Covid-19 discussion and humor thread [Was: CDC says don't touch your face to avoid Covid19...Vets to the rescue!

[The Dean]

4 hours ago, Figster said:

We're not talking about people that have Covid 19 and don't show symptoms. We're talking about people who came into contact with a confirmed Covid 19 carrier for 15 minutes or longer. A big percentage of which never catch the virus. 

 

I also tend to disagree with someone who has Covid 19 without symptoms being the most dangerous. They don't sneeeze, they don't cough and If all the guidelines are followed. Social distancing, mask wearing, I'm not sure how from a general public standpoint it makes them any more dangerous then your typical carrier displaying all the symptoms. 

 

With all due respect Dean

 

 

Hapless and 716 have already provided the rebuttal to your comment here. But I'd like to add a few things:

 

Yes, if you are infected and sneezing and coughing, that can spread the virus. But people with symptoms tend to, or at least SHOULD tend to, isolate themselves from others. Also since they are obviously sick, others can actively avoid contact with you, you should be sent home from work/school, etc. Add to that people are MOST contagious BEFORE they get symptoms. But  yes, sick people can spread the virus.

 

But since people are most contagious BEFORE they experience symptoms, and since many NEVER experience symptoms, the systems we typically have in place to avoid getting sick in general are not in play. How can you know if you've been into contact with a person who has Covid if you don't know the person has Covid? Only one way to know (as far as I can tell) and that is for as many people as possible to be TESTED.

 

And I will agree, IF everyone wore masks and engaged in social distancing, then the non-symptomatic folks might not be as great of a danger. But that simply isn't happening--at least not here in Florida. At the coverage of the celebration at our county's Republican primary, the only person I saw wearing a mask was the TV reporter---and he was nowhere near anyone else. Others were unmasked, hugging, shaking hands, arms around each other talking, etc. I did not see any coverage of the Democratic primary celebrations, so I can't comment on how they behaved. I'd suspect it was somewhat better, but far from where we'd need it to be, if we don't want to be concerned about unsymptomatic folks getting tested. 

 

IMO we should assume EVERYONE has it (including ourselves unless you've been very recently tested), and behave as such. But that just isn't our current reality.  The focus on "symptoms" is off base and making things worse.

 

Quote

 

"It's OK for kids to go back to school since they don't suffer as much from the virus." 

"I'm not afraid of getting the virus."

"Football players are young, and in good shape, they aren't likely to die from the virus,"

 

 

 

This is all selfish/moron talk, IMO. Virtually anyone can get the virus and they can infect others (with perhaps some rare exceptions) irrespective of what damage the virus causes to them personally.  Forget the focus for a minute on symptomatic damage. Instead, stay laser focused on how the virus spreads, and work on a way to snuff it out.

 

 

[Figster]

7 hours ago, Hapless Bills Fan said:

 

Right, but to break the transmission chain, you must identify those who do

 

5 hours ago, The Dean said:

 

 

Hapless and 716 have already provided the rebuttal to your comment here. But I'd like to add a few things:

 

Yes, if you are infected and sneezing and coughing, that can spread the virus. But people with symptoms tend to, or at least SHOULD tend to, isolate themselves from others. Also since they are obviously sick, others can actively avoid contact with you, you should be sent home from work/school, etc. Add to that people are MOST contagious BEFORE they get symptoms. But  yes, sick people can spread the virus.

 

But since people are most contagious BEFORE they experience symptoms, and since many NEVER experience symptoms, the systems we typically have in place to avoid getting sick in general are not in play. How can you know if you've been into contact with a person who has Covid if you don't know the person has Covid? Only one way to know (as far as I can tell) and that is for as many people as possible to be TESTED.

 

And I will agree, IF everyone wore masks and engaged in social distancing, then the non-symptomatic folks might not be as great of a danger. But that simply isn't happening--at least not here in Florida. At the coverage of the celebration at our county's Republican primary, the only person I saw wearing a mask was the TV reporter---and he was nowhere near anyone else. Others were unmasked, hugging, shaking hands, arms around each other talking, etc. I did not see any coverage of the Democratic primary celebrations, so I can't comment on how they behaved. I'd suspect it was somewhat better, but far from where we'd need it to be, if we don't want to be concerned about unsymptomatic folks getting tested. 

