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A Third Solution

paulbuchheit.blogspot.com

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Re: A Third Solution

#231

Post by thaumaturgy »

arcticbull wrote: post #209
thaumaturgy wrote: post #196

Earlier quoted context omitted.

"Just fine" is really misleading. The 45 - 64 age group accounts for 23% of deaths currently [1]. There are widespread reports of high hospitalization rates for people under the age of 50 [2][3][4][5]. Unfortunately, most of the statistics being collected are focusing on official mortality rates, which leads people to see much higher numbers for "old" people and assume there's no impact for younger groups, which isn'…

> Finally, please stop referring to what's going on as "panic". All things considered, most people have been remarkably calm. The only ones panicking seem to be the crazy attention-seekers blocking traffic. Stopping the world is the panic button. 100% of the news cycle devoted to coverage. All schools shut down. It can be justified or unjustified but I think it's a stretch to call it anything but panic. I'd say the o…

Oh, you're one of those. Okay, thanks for showing your hand.

For anybody else reading that's unaware: Sweden is still in the earlier stages of growth, not yet peaking in total cases [1], but they already have 6x the per-capita death rate of either of their neighbors, Norway or Finland, and 50% higher than the per-capita rate in the US. If the US followed the Swedish model, we'd need, conservatively, another 25,000 body bags. Probably a lot more than that given other comparative differences between the two countries.

[1]: https://www.worldometers.info/coronavirus/country/sweden/

Re: A Third Solution

#232

Post by lvs »

predxionbio wrote: post #173
vikramkr wrote: post #127

Really interesting read and sounds like it could be a game changer for testing - I know in NY we've been clamoring for increased testing for a while to help us reopen. I've got two questions I'm curious about: 0) Sensitivity/specificity: Any data yet on what the sensitivity and specificity of this form of test for SARS-COV-2 will be? And, is work in characterizing all of that far enough along that we can expect to se…

0) From a clinical perspective this is data we are generating on an on going basis. Analytically this is a largely a function of the characteristics of the affinity, specificity of the capture molecule used to capture the target (viral particle). As you point out EUA gives opportunities to launch sooner... But it's still critical to validate technogies both internally and externally probably to a greater extent than…

How is chip fabrication is more scalable than plastic 384-well plates and cotton swabs? Nothing shy of a home pregnancy test is more scalable than qPCR.

Re: A Third Solution

#233

Post by sandworm101 »

gremlinsinc wrote: post #145
sandworm101 wrote: post #102

Earlier quoted context omitted.

"Test and release" only works in science fiction. In the real world there is no absolute test that would enable practical test/catch-and-release processing of infected persons. From an epidemiological perspective, when applied to an entire population even tiny false negative rates will let countless infections slip through. False positive rates will see some people doomed to perpetual lockdown as, for whatever reason…

Can you be sure it's not an existential threat? Can you guarantee that a healthy person who gets this 3 times doesn't have a 100% fatality rate (i.e. it gets worse each time?) Can you guarantee asymptomatic people don't become sterile? (Not saying they do, but if they did this would be an existential crisis and lead to our extinction after a generation). Can you guarantee asymptomatic people still won't have lung dam…

>> (some asymptomatics athletic types have shown severe decline in lung abilities following covid19)

Which is 100% normal for any pneumonia. I myself once had a bad lung infection (on my back for over a week). It took months before I could swim laps as fast as I did before. That's not anything special. Infections always have secondary medium-to-long term impacts.

Re: A Third Solution

#234

Post by 762236 »

PeterisP wrote: post #84
762236 wrote: post #15

One way to achieve ubiquitous screening is for people to perform regular VO2max tests (loosely speaking; you can do submaximal exercises for this). You quickly figure out if you have a stress on your immune system (by watching various metrics), and there are sports-science papers showing this (because they use it to avoid overtraining, which also appears as a stress on the immune system). This is of course not easy t…

This seems like something that would detect symptomatic patients only, I haven't heard of any research showing that patients would see lowered oxygen saturation in the early stages of infection. So for people who are going to get sick it would trigger too late, letting them spread the infection for days until this test catches it; and all the many infected people who will never develop any symptoms (perhaps up to a h…

You wouldn't pay attention to oxygen saturation, and I'm not sure if you can even use that as a metric. Generally this involves heart-rate variability, heart-rate recovery, etc. This detects the stress on the immune system, which is detectable soon after your body starts dealing with an illness. If the asymptomatic case has a stress on the immune system, which it likely does, then this test will detect it (so it actually isn't asymptomatic in a strict sense). It won't be able to tell you that it is Covid 19, but it can be used as guidance to behave as if you have the asymptomatic case. You could even just look at your performance: a significant drop in output means your body is unhappy about something. Imagine running/biking/swimming/etc at full capacity when you have a cold: you can't.

Re: A Third Solution

#235

Post by zaroth »

Dr. Fauci explained very clearly and simply the problem with daily testing.

Fauci’s background is in AIDS. It’s what he’s worked on his entire career. With AIDS, you can take a test, come back negative, and a year later if you haven’t done any at risk activities, you can be assured you are still negative. Not so with SARS-CoV-2.

