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Comment by coliveira | Hacker News Reader

> Any feasible plan starts with massive testing, completely subsidized by the government. And yet just yesterday the president claimed we don’t need mass testing.

This is something I've been saying from day 1: short of universal vaccination, the only way to get back to some form of normalcy is widespread testing of the population. Any government with some sense of reality would spend billions in testing, to avoid losing trillions in the economy. Unfortunately it doesn't seem that the US government has any notion of how (or desire) to do this.

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Not to mention few outside a small group of think tanks appear to be thinking about this. Perhaps if we had a President realistically planning for what to do next it’d be a bit easier. Regardless it’s not the President who figures these situations out, but the leaders at the CDC, FDA, and NIH. If they put out realistic plans and the press focuses on something more than the President, then we have a chance to plan for the next steps. For example it wasn’t the President who prevented the FDA from authorizing emergency testing back in January and February; it was all the FDA leadership.

>widespread testing of the population

So you mandatory test everyone and determine that 28% of the population has been exposed to the virus. Now what?

Cheer! Because with 28%, you are close enough to herd immunity that you can push R0 below 1 with social distancing.

In fact, herd immunity does not require 70% of the population to be immune. It just requires 70% of all potentially transmitting contacts being eliminated. And if those 28% who contracted the virus first are also the ones that have more contacts than average citizen (which should be the case, because that is why they probably got it before the other 72%), we might already be fine. Let's these 28% have 72% of all human contact (because human is -like almost everything - not distributed equally), then we would already be there and have reached herd immunity. There would still be sporadic local outbreaks, but nothing dramatic any more.

I wonder whether taking the temperature is enough when combined with social distancing? For that, it would be interesting to know what percentage of people that are infectuous have an elevated temperature. 50% might already be enough, because that means we could cut the infection rate in half just by quarantining everyone with a slight fever.

I don't really understand the point of temperature taking as asymptomatic patients are contagious (sars-cvd-2 is far from alone in this respect).

This testing provides a false negative which allows vectors to mix with healthy people -- a false sense of security. You might as well not do it.

All testing has false negatives. The goal is to suppress the disease, not to ensure that nobody at all gets it.

Even if you only find half of all infected, it would already help a lot. The infection rate is cut in half if half the infected are immediately quarantined.

If they had just closed their borders earlier could this have all been avoided? Seems like that would have been a lot cheaper.

Definitely border restrictions plus testing seems to be effective in keeping it out, see Taiwan.

Once you get enough local transmission going then it didn't matter anymore. Every western country reacted too slowly in this regard.

A lot of trade goes over those borders, and it only takes a few cases on the wrong side. Sure if on 1 Jan the RoW had shut borders with china things might have gone ok.

You can never get 100%, but it seems you can get enough to prevent it from flaring into community transmission. Keep in mind if I'm wrong, this lock down never ends - that's the only way you can keep other hot spots in the world from reinfecting your country after you get it under control.

Border lockdowns do not stop community spread unless perfect. It's like the spark that starts a fire.

No because you cannot close borders off to American citizens. Even travel bans aren't terribly effective because you can pass through other countries or be infected in other countries.

But you can force them into quarantine for two weeks when they return? That's what we're doing here in Canada.

Testing when?

When you have symptoms? Too late.

330 million people testing weekly? Not possible.

There is no realistic way to mass test everyone in a meaningful way.

We can test people who care for the elderly, so that people in that age group can be protected.

We can tests a classroom weekly with one test. If it's positive, come back in three weeks, if not hear the parents cheer.

We can let companies be responsible for having people tested, if they want people in the office.

Once scaled up, we can have restaurants, bars even festivals be full of people, that the owner/organizers tested.

"When you have symptoms? Too late."

The goal has never been to bring the transmission rate down to zero. If we could quickly test everyone at the onset of symptoms, then trace and test anyone likely to have been exposed to the virus by that symptomatic individual, we could bring the transmission rate down considerably. It's been done in other countries. Add in some other precautions, like automatic temperate checks, and the transmission rate can be lowered even further. Low enough? Dunno, but lockdowns can't last forever and our healthcare capacity is getting better by the day.

How much money would it take to make testing everyone a realistic possibility? How much money are we losing by just shutting everything down? Which one costs more?

I'm not sure it's a function of money, probably more likely capacity and time to create capacity.

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