South Korea's drive-through testing for coronavirus
npr.org
npr.org
“You who have symptoms similar to coronavirus will not be tested in the future. This applies regardless of whether you have been in the areas that were previously exposed to infection or had close contact with someone you know is ill in covid-19.”
There are no test kits. Hospitals have run out of face masks. And it’s only just getting started here.
If someone is showing mild Corona virus symptoms and can safely quarantine themselves, then there isn't a lot of value in testing. The result isn't going to change what you do.
Where it's useful is controlling transmission. When you identify a patient, find out who they came in contact with and confirm whether or not they have it.
Why?
Because it no longer matters, the containment effort for individual cases is now over. Now we move on to more mass actions to delay and slow the peak of the epidemic - anyone with symptoms to self isolate for a week, regardless of positive test.
Most countries didn't even attempt containment, as far as I can tell. Leaders seem to have surrendered to mass infection at the opening of the battle.
It seems pathetic and criminally negligent. It's an intentional trade of hundreds of thousands of lives (potentially millions) in exchange for some unpredictable economic gain. This could conceivably make sense if an uncontained financial crisis would lead to even more human suffering than an uncontained infection.
But it seems that we're likely to end up paying in a massive number of lives and a massive amount of money. When an aggressive containment strategy might have cost us primarily in terms of money.
https://twitter.com/flightradar24/status/1238102765081186306...
It kinda hit me immediately why this whole containment thing wasn't really working out. And this was March 12! How on earth do we tell people to not go outside, but months after it all started there are still thousands of airplanes flying.
Honorary mention for the countries that sent military transport airplanes to rescue 100 citizens from China like an asteroid was about to hit it and kept them in barracks for weeks, but have this kind of air traffic streaming in.
There's no point. Better to just let people come to the hospital if they absolutely need to, rather than risk people coming to the ER just because they tested positive.
It is possible that Italy has made a mistake in doing as many tests as they have. I'm not sure what the numbers are but it could be that the addition of infected-but-not-seriously-ill patients is a major problem.
So maybe this anti-surveillance testing approach does make sense once you've conceded the battle to contain the infection.
That will help flatten the curve.
In concert, universal healthcare at point of service is a must.
As is propping up the people via direct material aid. Food. Rent money. Paid sick leave.
I thought I heard Trump say that interest on federal student loans would be “waived”. Did he mean forgive or defer? I don’t know if it’s at all true because he is a compulsive liar.
If it is true, great. But insufficient.
What we also need is a debt jubilee and infra & public investments that are truly net-positive for the neediest.
This will lead to inflation. Which by the way will be sorely needed. And by every affected country. I’m curious about the MMT community‘s point of view on this.
Source: https://www.cnbc.com/2020/03/10/coronavirus-some-airlines-ar...
In an ideal world we would already be doing this. I know that some people have to show up to work even if they're sick, but even at my job where we have unlimited sick leave, and are encouraged to use it, people still show up coughing and sniffling.
I don't get it.
If your employer encourages you to work from home when you're sick, and you're actually sick, please work from home! No one wants to catch your disease, whether it's Coronavirus or "just" the common cold.
However when it comes to the common cold that is something that will be going of for weeks and return several times for some people, just the light symptoms. No fever but some coughing and sneezing.
For some job roles and in some companies with good culture it works great to work home but for a lot you cannot really be home for like 6 weeks every winter because you are missing out too much or are not effective enough.
According to the CDC, the average adult gets the common cold 2-3 times per year with symptoms lasting 7-10 days[1]. So it's more like 2-4 weeks per year, but I would imagine that number would decrease if you didn't have people coming into work sick in the first place (again, I recognize not every job will allow for this). Hong Kong's flu season apparently ended early this year due to the self isolation of sick people[2].
[1] https://www.cdc.gov/features/rhinoviruses/index.html
[2] https://www.ft.com/content/ad7ae6b4-5eab-11ea-b0ab-339c2307b...
yes, the 'overzealous hero employee' archetype is very real. The Coronavirus aside I just wish this would generally become socially unacceptable. Not just during a pandemic but in general sacrificing health or sleep or some reasonable balance of life for work should not be celebrated.