 

IMO we should assume EVERYONE has it (including ourselves unless you've been very recently tested), and behave as such. But that just isn't our current reality.  The focus on "symptoms" is off base and making things worse.

 

 

 

This is all selfish/moron talk, IMO. Virtually anyone can get the virus and they can infect others (with perhaps some rare exceptions) irrespective of what damage the virus causes to them personally.  Forget the focus for a minute on symptomatic damage. Instead, stay laser focused on how the virus spreads, and work on a way to snuff it out.

 

 

 Absolutely, everyone assuming they have the virus and a National shelter in place order is the only way we stop Covid 19 IMO. No argument there Dean. You guys make good points. Break the transmission chain when possible. Of course. Its something that can be accomplished through quarantine. Test when symptoms show.  Its not that I think we should focus on the symptoms. Slowing down the testing process with people not showing symptoms is causing a delay for results in positive cases that do need to get tracked down IMO. I'm sure everyone must realize how important getting test results back in a timely manner would be when you are trying to get on top of the situation from a contact tracing standpoint.

 

My nephew has been waiting for longer then a week now for Covid 19 test results. Fever, coughing, and yes, even sneezing, all gone before he gets confirmation. Myself personally,  I can understand the kind of back log the CDC recommendations would be creating. The friction and non compliance you will face trying to get people who don't feel sick to get tested.  I'm glad we made the change.

 

Thanks for the discussion fellas... 

 

 

 

Edited August 28, 2020 by Figster

[shoshin]

17 hours ago, Figster said:

 

 

My home state of Pa by way of example has tested almost a million and a half citizens to find a little under 127,000 confirmed cases. Seems like an excessive amount of testing right?  It works out to about 1 in every 12 people have tested positive. Its not the cold or flu season. Covid 19 symptoms are fairly obvious. So why did we have so many people testing negative for Covid 19?  Testing people without symptoms was not helping the situation IMO.

 

 

 

PA is 49th in testing per capita, only ahead of Colorado.

 

As long as there is capacity (meaning as long as we are not delaying testing for people with symptoms and that seems like less of an issue than it was a month ago), we should ALWAYS be testing more. Focus on elderly and health care, people who have to interact more with others. For example, my wife is a hospice and home care social worker in PA--she has not once had a test--and she works for a mammoth health system, not some rinky dink small provider. Hell, I work from home mostly and I have had two tests as part of a volunteer study!

 

PA is almost the worst example you can use for a place that needs to test less. 

Edited August 28, 2020 by shoshin

[shoshin]

I keep reading about pooled testing and yet see it in use *so* seldom after months of people discussing its benefits. Any insight as to why? 

 

I would think it solves so many problems. 

 

Edited August 28, 2020 by shoshin

[Hapless Bills Fan]

6 hours ago, Figster said:

Absolutely, everyone assuming they have the virus and a National shelter in place order is the only way we stop Covid 19 IMO. No argument there Dean. You guys make good points. Break the transmission chain when possible. Of course. Its something that can be accomplished through quarantine.

 

Unless we're prepared to pay people to quarantine, it's an undue burden to ask everyone who is a contact with a positive case to quarantine for 14 days.  And even then, it's disruptive to their workplace. 

 

If tests results are delayed say, 24-72 hrs, they also won't know if they've been exposed until they're potentially infectious, so we need to identify the secondary infections and contact-trace them.

 

The thing is, Fig - this isn't a "new wheel".  It's part of the "pandemic playbook" for how to contain a disease.  Countries that have contained covid-19 are doing just this.  Test, trace, isolate, test the traced contacts, trace and isolate their contacts.  It's how you keep an 84 person disease cluster from becoming a 864 person disease outbreak.

 

6 hours ago, Figster said:

 Slowing down the testing process with people not showing symptoms is causing a delay for results in positive cases that do need to get tracked down IMO.

 

This is a separate issue, but the point is - people showing symptoms KNOW they need to stay home - so why test them?  It's people who aren't showing symptoms but who were infected down at Lake of the Ozarks last weekend and returned to work Monday at the Happy Valley Care Home that we need to identify and isolate.

Saying "don't test asymptomatic people" is putting a bandage on a spurting artery instead of repairing the vessel.  Testing is broken because 1) pool testing is not being utilized widely 2) there is no national load-sharing system

 

 

6 hours ago, Figster said:

My nephew has been waiting for longer then a week now for Covid 19 test results. Fever, coughing, and yes, even sneezing, all gone before he gets confirmation.

