Show HN: A Covid-19 testing location site that a group of us are building
findcovidtesting.com
findcovidtesting.com
Over the last week DataDrivenMD and I were able to pull together 15 developers to get this out. The speed that we were able to cobble together a team that can work smoothly, 100% remotely from all different organizations has been amazing. The crisis action team for the state of CA has reached out to see if they can collaborate with us, and we’re doing our best to understand how to work with state and local governments going forward.
Thanks to the fantastic volunteers, we have we were able to refactor early, away from the junk front end I built, to something that we can actually scale on the front and back end. We’re currently struggling with how to scale our collection and updating of test locations as they spring up, and we hope to build an application to allow providers to submit their locations on their own. Right now that whole process is manual, based on manually scraping/validating locations that are publicly stating they are doing testing. If infrastructure existed to identify places that are testing, we would be using it, but it doesn’t as far as we know, so we’re building the communication infrastructure for these test sites as it starts forming.
We’re US only right now but if we can get to a scalable way to collect test location data we can be worldwide.
This is a 100% volunteer effort explicitly for public good. We will not monetize the site, sell access to any resources we have, or in any way monetarily or personally benefit from this project, we have no plans to continue as a group any longer than we need to. No single organization is sponsoring this, and we have credits from GCP and AWS to run our infrastructure so Jorge and I don't go broke!
Please help us: Post in this thread any feedback, suggestions for scaling how we source and verify testing location data (manual currently), or anything you think useful! We’ll be monitoring the thread.
Our code is 100% FOSS: https://github.com/codersagainstcovidorg/covid19testing-map. We're available at @findcovidtest on twitter and contact@codersagainstcovid.org. Thanks!
Just some feedback, this runs pretty slowly for me on my laptop. Is the full screen map necessary? Might be nice to have a Google Maps feel where it has the list on the side of the locations currently in view
contact@codersagainstcovid.org
One technical issue though - I'm seeing a white (blank) page when visiting in Firefox, though it seems to load fine in Chrome.
2 errors in the JS console, in case they help:
TypeError: "navigator.geolocation is undefined" at react-dom.production.min.js:196:194
TypeError: navigator.geolocation is undefined at App.tsx:121:4
Unfortunately not necessarily. We are past testing in some areas, and people seeking testing is putting strain on overloaded resources.
See for example:
“Not every single person in the U.S. needs to get tested,” said Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases. “When you go in and get tested, you are consuming personal protective equipment, masks and gowns — those are high priority for the health care workers who are taking care of people who have coronavirus disease.”
https://www.washingtonpost.com/health/2020/03/21/coronavirus...
I understand you're upset, it's a very upsetting situation. But venting to HN won't really help the things that are upsetting to you.
It's more effective I think to explain the situation clearly and help other on this site understand why mass testing is not a good idea in parts of the US.
EDIT: thanks the edit is much more effective!
EDIT I hope the downvoters and their families make it through the epidemic alive.
Thanks again for making this!
Do you mind making it clear in the tool that someone viewing the site should first contact a teledoc?
But shouldn't an effort be made to make things easier and safer? Imagine a drive-through location with the web address of an intake app over entrance. You do intake with the app in the parking lot and then get cleared to go through. Everything automate and nearly free of human contact.
Sure, we have a shortage. But mask and other equipment production is going to be ramped up shortly. Testing and is going to be the second part of any virus suppression effort.
And yeah, currently, we got nothing. Everyone quarantine, the sick-enough go to the soon-to-be overwhelmed hospitals. But we have to look plausible measures once we have resources, right?
People would get in line with their car to ask the attendant questions or for IT app support. There are language, accessibility/disability, cultural, etc. barriers (to name a few).
I'm curious what data/feedback you used to conclude this need existed. I haven't seen any news articles that say the bottleneck is knowledge of locations. As many others have pointed out, the issue is with healthcare staff safety, test supplies, etc.
If you end up looking for a pivot, perhaps you could convert this into a map of locations where people could safely donate their excess supplies of masks, etc that they're holding onto unnecessarily. That could contribute to the problem of lack of supplies for healthcare workers.
thanks.
https://www.kxan.com/news/coronavirus/masks-gloves-and-therm...
I hope you don't mind, I saw this today and was inspired to build this:
I'm planning to extend it with search functionality & an admin interface to help scale the sourcing of new data & validating it at scale.
Would you like to work on this together?
"If you think you have COVID-19 and your illness is mild, you do not need to see your health care provider and you will not be tested. Getting tested will not change what your provider will tell you to do to get better. They will tell you to stay home so you do not get others sick.
