Hacker News Reader

"Testing is NOT a solution. Testing will not make a sick person better. ... Tracking this is a waste of resources"

This is just wrong on so many levels.

First, on an individual level, if doctors know you're infected with COVID-19, and your illness is severe enough, they might be willing to try an experimental treatment (like chloroquine) that they wouldn't for seasonal influenza or some other illness.

You might also be offered to participate in one of the hundreds of research studies that are ongoing in trying to find a treatment for this disease. You would not be a candidate for those studies unless they knew that you did in fact have COVID-19.

If doctors know you are infected with COVID-19, they are also more likely to isolate you and wear protective equipment that is essential to keep the disease from spreading to our precious medical personnel and vulnerable hospital populations.

Then, on the public health level, we need to understand how this disease is spreading, who is the most vulnerable and who is the least vulnerable and why. We also need to understand who has recovered and why they've done so, and if people have gotten sick again from re-infection, and why. Alternatively, maybe people have had been re-exposed to the disease but not gotten sick. Why is that?

We need to effectively plan for future outbreaks, to allocate precious resources to places that are the most affected, to quarantine areas that are hardest hit.

None of that can be done unless we have a better grasp on who has the disease and who doesn't.

Testing is critically important for all of this and more.

To advocate for the abandonment of testing simply because it's not perfect is madness. It's better to drive with one eye open than both eyes closed.

This is an extremist position that isn't useful.

Testing is critical for contact tracing which still plays a fundamental role even in mitigation phase.

Infinite social distancing isn't practical. Some people still need to work and we need to know who has just a damn cold vs covid-19.

--edited because I don't think it matters if there are false positives what matters is the public understands the serious nature of the situation.

I have no medical training but below is my observation

Your points are valid (not regarding false positive rates), but the population still thinks the numbers put out are valid. So if we could ramp up testing very quickly (which seems to be possible given what the Cleveland Clinic is able to do) it would be beneficial for the public to see how bad the situation is. I haven't been able to convince anyone with symptoms that they are in fact likely to have it. (it could also be useful for hospitals to apply specific treatment regimens, when they get more defined)

Gaming the metrics to convince the public of something never ends well.

Extensive testing is very useful at the beginning. It becomes less useful as the pandemic progresses.

A danger is that so much outrage has built up over the US’s failure to test that lobbying for testing will result in too many resources devoted to testing long after it’s still useful.

Ignoring the controversial parts of your comment - voluntary distancing to the point of "work disobedience" is of extreme importance, and we developers should responsibly lead the charge and flat out stay home regardless any policy or management opinion.

We have it easy we can trivially work from home and no one will fire us during this crisis. So don't wait just do it.

> no one will fire us during this crisis

There are many businesses out there that are going to be suffering heavily from the total collapse of tourism, downtown office work, community events, etc; I wouldn’t assume any job is sacrosanct given that level of belt tightening.

In agree with the rest of your message, however.

Yup gotta keep those numbers down, right?

But seriously, the only way to get ahead of this is to test everyone. Didn't you learn anything in epidemiology?

Work from home. This is great advice for people who work by typing commands on a computer. Seems like people who are in tech think that coding, chatting on slack, etc. is what work is all about. There are so many jobs out there that we depend on require that people physically come to work.

I wonder what percent of jobs are reasonably safe to do (e.g. no forced close proximity to others). Office jobs are particularly bad and often easy to do from home, and many warehouse jobs don't have as close of proximity to other workers (many machines are operated by individuals), while jobs like trucking require almost none.

>I have news for you, if you think you have it you got it! Everyone will get it. Tracking this is a waste of resources at this point as the false positives mean additional limited Frontline Health Care workers treating actually sick individuals.

I'm glad to see someone say this. The over reaction is causing more problems than the actual virus. With every other recent potential pandemic, there was a reasonable response, the severity of the diseases were responded to accordingly, panic was at a minimum, especially considering more recent scares have been with viruses that cause far more serious diseases than this latest one.

This time, there's been an extreme focus on infection rates and zero focus on actual symptoms, which from every account i've seen so far, do not seem to be very terrifying for 99% of the population, yet the reaction has been just over the top everywhere.

This is going to spread around the world, we'll either get it or we won't, it's not going anywhere, it's out in the world, as soon as the first person got sick and spread it, it was inevitable. There's so much effort globally going into trying to stop or hide from this and I still don't really understand why.

