COVID Testing and Outcomes

[OverTheTop]

Just curious: How many people here have been tested and how many have come back positive (I hope I am not getting too personal here ). Just trying to get a feel for the amount of testing being done.

I have not been tested myself and, more concern is that I know of nobody else that has been tested.

I have set up the poll so you can change your vote if you do get tested in the future.

This lack of testing concerns me, as a control system is only as good as its inputs. With almost no data how can this be brought under control in a short time? Unfortunately I also suspect the reported numbers a low as a lot of infections and deaths could be assigned to other and unknown causes.

Here is a useful graph summarising current virus statistics:
https://www.mapbox.cn/coronavirusmap/#1.8/0/126.9

Here is an example screenshot

 

[mpitfield]

I live in Canada, where as you know, we have a "free" healthcare system. The only way you get tested is if you are sick enough to be in hospital or you know someone, like the PM's wife. We don't have anywhere near enough test kits to deal with this and our federal government's strategy is to just tell people to stay home if they are sick. The problem with that is unless you can prove that you had it and you are now immune, people are not going to fully engage with normal life. This will simply result in a slower economic recovery. As far as I know they are not planning on ramping up the test kit production to make it more available. I think this a short sighted strategy and view it as an investment that would pay back many times if they made an effort to test more. However, our federal government has been very slow to react and has yet to demonstrate any commonsense or proactive strategies.

 

[K'Tesh]

I'm in China, and though I wasn't swabbed, I frequently had my temp taken.
..

 

[cwbullet]

There are differing opinions out there, but swabs, tests, and resources are short because people are over-testing. The test requires 24-72 hours to result. If you are not symptomatic and have not had a direct 1 on 1 encounter with a positively tested and confirmed infection, you do not need testing. If we test every one or folks that are lower risk, the supplies will run out for those that really need testing to inform treatment.

Testing:

1. The vast majority of us, testing will nothing but confirm you should stay in your home and you should do that anyway when you are sick.
2. For a small group, it may confirm the possibility of using extremely harsh but helpful medications to treat.

Look at Italy, they tested everyone and ran out of vital supplies. Testing did nothing to stem the tide of this illness. We have learned a lot from other countries' successes and failures and they play into out testing decisions.

 

[NateB]

We screen ourselves at the start of every shift. I have not been tested, but don't have a reason to be at this point. I have been around people over the past 2.5 weeks who were exposed without PPE, but have not had direct contact with confirmed cases myself.

 

[Steve Shannon]

I live in Canada, where as you know, we have a "free" healthcare system. The only way you get tested is if you are sick enough to be in hospital or you know someone, like the PM's wife. We don't have anywhere near enough test kits to deal with this and our federal government's strategy is to just tell people to stay home if they are sick. The problem with that is unless you can prove that you had it and you are now immune, people are not going to fully engage with normal life. This will simply result in a slower economic recovery. As far as I know they are not planning on ramping up the test kit production to make it more available. I think this a short sighted strategy and view it as an investment that would pay back many times if they made an effort to test more. However, our federal government has been very slow to react and has yet to demonstrate any commonsense or proactive strategies.

There has been a lot of criticism of the US government for not just adopting the W.H.O. test. Without getting into politics, did Canada adopt the W.H.O. test or something else?

 

[mpitfield]

There has been a lot of criticism of the US government for not just adopting the W.H.O. test. Without getting into politics, did Canada adopt the W.H.O. test or something else?

I believe they adopted the W.H.O. test. However the issue is not limited to just an inadequate supply of tests. We don't have enough labs, reagents, etc. As a result, a test result can take many days and they are limiting the tests to only hospitalized patients and the front line health workers. Oh, and Justin Trudeau's wife who was not only tested but she miraculously had her results within hours. Sorry, I digress, the last part I couldn't help.

 

[Marc_G]

I work for one of the companies that is now part of the US consortium ramping up test capacity, though not specifically for the diagnostics division.

In late January a lot of us were wondering "Why the hell isn't EVERYONE returning from ex-US" plus "EVERYONE presenting with flu-like symptoms but influenza-negative tested" being tested and quarantined until the negative test was confirmed. That was the time, through probably mid to late February, when we could have contained this in the US. If the administration had reached out in January to the same companies tapped in early March, we would have had the ability to contain this here. But the quarantine facilities sat largely unused, the administration narrative was "it's just a flu," and the CDC for whatever reason wasn't on the stick about ramping their own testing capabilities. And here we are.

There is a lot of blame to go around. But at this point as Chuck says it has already spread widely and testing changes very little for most folks with COVID-19.

 

[mpitfield]

But at this point as Chuck says it has already spread widely and testing changes very little for most folks with COVID-19.

I disagree. There is a bigger threat than covid-19, a global recession. In an ideal world, if we could freely get tested, then for those confirmed and recovered, they could enter back into the economy. Without a test people will be cautious and reluctant to attempt some normalcy.