Unless you are hospitalized and a diagnosis will impact your care, you will not be tested. Limiting testing protects health care workers and saves essential medical supplies, such as masks and gloves, that are in short supply."
https://www1.nyc.gov/site/doh/health/health-topics/coronavir...
Their 2020 Advisory #8 COVID-19 Update for New York City [1] directed towards healthcare providers states in the summary that "Outpatient testing must not be encouraged, promoted or advertised."
Additionally, "To preserve PPE for HCW providing medically necessary care for hospitalized patients, the NYC Health Department is directing healthcare facilities to IMMEDIATELY STOP TESTING NON-HOSPITALIZED PATIENTS FOR COVID-19 unless test results will impact the clinical management of the patient. In addition, do not test asymptomatic people, including HCWs or first responders. COVID-19 testing is only indicated for HOSPITALIZED PATIENTS."
[1] https://www1.nyc.gov/assets/doh/downloads/pdf/han/advisory/2...
I really hope that after this is over, we have the political strength to diagnose the problems and deal with them. However I fear that the current regime will prevent any such correction because of fear that they could blamed, and the extreme dictator-like narcissism that prevents any corrections because it would mean admitting imperfection.
Testing a new virus is not the difficulty! We've had all the info we needed for months, and the bottlenecks are not anything specific to SARS-COV-2. IDT, TWIST, and others can produce the specifics for this virus in no time.
What we are seeing is a massive logistical and organizational failure, driven right from the top of all of the organizations.
https://www.politifact.com/factchecks/2020/mar/16/joe-biden/...
It still makes sense to ask why FDA only allowed CDC to develop a test, vs allowing all extant, validated tests and/or allowing private US tests.
(Edit: typo: just noticed I accidentally wrote false positives instead of false negatives.)
[1] https://www.businessinsider.com/coronavirus-south-korea-spre...
This great write-up suggests to shut everything down to get cases back to a manageable level and then move to the SK and Singaporean model: https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-th...
Strongly recommend the read.
South Korean foreign minister believes it's testing that was key: https://www.bbc.com/news/av/world-asia-51897979/coronavirus-...
Singapore was hit hard by SARS. They adjusted their strategy and are successful with COVID-19. paper: https://academic.oup.com/jtm/advance-article/doi/10.1093/jtm...
Maybe they were just lucky, but if it was my decision, I'd put my money on the strategy that worked in those two countries and minimized cost in lives and economic impact.
Really, there’s no excuse for the abysmal US testing regime. We’re beyond a point where contact tracing is feasible, but there is no reason we had to get to this point.
[0]https://www.reuters.com/article/us-health-coronavirus-testin...
They were ready long before Covid-19 showed up.
https://www.propublica.org/article/how-south-korea-scaled-co...
It's not about test availability, but rather exposure of healthcare workers and use of PPE. If you're already in the hospital people will be wearing PPE if they can get it.
Now that NY has gotten to this point PPE seems to be the bottleneck.
Nations such as S. Korea are doing considerable and widespread testing and are able to protect their healthcare workers.
And S. Korea is not on lockdown and they have suppressed their outbreak.
Given that we're not going for 'herd immunity' in the short term, the only alternative is widespread testing, forced isolation and excessive testing of those with a recent history of contact of those who turn up positive.
This will take coordination, moreover, it will take fairly comprehensive testing.
I'm not sure if the USA is geared to do this. Maybe a few states, but not the others, which then creates problems.
If those $20 testing kits are available in volume, enough people will able to 'test themselves' and that will serve as a really good '1st pass filter' for the regular medical testing systems.
If your symptoms are mild enough to not need hospitalization, your instructions are the same regardless of if it's the coronavirus, flu, or common cold. Now they're just telling the general population to follow those instructions.
What really disappoints me is that people seem to think it's okay to ignore those instructions if it's not the coronavirus. One possible silver lining to this mess is that flu cases will probably be significantly reduced in the short term.
Instead we're effectively doing the opposite, which is testing IF AND ONLY IF you BOTH have symptoms AND can prove contact with a confirmed case. Which doesn't do much to stop transmission (it's too late at this point; you've already spread it), and certainly doesn't give an accurate picture of the prevalence or behavior of the disease.
(EDIT: Found an article I saw the other day about this being done in an Italian town with the claim that the virus has been "eradicated" there as a consequence: https://www.theguardian.com/commentisfree/2020/mar/20/eradic...)