I mean, the Johns Hopkins map shows 13 infections in Ohio, and you have the director of the Ohio Department of Health saying it's 100,000. How do we know if either are anywhere close to right?
Presumably when things get bad it'll be impossible to hide it, as the hospitals will be over capacity. That's already happened in Wuhan and China, and probably Iran and some other places as well.
It would be nice if we had some sort of indication of where a particular region is on the scale from "hardly anyone has this yet" to "we're experiencing rampant community spread" that's more trustworthy/accurate than the official numbers.
Here is data where “Total” is meant to represent the number tested. Ideally we would see this also represented as a percentage of the local population.
We as nation put on extreme measures but there is no visibility.
What is the true number of infected in Denmark? There is no sampling or systematic measurement going on.
We probably know less than you guys in Sweden yet we choose the most extreme actions.
We just had our PM go on national TV and call on all Danes to return to Denmark as she shut down the border.
There are not many medical systems on the planet that could handle that per capita case load increase in such a short amount of time (specifically the intensive care patients that will go with it in the coming days and weeks).
There are 10 people in hospitals in Denmark for COVID19. None dead.
By the publicised numbers Sweden is hit about the same as Denmark; yet they choose a much more moderate approach.
As if China can be explained that way.
I have no opinion on whether this is blown out of proportion.
I can just see that my own country is choosing the most extreme measures (packaged in nationalistic rhetorics) where as our neighbours are not.
The idea that the population should be sampled so the exact extent of the spread can be measured (and so can the effect of the various policies) is not mine. Here is a Danish doctor calling for the same:
https://www.altinget.dk/artikel/overlaege-regeringens-corona...
In Danish. Headline: The Government's Corona-strategy misses focus on the engine of the epidemic
So far the people infected skews fairly young
And the pandemic took hold around Tuesday and it takes about a week for hospitalization to be required in the severe cases
At least next time around we should all be prepared like Taiwan was this time.
It's not just the inefficiency of central governments. The main problem, at least here, is that people seem reluctant to follow guidelines, and thus the state had to enforce stricter rules. The same happened in Italy and it's the reason incidents skyrocketed. Everyone was fucking around thinking that it's just another variant of the flu. And then reality hit them like a ton of bricks.
sarcasm? or heard on TV to calm the population?
This is how extreme measures look like https://www.youtube.com/watch?v=TXpHD9bjGe0
Denmark is negligent, as is rest of Europe.
Three weeks ago our PM was busy playing petty political games with the opposition, today she is shutting down our borders preventing all foreigners entering the country.
They said the symptoms sound like coronavirus, but it's not being tested anymore (it was still being tested at drive-throughs 2 days ago) as the government has moved from "contain" phase to "delay" phase - advised to stay at home for 7 days and call back if it gets worse.
I asked if his brother can continue going to school, given he is probably exposed - the advise was yes, as long as he isn't showing any symptoms.
They have given up trying to contain this and it's difficult to see how you can trust reported case numbers going forward since testing has stopped.
Otherwise healthy people should not go to hospital if they feel symptoms. For most people it's just a flu.
All events with more than 500 people are forbidden.
I read thats more labs than can do the same in the US.
A transparent hose, add UV-LEDS to sterilize the flowing air. Dry the air at the start with silica gel. All that is needed then is a battery.
The silica gel can be heated every once in a while to loose any moisture bound it and sterilize virus particles attached to it.
At a glance they sell LEDs around 400nm which from my cursory reading wouldn't be effective for what you're imagining.
Not to say this would never work. Just that you would need special parts that are less common and more expensive by orders of magnitude.
I've also read that sterilizing very fast moving air doesn't work well. It seems HVAC systems use extremely intense light order to be effective in these conditions, which a small LED (or a few) wouldn't accomplish.
While the length of UV exposure time required to kill viruses is probably impractical for a mask, certain UV bands could be instrumental for sanitizing public areas and hospitals. [0]
[0] https://www.webmd.com/cold-and-flu/news/20180212/can-uv-ligh...