 

[boatgeek]

There are differing opinions out there, but swabs, tests, and resources are short because people are over-testing. The test requires 24-72 hours to result. If you are not symptomatic and have not had a direct 1 on 1 encounter with a positively tested and confirmed infection, you do not need testing. If we test every one or folks that are lower risk, the supplies will run out for those that really need testing to inform treatment.

Testing:

1. The vast majority of us, testing will nothing but confirm you should stay in your home and you should do that anyway when you are sick.
2. For a small group, it may confirm the possibility of using extremely harsh but helpful medications to treat.

Look at Italy, they tested everyone and ran out of vital supplies. Testing did nothing to stem the tide of this illness. We have learned a lot from other countries' successes and failures and they play into out testing decisions.

On the other hand, look at S Korea. They had their first confirmed case the same day we did in the US. They jumped on it like a ton of bricks with aggressive testing and isolation of infected people. For a while, they were well ahead of the US in numbers of confirmed cases. Now they have about a third as many total cases and deaths, with only 100-200 new cases/day.

I agree that testing has little impact on personal medical treatment. It has a huge impact on how public health authorities respond to the virus.

Thank you for all of your effort and service. You'll be due a vacation at the end of this!

 

[Bat-mite]

And now NYC is being overrun with cases, just like Italy.

https://news.yahoo.com/top-york-sur...-015200406.html?.tsrc=daily_mail&uh_test=1_02

 

[jderimig]

On the other hand, look at S Korea. They had their first confirmed case the same day we did in the US. They jumped on it like a ton of bricks with aggressive testing and isolation of infected people. For a while, they were well ahead of the US in numbers of confirmed cases. Now they have about a third as many total cases and deaths, with only 100-200 new cases/day.

But S. Korea has about 1/6th the population as the US.

 

[boatgeek]

But S. Korea has about 1/6th the population as the US.

S Korea’s cases are also basically flat now instead of doubling every 3-5 days. They contained it early and stopped the spread.

 

[jderimig]

S Korea’s cases are also basically flat now instead of doubling every 3-5 days. They contained it early and stopped the spread.

That's good news. Trouble is US has alot dumbasses who have not accepted isolation.

 

[Steve Shannon]

That's good news. Trouble is US has alot dumbasses who have not accepted isolation.

Some of us enjoy it. [emoji6]

 

[Rocketjunkie]

No one has mentioned that the current tests are for active infection. Once you recover, you will get a negative result. Once we have antibody tests, we will know how many people have had it and recovered even without seeing a doctor.

 

[NateB]

No one has mentioned that the current tests are for active infection. Once you recover, you will get a negative result. Once we have antibody tests, we will know how many people have had it and recovered even without seeing a doctor.

Once we have an antibody test, I would be glad to have a sample drawn. I'm really curious how many of us have or will be exposed.

 

[mpitfield]

Once we have an antibody test, I would be glad to have a sample drawn. I'm really curious how many of us have or will be exposed.

No one has mentioned that the current tests are for active infection. Once you recover, you will get a negative result. Once we have antibody tests, we will know how many people have had it and recovered even without seeing a doctor.

Do we have any idea on the status of an "antibody test?" Or is the type of test that would have a lower priority so it is likely not going to come until later, if at all?

 

[Steve Shannon]

Do we have any idea on the status of an "antibody test?" Or is the type of test that would have a lower priority so it is likely not going to come until later, if at all?

https://www.sciencemag.org/news/202...es-could-show-true-scale-coronavirus-pandemic

 

[jsdemar]

On the other hand, look at S Korea. They had their first confirmed case the same day we did in the US. They jumped on it like a ton of bricks with aggressive testing and isolation of infected people. For a while, they were well ahead of the US in numbers of confirmed cases. Now they have about a third as many total cases and deaths, with only 100-200 new cases/day.

S. Korea has had 171 cases per 1M population. The US has had 117 cases per 1M population. Are we doing better? No, because they peaked two weeks ago.
https://www.worldometers.info/coronavirus/

 

[Rocketjunkie]

https://www.sciencemag.org/news/202...es-could-show-true-scale-coronavirus-pandemic

Exactly.

 

[afadeev]

There are differing opinions out there, but swabs, tests, and resources are short because people are over-testing. The test requires 24-72 hours to result.

Once we have an antibody test, I would be glad to have a sample drawn. I'm really curious how many of us have or will be exposed.

Better yet - there is a new 30-minute viral protein test in the wings, awaiting FDA emergency authorization.
More info on various types of tests here:
https://news.mit.edu/2020/covid-19-diagnostic-test-prevention-0312

Look at Italy, they tested everyone and ran out of vital supplies. Testing did nothing to stem the tide of this illness.

There is no evidence that Italy "tested everyone" nation-wide (no country did, or could):
https://ourworldindata.org/covid-testing

Italy did, however, test everyone who has recently died for Covid-19, thus they are reporting a far higher mortality rate then the rest of the world:
https://www.bmj.com/content/bmj/368/bmj.m1065.full.pdf

We have learned a lot from other countries' successes and failures and they play into out testing decisions.

