The explosion of new coronavirus tests that could help to end the pandemic
nature.com
nature.com
We could have this disease under control by the time school starts by giving everyone (or at least everyone in highly affected areas) tests every day.
This is possible, practical, and affordable.
The technology for fast pregnancy-test style tests for COVID-19 exists right now, and they could cost as little as $1 per test.
The reason these tests aren't being used yet is because of the FDA's misguided requirements for extremely high sensitivity for COVID-19 tests. If these requirements could be relaxed to allow lower-sensitivity tests, then these tests could go out on the market... or, better yet, the government could take over and ensure everyone gets tested with these tests every day for $1 a test.
Even a more limited plan of testing just all schoolkids every day for $1 a test would be way better than what we've got now.
[1] - Starting at about 6'20" in to episode 640: https://www.microbe.tv/twiv/twiv-640/
Testing and contact tracing is a bargain compared to continuing to pay everyone to stay home. I don't understand why we're not seeing for-real effective contact tracing from our governments yet.
(We're currently running 11/million new cases per day @ 3,2% unemployment. At one point our per capita case rate was much worse than that in the States.)
https://www.lemonde.fr/les-decodeurs/article/2020/03/27/coro...
Prices would come down fast as this scaled up too
The trump administration does the worst thing possible in any situation.
Particularly please don't take HN threads further into political flamewar. Comments like this lead nowhere good.
Which $1 test currently in production would this be? And as a point of context, there’s been nowhere near the ~10B tests (I assume you’re talking about a 180 day school year) you’re proposing administered _worldwide_. Furthermore, what factory produces and ships 56 million of anything on a daily basis? I’ve said this before but I think HN readers suffer from thinking that everything in the world works like AWS in that you can just spin up unlimited “anything” on a moment’s notice.
It's not about what's "currently in production." It's about what should be a strategic goal to produce the bigger number of tests and use them frequently.
1) The current arguments against the speed tests is that they are not "sensitive" enough. But if one's goal is to do day to day testing and isolating from some environment those that can spread, there's no necessity to detect the RNA leftovers detected by the "sensitive" tests. Rather, the goal is to detect those that are the "powerful spreaders" who in fact have way more instances of virus present in their samples at the moment they are tested. Apparently even the "less sensitive" tests are in fact sensitive enough to catch these who produce a lot of virus. Those who produce a lot of virus have many orders of magnitude more virus RNA present in their samples than those who are in the phase of infection where they aren't so dangerously infective.
Once one accepts that the "ultimate sensitivity" is not necessary, much cheaper tests than those currently used are possible.
2) Even if a single test is still e.g. 20 USD, just stating the goal of having very frequent and regular tests for the sole purpose of protecting a big group of people allows for "pooling" the tests, e.g. testing 20 people together using just one test.
Running the numbers for a university of 1000 people:
1000 / 20 = 50 means only 50 tests per day allow for testing for protection of all 1000 people. Once one batch of 20 is positive, which should not happen every day, additional 20 tests allow for recognizing the one who is the actual carrier. Again, as those that are "dangerous" have many orders of magnitude more virus in the samples, pooling of 20 samples together should be still keep the result detectable enough.
3) Moreover, the test should be less complicated as the one used now: the idea is to test the spit, not to swab the deeps inside of the head.
4) Expensive and slow tests are simply not giving us the possibility to do these "detect early and often" strategies. The really sensitive PCR tests are indeed expensive and aren't as fast as the less expensive can be.
How can the cheap test be made? For example, by designing them to be used the same way the diabetics test their blood sugar levels:
https://www.diabetesaustralia.com.au/blood-glucose-monitorin...
Or even the way the pregnancy tests work:
https://www.123rf.com/photo_107386863_positive-pregnancy-tes...
In short, just new test strips.
Moreover, there are already companies that did some development of such kinds of tests.
It could be done, but it depends on the goals being set.
China successfully used pooling to test the population of 11 million:
https://www.bloomberg.com/news/articles/2020-05-29/how-china...
The technology to make these tests currently exists, but the companies which own the technology have chosen not to put them in to production because the tests aren't sensitive enough to gain FDA approval under current regulations.
If the regulations were relaxed to allow these less sensitive (but perfectly adequate) tests, then they could be put in to production.
So what's necessary for us to get $1 tests is to convince the FDA that these less sensitive tests are adequate for use, which is what the This Week in Virology podcast and the NYT article linked to earlier argue for.
