing you are missing is world governments want to milk this crisis, not act objectively. There is simply no other explanation.

What would a government, and specifically a ruling party gain from slowing down the economy and alienating its people (which always happens to some non-zero extent when you quarantine and constrain people)?

Re: Covid-19 at a homeless shelter in Boston: Implications for universal testing

#186

Post by makomk »

rrrrrrrrrrrryan wrote: post #183
microtherion wrote: post #160

Earlier quoted context omitted.

It depends on where you draw the line for "large", but the US is really not doing all that great (though it has caught up significantly over the last month): https://www.worldometers.info/coronavirus/ Drawing the line at ~5M inhabitants, the following countries/territories have conducted more tests per million population than the US: The UAE, Norway, Switzerland, Germany, Portugal, Italy, Ireland, Austria, Hong Kong,…

The U.S. has more resources per capita at its disposal, but if everyone is starting at zero tests, I'd still expect smaller countries to be able to ramp faster relative to their population, and all the countries you've listed are indeed smaller than the U.S. There's the old adage "nine women can't make a baby in a month". Sometimes there are real-world limits to scaling, and the U.S. does have an incredible amount of…

Yeah. One big reason I'm not counting small countries (that is, anyone much smaller than Germany) is that there's a limited global supply of pretty much every consumable you need to test for coronavirus, and smaller wealthy countries can get a major boost in per-capita testing by just buying up more of the supply. So there's a whole bunch of smaller countries with really substantial per-capita testing advantages over all the larger ones.

Re: Covid-19 at a homeless shelter in Boston: Implications for universal testing

#187

Post by phillipseamore »

Retric wrote: post #129
yters wrote: post #91

Earlier quoted context omitted.

what do you think about iceland?

Iceland’s peak was significantly more recent than China or South Korea which continued to have regular deaths over a month after their peak. So, my expectation is their deaths will likely double in the next three weeks. Which would be consist with ~1/2 their ICU cases dying. That said it’s a small sample size so significant variability is possible. Just compare new cases vs new deaths here: https://en.wikipedia.org/w…

Just a point on the comment "~1/2 their ICU cases dying".

The University Hospital handles most of the cases (and all except two deaths). According to their statistics* a total of 25 have been in ICU ("Á gjörgæslu frá upphafi"), total of 13 on ventilators from the beginning ("Í öndunarvél frá upphafi"), with as-of yesterday 3 still on ventilators ("Í öndunarvél") and 6 deaths ("Andlát samtals vegna Covid-19"). So that's less than a quarter of ICU cases dying and half of those on vents.

* https://www.landspitali.is/default.aspx?pageid=b629a8e0-b262...

Re: Covid-19 at a homeless shelter in Boston: Implications for universal testing

#188

Post by rjvs »

DenisM wrote: post #102
arcticfox wrote: post #70

Earlier quoted context omitted.

I mean, it's not great, but imagine if it was so cheap and fast we could test the entire population on a consistent basis. In a hypothetical scenario of 1% of the population actually having COVID and 9% testing false positive, you could ask all 10 positive results to self-quarantine and that'd probably be a pretty effective way of shutting down the virus without asking the whole population to stay home. Once the viru…

You need to also take into account the false positive too (1% iirc). Under your priors a group of 100,000 people will have 1000 infected and 99,000 not infected. Specifically: 99,000 0.09 = 8,910 false positives 99,000 0.91 = 90,090 true negatives 1,000 0.99 = 990 true positive 1,000 0.01 = 10 false negative So going through your plan will isolate 8,910 + 990 = 9900 people (9.9% of the population), catching 990 actua…

> All we need is the tests now.

Plus people to then do what they are told...

Re: Covid-19 at a homeless shelter in Boston: Implications for universal testing

#189

Post by dorgo »

IAmEveryone wrote: post #64
jcp2fa wrote: post #6

> Cough (7.5%), shortness of breath (1.4%), and fever (0.7%) were all uncommon among COVID-positive individuals It seems the more important point here is that the majority of the COVID-positive individuals were asymptomatic, putting another datapoint towards the conclusion that there are orders of magnitude more people that have this disease than have tested positive. We need more studies to gather data on these asym…

> Imagine if 10+% of the population already had COVID and where immune, we'd be much closer to heard immunity than we currently think. We’d be about 1/7 the way there. Meaning we’d see another 6x current deaths to get through this. That’s not even close to acceptable. And the 10% aren’t realistic, anyway. At least nationally. Assuming nationwide rates of 10%, then scaling up by death numbers, would put infection rate…

>That’s not even close to acceptable.

Is there a choice?

Re: Covid-19 at a homeless shelter in Boston: Implications for universal testing

#190

Post by pm_me_ur_fullz »

MaulingMonkey wrote: post #177
pm_me_ur_fullz wrote: post #146

Earlier quoted context omitted.

People don't advance a hypothesis without enough anecdotes to say "look over there" People like you can help fill gaps of savants saying "this isn't a constructive methodology but it isn't inherently without merit" versus "I don't want to believe that because thats not consensus right now" versus "hm thats interesting maybe worth a look sometime before the 2022 congressional committee to fund the epidemiologists?"

> People don't advance a hypothesis without enough anecdotes to say "look over there" They do so all the time. They'll advance hypothesis even without ancedotes on the vaguest of hunches, and bias towards Type I pattern recognition errors ( https://www.youtube.com/watch?v=1AjLmU0Sfu4 ). This is in fact half the problem - why anecdotes alone aren't terribly useful, and must be treated with so much caution and skeptici…

> On the off chance that I'm wrong, it invites a proper useful rebuttal or counter-argument.

Thanks for the invitation. Lets see where the goal post is here

> Either the ancedotes form useful data or they don't - you can't have it both ways.

In this case they do if you test for antibodies. We can't test for antibodies. It has been gaslighting from you to willingly ignore what the limitations of data are and how to solve them, if this is a term that bothers you make sure to look at it from my perspective as well, are you recycling this argument for everything epidemiologists aren't currently doing and doesn't currently have consensus? Or is it just for me, as I don't think you have factored in the exact argument here and I'll get to that:

> Does our political and epidemic policy really change if, say, technically this started several months earlier than we realized in Russia?

Yes it does, because it means the bay area is safe and can change its own policy. I don't see how you missed this in your effort to convert the word hypothetical into a pejorative.

> But since you seem to be hypothesizing about 2022 congressional committees

This was hyperbole but also likely what is going to happen. After the dust has cleared, Congress makes committees to see what exacerbated dysfunction - and they may then notice this discrepancy in the bay area as well. Meaning that it has nothing to do with a national policy decision because my hypothesis is relevant on a local level for the Bay Area as this whole thread made abundantly clear. For everywhere else it is merely interesting.

The difference is that one major economic center of the US can resume with a level of certainty and forward guidance.

Post reply on HN