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Comment by surfsvammel | Hacker News Reader

I think there is a more reasonable explanation why they are not testing you. Simply because they wouldn’t do anything with that information anyway. If the test is positive they’ll send you home to quarantine telling you to call back if your fever worsens. If the test would show negative, they’d tell you, guess what; “please call back if your fever worsens, and stay in quarantine anyway”.

So the information doesn’t really matter.

In Sweden once they change tactics from trying to track each and every case, and who they might have gotten it from etc, to a a strategy more about just accepting that it’s spreading and trying to limit the spread in general, and protect the weak. Then they also stopped doing testing here.

Unless you are in a risk group, the test doesn’t really make a difference.

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> Unless you are in a risk group, the test doesn’t really make a difference.

If the test is positive, you can self-quarantine and notify everyone you've been in contact with that they need testing. Then any one of those people that tests positive can do the same thing, etc. etc.

If you don't do any testing, you end up with a bunch of positive but asymptomatic carriers wandering around unknowingly infecting other people.

South Korea is taking this approach and they seem to be doing a lot better than most other countries.

Indeed and it probably makes much of the difference why active cases in Korea have kind of leveled off while in Europe they are growing about 25%/day. And just a reminder that's 800x a month.

Is it possible for the number of cases counted to go up simply because more testing is occurring, while the number of people with the virus has leveled off?

Jup, but they are already at their test capacity so they already need to priorize who is beeing tested.

So unless you have the lab infrastructure in place already (I don't know how it is in Japan), you can't really invent it out of thin air in the midst of a crisis.

The truth is that neoliberal ideology all around the globe did its best to make hospitals and health systems "more economic" by cutting (at the time) unneeded capacities, without any real concern about the resillience of the system as a whole. This is (aside from timing and culture) where you see the main difference between nations today. This is e.g. why Spain decided the privatization of their hospitals was a grave mistake.

Thank you!

There is a HUGE cost to "shelter-in-place". People's businesses and jobs depend on customers going out and using their services, and without customers, they won't have jobs, business will fail, and people will get hurt, and die. (Hopefully fewer now that Trump's doing a bail out.)

Shelter-in-place may be the right thing to do, now that that containment has failed, because people will get hurt and die otherwise, but containment wasn't doomed to failure from the start. It's wrong to frame it that way. It's like running for the bus. You don't have to run as fast as a bus can possibly, you only have to run fast enough to catch it before it leaves the bus stop.

Containment isn't supposed to last forever, it lasts as long as it lasts. It absolutely required far more aggressive action to be successful, and one of those was testing. Which we dropped the ball on.

> So the information doesn’t really matter.

It would matter to me. If I know I have it, I would stay at home and have somebody else do shopping and leave stuff in front of the door. If I dont know that, I do shopping by myself.

Having it or not is also difference between whether one can join one of those programs where young people shop for elderly and leave stuff in front of the door. Of course the caution must be taken with everyone, but also those with confirmed case are out.

It makes difference for people who still have to go to work.

Even official expectations on people with corronavirus are different then on others.

I tend to agree with you, I would like to know as well. But consider this: if it is cold or flu - would you want to risk your health being more prone to the infection while your immune system fights another virus, or bringing more people into the same situation in circumstances like these?

If it is cold of flu, when it passed, it passed. 7 days and you are fine. Corona is can get better and become worst and take weeks. So it is still a difference.

Is it a fact that corona in general takes long to get better from? Thats not what Ive heard/read. Unless you are unlucky and get pneumonia.

I'm always wary of any strategy that is fine with having less information. Of course cost of information is never zero but in this case the actual cost of tests is relatively low.

The cost as in “COGS + markup” may be low but the opportunity cost (cost of not doing a test when it is more important) might be higher when the supply of tests and lab time is limited. While it is absolutely important to ramp up both, it is a different story.

^^^^^^^

This, right here. The entire world is struggling to get enough testing supplies. Testing somebody who's experiencing mild symptoms takes away from testing cases that are much more important - because part of what is happening right now is that everybody with a light fever is all "I GOT THE COVIDS" and wants a test.

Fact of the matter: We don't have enough tests, worldwide. We can't produce them fast enough. We need to triage.

Yes, but it is also true that the number of available tests is increasing rapidly, and also is partly in response to government demand.

If the the available number increased to the level where everyone with symptoms could be tested, would you favor doing so? and do you think that governments should push til enough tests are available to do that?

Late reply, but yes to the former, with the caveat that it's contingent on sensitivity and specificity. (I.e. false negatives/positives)

Probably yes to the latter, unless it takes away resources we need more urgently elsewhere.

But really, what we need to do is depress the count of infected people to a point where it's even feasible to test everybody with symptoms.

Even if we rolled out testing to a point where we can test 1M/day (I think it's 200K/day right now?), it'd take a year to test all of the US. If we're in flu-prevalence territory, that's only 19M, and so suddenly much more doable.

And at that level, we need the ability to both test anybody with symptoms and to conduct random samplings of asymptomatic people, because without that, we couldn't lift shelter-in-place until we have a vaccine. That's... a tad long.

So, more tests, plus suppression doing its job. And it'd be lovely if our government would push to get anything done, really. They've wasted 8 weeks by now, at least. Coordinated response is allowed to kick in any day, by my book.

Cost isn’t zero though. Have a lot of people with mild symptoms come in puts strain on health care, and increases the risk that important health care workers get the affliction.

If the test could be done yourself, at home, then I would agree with you.

If you know how much the general spread is, and how often it requires different sorts of treatment (or is asymptomatic), you can plan your mitigations and restrictions much more effectively.

You don't need to know, the immediate doctor telling you to wait and see at home doesn't need to know, but the government absolutely needs to know.

You should not be giving medical advice. 3% of people with no fever who test positive end up needing ITU admission. Deterioration can be sudden after the first week.

You’re right. I’ll edit it. Edit: I cannot edit it:(

The results of the individual test might have limited use to the individual.

But the idea that the information won't be used is nonsense. It's invaluable for the overall response. We have only the vaguest of ideas how many people (in the U.S.) are infected. The more information we have about cases with few or no symptoms, the more we can understand the spread and take appropriate measures (that will also be more obviously justified, countering people who claim overreaction).

More accurate information about symptoms would also help individual people:

- help them understand that they can feel fine and still be getting other people sick

- help them have an accurate picture of contracting the disease, instead of leaving it to nightmares

There's no universe where having more information about the situation would not be better.

In my experience, government/businesses/schools have been slow to close without confirmed test results. If you don't get the tests, no one is going to pull the trigger on quarantining. That is frustrating to me.

Did you even read the article? The article points out that identifying those infected and isolating them from those who are not reduces infection and also increases the number of those that get better.

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