US testing decisions are driven by shortage of tests available, and the time it takes to back the results. Not "lessons learned". At least not in NY/NJ (my parents are retired Dr's, TMI).

Testing may only be marginally helpful for determining course of treatment.
However, it is essential for identifying asymptomatic infected who are not aware they've picked up the virus, yet are actively spreading it. There is simply no other way to inform asymptomatic carriers of the status, and have them change their behavior:

• "Cuomo told the Centers for Disease Control (CDC) to “wake up” and allow states to conduct their own testing of individuals to take initiative on containment." https://www.amny.com/coronavirus/cu...let-new-york-hospitals-run-coronavirus-tests/
• "they had tested the inhabitants twice and that the study led to the discovery of the decisive role in the spread of the coronavirus epidemic of asymptomatic people." https://www.theguardian.com/world/2...ss-tests-in-italian-town-have-halted-covid-19

Relying on the entire 330+M of US population to consistently and diligently self-isolate is, unfortunately, unrealistic. As important and essential as that recommendation is, and as much as we should attempt to enforce it, we still need to maintain essential services, and people who provide them, can be asymptomatic.

Either way, now it is what it is.

Best of luck and health to Chuck, Nate, and all health professionals who are on the front lines of Covid-19 response!

 

[Speaknoevil]

Once we have an antibody test, I would be glad to have a sample drawn. I'm really curious how many of us have or will be exposed.

I really find the epidemiology interesting. Starting with one person in mid-November, given their normal set of friends and family, the supposed R0 of 2.2, and given the travel in/out of the Wuhan province, it is hard for me to imagine that those parameters can account for the global spread we have seen in just over 3 months--specifically to the point of impacting an 80 year old man I know in Terre Haute, Indiana who never travels and lives in relative isolation(??). Is it possible that this virus has been gestating in humans for a much longer time? And is just now mutating into a lethal form in concert around the world? Or is that even possible?

 

[heada]

I really find the epidemiology interesting. Starting with one person in mid-November, given their normal set of friends and family, the supposed R0 of 2.2, and given the travel in/out of the Wuhan province, it is hard for me to imagine that those parameters can account for the global spread we have seen in just over 3 months--specifically to the point of impacting an 80 year old man I know in Terre Haute, Indiana who never travels and lives in relative isolation(??). Is it possible that this virus has been gestating in humans for a much longer time? And is just now mutating into a lethal form in concert around the world? Or is that even possible?

 

[NateB]

given the travel in/out of the Wuhan province, it is hard for me to imagine that those parameters can account for the global spread we have seen in just over 3 months

This article describes the global travel in and out of Wuhan which is a huge hub of travel and business activity in China.

https://www.wsj.com/graphics/how-the-coronavirus-spread/?mod=WCP_FB_BRD_CVSPREADFB

Think about work and educational conventions, trade shows, and other large gatherings where people fly in from all over to attend. Nursing homes aren't that isolated, family members come and go, employees might have multiple jobs, vendors and delivery drivers in and out all day. It doesn't take much to spread a disease.

I do think this virus was circulating around before we knew about it in November or December. Sure there was the first jump to a human host, but from there, multiple people had to become infected and sick enough with the same symptoms to make a pathologist curious to see what this was. With most people not needing hospitalization, it could have been worldwide before researchers even started to look for it.

 

[Speaknoevil]

OK, took me a while to find, but the video pretty much gives a mathematical answer in the 5:00 to 7:00 range (assuming his, or I guess anybody's numbers are right on R0).

 

[Speaknoevil]

... multiple people had to become infected and sick enough with the same symptoms to make a pathologist curious to see what this was. With most people not needing hospitalization, it could have been worldwide before researchers even started to look for it.

This makes sense.

 

[Speaknoevil]

So given that the virus spreads so fast, i.e., world population in months, it seems the correct course of action would be to isolate those 50 and over and let it spread as quickly as possible in the young and healthy. Then herd immunity would be achieved and transmission halted. This would transpire far sooner than any vaccine could be developed, or even mass testing done.

 

[NateB]

There are plenty of younger people getting pretty sick too. I don't think isolating people of a certain age would be effective in slowing this down.

 

[Steve Shannon]

So given that the virus spreads so fast, i.e., world population in months, it seems the correct course of action would be to isolate those 50 and over and let it spread as quickly as possible in the young and healthy. Then herd immunity would be achieved and transmission halted. This would transpire far sooner than any vaccine could be developed.

My other daughter had an acquaintance who recently died from (they think) the coronavirus. He was 40, a biker, a mountain climber, very active outdoor person.
On average it kills 1% of those who get it. For 10-39 year olds the death rate is “only” twice that of the flu, 0.2%.
There are about 120 million people between those ages in the USA. 0.2% of that is 240,000 people.