Comment by 40four | Hacker News Reader

Comment by 40four | Hacker News Reader

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Don’t get me wrong, I’ve been a big proponent for highly accessible, rapid testing from the get-go. But, I don’t know what the benefit of a 15 minute test is.

Can anyone tell me why this is any better than the already demonstrated, very accurate, testing methods already in place? Is it just a company IP type of thing?

What does it matter that we can get a result before we leave the test site, versus a few hours after we go home, eat some lunch, and do a little work?

Maybe I’m overthinking it. Great. Please, Abbot, manufacture these things as fast as freaking possible. Distribute them across the whole country in huge volume. But I can’t help feel like this article (on Abbot’s own website no less) is just a bunch of sales/ marketing BS.

Honestly, it mostly just pisses me off that an American company as big & powerful as Abbot, didn’t have these things ready to go from the get go. There should have been thousands of these available to every Governor in the country at least a month ago.

Maybe then, our leaders (in the USA) would have had the capacity to craft smarter policies. Instead almost every governor in the country just threw blind, blanket lockdowns over entire states. Never mind that rural areas were not experiencing the same rates of infection, or pressure on health care systems, as densely populated cities.

They probably just didn’t have data pints they needed to decide. So they treated everyone the same. Much to the detriment of smaller, rural regions.

> But, I don’t know what the benefit of a 15 minute test is.

At the risk of sounding snarky... Really? You can't think of any way in which a 5-15 min result is more valuable than a multi-hour/day result? We have governors setting up roadblocks at state borders to turn away out-of-state license plates; a quick test seems like it might help there. Then think about what that means for international flights.

Well, maybe I’ve come around after sleeping on it :) Sometimes I can’t resist an angry rant right before bed.

@mkrumm schooled me on multiple valid use cases and, I think, outlined how these things will actually be used.

They seem to allow medical professionals to be able to make rapid, urgent decisions, about specific patients or cases. Most likely in emergency situations. I doubt they can be used assembly line style to process large volumes of tests, so I’m afraid things like testing a whole plane flight or a big group of people waiting at a roadblock are not very feasible.

This sort of rapid test (say, results in under 4 hours from collection) is useful in a few different acute situations:

- Patients needing emergent surgery while also presenting with symptoms concerning for COVID-19.

- Critical healthcare workers (physicians, nurses needing rule out and rapid return to work)

- Patients presenting who may have contributed to exposure of other high risk individuals (to speed up time of tracing)

Your other points are valid.

Ok, good thinking. Those are all pretty good use cases for a 15 minute test, assuming they can actually achieve that.

Maybe I’m just too sour and frustrated with the whole situation in the USA, and had to vent a little bit, my fault :(

This does actually sound like nice technology where they can pump out test results from this little appliance sized device on site.

Other rapid (result in hours) I’ve read about still require sending specimens to a remote lab. Let’s just hope they can manufacture them like crazy, and quickly get them to the health workers that need them most.

My elderly neighbor went to the ER complaining of shortness of breath and chest pain. They wouldn't do any heart tests until they got back the result of a covid test. They kept him for 5 days without treatment. After 5 days the test came back negative. A 15 minute test sounds good to me if it can be done on site and not shipped away for analysis.

That's not how things are typically done (in fact, I'd be very surprised if it actually took place as described by your neighbor).

One of the ways to "rule out" COVID is to confirm it's something else. Someone with the symptoms you describe would, at the very least, get an EKG and some blood work to confirm it wasn't a heart attack.

Poor guy, that doesn’t sound like a correct way to treat someone, but I am not a doctor. This is probably where this device will shine. On site, no remote lab, and allows healthcare workers to make rapid decisions for emergency situations.

A 15 minute test could be more easily done before boarding a flight for example.

I'm not sure if it is really necessary either but mentally I'm at the point where I think we should just fire all available bullets at this thing, as they become available.

I think where you are going with pre-flight testing. Even if we get numbers way down by containment measures like a complete shut down, the virus will still be there and we will need to very actively test and trace (see below article). For that to work, fast test will be invaluable. Testing everyone who is traveling or going to large events or even better just going to a grocery store would really help to get back to something that's somewhat normal without having to shut everything down again periodically or losing millions of people in the process.

https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-th...

If you had a plane with 200 passengers and two machines at the gate, this would take an additional 25 minutes to board the flight to test everyone, assuming there is no prep, which I’m sure there is. So realistically probably an hour.

It seems like a great idea in theory, but in practice? I’m not so sure.

Considering you can have the disease and present no symptoms but be contagious, you’d have to test everyone. I guess it is better than nothing in some cases.

Are you joking? This test could be done in less than the time it took me to take off my belt, my shoes, half my clothes, then empty my pockets, then pose for the body scanner, then get the wand, then the pat down, then recover my belongings and re-dress. That was my last experience at the airport.