"Furthermore, what factory produces and ships 56 million of anything on a daily basis?"
From the TWiV podcast[1]:
"Take every manufacturing company that knows how to print paper, adapt their tools to print monoclonal antibodies on to those sheets and just start slicing it up and shipping it out. It's as easy as that, I mean, you know, I'm simplifying it a bit, but..."
[1] - from about 32'30" in to the podcast https://www.microbe.tv/twiv/twiv-640/
Maybe more than one factory would be needed.
The idea that 56 million a day of anything is outside the realm of anything but software might be exaggerated. Global production of microcontrollers, for instance, seems to be around 80 million per day.
https://www.grandviewresearch.com/industry-analysis/microcon...
So, you now cannot say "always" in that statement, because I deal with customers daily.
My point is, the minimum wage workers at many of these businesses could not care less whether you are following mask rules or not.
See: https://www.workplacefairness.org/medical-privacy-workplace#...
Also, just as a personal aside...I will gladly join massive, maskless protests to underscore that I will never accept medical testing as a condition of engaging in society. This is a completely unacceptable violation of civil liberties.
But that section explicitly states, "... unless they are related to your job and necessary for the conduct of your employer's business.
I think there's a pretty strong case that the health and safety of fellow employees and/or customers during a pandemic qualifies.
The Supreme Court has repeatedly held that the government has a pretty wide reaching authority when it comes to fighting disease. If the federal government can quarantine entire towns and force vaccines, they can similarly force you to be tested.
They can't quarantine towns from the federal level. Not in the least. A state might be able to, because the 10th amendment is a thing, but Federal government cannot. And neither state nor federal government can force vaccines because it violates the 4th amendment. You don't get to search my body for diseases and use them to discriminate against me. Sorry. Furthermore, Roe v. Wade was argued on the basis of a right to privacy that's implicit. So no, I'm right on this.
I mean, you’re entitled to your opinion, but at least some people disagree.
Edit: and, your claim that there is no such precedent is a flat out lie.
I am so embarrassed on your behalf.
This would no more violate the ADA than random drug testing (legal) or requiring temperature checks, which some employers are already doing to protect against COVID-19.
Also, the ADA is not a constitutional amendment, so even if there is a potential conflict with ADA, Congress could easily address that in a new bill without needing to pass a new constitutional amendment.
Of all the hills to die on, "not wearing a safety mask" [0] is one of the more batshit crazy, but in a nation where the people have decided that "schoolchildren being slaughtered in their classrooms" is an acceptable price to pay for free and easy firearms, I guess it's not surprising that "people dying horribly, gasping for breath as their lungs fail" is an acceptable price for not wearing a safety mask.
[0] This poster's particular hill isn't the mask, but it is for some, and if I'm doing "batshit crazy", there it is.
There hasn't been a single death in California from Coronavirus for any child, period. In the US, there've been about 20 deaths, nationwide, of children from COVID.
Ever heard of big tobacco? I got lots of relatives that died like that after enjoying cigarettes all their life. It is not surprising.
But, when you consider that the second amendment is an inalienable right, one has to wonder how to separate children from their guns.
"Parents, please don't send your child to school with their gun."
"Blood test detects positive COVID-19 result in 20 minutes" - https://medicalxpress.com/news/2020-07-blood-positive-covid-...
"Fresno health clinic offering rapid COVID-19 tests that give results in minutes" - https://abc30.com/fresno-county-coronavirus-covid-19-everyda...
"15-minute COVID-19 test proves accurate at confirming infection" - https://www.upi.com/Health_News/2020/05/08/15-minute-COVID-1...
"New rapid COVID-19 test approved by FDA, results in as little as 15 minutes" - https://www.msn.com/en-us/health/video/new-rapid-covid-19-te...
"A new COVID-19 test can return results in 5 minutes" - https://www.theverge.com/2020/3/28/21197944/coronavirus-test...
This is never happening with Trump.
Self-isolation, social distancing, proper hygiene are going to slow the virus down. To implement those properly requires paying low-income workers to stay home.
A vaccine will stop the virus, but we don’t have one yet. It looks like it will be a year or more for a vaccine to be available.
Maybe soon we'll have dogs that can smell Coronavirus too[1]!
[0] http://news.mit.edu/2020/signs-covid-19-may-be-hidden-speech...
[1] https://www.ecowatch.com/dogs-smell-covid-19-2646105814.html
The pandemic already is under control in most places and I'm not sure testing had all that much to do with it. The successful strategy seems to be pretty straight forward. Initial lockdowns if the country is hit badly to curb the disease, then strong compliance with basic health guidelines and regional lockdowns if necessary.