> It takes anywhere from hours to days to get test results. A doctor with a patient in Boise could have results in a matter of hours, because of proximity to the state laboratory. But samples that go to private labs in Utah and Washington take longer, due to shipping time and the hours it takes to run the tests.
https://www.idahostatesman.com/living/health-fitness/article...
> The coronavirus tests run on the Utah Jazz’s players and team employees came from a good portion of the state of Oklahoma’s supply.
> The 50-plus tests that were run on the Jazz’s traveling party after Rudy Gobert tested positive for COVID-19 were from the state and not a private lab. And the number of tests run on Jazz players represents over half of the state’s daily peak capacity testing levels.
> “We have the capacity to run about 100 tests a day and we have a number of test kits,” Oklahoma commissioner of health Gary Cox said at a Thursday news conference. “We're ordering additional reagents at the time. So, we have the current capacity I think for about 300 tests.” Oklahoma has had three positive cases of the virus so far with four still pending. Thirty-six tests have returned negative.
The market is better at addressing problems than government and if the FDA and CDC hadn't gotten in the way in the US, our testing response would have been far better.
Seegene's kits test for all three marker genes and aren't even available in the US because it doesn't yet have FDA approval. At least 30 other countries are placing orders for Seegene's kits.
bureaucracies, including corporate ones (see: innovator's dilemma), are typically not nimble enough to respond to rapidly changing circumstances. it's not a market vs government (false) dichotomy.
The market is just shorthand for people.
That is something that “the market” often lacks in their relentless pursuit of shareholder value.
This is nuts. The market doesn't pursue shareholder value. Corporations do. However, the market, which consists of consumers and small producers as much as corporations, certainly does not always, as is seen in consumers (and frankly corporations as well) oftentimes irrational behavior.
And yep, that trade is "market" too. And it does get blamed for a lot of things, some of them unwarranted.
that is the market doing its thing.
The CEO made that decision 4 days before South Korea had its first case.
SK is really lucky that they have that company who was focused on testing kits and even uses machine learning to quickly identify viruses. Why doesn't the US have such a company? Is it regulations? Surely not, when something like Theranos was allowed.
There's plenty of demand. Where's the supply? Market failure.
- What is the false positive rate?
- What is the false negative rate?
- Considering the above, what is the efficacy of mass testing?
(Not saying it is or isn't effective, hard numbers are necessary)
> the total positive rate of RT-PCR for throat swab samples was reported to be about 30% to 60% at initial presentation [1]
> In patients with negative RT-PCR results, 75% (308/413) had positive chest CT findings; of 308, 48% were considered as highly likely cases, with 33% as probable cases [2]
> For patients with negative RT-PCR tests, more than 70% had typical CT manifestations. On the one hand, due to the overlap of CT imaging features between COVID-19 and other viral pneumonia, false-positive cases of COVID-19 can be identified on chest CT. Nevertheless, considering the rapidly spreading epidemic of COVID-19, the priority was to identify any suspicious CT case in order to isolate the patients and administer appropriate treatment [3]
> Conclusions: In the close contacts of COVID-19 patients, nearly half or even more of the 'asymptomatic infected individuals' reported in the active nucleic acid test screening might be false positives [4]
[1][2][3]: https://pubs.rsna.org/doi/full/10.1148/radiol.2020200642
Other weird thought I had was how does security deal with some lunatic who gets tested positive and runs around infecting others...just walks into some critical hub like a hospital and pat's everyone on the back.
Pick the 10 most likely to develop complications due to age or comorbidity and quarantine the rest so that you don’t get 200 more next week. We’re still in the “stop the bleeding” phase of treatment.
This is the procedure at most hospitals. You give the beds to those who need them, and are most likely to "make good use" of them (= not "waste" them by likely dying anyway; sorry for the atrocious wording)
Isolate those 100 people. Then use whatever methodology[1] your society uses to allocated hospital beds to the ones that will get sick enough to need them.
Just because you test positive doesn't mean you'll need a hospital bed.
Oh, and while you're at it, ban public gatherings, and close schools. Because if 100 people tested positive, there's probably another 200-300 people walking around, infecting others.
