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Comment by kryogen1c | Hacker News Reader

> How are doctors this stupid? ... the doctor can't fucking say that you can't have it. What happened to evidence-based medicine?

You clearly have no idea what youre talking about. When something 100x less severe than the coronavirus happens, there is an ABSOLUTE AVALANCHE of people calling in on the full spectrum of sickness, from psychosomatic, to actually sick but with the wrong thing, to actually sick with the right thing but minor cases, to people that will actually die if not seen but cant make their case clear. The reality of the situation is that without instant, free, over-the-phone test results, this is a reasonable response from oversaturated medical systems.

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Test, test, test. South Korea has tested 100.000 people. In Europe? Nobody is doing anything. You can't respond to something when you have zero idea what the scale is. We're literally seeing Europe stick its head in the sand.somebody comes in with flu-like symptoms, you fucking test. Psychosomatic doesn't matter, either you have the symptoms or you don't. And if you do, you test, test, fucking test. Not tell people to go home, you obviously can't have coronavirus.

The diagnostic is dead simple. Look at any health ministry of any country. It doesn't take a medical degree to understand that if you have flu-like symptoms, you need to be tested for the flu. And if you don't have any of the flu strains making the rounds, test for Coronavirus. You know, exactly what SK is able to do but somehow Europe isn't.

Tests are not free, not 100% accurate, and not 100% available. The doctor you called stupid is in control of exactly 0 of those factors, and has no effect on europes policy.

And Europe's policy needs to change. Nobody is saying dealing with this epidemic is going to be free.

Yet the doctor is one of many who are dismissing the likelihood of somebody having coronavirus just because they haven't been to Italy. So yes, stupid.

There are false positives and false negatives.

Now the infected population is very small, so if too many non infected people is testes, the false positives would be much bigger than the true positives. So you would get a lot of people unnecessary in the hospital while they have a normal cold or flu.

Anyway, if the symptoms of a normal cold or flu are so bad that deserve hospitalization, the doctor will send you to the hospital even if it is not covid19.

[If you are in a risk group, get the flu vaccine. It will not protect you from covid19, but you definitively don't want to catch a bad flu while the hospital if full of covid19 patients.]

> dismissing the likelihood of somebody having coronavirus just because they haven't been to Italy. So yes, stupid.

The amount of infected people calling in who havent traveled is _infinitecimal_. The doctor saying you're not infected is correct an OVERWHELMING amount of the time, probably >99% accuracy. Eventually, this wont be true, but then the doctor wont be telling everyone to go away because theyre not stupid.

Now, if you want to argue the merits of extreme overcaution and attempting things like 100% testing for a global pandemic mitigation plan, good for you. You have a lot of hurdles to overcome, some of which you named yourself, but none of them are the doctors fault. You are simply wrong.

What I'd like to see doctors do differently is encourage people to treat their illness as if it were covid-19 regardless of the test result.

If my health care provider can try to sell me antibiotics despite a negative strep test, "just to be sure, because sometimes you get a false negative", then they're surely not ignorant of the phenomenon where tests are less than 100% accurate. (Perhaps they're just variably aware of it, depending on what the bean counters from the health care network's corporate office are telling them to do. But still.) And, if you take a "better safe than sorry" attitude regarding false negatives, then you're not too far off from realizing that not having the test is not that big of a deal, because you'd be telling people to stay home when they're sick in either case.

(And keep doing so even after covid-19 blows over, so that we can maybe start reducing the influenza body count, too.)

What do you think "treating their illness as if it were covid-19" means?

This is a viral illness. There is simply no treatment. You go home, rest and eventually get through it in most cases. If you have annoying symptoms, you try to alleviate those in the usual ways (as if it was any other cold/flu). If you get life-threatening symptomps, you call for help and they'll take you to the hospital (at least while they aren't completely collapsed).

What would you like the doctor to say or do here?

Sorry, ambiguous language. "treat" in the general sense, not specifically in the sense of medical treatment.

Specifically, I would like the doctor to say, "Stay the eff home and keep your germs to yourself, sickie."

More doctors doing this would also help put pressure on employers to change their policies. Maybe (dare I dream?) we can even get restaurants to start giving their employees sick leave, and encouraging them to use it, instead of requiring them to show up and germ up all the food on pain of losing their jobs.

Last week I had the flu. Me and my whole family. We are fine now, but coughing like crazy. Nobody tested us. We all went to see our respective doctors and they all said, its the avian flu (H1N1), with no testing whatsoever.

I'm in Catalonia, Spain.

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