Japan has performed about 800k tests in total on a population of ~120 million, which is lower than most other countries by a magnitude and about 50 times less than the US, but has had very few excess deaths.
At the end of the day the virus cares about behaviour, not testing.
This is an interesting claim. I think it's potentially misleading, and possibly motivated by a need to portray places where it isn't under control as isolated.
I suppose it might be technically correct if you count a list of "places" and divide the number where it is growing rapidly by the number where it isn't. However, the results you get are very dependent on how you define a "place".
If you divide the world into Europe, North America, Asia, South America, Africa, and Oceania, the only one that definitely seems to be under control right now is Oceania. Africa and Europe are growing much slower than the others, but not obviously "under control", and Asia notably is seeing over 60,000 new cases per day even though it previously seemed to be under control until India started reporting large increases.
If you count countries, you could claim that about 3/4 of them have it under control, but that might not be permanent. Considering Brazil (which I think people would generally consider to have a serious problem right now) and everywhere the epidemic is growing faster, it is a minority of countries, but very near half of the world population.
Source (as usual) is https://www.worldometers.info/coronavirus/
I assume it is the latter, which means the stats can be skwed somewhat. I can't say what degree it would be but I've had 8 tests. Which means I show up in the testing stats 8 times. My situation is somewhat unique, but I'm not alone. Hence the distinction I am curious about.
It wasn't mentioned in "Contagion" for instance.
A vaccination or cure was always known as not possible but the media pushed these false hopes.
In part I suspect this is the usual medial malpractice of doctors keeping their profession wealthy and keeping everything they can tied up and regulated.
I'd be interested to look at HIV and testing in the 80/90s to see whether at home tests were stopped by doctors or technology.
That's not true generally.
Perhaps because of this misconception we are missing out on a paradigm shift, testing technology needs more money but first get comfortable with anyone using the test and making mistakes, which includes the real poor, including illiterate people.
Because medical has been locked up for so long, researchers and governments aren't looking at people looking after themselves.
The pandemic planning stuff I've read from before this year seems to suffer from a number of assumptions that were violated by covid, from asymptomatic transmission to the long lead time. E.g in MERS or Ebola or even flu, the infectious but asymptomatic period is more like Contagion. You don't have to worry about infected people wandering around town for a week or two.
Most planning mentions the need for having tests, and quickly gathering materials etc, and then moves on to tactics for containment and vaccine development. Where testing is focused on, it's as a way to differentiate between people who have symptoms but are actually infected with a non-panfemic disease, so that resources aren't wasted quarantining them. I haven't yet found a scenario studied with a long lead time and possible low level or asymptomatic presentation as standard.
It is possible.
Listen to episode 640 of This Week in Virology[1] for details.
[1] - Starting at about 6'20" - https://www.microbe.tv/twiv/twiv-640/
http://traffic.libsyn.com/twiv/TWiV640.mp3
It should play in any media player.
Bloomberg: You seem optimistic researchers will succeed in coming up with vaccines. How do you assess the prospects and potential risks?
Stohr: The coronavirus is not a particularly difficult virus to handle. Even the conventional vaccines could make a difference, and we have different approaches, vector vaccines, mRNA. That is very promising.
https://www.bloomberg.com/news/articles/2020-07-18/covid-mos...
The thing I just can't understand is why they didn't require everyone back then to wear condoms all the time, regardless of whether they were HIV-positive. Those people were so callous in their regard for human safety!
But to address the absolutism in your question. If everybody in possession of a penis wore a condom at all times (a) they'd get nasty and possibly gangrenous, [so i'll assume you mean "when the penis is deployed in/on/around a second party"] and (b) it would reduce the birth rate by about 90%.
That would be about as likely as everyone wearing a mask at all times.
> The thing I just can't understand is why they didn't require everyone back then to wear condoms all the time
Its not just me.
EDIT: Actually not quite. To elaborate a little further - it has become understood that it is just and reasonable for the state to have jurisdiction over interpersonal interactions that involve money (though the converse is not necessarily implied) - this is 'the market'. Thus going to the store operates under a different regime than going to a friend's birthday party in their own home. Your example would equate to the state mandating condom usage with prostitution, assuming that was legal in the first place.
What you get up to at the store can be regulated by the state - what you get up to in the bedroom (without financial exchange) should not - assuming meaningful consent