 

So while he was feverish and coughing, was he staying home, or was he bopping about partying?

 

I mean great, be glad we "made the change" yourself, but it's Lipstick on a Pig as a way to fix a testing problem.  The fact that they discussed and implemented it while Fauci was literally under general anesthesia for surgery and a former CDC director and others have spoken out against it speaks volumes I think.

 

[Hapless Bills Fan]

3 minutes ago, shoshin said:

I keep reading about pooled testing and yet see it in use *so* seldom after months of people discussing its benefits. Any insight as to why? 

 

I would think it solves so many problems.

 

I got Nothin, Shoshin.  I think fundamentally, the problem is that we lack a coordinated national strategy.  The FDA seems to be authorizing it on a case-by-case basis, for example, rather than having a national strategy that says "this is what we need to do, Giddy-up, GO!"

 

There are concerns about loss of sensitivity.  But there are ways to mitigate this, one of them being to extend the cycles of the PCR reaction (if you get 1 RNA molecule into the reaction instead of 10, just amplify a couple more cycles and you get to the same number of amplified molecules).

 

There are concerns with the simplest strategies that if the positivity rate is too high - more than 8%, say - it doesn't save materials because too many samples will require to be re-tested.  But there are ways to work around that too - strategies that combine the same sample into different pools so that you can tell which of the samples were positive by which pattern of pools is positive. 

And even if you don't want to do that - it's useful for surveillance testing to protect vulnerable populations.  Say you've got 100 caregivers working at a nursing home or senior living, why not pool them for surveillance testing and prevent outbreaks amoung the vulnerable Seniors that are most costly in terms of severe disease and lives?

China is making extensive use of pooled testing to test whole cities or regions of cities quickly.  Rwanda is making use of pooled testing.  Israel is using pooled testing.  The state of Nebraska uses it.

 

We should have done it months ago here - it's not as though there isn't an experience base with this internationally as well as a building experience base from surveillance testing programs like Cornell's.

[shoshin]

2 hours ago, Hapless Bills Fan said:

 

I got Nothin, Shoshin.  I think fundamentally, the problem is that we lack a coordinated national strategy.  The FDA seems to be authorizing it on a case-by-case basis, for example, rather than having a national strategy that says "this is what we need to do, Giddy-up, GO!"

 

There are concerns about loss of sensitivity.  But there are ways to mitigate this, one of them being to extend the cycles of the PCR reaction (if you get 1 RNA molecule into the reaction instead of 10, just amplify a couple more cycles and you get to the same number of amplified molecules).

 

There are concerns with the simplest strategies that if the positivity rate is too high - more than 8%, say - it doesn't save materials because too many samples will require to be re-tested.  But there are ways to work around that too - strategies that combine the same sample into different pools so that you can tell which of the samples were positive by which pattern of pools is positive. 

And even if you don't want to do that - it's useful for surveillance testing to protect vulnerable populations.  Say you've got 100 caregivers working at a nursing home or senior living, why not pool them for surveillance testing and prevent outbreaks amoung the vulnerable Seniors that are most costly in terms of severe disease and lives?

China is making extensive use of pooled testing to test whole cities or regions of cities quickly.  Rwanda is making use of pooled testing.  Israel is using pooled testing.  The state of Nebraska uses it.

 

We should have done it months ago here - it's not as though there isn't an experience base with this internationally as well as a building experience base from surveillance testing programs like Cornell's.

 

I'm deeply invested in this because I have a Freshman who can't go to college. 

[Figster]

7 hours ago, shoshin said:

 

PA is 49th in testing per capita, only ahead of Colorado.

 

As long as there is capacity (meaning as long as we are not delaying testing for people with symptoms and that seems like less of an issue than it was a month ago), we should ALWAYS be testing more. Focus on elderly and health care, people who have to interact more with others. For example, my wife is a hospice and home care social worker in PA--she has not once had a test--and she works for a mammoth health system, not some rinky dink small provider. Hell, I work from home mostly and I have had two tests as part of a volunteer study!

 

PA is almost the worst example you can use for a place that needs to test less. 

