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

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

#2
(Regarding the Headline) Surely you mean 35% of homeless who were tested. We can't say for certain that the sample is an exact representation of the general population of the homeless in Boston.

"Upon observing a cluster of COVID-19 cases from a single large homeless shelter in Boston, Boston Health Care for the Homeless Program conducted symptom assessments and polymerase chain reaction (PCR) testing for SARS-CoV-2 among all guests residing at the shelter over a 2-day period. Of 408 participants, 147 (36.0%) were PCR-positive for SARS-CoV-2"

The key thing here is they tested people from one single homeless shelter. Is this one homeless shelter in Boston representative of all homeless shelters in Boston? There is not enough info in this article to make that assumption. Nor is it enough information to make generalizations about the populations of the homeless who do not live in shelters.

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

#3
post #2

(Regarding the Headline) Surely you mean 35% of homeless who were tested. We can't say for certain that the sample is an exact representation of the general population of the homeless in Boston. "Upon observing a cluster of COVID-19 cases from a single large homeless shelter in Boston, Boston Health Care for the Homeless Program conducted symptom assessments and polymerase chain reaction (PCR) testing for SARS-CoV-2…

This is fair feedback on the headline, as the linked article does NOT make that claim. Instead, it makes the same point as @zadkey that "illustrate the rapidity with which COVID-19 can be widely transmitted in a homeless shelter setting and suggest that universal PCR testing, rather than a symptom triggered approach, may be a better strategy for identifying and mitigating COVID-19 among people experiencing homelessness."

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

#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 asymptomatic cases if we want to reopen the economy soon. Imagine if 10+% of the population already had COVID and where immune, we'd be much closer to heard immunity than we currently think.

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

#7
post #4

Also 15% of pregnant Moms in NYC had the virus. This could already be much more widely spread that people think. https://www.nbcnewyork.com/news/local/nyc-hospital-finds-hig...

The Boston Globe this morning ran an op-ed advocating testing a random sample of residents to get a better sense of community-wide infection rates.[1] It's amazing that this needed to be stated in a major market newspaper four weeks after most business and school was stopped due to the virus. Goverent is doing some interesting things, random sampling apparently isn't one of them, for reasons it's hard to understand.

[1]. https://www.bostonglobe.com/2020/04/15/opinion/how-get-bette...

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

#8
post #4

Also 15% of pregnant Moms in NYC had the virus. This could already be much more widely spread that people think. https://www.nbcnewyork.com/news/local/nyc-hospital-finds-hig...

Yup. And for far longer.

It seems to indicate this disease infected a lot more than what we see, and maybe mortality rate is lower than what we currently assume. Maybe it's around 0.1% to 0.5%.

So is it possible this disease appeared in China way before December, maybe a few months back. Then in December it reached a saturation point (i.e. infected hundreds of thousands of people, so deaths started to get noticed by respiratory specialists). Then around January/February this disease spread to the world, but it went unnoticed. Then in March it reached the same saturation point that the deaths became too many not to notice.

Is this a realistic scenario?

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

#9
post #4

Also 15% of pregnant Moms in NYC had the virus. This could already be much more widely spread that people think. https://www.nbcnewyork.com/news/local/nyc-hospital-finds-hig...

Yup. And for far longer.

I really don't understand why people immediately want to discredit the idea that US patient zero was not the first in US. Or that this virus was around earlier and that there are limitations in contact tracing capabilities.

This seems to have the toughest aspect of gaining consensus.

Need antibody tests now, and ones that work reliably.

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

#10
post #4

Also 15% of pregnant Moms in NYC had the virus. This could already be much more widely spread that people think. https://www.nbcnewyork.com/news/local/nyc-hospital-finds-hig...

NYC has something like 15x the death rate per capita of the the US ex-NYC. Even if you think that NYC is approaching herd immunity (debatable), that means the rest of the country is only 5-10% of the way there.
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