I'm just a lay observer of all this, not an authority. But my impression is that the U.S. could have done it effectively if a) the CDC test situation had not been borked and b) the federal govt had acknowledged the risk of epidemic (because I expect it's the CDC who has expertise in this tracing exercise, much more than state health departments).
As to whether it's too late, I honestly don't know. But it seems like it would be useful in controlling the epidemic regardless of its state.
Have a read of /r/medicine, it absolutely is.
They're already making (probably split-second) choices between endangering themselves without PPE or leaving patients untreated, in countries that have a long, long road ahead.
PPE seems to be the primary equipment shortage, not ECMO/ventilators, though that's an issue too.
2. This comment [1] illuminates a bit the point about not getting tested by your healthcare provider.
[0] Around 11:30 https://www.ny1.com/nyc/all-boroughs/coronavirus-blog/2020/0...
[1] https://www.reddit.com/r/nyc/comments/fmb6p5/just_had_a_sobe...
All around the country, many (most?) people with symptoms are being denied any form of testing. We need to go beyond that to massive testing of even asymptomatic people that have come into contact with people who have tested positive.
The healthcare workers are thinking about how to best help the people under their care, with severely limited resources. And for them, testing doesn't matter unless it changes treatment. But there are other reasons to test.
What the rest of our leaders need to be thinning is how to engage a strategy to contain the broader spread and let people return to normal life, safely, as soon as possible.
South Korea has shown us one way, massive testing:
https://twitter.com/trvrb/status/1240444836982878213?s=21
https://www.reuters.com/article/us-health-coronavirus-testin...
The other ways or get there will be some sort of antiviral treatment or vaccine, but those will not be fast.
No - this is not accurate. Both your statement and the statement by Cuomo are not true.
As of last Wednesday, S Korea has done 295 000 people, of ~50M. [1]
As of yesterday, NY has done 45,437 tests for ~20M people.
So Cuomo's statement is looking a little Trumpish, I'm not accusing him of lying, but he's spreading false information which happens to make him look good, he needs to be more accurate.
Also - your statement misinterprets his - the NYC statement says 'any other state' - not 'any other place'. Canada is testing a little bit more widespread than NY, surely there are others.
So NYC is acting, but there's no 'cutting edge' or 'exceptional' response in America of anything right now. S. Korea, Taiwan, Singapore are looking like 'world leaders' here, granted, they have different kinds of systems entirely.
It's possible that some of their other social artifacts, such as 'basic face masks' might actually be responsible for reducing spread. Since 'lockdown' in North America the spread has continued unabated, and in S. Korea, there's no lock-down and they have it under control (though they are doing more testing as well).
There might possibly be something very specific about the spread of the virus that we don't understand, which if we were to be able to focus on, we could be more effective.
[1] https://fortune.com/2020/03/19/coronavirus-south-korea-test-...
If you're not sick enough to need hospitalization then don't go force somebody to waste PPE to tell you to go home and stay hydrated.
On a side note, out of curiosity, would you happen to know how much the test costs in US?
https://www.cms.gov/files/document/mac-covid-19-test-pricing...
https://www.latimes.com/california/story/2020-03-20/coronavi...
This is amazing. Thank guys so much for building something like this. Rapidly building up access to, and information on testing sites is one of the most important things we can do right now.
Our leadership (in the USA) certainly isn’t doing it. I feel like anytime I say we should follow the example of countries who focused on testing, I’m immediately rebuffed with talking points, excuses why it won’t work, or why we should just hide in our house for an undetermined amount of time.
This is one of the best Covid-19 related projects I’ve seen come across the front page. You guys identified one of the most pressing problems, and figured out how to get it done.
Thank you so much!
https://www.propublica.org/article/how-south-korea-scaled-co...
I was pleasantly surprised that there is a testing centre 3 blocks from my apartment (i don't know where else I could have found this information).
I also really like this "Unless you are explicitly told otherwise, you MUST complete your self-isolation period - even if your test result is negative for COVID-19." I'm quite concerned by hypochondriac's and general attention seekers spamming the test system, being forced to self-isolate regardless is a perfect deterrent.
I have a tangentially related question, hoping that someone knowledgeable can answer. What are the main bottlenecks to scaling testing, in particular in the following stages:
- the supply of virus-specific reagents (primers, perhaps virus-specific reporting probes - are these necessary, or can just generic reporters be used?)
- the supply of other reagents (in case of PCR, polymerase, nucleotide material, buffer)
- the supply of disposable testing equipment. I know that swabs are in short supply for some reason, anything else?