If you look back on my posts I made the same point earlier.  We have been testing the wrong people is the point that I'm trying to make. It wouldn't surprise me If other states are worse. Or better, depending on ones perspective I suppose. I think testing data/ totals is a reflection of the virus spread and the states ability or inability to control it IMO.

 

Myself personally, I think I may have a better understanding now on why our president thinks we are testing to many people. The Trump administration is trying to correct the problem IMO. 

 

Thanks

Edited August 28, 2020 by Figster

[Figster]

8 hours ago, Hapless Bills Fan said:

 

Unless we're prepared to pay people to quarantine, it's an undue burden to ask everyone who is a contact with a positive case to quarantine for 14 days.  And even then, it's disruptive to their workplace. 

 

If tests results are delayed say, 24-72 hrs, they also won't know if they've been exposed until they're potentially infectious, so we need to identify the secondary infections and contact-trace them.

 

The thing is, Fig - this isn't a "new wheel".  It's part of the "pandemic playbook" for how to contain a disease.  Countries that have contained covid-19 are doing just this.  Test, trace, isolate, test the traced contacts, trace and isolate their contacts.  It's how you keep an 84 person disease cluster from becoming a 864 person disease outbreak.

 

 

This is a separate issue, but the point is - people showing symptoms KNOW they need to stay home - so why test them?  It's people who aren't showing symptoms but who were infected down at Lake of the Ozarks last weekend and returned to work Monday at the Happy Valley Care Home that we need to identify and isolate.

Saying "don't test asymptomatic people" is putting a bandage on a spurting artery instead of repairing the vessel.  Testing is broken because 1) pool testing is not being utilized widely 2) there is no national load-sharing system

 

 

 

So while he was feverish and coughing, was he staying home, or was he bopping about partying?

 

I mean great, be glad we "made the change" yourself, but it's Lipstick on a Pig as a way to fix a testing problem.  The fact that they discussed and implemented it while Fauci was literally under general anesthesia for surgery and a former CDC director and others have spoken out against it speaks volumes I think.

 

What do you think the CDC was expecting you to do when they inform you that you have been in close contact with a Covid 19 carrier? 

 

Hello, we think you might have Covid 19, but carry on with your normal daily routine as you get tested and wait for test results?

 

Seriously? Meanwhile you create a back log slowing down the whole testing process when we have actual sick people waiting to get results back. How does your employer or fellow workers feel about the situation? Do you think they want to work with someone waiting on test results? Talk about disrupting a work place.

 

I'm not sure why testing or not testing asymptomatic carriers keeps entering into the discussion.

 

Well, we did all get together ( party up ) to play in the Warzone...( C O D )

 

 

Edited August 28, 2020 by Figster

[Hapless Bills Fan]

49 minutes ago, shoshin said:

I'm deeply invested in this because I have a Freshman who can't go to college. 

 

I understand!!! 

 

You might find this interesting.  Robots, know-how drive COVID lab’s massive testing effort  They already had a veterinary diagnostic lab with adequate RT-PCR capability, that was used to do diagnostic testing on dairy herds.  They busted their humps for 50 days to set up robotic RNA extraction, hire and train technicians, work out the logistics of the whole thing and get FDA approval. 

 

They are planning to run 50,000 tests per week on approximately 30,000 people, with test frequency driven by perceived risk (undergraduates test more often, lower contact staff less often).  By doing 10 person pools, they test 7,000 people per day using 700 tests - which is 8 96-well plates per day (they already had that capability).  They are using the most sensitive tests, full-blown RT-PCR with RNA extraction, not antigen testing or the shortcut no-extraction NBA/YaleUofI test. 

 

So...they're open...kinda.  A lot of big classes are still online; recitation and discussion sections and some labs are in-person.  My kid will be teaching an in-person discussion section!  All the students have to sign a "behavioral compact" stating they will wear masks at all times inside Cornell buildings (except their dorm rooms) and outdoors when distancing is not possible and agreeing to a bunch of other stuff.

[shoshin]

3 hours ago, Hapless Bills Fan said:

 

I understand!!! 

 

You might find this interesting.  Robots, know-how drive COVID lab’s massive testing effort  They already had a veterinary diagnostic lab with adequate RT-PCR capability, that was used to do diagnostic testing on dairy herds.  They busted their humps for 50 days to set up robotic RNA extraction, hire and train technicians, work out the logistics of the whole thing and get FDA approval. 

