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

wsj.com

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

#211

Post by simonsarris »

ardy42 wrote: post #158
Thriptic wrote: post #27

Earlier quoted context omitted.

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. Saying "masks don't work because they don't fully stop the virus and users misuse them" Surgical masks aren't about protecting the wearer from everyone else, they're about protecting everyone else from the wearer [1]. They may provide the wearer some protection, but that's not really the point. The emphas…

> Surgical masks aren't about protecting the wearer from everyone else, they're about protecting everyone else from the wearer [1]. They may provide the wearer some protection, but that's not really the point.

Normal people using surgical masks in public are definitely also for protecting the wearer, and do offer protection.

"Any type of general mask use is likely to decrease viral exposure and infection risk on a population level, in spite of imperfect fit and imperfect adherence, personal respirators providing most protection."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2440799/

Additionally, the number of asymptomatic carriers who may be able to spread the disease is possibly quite large.

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

#212

Post by mbreese »

dahart wrote: post #87
XorNot wrote: post #56

Earlier quoted context omitted.

It's quite likely that in all the scenarios a mask may have a useful effect, N95 or better is the only time it works. For medical professionals in close contact with patients and dealing with airborne-protocol pathogens (which is what a droplet-mediated pathogens like SARS2 becomes classed as once patients are coughing and being intubated) then a bad mask is quite probably worse then no mask (this has precedent: inef…

> It’s quite likely that in all the scenarios a mask may have a useful effect, N95 or better is the only time it works. You’re saying you think anything less than an N95 has 0 effectiveness. Why do you believe this is likely? Are you aware of the data that says otherwise? https://news.ycombinator.com/item?id=22655436 https://www.researchgate.net/publication/258525804_Testing_t...

The data from the Davies paper is not very convincing. The home made solutions offered significantly less protection and and had major problems with fit. Even their conclusions were — it’s better than nothing, but not a proper substitute.

> However, these masks would provide the wearers little protection from microorgan- isms from others persons who are infected with respiratory diseases. As a result, we would not recommend the use of homemade face masks as a method of reducing transmission of infection from aerosols.

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

#213

Post by JamesBarney »

SkyMarshal wrote: post #32

I hope one thing that comes of this outbreak is that all nations develop the processes and capabilities to quickly stop the spread of outbreaks in general. COVID19 is worse than flu, but not as bad as it could have been. We could get hit with something worse in the future. Imagine a strain of Ebola that gestates asymptomatically longer, or another coronavirus with higher mortality rate. This outbreak is good preparat…

Yeah maybe it'll be in place for next time. But this looks to be about a once in a century event. It happened in 1917 and happening now. I doubt we'll handle it better in 2115.

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

#214

Post by kps »

SpicyLemonZest wrote: post #81
erentz wrote: post #60

Earlier quoted context omitted.

I really want to hear the back story on this. Who is the distributor? Why did they end up at a Target? I'm betting the distributor tried to sell them to hospitals but the hospitals said they weren't appropriate/certified for medical use so couldn't take them? Not much to go on from a tweet but definitely needs investigating.

The respirators in question have exhalation valves[1], so they definitely wouldn't be normally certified for medical use. [1] https://twitter.com/anndornfeld/status/1241372544764006400/p...

Looked this up…

“Respirators with exhalation valves can be used in a healthcare setting when it is not important to maintain a sterile field (an example of an acceptable practice would be when taking the temperature or blood pressure of a patient). Respirators with exhalation valves should not be used in situations where a sterile field is required (e.g., during an invasive procedure in an operating or procedure room) because the exhalation valve allows unfiltered exhaled air to escape into the sterile field.”

https://www.cdc.gov/niosh/npptl/topics/respirators/disp_part...

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

#215

Post by tomp »

SkyMarshal wrote: post #32

I hope one thing that comes of this outbreak is that all nations develop the processes and capabilities to quickly stop the spread of outbreaks in general. COVID19 is worse than flu, but not as bad as it could have been. We could get hit with something worse in the future. Imagine a strain of Ebola that gestates asymptomatically longer, or another coronavirus with higher mortality rate. This outbreak is good preparat…

> overreact early, quickly and briefly

People were worried that overreacting (in particular if the outbreak fizzled out, in which case any reaction would have been an overreaction) would damage the economy. Personally, I viewed that as a positive - a decently resilient economy would absorb such short-term shocks without any long-term issues. Easiest way to force-create such an economy? Stress tests (c.f. Netflix’s Chaos Monkey). If governments overreacted 1-2 times every year, people (travellers) and companies (supply chains) would get used to occasional flight blockade, border closure, discontinuity and disruption. We’d build a much more anti-fragile world.

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

#216

Post by Symmetry »

Congeec wrote: post #199
Symmetry wrote: post #131

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…

It's called SARS-Cov-2, not -19

Argh, thanks, corrected.

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

#217

Post by LaMarseillaise »

XorNot wrote: post #80
CriticalCathed wrote: post #42

Earlier quoted context omitted.

This is so completely blowing this crisis out of proportion. I am so confused by the tenor of the discourse on HN. I expected more from this place.

This pandemic is potentially going to kill a lot more people then Chernobyl did. And permanently injure (via lung function damage) many more.

This has already killed many times the number of people that Chernobyl did.

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

#218

Post by Munky-Necan »

blhack wrote: post #165
Munky-Necan wrote: post #37

My colleagues are out of PPE and now using scarves because we are so under supplied. CDC guidelines were just changed to allow staff to be exposed to COVID patients without properly protecting themselves. I was talking with some physicians and providers when I said that I think this will be the Chernobyl like moment of our era: where the truth is hidden from people to prevent a panic paradoxically exacerbating the cu…

Where are you located?

In the US, that's all I'm comfortable saying. The people I said this to are at an institution 99% of people in the US would recognize.

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

#219

Post by darrinm »

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.

Agree. If coughing into my arm helps (CDC recommended) it’s hard to imagine any kind of mask wouldn’t help too. Also recommends mask: https://www.cdc.gov/flu/pdf/protect/cdc_cough.pdf

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

#220

Post by Consultant32452 »

ardy42 wrote: post #207
Consultant32452 wrote: post #203

Earlier quoted context omitted.

>Surgical masks aren't about protecting the wearer from everyone else, they're about protecting everyone else from the wearer [1]. They may provide the wearer some protection, but that's not really the point. I think you're confusing the normal use for these masks with what they are actually capable of doing. Yes, in a surgical setting the masks are worn primarily to protect the patient from the surgeon, but the mask…

>> Surgical masks aren't about protecting the wearer from everyone else, they're about protecting everyone else from the wearer [1]. They may provide the wearer some protection, but that's not really the point. > I think you're confusing the normal use for these masks with what they are actually capable of doing. Yes, in a surgical setting the masks are worn primarily to protect the patient from the surgeon, but the…

Yes an N95 mask provides more protection than a surgical mask. That's completely different from whether either mask protects the wearer. Both masks absolutely protect the wearer from infection. I'm sure you understand that, but the way you are wording things makes this unclear.
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