- safety in handling both the samples and the amplified product (can you basically flush the processed sample down the toilet, or do you need to handle it with extreme precautions)
People need to call their local non-emergency line for instructions if they have symptoms.
This map is incomplete by your own admission, which makes it practically misinformation.
We don't need guerrilla tactics in this war.
Oscar was started by Jared K, (tRUMP's S-I-L). Visitors of their site (at hioscar-dot-com-slash-covid19) are given a "free" assessment and referral to a testing center. So far so good, right?
In the back end, a "service fee" is charged to the Fed Govt for each person that uses the system. Being that Jared's in the family, there's no doubt that Oscar will get paid everything it asks for.
In the US, how much help is testing now other than to sample the population to get an idea of the spread?
Would it not be more interesting to know how well people are self isolating? Finding out where the message isn't getting through?
But please don't just go there to check if you have corona unless you have some of the symptoms. Otherwise you are going to flood the already strained system.
cmiiw, by default the website shows locations which are not public health agencies and "checks patients for symptoms" and if we want to see all locations which provide COVID-19 testing we need to enable (toggle) radio button "Offers COVID-19 testing" in filter which is present in flyout at top left corner. Correct?
That being said, there are many areas of the country where the local, county, and state health departments effectively function as gatekeepers. In those communities, people have no choice but to call their health department and hope for the best. If they meet testing criteria, then they are referred to a testing location or fast-tracked through an existing healthcare provider’s queue.
If nothing else, this site crystallizes the fuzzy image that we all had in mind with respect to testing capacity. The situation is changing all the time, and we expect things to get better. You can help by raising awareness, and asking people you know in the Midwest and Southern states to visit our site and share their on-the-ground knowledge of the situation.
When I need to be tested, I don't want to phone several providers but I want to find the closest free slot for a test that suits my needs. E.g. if I don't have symptoms, I cannot use an antibody test.
It is insane that this is not being done by the government, and that it's left to random coders to throw this together in their free time.
Edit: This item's page doesn't work on iPad. After three seconds, the page freezes.
Or you can add a site here that we will validate:
https://docs.google.com/forms/d/e/1FAIpQLSe2sCuCrQwEHwi3FLiy...
We will also continue to research and update the site as new options become available - including home-based testing. We've already heard from a couple of companies in this space, but we're waiting for them to provide us with proof that their test is FDA validated and approved. Once they do that, we'll add their information to the site as well.
Which I hope the makers here are thinking about how people will behave. I would be tempted to only show places that were basically testing anyone on a map and then provide per state/jurisdiction information about figuring out whether it's worth going somewhere otherwise.
Figuring out where to go to provide a sample is the easy part.
Most of the locations are by appointment - even that is still hard to get. We need to make that clearer up front so thanks for the feedback both of you.
This idea seems like it would only be useful when coupled w a screening app that asks questions, give your temp and O2 oximeter reading, then provide locations, but even then, each county of each state has a completely different protocol for scheduling.
Early in the process of sourcing data for this project, we realized that the CDC guidelines are used as a starting point, and that other factors come into play that are less transparent to the public. For example, there are still many states with extremely limited capacity. In those areas, public health departments have been forced to create lists of patients that would be tested immediately if it were possible. Lacking sufficient testing capacity, they prioritize the list of persons under investigation (PUI) using criteria that they develop internally through a collaborative effort with key stakeholders.
On our site, you will note that there are pockets of the country with lots of testing options. But that doesn't mean that testing is easy to come by. We learned that those areas are enriched for academic medical centers and large hospital systems that have been granted FDA approval for their own (custom) version of the COVID-19 test. Through strategic partnerships with community-based medical groups that predate the pandemic, patients in the broader community benefit from direct access to testing services. But the the problem has resurfaced: the demand for testing is already exceeding supply, and we witnessed the turnaround time for test results grow from 4 hours -> 12 hours -> 24 hours -> 4-5 days since we began this project exactly 7 days ago.
Make no mistake about it: the testing problem is far from resolved. Screening tools are a stopgap designed to lessen the mental anguish experienced by those who are tasked with rationing a (literally) vital resource. We will continue to explore ways to incorporate them into our project, but will approach the decision mindful of our commitment to empower everyone with the information they need to flatten the curve. To the extent that screening tools have thus far played a role in obfuscating where we are on the curve, you can rest assured that, if a screening tool finds its way onto our site, it will serve a greater purpose for a greater number of people.