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

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

#41
post #29
post #9

Earlier quoted context omitted.

Something does not add up about the advice. Specially given that Eastern authorities encourage the use of makes by the general public. Which part of the World is better handling this pandemic?

Masks should just be a given. If we consider a place like South Korea, or Singapore, the executive actions contrast wildly with the executive actions that our city, state, and federal governments have taken. If I'm not mistaken, in Singapore they even went so far as to distribute packs of masks to each and every family. I don't ask for that level of efficiency, but it does illustrate an example of effective executive…

> I don't ask for that level of efficiency,

Well, why the crap not? Why is the west so unbelievably bad at handling this epidemic? Why aren't we able to produce our own masks? These things are essential and it was all off-shored to China. Now the west is screwed while life goes on in Asia.

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

#42

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…

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.

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

#43
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.

It's not all that confusing. The science is pretty clear. The best use of masks on people in public is on the sick themselves. You can't use the standards and practices in something like a TB hospital for medical personnel in public spaces. Not only is it an inefficient use of resources, but the efficacy is in question. You cannot expect the general population to adhere to the standards of a TB hospital. It cannot be…

[deleted]

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

#44

My concern here is that bad decisions were made early on in the US, and there will be no accountability. What do mechanisms for accountability here look like? Will they be used? Edit: And more importantly how will we prevent theses same mistakes from happening again?

Congressional hearings are one big way to hold the executive branch publicly accountable. Then, there’s the election.

My sense is that a lot of the bad decisions don’t necessarily rise to the level of negligence, so civil/criminal penalties are unlikely.

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

#45

Earlier quoted context omitted.

Washington state just seized a restock from a Target in Seattle. https://twitter.com/GovInslee/status/1241505423259099136

The message to commercial entities is clear: don't bother responding.

If you're gonna respond by selling N95s to consumers right now, instead of to hospitals, then I'd rather you didn't bother responding.

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

#46

CDC has there shortcomings, no doubt but let’s not forget who’s truly to blame for the mess we’re in now. The trump administration’s disbandment of federal institutions created to combat this and the ongoing denial of a serious problem have led to a collapsing economy and isolation of millions. Good article here for sure but let’s not pass the blame to the CDC. We know who to blame...

Evidence? CDC has more funding than ever. And it's a myth trump got rid of the pandemic team at NSC. They just renamed it the bioterrorism team after people left.

https://www.politifact.com/factchecks/2020/mar/17/instagram-...

https://www.politifact.com/factchecks/2020/mar/12/joy-behar/...

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

#47

> As the coronavirus epidemic spread around the globe, the Centers for Disease Control and Prevention provided restrictive guidance on who should be tested, archived pages on its website show. While agencies in other countries were advising and conducting widespread testing, the CDC, charged with setting the U.S. standard for who should be tested for the virus, kept its criteria limited Well, "other countries" also d…

Well, that's a good point.

If you don't have the tests, you don't have the tests. I get that.

But then just say, "Sorry guys, we can only test critical cases and emergency personnel right now because we don't have the tests."

What's concerning is that it's possible to reach a point where a person presenting with pneumonia, is not a critical case.

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

#48
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.

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…

If there are two "mental tools" I wish we could teach every person, they are exponential growth and statistical thinking. Neither is intuitive, but they would help people understand this whole situation (and many others) a lot better.

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

#49

My concern here is that bad decisions were made early on in the US, and there will be no accountability. What do mechanisms for accountability here look like? Will they be used? Edit: And more importantly how will we prevent theses same mistakes from happening again?

[deleted]

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

#50
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.

For reference, this is the recently released guide on mask usage by Chinese National Health and Medical Commission: https://zhuanlan.zhihu.com/p/114129365

Cat meme because it was reposted to Chinese Quora. Obviously consider that Asian countries have no mask shortage due to existing cultural practices. Masks should be prioritized to prevent collapse of medical capacity when there is shortage - the policy suggestion most western countries are seeing. The TL;DR of the guide: the only scenario not to wear (normal surgical) mask is when you're alone. Surgical masks for almost every other situation, N95+ for high risk situations. On efficacy for public health, The microbiologist Yuen Kwok-yung, from HK who was a key figure in SARS and one of the expert teams on Covid response:

>Given this novel coronavirus is so "cunning", with probably many infected but asymptomatic people moving around in communities, how should ordinary citizens protect themselves?