When I was a kid, it was a regular thing to expose kids to chickenpox because it was just better to get it and get it over with, chickenpox sucked a whole lot. A whole lot more than having covid-19 would be from what I can tell.

It's the symptoms of a disease that scare me, not whether i'll get it. Personally, I was a lot more worried about the recent flu virus from a few years back that was killing young healthy people, than this disease that's not much more than a bad cold unless you're knocking on death's door already or in your 80's.

If people that get it, don't even realize they have it and nothing bad is really happening to them, then why should I be losing my shit and freaking out? Why should I be scared of getting a disease that's about the same as something I get nearly every year anyway?

I think you're slightly off track as to the frustration with lack of testing:

Let's start with widespread complacency opposed to requests to take distancing measures: people (not me, but .. read FB comments from regular people on news stories) are mad at sports events being canceled because "nobody has the virus". So we don't get the social distancing response needed.

If on the other hand we had some testing data from the general population, or even from just mildly sick people, then the requests for social distancing could be presented with "and we know this thing is here now, so these measures are going to have a significant effect".

Because you aren't everyone else. There are lots of people that would be hit very hard and require intense hospitalization or face death if they were to get COVID-19.

Furthermore, this would put a strain on medical resources if the number of patients is higher than medical capacity. Suddenly all the treatable conditions that require medical supervision become deadly because there aren't enough medical personnel and resources to treat everyone. Got in an accident requiring emergency care? Maybe you won't be able to get it now.

More still, all the medical personnel who would otherwise have gotten a flu shot and been immune to its spread now have to worry about catching COVID-19 and having medical resources spread even more thin, at the worst time.

You can't just think of yourself, you have an ethical duty to consider the externalities of your actions.

Edit: Maybe I should point out that panicking or worrying about it does no good and that should be minimized as much as possible. However, if people are not treating it as seriously as they should, then maybe a little bit of panic and worry would be a good thing to get people into a proper state of mind about what is going to happen.

> do not seem to be very terrifying for 99% of the population

This is a dangerously bad take. The death rate is in the 2-3% range. Hospitalization in China was 15%, with 5% in critical care.

Even if you are not personally vulnerable, please understand that those who are also actual humans, and have actual humans as family members. And if you can't manage to care about that, recognize that a pandemic of this magnitude could easily overwhelm the US hospital system: https://www.statnews.com/2020/03/10/simple-math-alarming-ans...

As we're seeing in Italy, an overwhelmed hospital system leads to increase death rates from many other causes, because suddenly the level of care goes down. If all the ICU beds are full and you, say, get hit by a truck, you'll be triaged along with all the other people needing ICU. If a COVID-19 patient looks more likely to recover than you, well, you'll be left out in the hallway.

Well one concerning statistic is the 20% of cases that require hospitalization. Not sure what that is for the standard flu but I suspect its not that high. If the hospitals are full like what happened in Italy and China and people who need medical help can't get it, it seems like the death rate is much higher like 3.5% vs. .1% for the standard flu. The virus really is mostly a danger for the elderly and so the public health goals are slowing the spread, flattening the curve so that the people who get it whose immune systems aren't able to overcome it as well can get the medical help that they need vs. being told to go home and die like they have had to do in Northern Italy.

Also the difference in asymptomatic incubation is a lot higher than the flu so people can spread it w/o realizing it. I read flu has max of 4 days incubation with typical period of 1.5 whereas this has a mean of 5 and max of 14, and possible shedding during asymptomatic period so you could be infecting people a lot longer before you get sick and its harder to trace all contacts.

The disease is not bad for most people. HOWEVER, the the real threat is too many people getting it at once, 10% need critical care, and that overloads our medical services.

That is what has happened in Italy.

https://www.flattenthecurve.com

Every meaningful authority is suggesting you do the opposite — Do not panic, there is no need to freak out.

But you should still avoid getting it and spreading it to others. Having a slower, more controlled growth gives us significantly more time to find a vaccine and learn more about the virus.

People who are immunocompromised, whether by age or otherwise, are a vulnerable part of our society worth protecting.

This virus isn’t an inconvenience like the chickenpox, it is killing people.

This is wrong on so many levels.

Just because the tests are not 100% accurate does not mean they are useless.

"if you think you have it you got it" This is patently false.

Given potential asymptomatic spread, widespread testing is the only way to limit the virus like what South Korea did

> if you think you have it you got it!