[1] First-come-first-serve, youngest-and-healthiest-first, whomever-can-pay-more are the most popular methodologies for this.
It's happened. Criminal charges for assault probably work.
1. CNN article (March 12, 2020) on Seegene https://www.cnn.com/2020/03/12/asia/coronavirus-south-korea-...
The CNN text article is actually pretty good article and also the video is good. The company reports they used AI to speed up the development. They were able to accomplish it in 2 - 3 weeks with a few people instead of 2 - 3 months with many more staffers getting involved.
From the CNN article
The firm is making about 10,000 kits a week and each kit can test 100 patients. So it is making enough to test one million patients each week, at a cost of under $20 per test.
Seegene is now looking to export of the excess capacity to 30 countries including Germany and Italy.
2. Below is 2017 video of a mini-seminar of Seegene's solution platform at a trade show. https://www.youtube.com/watch?v=RKL5D19r6t8
The last part shows that they have a software solution for helping faster diagnosis.
As a layman, I felt Seegene's product focus is on getting as many tests done as possible by using following: - One test vial can test multiple issues - Integrating barcode/software to allow faster diagnosis
3. I frankly don't understand why FDA can't approve Seegene's product into US. It's not like people will be injected with liquid/medicine.
https://media.npr.org/assets/img/2020/03/13/gettyimages-1205...
Europe (and likely USA)
https://static01.nyt.com/images/2020/03/12/upshot/12up-healt...
Leaning into the car with facemask down. Should end well.
Also with the air-conditioner on exhaust and the people taking swaps without protective gear, or even with, moving the virus from car to car so efficiently.
Look at this crazy photo: first guy is leaning into the car with facemask down. Totally going to happen at half the Walmarts.
https://static01.nyt.com/images/2020/03/12/upshot/12up-healt...
Then people who are to be tested and are in quarantine at home (mostly after visiting affected areas in Italy and elsewhere or by being traced to someone infected) make appointments over phone, then arrive by private car at the designated time.
They will actually not set foot in the tent, instead a swab sample is taken by a medic in full hazmat suit. The tent houses the medic & sample handling equipment.
The people who have been tested then return to quarantine at home and wait for the results.
This is also compounded by a dedicated ambulance with team in full protective gear that takes samples from people at home.
Will anyone? Has this been discussed anywhere?
I've read however that FDA just approved a new test on Roche lab equipment which many labs already have.
https://www.cnbc.com/2020/03/13/scott-gottlieb-us-to-conduct...
Here is FDA authorization for CDC test: https://www.fda.gov/media/134922/download. The required machine is Applied Biosystems 7500, and CDC targeted it because it is approved, widely available, trained on, etc. in USA.
Here is product information page from one of South Korean test suppliers: http://www.solgent.com/english/sub03020102/view/id/45. It is compatible with Bio-Rad CFX96 and Applied Biosystems 7500, and was approved as such in South Korea. While Bio-Rad's machine is more popular in South Korea, they obviously thought of exporting.
Hopefully ones that work. Here's what you can buy on Alibaba.[1] Some of those are probably totally bogus.
[1] https://www.alibaba.com/trade/search?fsb=y&IndexArea=product...
Seegene is in talks to export of the excess test kits to 30 countries including Germany and Italy.
No mention of US.
https://www.reddit.com/r/Coronavirus/comments/fhvvzl/chinas_...
And as the situation in the US worsens to a certain point, I'm sure China would officially send supplies too like it's currently doing with Italy and Iran. Question is whether Trump will accept that.
Today’s presser sure gave me the impression that the delay in testing was so they could roll out this nebulous private-public partnership drive through testing and I guess boost CVS’ stock price or something.
Realistically, how would you envision tests on this scale being performed? In theory, it’s a great plan. Pretty much everyone in the US is close to a Walmart/CVS/Target. Drive up, get swabbed, check results online. Fast and minimal human interaction. The implementation remains to be seen but I can’t imagine the alternative of having everyone rush doctor’s offices and hospitals working very well.
https://www.c-span.org/video/?470277-1/federal-health-offici...
I listened to trump address the nation in the rose garden live today. The npr correspondent confidently said that this virus “isn’t going away.” It’s a flat out lie and hysteria.