 

They are planning to run 50,000 tests per week on approximately 30,000 people, with test frequency driven by perceived risk (undergraduates test more often, lower contact staff less often).  By doing 10 person pools, they test 7,000 people per day using 700 tests - which is 8 96-well plates per day (they already had that capability).  They are using the most sensitive tests, full-blown RT-PCR with RNA extraction, not antigen testing or the shortcut no-extraction NBA/YaleUofI test. 

 

So...they're open...kinda.  A lot of big classes are still online; recitation and discussion sections and some labs are in-person.  My kid will be teaching an in-person discussion section!  All the students have to sign a "behavioral compact" stating they will wear masks at all times inside Cornell buildings (except their dorm rooms) and outdoors when distancing is not possible and agreeing to a bunch of other stuff.

My freshman is at Penn but they are all remote. Fingers crossed for spring. 
 

Testing and the compacts are critical. It seems like in many places, the kids are getting the memo. 

Edited August 29, 2020 by shoshin

[K-9]

32 minutes ago, shoshin said:

My freshman is at Penn but they are all remote. Fingers crossed for spring. 
 

Testing and the compacts are critical. It seems like in many places, the kids are getting the memo. 

Mine is a sophomore in Wooster, OH. Dropped her off last week. The students all signed a letter of conduct that expels them for a second violation of campus containment efforts. The protocols have been stringent. There was testing immediately upon arrival and then quarantine in her dorm room for the two days to get the results. All classes are virtual until 9/7 and then it will be a combination. They’ve brought in tents for as much outdoor instruction as well. Of course, all sports have been cancelled. Masks and social distancing mandatory. 

If there is a shut down, it won’t be because the school didn’t exercise an abundance of caution. As a parent, that’s all I can ask for. 
 

Good luck to yours.

Edited August 29, 2020 by K-9

[Hapless Bills Fan]

On 8/28/2020 at 12:48 AM, Figster said:

Absolutely, everyone assuming they have the virus and a National shelter in place order is the only way we stop Covid 19 IMO. No argument there Dean.

 

Figster, it's demonstrably untrue that a "national shelter in place order" is the only way to stop covid-19.  Once the initial infection was contained, other countries have successfully contained with a test-trace-isolate strategy and with occasional localized lockdowns while mass testing of that locale takes place.

 

There is only one country that has done as crappy a job with covid-19 as the USA and that is Brazil.  It's no accident that both Brazil and US have leadership that display a "who cares?" "it is what it is" attitude.  There are a few countries that slacked off too far and are struggling - Spain, Israel, maybe France, we'll see what they do to contain.  This isn't an accident or a coincidence; it's a predictable epidemiological result.  Source: Our World In Data

 

 

14 hours ago, shoshin said:

My freshman is at Penn but they are all remote. Fingers crossed for spring.

Testing and the compacts are critical. It seems like in many places, the kids are getting the memo. 

 

Good luck!

 

I think most kids do get the memo.  The problem is, kids do tend to pick up their families' attitudes and there are always a few who are still "invulnerable" and don't get the memo that their job is to protect the 60 year old German professor, the 45 year old custodian living with an 80 year old diabetic mother, and the 30 year old coffee shop clerk with an immunocompromised husband.

[Hapless Bills Fan]

20 hours ago, Figster said:

What do you think the CDC was expecting you to do when they inform you that you have been in close contact with a Covid 19 carrier? 

 

Hello, we think you might have Covid 19, but carry on with your normal daily routine as you get tested and wait for test results?

 

Seriously? Meanwhile you create a back log slowing down the whole testing process when we have actual sick people waiting to get results back. How does your employer or fellow workers feel about the situation? Do you think they want to work with someone waiting on test results? Talk about disrupting a work place.

 

I'm not sure why testing or not testing asymptomatic carriers keeps entering into the discussion.

 

Um, to that last - testing asymptomatic people who have known close contacts is entering the discussion because the recent CDC guideline change that asymptomatic close contacts of a known covid-positive person need not get tested is the SUBJECT of this branch of the discussion.

 

The testing backlog is a very real and present problem, but the cure isn't to say "don't test asymptomatic contacts", the cure is to fix the testing backlog, which could be done by several means.  One of them would be national load sharing.  Another would be more widespread use of pooled testing.

