US admits 'failing' on testing, says Fauci
bbc.com
bbc.com
Seriously, how are we so bad at this? We knew it was coming and South Korea has been testing 10k/day since Feb, so it's clearly doable. We've done <10k total! What in the world is going on with the tests?
It appears the main driver has been lack of chemicals and in the beginning, the cdc required tests to be sent to them. The states can now test on their own.
https://www.vox.com/science-and-health/2020/3/12/21175034/co...
If they didn't make their own test, they wouldn't have fubarred the manufacturing, which would have given us more tests.
One of the CDC's main goals, if not the main goal in this, is to spread out the panic. Given this goal, the fact that we're in flu season, and the lack of test kits, I can understand the stringent testing criteria. They choose the best option in a bad situation, and I think they've done a pretty good job. However, it seems like a lot of problems could have been avoided if they just used the WHO tests.
In summary, the testing early doesn't change the decision tree, which is stay quarantined for 14 days, until symptoms present or not, so little point was seen to testing until then.
Problem is now, we can't track it, so everyone ideally should self quarantine or limit as much as possible social interaction and get tested if they have good reason to believe they've been exposed. Early testing will catch a lot of people but not all, so it will slow the spread, so at this point the decision tree changes and we need to start testing more, if nothing else to get a sample to extrapolate the true spread of this thing.
That makes a ton of sense. Thank you!
The Cleveland Clinic just came out with an 8 hour test and hopefully this will help the situation if they share the process.
https://www.vox.com/science-and-health/2020/3/12/21175034/co...
Offering a diagnostic test without FDA approval is illegal
2) The reagents needed for the testing are also in extremely short supply, and labs are having a hard time getting more. So, you can develop a test, but your testing capacity will remain limited.
*unscientific guess for literary effect
Most university hospitals' in house test results are / are going to be available in similar time frame, but they do not have the media budget of the Cleveland Clinic. Vox article links to a CCF press release fluff piece.
Other labs across the US are ramping up similar tests. This is exactly what we need and we shouldn’t mind all of them taking credit for their contributions.
https://www.sciencemag.org/news/2020/03/were-behind-curve-us... Q: What's the turnaround time when you have a sample on hand? How long does it take to extract RNA from the sample, put it into a polymerase chain reaction machine, etc.?
A: About 2 to 3 hours to do the testing, but because the process requires us to batch samples, you can't really just test the sample as they come in. In order to conserve reagents and labor, you' wait until you have a certain bolus of samples and then test them together. So you do testing once or twice a day.
If FPR is 10% and we test 100,000,000 people in the US but only 100,000 have the disease right now, then assuming a TPR of 100% (and a FNR of 0%) we will have 10,100,000 positive results = 101 x the number of people with COVID? How is that useful?
Disclaimer: I am maybe an idiot.
A clinical lab that is used to running these kinds of (very common) protocols will see no difference in this protocol from others they commonly run (from a chain of custody, sample integrity, etc. perspective), just with a slight change to their reagents to specifically test for COVID. Their handling should be no different.
But yes: we messed up. We weren't prepared to begin with, we rolled back a bunch of existing preparedness work, when the disease arrived we turtled instead of testing, and then we refused to scale the testing capability for critical weeks. At this point it's too late. Better testing is still needed to inform the hard public health decisions that will have to be made, but it's no longer able to contain outbreaks that have grown orders of magnitude too large.
People in the media and elsewhere have been clamoring for months for details from the CDC about how they'll be rolling out testing, and it never arrived. It still hasn't arrived. We're still in the low dozens of tests per day. You're telling me that it's somehow physically impossible for the CDC to have ramped testing beyond that when other nations are in the thousands or tens of thousands per day?
And as far as China not cooperating: they published the full sequence of this thing back in January. We had the genes for this thing even before we had a name for it, or for the disease. And that's not enough help for the CDC?
Where are you getting this information from? Please tell me it's not partisan media.
Or you can not test, and treat everybody as infected. For hospitals and high risks people you should be doing that anyway.
Instead of going it alone, the focus could've (perhaps should've) been on early collaboration with those partners on establishing consistent testing procedures (whether they used precisely the same measures, validation that they were getting the same results) and a process to distribute the workload.
This wasn't done, that's the reason the scaling failed.
It's just RNA sequencing, it can be done at any university using standard equipment and materials
b) If it's that scarce, we should've been stockpiling more.
c) If it's that scarce, we should've been manufacturing more.
Be interesting whether this is official or behind the WH's back, this BBC article doesn't have too many details.