You're complaining that a 15 minute covid test is just too much?

To start with, calm down!

I am not complaining. I'm speculating on the usefulness of thi s given that there is already a fair bit of overhead with boarding a plane in 2020 as opposed to say getting on a train.

There are a LOT of flights that happen each day, If you add up all the time combined, this would actually add a bit of overhead to an already rather long airport check-in process.

Not to mention the obvious which is that, if flights are still running at full pace, well you still have a lot of potentially infected people gathering in a rather confined area (airport), which is not really a good idea anyway.

This is obviously useful for something like triaging at a hospital, will wee see it at a check-in gate or at a bus stop? I doubt it.

Also that's clearly a lie it will take less time than for you to take off your belt, it clearly says it takes up to 15 minutes for a result. Don't talk nonsense.

Just two words: cost and benefit can help you to understand the value behind quicker tests.

Flights are getting cancelled already, and some countries closed their airports at all. There are places where you can get stuck at a border crossing, or a roadblock if you have no proof of a recent medical checks. On this background any tests which add 15 min, or even 1 hr overhead sounds more like a solution, not a problem.

No after thinking about it, I think @bamboozled is right. Testing everyone trying to board a flight, or cross a roadblock is not a feasible use case for this device. They will not be used like this. It isn’t a magic wand you can wave, there is a real bottleneck at the hardware level.

It’s not 15 mins from the time you get swabbed. It’s 15 once it’s prepared and put in the machine. Then there will be cleanup time after. Either way, even if you could run them through assembly line style every 15 minutes, 1 machine would take a whole 24 hours to process 100 people.

Another commenter @nkrumm pointed out multiple good use cases. I think they will be used to allow health care workers to make rapid decisions, for specific patients, likely in emergency situations. Not to process large volumes.

>whole 24 hours to process >100 people.

That's excellent compared to inability to leave an area, or forced two weeks quarantine upon arrival, isn't?

If 7500 people land in Sydney tomorrow (I think that’s the real number about to enter mandatory quarantine) even in the best case scenario using one machine without considering preparation time it will take around 1875 hours to process everyone. Around 18 hours for ten machines running, even then, that’s without prep time.

That’s a pretty long customs line.

To add to that, at a accuracy rate of 99% there will be about 75 people who will go through with the wrong diagnosis unless retests are done, which will add extra time. I really don’t see this working out at that scale.

You’d really need a sub 60 second test for this to scale.

Not sure, if you are following the news really. If there will be no possibility to check 7500, then 7500 will not be allowed. It's easy as that. Nobody will scale tests to a number of arrivals, its number of arrivals which will be scaled down. And possibility to test quickly may allow thin stream of visitors, and/or shorter quarantine terms for them.

Depending on how many people are waiting with you and how many machines they have running in parallel, it may still take two weeks for you to be cleared.

Better than nothing, but I wouldn't get too excited yet.

It’s just not what these machines are meant for clearly. The headline is catchy, but these are clearly not meant for processing huge volumes. That’s what a big lab is for. They can process huge amounts of samples in parallel.

These are for on the spot, emergency or very urgent, situations where particular patients care decisions will be determined by a rapid result.

Think at scale. Ignoring the very real human benefits because humans are impatient, a system where a single job run takes an order of magnitude less time to run has a much, much higher throughput overall, with much lower penalty when there are errors. And tired over-worked humans make mistakes. Given the extreme shortage we are under, I'd expect any of the room-sized Roche machines to be running 24/7 if there is no other bottleneck like reagents. The quicker the test, the more tests per hour or per day can be run.

Consider how effective instant read temperature tests (thermometers) are in post lock down mitigation efforts right now.

Abbot is doing something at least. This article is indeed marketing material though. It makes me wonder how quickly this form of testing could be deployed across populations if IP was not enforced.

Edit: I agree with your other points, although currently I feel lucky to have a pretty good governor.

So in the UK in the some paediatric wards, there is a 15 min flu tester.

This is useful because it forms part of triage. You come in, to ER/A&E, do the test along with the history.

When you get seen by a doctor you have the results of the test and can plan accordingly.

same goes here, as part of the history taking you can get a test to see if they have CV or something else.

Honestly just extra capacity is valuable? Regardless of whether it's also faster.

Here’s a scenario. Every morning and evening when you brush your teeth, you also do your covid-test. It’s that simple and that cheap.

If everyone could do that we can live with this virus.

We don’t have to run and hide from it in our homes. We can go back to a normal life, while waiting for a vaccine that can take years.

Blanket lockdowns are designed to dissuade city people fleeing to the countryside. Rural areas need to be perceived as unappealing or at least having similar situations as urban/suburban areas.

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