You gotta get it together man, this is bigger than anything you’ve ever seen in your life. If we’re very lucky it’ll be bad in the coming weeks and months, if we’re not it’ll be much much worse.
This is appallingly wrong.
If you're commenting here on HN and referring to legit medical sources, then you're also smart enough to see what has happened in Wuhan and Italy where hospitals are completely overwhelmed, where triaging is leaving many people without any care. Over 65? Comorbidities? Sorry, 'just die' or hopefully not, is the medical response because they are overwhelmed.
That under 30 are less likely to die is irrelevant when most of the population is >50 and the rate of spread, the severity of cases is such that health services are completely overwhelmed.
Hospitals around the world are facing 'Denial of Service' attacks and everything is crumbling.
The way to make this survivable is to control the spread of the disease so as to make care available and give enough time for rapid trials etc..
"The worst case scenario is that a very small number of people die before herd immunity slows the spread to nothing"
No! The 'worst-case scenario' is 10's of millions of infected, (possibly over 100 million in the US), 1000-to-1 infected to ventilator ratio, total and complete overwhelming of US medical services, several million dead, 10's of millions out of work and isolated for many weeks, unable to work, contribute, teach, provide medical services, run the 'toilet paper factory', etc..
Literally the worst disaster in US history - worse than WW2 or the Civil War (~2% death rate) in terms of domestic turbulence.
Now - add in how many people are going to die from 'regular things' because the healthcare system is null.
No, there's a 100% chance we will see it if we don't take measures. Watch the news from Wuhan, Italy - it's apoplectic. It's really bad, and if they didn't shut everything down, it would be a zombie movie.
We know that 'shutting things down' works because in China, the virus is contained, at least for now and medical facilities are starting to be able to cope.
>>> "The morbidity rate is far less than 3%"
Source? Because every credible source and the data coming out of various countries puts the rate at somewhere near 3%, not 'far less than' 3%. Some facts [1]
Even a 1.5% death rate is existentially problematic, we're still talking millions of people dead.
Moreover, if you bother to look at the data, you'll see that morbidity rates are a function of access to care, meaning that when Hospitals are 'overwhelmed' - people die at much greater rates. In Italy, it's 5%.
But there's a bigger issue: 20% of people who get it requires specific medical intervention, and at least 5% of them 'intensive care'. COVID is totally overwhelming medical the medical system in 100% of the areas wherein the contagion has let loose; people getting zero treatment, medical staff getting infected, people dying in the hallways, in their homes.
FYI 20% of 330M Americans is 66M people, only a fraction of whom need to be infected for 'zombie apocalypse' in the Hospitals, again: see Italy, Wuhan for what will happen.
>>> Antibiotics?? Antibiotics are not part of this equation.
>>> "and if people did a few basic things like wash their hands and stay at home if they have a preexisting medical condition, then basically nothing would happen. "
No - absolutely not. Having a few people 'wash their hands' and having the elderly 'stay home' will do very little to quash the pandemic.
The evidence from other countries is writ large, the variables are established: extensive testing, restricted travel, social distancing, isolation for any sick person, aggressive operational preparation by medical staff, keeping social order, restriction on large scale events etc. etc..
This is the 'new normal' for at least a few months.
[1] https://medium.com/@tomaspueyo/coronavirus-act-today-or-peop...
And even though this guy destroys all of your panic driven assumptions and ideas, you probably won’t upvote me will you?
https://en.wikipedia.org/wiki/Human_coronavirus_OC43
https://en.wikipedia.org/wiki/Human_coronavirus_229E
Both of these viruses do exactly that. They're among the many that give us colds.
"Coronaviruses have a worldwide distribution, causing 10–15% of common cold cases. Infections show a seasonal pattern with most cases occurring in the winter months."
Consider the possibility that your source is full of it. It happens to the best: https://rationalwiki.org/wiki/Nobel_disease
Yeah forget those people.
/s
I have watched https://www.youtube.com/watch?v=E3URhJx0NSw&t=2357s with Michael Osterholm as guest. This is not a flat out lie.