With a virus as transmissible and prevalent as corona, you can test negative on Monday, and be shedding virus on Tuesday. A negative test gives you some confidence that you weren’t infected yesterday. It gives you no confidence that you weren’t exposed this morning.

The final nail in the proverbial Daily Testing coffin, even aside from the absurd logistical challenges, even aside from the civil rights issues of baring someone from leaving their home unless they wear a special colored armband, the biggest problem is that it just doesn’t work. The false positive rates on a test like this will be high enough that daily repeated testing will give the average uninfected person a 50% chance of testing positive by the end of the week. Don’t forget that we now have evidence that even a 14-day quarantine is insufficient, and that totally asymptomatic people can shed virus.

Ignoring that TFA is a sales pitch, which makes the whole thing rather nauseating, I hope that people will start taking a hard look at the absurdity of such a response, and perhaps not usher in a totalitarian regime with such open arms.

There’s certainly some sick irony involved in this post’s title. Gives me shivers.

Re: A Third Solution

#236

Post by slg »

true_religion wrote: post #207
slg wrote: post #186

Earlier quoted context omitted.

You can't just ignore people who don't travel by car. The hardest hit place in the country in New York City. Most New Yorkers don't own cars and many go months at a time without entering one. And even outside of cities, it is still classist to only allow people with cars to reenter society. The system also becomes much more complex and requires a bigger infrastructure if you aren't literally testing people at the doo…

A solution that works outside of the vicinity of New York, would still allow at least 47 other states to open up. As for checking who has a test, simply give colored stickers. If someone wants to “beat” the system, so be it. Social disapproval and common sense will keep most people honest.

New York City isn't the only place in which car ownership is low. What about Chicago, Philadelphia, San Francisco, Los Angeles, Boston, DC, etc? If your plan for reopening the nation doesn't include reopening our cities, it isn't a real plan for reopening the nation.

You need a plan for people who want to beat the system because they present a huge danger. The whole idea behind this system is to allow the people inside the secured bubble to return to normal behavior. They aren't going to be wearing masks, social distancing, or taking other precautionary measures. Therefore one person acting inappropriately could present a huge problem for the people on the inside. Keep in mind there are still people who think this entire thing is a conspiracy and that COVID-19 is no worse than the flu. You have to consider what happens with people like that who might not participate in this system in good faith.

Re: A Third Solution

#237

Post by danieltillett »

arcticbull wrote: post #219
danieltillett wrote: post #210

Earlier quoted context omitted.

I was making the point that this disease is an issue for the young and it causes damage to the lungs even in the absence of symptoms. This is a serious disease that needs to be taken seriously.

> I was making the point that this disease is an issue for the young... [citation needed] > ... and it causes damage to the lungs even in the absence of symptoms. The data you provided did not back up your assertion. I have not seen any data the backs up your assertion. If you have some, please do share it. The data you provided suggested 73% of those folks were asymptomatic when in fact only 18% of them were upon fu…

I am not sure the relevance of flu in children for the problem of COVID-19. The flu rarely causes serious illness in children and thankfully SARS-CoV-2 also rarely causes serious illness in children.

Re: A Third Solution

#238

Post by dang »

thaumaturgy wrote: post #231
arcticbull wrote: post #209

Earlier quoted context omitted.

> Finally, please stop referring to what's going on as "panic". All things considered, most people have been remarkably calm. The only ones panicking seem to be the crazy attention-seekers blocking traffic. Stopping the world is the panic button. 100% of the news cycle devoted to coverage. All schools shut down. It can be justified or unjustified but I think it's a stretch to call it anything but panic. I'd say the o…

Oh, you're one of those. Okay, thanks for showing your hand. For anybody else reading that's unaware: Sweden is still in the earlier stages of growth, not yet peaking in total cases [1], but they already have 6x the per-capita death rate of either of their neighbors, Norway or Finland, and 50% higher than the per-capita rate in the US. If the US followed the Swedish model, we'd need, conservatively, another 25,000 bo…

Please don't cross into personal attack, no matter how wrong another commenter is or you feel they are. It makes the thread strictly worse, and you can make your substantive points without that.

https://news.ycombinator.com/newsguidelines.html

Re: A Third Solution

#239

Post by IdoRA »

tptacek wrote: post #229
zmmmmm wrote: post #212

The post refers to an alternative method of testing for COVID-19 based on surface plasmon resonance that would have significant advantages, but unfortunately it provides absolutely no real substantiation that the test exists or works. The link about surface plasmon resonance goes to a generic Wikipedia page, the link about saliva is a small scale study that was conducted on RT-PCR not surface plasmon resonance, and t…

According to my biochem-undergrad kid, surface plasmon resonance is a thing; it had come up in classes. "It's like doing an ELISA with no secondary antibody". Someone here will know what that means. I don't!

If one is clever, one can use SPR to interrogate a surface: monitor the surface and you can “see” the surface changing when stuff is sticking to it. If you have something with specific binding properties on that surface, like an antibody (as is used in an ELISA), with some additional effort you can maybe have an assay that detects something binding to that antibody.

Re: A Third Solution

#240

Post by justnotworthit »

> With early detection, we can get the best known treatments

From WHO: What is the treatment for the coronavirus disease? No pharmaceutical products have yet been shown to be safe and effective for the treatment of COVID-19.

What is the author referring to?

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