Most people who think they have it actually have a cold or flu.

And if they stay at home then that means less vulnerable people will get those diseases, making it easier to cope later.

This is what Illinois seems to be doing anyway. It makes sense to me. We don't have enough tests or medical staff to test everyone. Easier to just make everyone stay home. "If you are sick and have respiratory symptoms, such as fever, cough, and shortness of breath, stay home unless you need medical attention" http://dph.illinois.gov/topics-services/diseases-and-conditi...

All the other illnesses in the world are still here, too.

> Testing is NOT a solution

This might be right, iff testing were some kind of binary choice that needed to be made one way or the other. But why should the tool of testing be politicized and debated, rather than it simply being one resource available to doctors to use as they see fit?

Wont extreme social distancing just lead to another outbreak in the near future?

I think the hope is to lower the infection rate over a longer period of time so hospitals aren't overwhelmed

Which hospitals are overwhelmed?

5 weeks, not 14 days.

You do need testing to dial in what level of social distancing brings the rate down to a level the health care system can handle without dragging out the crisis needlessly long.

> I have news for you, if you think you have it you got it

This is a ridiculous thing to say after talking about test accuracy.

You can't improve what you can't quantify. Also your assumption that so many people have a job they can do from home or over email is ridiculous.

In fact, you won’t know if your test is inaccurate if you don’t test! Over and over again I hear people talk about how it is a waste of resources to test. Tests are not expensive in time or material. They will pay off.

No, they don’t help you cure anything. We dont have a cure!

Tests help you quarantine and mitigate.

> You can't improve what you can't quantify.

That's obviously false.

It may not be 100% true, but quanitfying the accuracy certainly helps.

Sure, you can randomly shotgun a bunch of potential solutions and hope for the best, but any systematic improvement process relies on quantitative measures and root cause analysis.

How would you know if it was?

Random changes can be positive and you don't need to quantify anything to do them.

Also quantifying after the fact isn't what we're talking about so I could test and verify that indeed you did improved something 10 years ago and you made that improvement without quantifying anything yourself.

How do you know if something is positive without being able to quantify it?

You don't need to know about something for it to be true.

You don't know if something is true if you can't measure or test it.

When you throw dice 1000 times without looking you don't know when you got a 6 but you know you did.

Too bad we don't have 1000 societies to randomly try things on.

Also you don't know that you rolled a six, the probability is high that you did, that's very different. If you don't know where you rolled the number you wanted, how can you repeat it? If you can't repeat it how can you build on top of that?

> Also you don't know that you rolled a six, the probability is high that you did, that's very different.

By that standard you don't know anything about the world at all - gravity may stop working the next minute - it's unlikely but not impossible. We don't have a proof it won't - we only have assumptions(models) supported by statistics. For me the standards that physics use is good enough - I say I know gravity works and I know I rolled a 6 when I rolled 1000 d6. You might call that differently but I'm pretty sure you won't jump out of a cliff and you won't bet money on NOT rolling a 6 in 1000 tries.

> Too bad we don't have 1000 societies to randomly try things on.

That's exactly why we shouldn't wait for results.

We have data from 1000s of people though and several countries that tried various strategies. Social isolation works best so we should do that, immediately.

With exponential growth doing the right thing NOW is more important than making sure you're doing it in an optimal way but a week later.

> If you don't know where you rolled the number you wanted, how can you repeat it? If you can't repeat it how can you build on top of that?

In the case of this disease we know how to prevent it overwhelming our healthcare systems so that less than 1% of population dies instead of over 5%. That's the most important thing, producing the vaccine and drugs, calculating the exact number of people sick, discovering the exact properties of the sickness - these things come after the fact. We won't have a vaccine nor drugs in time anyway.

People arguing to measure and then act in case of a disease that infects 1000 times more people every month are insane. In 3 months the whole world population would be sick and most of it AT ONCE. Who will treat the 5-10% of patients that need help? Nobody - that's who. So they will die.

Testing and understanding the past is not the same as predicting the future. Our physical world has been extensively tested, which how we learned about it. If you want to treat gravity stopping in the future as a probability you can, but once but the more you understand the more you would realize that it is astronomically low.

This is not the same as saying that from some technical extreme semantic definition that something can be improved without testing results. In a complex system you need to know your results to inform your path forward. Trying to come up with some super narrow, reductive, irrelevant definition on your own is worthless in this context.