 

[Figster]

2 hours ago, Hapless Bills Fan said:

 

Um, to that last - testing asymptomatic people who have known close contacts is entering the discussion because the recent CDC guideline change that asymptomatic close contacts of a known covid-positive person need not get tested is the SUBJECT of this branch of the discussion.

 

The testing backlog is a very real and present problem, but the cure isn't to say "don't test asymptomatic contacts", the cure is to fix the testing backlog, which could be done by several means.  One of them would be national load sharing.  Another would be more widespread use of pooled testing.

 

Asymptomatic people are brought into the discusssion to side step what the CDC recommendation change was really about and to make a political party look incompetent IMO. I explained to you how people who don't show symptoms could be quarantined without creating a back log.  Allowing the people who are showing symptoms a quicker response on test results so a contact tracer can get control of the outbreak before it spreads to 100's even thousands of people.

 

The guideline change prevents hundreds of thousands of people who don't have Covid 19 from being tested so sick people and the ones they've already come into contact with can be notified quicker.

 

 

[Figster]

 

4 hours ago, Hapless Bills Fan said:

 

Figster, it's demonstrably untrue that a "national shelter in place order" is the only way to stop covid-19.  Once the initial infection was contained, other countries have successfully contained with a test-trace-isolate strategy and with occasional localized lockdowns while mass testing of that locale takes place.

 

There is only one country that has done as crappy a job with covid-19 as the USA and that is Brazil.  It's no accident that both Brazil and US have leadership that display a "who cares?" "it is what it is" attitude.  There are a few countries that slacked off too far and are struggling - Spain, Israel, maybe France, we'll see what they do to contain.  This isn't an accident or a coincidence; it's a predictable epidemiological result.  Source: Our World In Data

 

 

 

Good luck!

 

I think most kids do get the memo.  The problem is, kids do tend to pick up their families' attitudes and there are always a few who are still "invulnerable" and don't get the memo that their job is to protect the 60 year old German professor, the 45 year old custodian living with an 80 year old diabetic mother, and the 30 year old coffee shop clerk with an immunocompromised husband.

Do you honestly think someone is going to wave a magic wand here in the USA and gain compliance? You will never get everyone to wear a mask, or to stop the partying, or the low participation in contact tracing. To many freedoms. To many people worried more about their own privacy, about their own personal wants and needs, and its not going to change. Our younger generation will continue to rebel as some of our oldest and wisest citizens continue to fall prey to the pandemic. Sigh 

 

So while I agree, a united response with everyone on board could work and already has in other countries.  It won't work here in my humble opinion.

 

 The candid discussion is much appreciated, 

 

Thanks

 

 

 

 

 

 

 

Edited August 29, 2020 by Figster

[shoshin]

On 8/29/2020 at 10:36 AM, Hapless Bills Fan said:

 

Figster, it's demonstrably untrue that a "national shelter in place order" is the only way to stop covid-19.  Once the initial infection was contained, other countries have successfully contained with a test-trace-isolate strategy and with occasional localized lockdowns while mass testing of that locale takes place.

 

There is only one country that has done as crappy a job with covid-19 as the USA and that is Brazil.  It's no accident that both Brazil and US have leadership that display a "who cares?" "it is what it is" attitude.  There are a few countries that slacked off too far and are struggling - Spain, Israel, maybe France, we'll see what they do to contain.  This isn't an accident or a coincidence; it's a predictable epidemiological result.  Source: Our World In Data

 

 

 

Kind of a dubious measure though, cases. If you look at deaths per million, several European countries are still way ahead of the US and their cases are rising now that they stopped their draconian lockdowns...so their deaths are not yet done climbing. I don't expect we will see big rises here from here on out (except maybe for CA) because we didn't have that kind of lockdown. 

 

Our leadership has sucked on this, no doubt, but just saying that the cases graphic is not the best measure. 

 

Edited August 31, 2020 by shoshin

[Hapless Bills Fan]

13 hours ago, shoshin said:

 

Kind of a dubious measure though, cases. If you look at deaths per million, several European countries are still way ahead of the US and their cases are rising now that they stopped their draconian lockdowns...so their deaths are not yet done climbing. I don't expect we will see big rises here from here on out (except maybe for CA) because we didn't have that kind of lockdown. 

 

Our leadership has sucked on this, no doubt, but just saying that the cases graphic is not the best measure. 