>We can only rely on telling everyone to wear a mask, wash their hands frequently, use alcoholic sanitiser. I had called for everyone to wear a mask when I was in Beijing, but many people disagreed, saying that the World Health Organisation (WHO) said healthy people don't need to wear masks unless they go to crowded places. Nevertheless, if people wear masks only when they feel sick, then the eight infected people on the Diamond Princess would have transmitted it to others because they were not feeling uncomfortable. Wear a mask to protect not only yourself but also others, because if you are infected but asymptomatic, you could still stop the spread by wearing a mask.

>In our experiments previously, we found 100 million virus strands in just one milliliter of a patient's saliva. Therefore, scenarios with the potential for exchanging saliva are generally quite dangerous. The temporary success of virus control in Hong Kong this time is not only due to population controls, but also contributed by the early advocacy for mask-wearing, hand-washing, and social distancing. Otherwise, with such a dense population in Hong Kong, the epidemic would very likely have spread the same way as in Italy or Daegu in South Korea.

https://www.straitstimes.com/asia/east-asia/exclusive-qa-wit...

Google translate of guideline:

The general public

(1) Home and outdoor, no people gathered, well ventilated. It is not recommended to wear a mask.

(2) Being in a crowded place, such as office, shopping, restaurant, conference room, workshop, etc .; or taking a box elevator or public transportation. In low- and medium-risk areas, it is recommended that you wear spare masks (disposable medical masks or medical surgical masks) with you, and wear them when in close contact with other people (less than or equal to 1 meter). In high-risk areas, disposable medical masks are recommended.

(3) For those with cold symptoms such as coughing or sneezing. It is recommended to wear disposable medical or surgical masks.

(4) For those who live together with those who are separated from home and discharged from rehabilitation. It is recommended to wear disposable medical or surgical masks.

Personnel in specific places (1) It is located in densely populated hospitals, bus stations, railway stations, subway stations, airports, supermarkets, restaurants, public transportation, and community and unit import and export places. In medium and low risk areas, it is recommended that workers wear disposable medical masks or surgical surgical masks. In high-risk areas, it is recommended that workers wear medical surgical masks or protective masks that comply with KN95 / N95 and above.

(2) In prisons, nursing homes, welfare homes, mental health medical institutions, school classrooms, construction site dormitories and other densely populated places. In medium and low-risk areas, it is recommended that you always wear spare masks (disposable medical masks or surgical surgical masks) with you daily, and wear masks when people gather or come into close contact with one another (less than or equal to 1 meter). In high-risk areas, it is recommended that workers wear medical surgical masks or protective masks that comply with KN95 / N95 and above; other personnel wear disposable medical masks.

Key personnel

Suspected cases, confirmed cases, and asymptomatic infections of new coronavirus pneumonia; close contacts of new coronavirus pneumonia; immigrants (from entry to end of quarantine). It is recommended to wear medical surgical masks or protective masks without exhalation valve that conform to KN95 / N95 and above.

Occupational exposure

(1) Medical personnel such as general outpatient clinics and wards; emergency medical personnel in medical institutions in low-risk areas; administrative personnel, police, security, cleaning, etc. engaged in epidemic prevention and control. Medical surgical masks are recommended.

(2) Personnel working in the ward and ICU of patients diagnosed with a new type of coronavirus pneumonia, suspected case patients; medical staff at designated medical institutions for fever clinics; medical staff in emergency departments of medical institutions in middle and high risk areas; epidemiological investigations and experiments Room testing, environmental disinfection personnel; transfer of confirmed and suspected cases. Medical protective masks are recommended.

(3) Operators engaged in the collection of respiratory specimens; staff who perform tracheotomy, tracheal intubation, bronchoscopy, sputum suction, cardiopulmonary resuscitation, or lung transplantation, pathological anatomy in patients with new-type coronavirus pneumonia. Suggestion: hood-type (or full-type) powered air-supply filter respirator, or half-plane power-supply air-filter respirator with goggles or full screen; P100 anti-particulate filter should be used for both types of respiratory protection Elements and filter elements should not be reused. Use protective equipment after disinfection.

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