 

 

You normally make a number of good points in this thread, but I'm unclear what point you're trying to make here.

 

Spain and Italy are not handling covid-19 well....as they ended their lockdowns, they relaxed too far, as California did and they did not successfully persuade people to continue mitigation policies such as mask wearing.

 

Fundamentally, is it somehow admirable or show that the US did a great job handling covid if our death rate per 100,000 is lower than other countries that suffered early waves, such as Spain, UK, and Italy?  Why overlook data from all the "first world" EU or NA countries that had no more warning than we had, and had and have much lower death rates such as France, Ireland, Germany, Austria, Switzerland, even Canada? 

 

Does it somehow make our response better to point to other countries that did worse?  What am I missing here?

 

Logically speaking, the kind of lockdown we had or they had, doesn't influence the current death rate...what will influence the death rate is: 1) current behaviors, and whether community spread of covid-19 is widespread enough that it will inevitably find vulnerable people, especially find its way into concentrations of vulnerable people as in rehabilitation homes and nursing homes.  This will especially happen if mask wearing is disregarded or lax and if asymptomatic people are not tested. 2) treatment, which has improved but not as much as one would like.

 

Cases precede hospitalizations precede deaths is still likely to be true even if the death rate will be lower due to treatment and the hospitalization rate may be lower if precautions such as masking are well enforced in care homes (from what I've seen, they aren't)

 

 

[thebandit27]

On 8/29/2020 at 10:51 AM, Hapless Bills Fan said:

 

Um, to that last - testing asymptomatic people who have known close contacts is entering the discussion because the recent CDC guideline change that asymptomatic close contacts of a known covid-positive person need not get tested is the SUBJECT of this branch of the discussion.

 

The testing backlog is a very real and present problem, but the cure isn't to say "don't test asymptomatic contacts", the cure is to fix the testing backlog, which could be done by several means.  One of them would be national load sharing.  Another would be more widespread use of pooled testing.

 

I’m probably late to the party with this, but in your well-educated opinion, does the live-virus threshold that’s considered a positive need to be lowered to more accurately reflect infectious persons?

 

https://www.google.com/amp/s/www.nytimes.com/2020/08/29/health/coronavirus-testing.amp.html

 

To a layman such as myself, the argument makes intuitive sense, but I’d appreciate your take on it.

[Hapless Bills Fan]

26 minutes ago, thebandit27 said:

I’m probably late to the party with this, but in your well-educated opinion, does the live-virus threshold that’s considered a positive need to be lowered to more accurately reflect infectious persons?

 

https://www.google.com/amp/s/www.nytimes.com/2020/08/29/health/coronavirus-testing.amp.html

 

To a layman such as myself, the argument makes intuitive sense, but I’d appreciate your take on it.

 

I think it's a reasonable question to ask.  I think there are at least problems with this approach:

1) We have no hard data on a threshold of infectivity, and it may depend upon many factors - if I live with, or receive hours of care from, someone with low titer, I may still become infected even if they wouldn't infect someone they spent 30 minutes dining with.  Time, shielding, distance, and dilution (airflow) all matter.

2) We have no hard data on how viral titer varies with sampling technique.  in other words, if I get a "brain poker swab" 4 times in a row from 4 different test takers, will the titer vary?  Will it vary depending upon whether I get a nasopharangeal swab or a nares swab?

3) It's not just the current viral titer that matters, but the progression of the infection.  Consider for example this graph, published as part of a May article in "Annals of Internal Medicine", especially since you may not know your actual date of exposure - even if you're being tested in response to a known exposure, you could have had a later exposure that actually infected you.  But let's say you're tested on Day 4, which has a wide spread of probable values....by day 5 or 6, you may have 3x the titer and be more infectious.

 

 

 

Key message from article:

.....But researchers say the solution is not to test less, or to skip testing people without symptoms, as recently suggested by the Centers for Disease Control and Prevention.

Instead, new data underscore the need for more widespread use of rapid tests, even if they are less sensitive.   “The decision not to test asymptomatic people is just really backward,” said Dr. Michael Mina, an epidemiologist at the Harvard T.H. Chan School of Public Health, referring to the C.D.C. recommendation. “In fact, we should be ramping up testing of all different people,” he said, “but we have to do it through whole different mechanisms.”