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The goal isn’t to arguably not be failing worse than some other countries are failing.

The NYT piece isn’t about comparing the US to other countries anyway—that’s your narrative, in this context.

The question is whether is makes sense right now in the US to curtail testing of asymptomatic people who have had a high-risk exposure event, as the CDC is recommending now.

That’s hard to understand from a health policy perspective. Meanwhile the ultimate boss of the CDC has explicitly stated he’d like to see less testing so we’d have fewer cases, so it’s not that wild a conspiracy theory to wonder if this isn’t a partisan political recommendation not a scientific one.

The article uses the testing of asymptomatic people who've potentially been exposed as a jumping-off point to push the authors' proposal for testing asymptomatic people regardless of known exposure. These are of course completely unrelated in terms of actual benefits, practicality, etc but it treats one as though it were an extension of the other. It can even make sense to test selected high-risk or high-danger people without known exposure whilst not testing people known to be exposed in general; I know the UK is doing this to a certain extent for example.

As for testing of potentially exposed people without symptoms, it has its issues as the CDC pointed out. The test just can't reliably detect people who're infected but still in the incubation period of the disease, so testing them will tell a bunch of them that they're negative and some of them will think they're in the clear and go about their normal business. I think New Zealand had a incident recently where a health worker in a city they were hoping to stop the disease spreading to tested negative, went back to work, and then tested positive again later after developing symptoms and working for a while whilst infectious, though that one was probably hard to avoid. It's also not terribly commonplace, especially as a companion to mass testing everyone with symptoms rather than an alternative - I know the UK in particular, which is the other country with a big mass testing program and probably the only one with relatively working contact tracing too, doesn't do this as a matter of policy. It also consumes a bunch of tests that would be more usefully used dealing with the test backlog - finding potentially exposed people should work a lot better if you find out they're potentially exposed sooner, and the main tactic is getting them to self isolate.

Well, the Times article acknowledges that testing is limited and suggests we "make well-informed predictions about those who should be given priority".

That seems pretty much compatible with your comments.

Everything about COVID is hard to understand from a health policy perspective. Motivated reasoning is everywhere.

See this: the CDC was a beacon of technocratic science right up until it stopped arguing for mass government action, now suddenly it's politically motivated. Maybe, but you'd have to demonstrate that with some evidence.

Here's an easy demonstration of the opposite: scientists were in agreement that masks were of no use, right up until political lobbying caused a total reversal of position as confirmed by the BBC [1]. Yet on HN we can read all the time that the new consensus is totally scientific, and it was the previous position that was unscientific. Lockdowns weren't recommended by the WHO or CDC, right up until they suddenly became the only responsible scientific thing to do.

There's a clear pattern here - when an agency is recommending massive government action, a certain segment of the population praises them as 'scientific'. When an agency says maybe there's less for governments to do, they are damned as political and partisan. It's quite obviously ideological reasoning.

Mass testing has to end at some point. That means at some point the CDC has to make such a recommendation. Or do you believe it should never end?

[1] https://twitter.com/ClarkeMicah/status/1282987860090593280

Yes, the US government has failed.

> It's gone hand in hand with a narrative that the US is behind the rest of the world in its level of Covid-19 testing, when in fact it's ahead of almost everyone else.

Yes, the US is ahead of many nations in raw testing numbers, and in terms of tests per capita (although some do beast us in terms of per capita testing).

> Last I looked, this trick was being pulled off by comparing based on the number of tests per positive

Indeed, I mentioned this the last time you posted a similar statement. Here's the graph of test positivity rate for a number of nations: https://ourworldindata.org/grapher/covid-19-daily-tests-vs-d...

So why is test positivity rate important? Because test positivity measures how well you're controlling the outbreak. New Zealand doesn't need to test the entire nation regardless of symptoms. The fewer infected people there are in the population, the less value you get from testing random asymptomatic people. But, if all your tests are positive, it means that you aren't using any on asymptomatic people. You need to test asymptomatic people to prevent asymptomatic/community spread and as part of contact tracing. If you can't do those things, you'll end up with unquarantined infected people spreading the virus.

So as test positivity goes down, even as testing rate goes down, you can know that you have a smaller number of cases overall. (and that your reinfection rate is <1).

> Clearly it has absolutely nothing to do with how close a country is to being able to test a particular proportion of the population on a regular basis regardless of symptoms.

So while you're correct here, this isn't actually the goal if you can trace reasonably. Which, like, the US can't because too many people are infected. So insofar as controlling things are, the US's case numbers are, to use your words, "catastrophic", while many other nations' are not.

You aren't wrong. This article describes another trick:

https://www.conservativereview.com/news/horowitz-mass-testin...

The Harvard Global Health Institute was claiming the USA needed to do 500k tests per day to succeed at fighting COVID. The moment this was achieved they suddenly changed their recommendation to 1.6 million tests per day. Just weeks later they were recommending 3.5 to 5 million per day. CNN interviewed an administration official who stated that the numbers keep changing, and the presenter actually 'corrected' the guy by claiming Harvard's recommendations had been the same for months.

Their reasoning is the more cases there are, the more tests need to be done. With any non-zero FP rate increasing the number of tests increases the number of cases, so this is purely circular and yields a no-win situation in which no matter how much testing the USA does it can never be sufficient. You do have to wonder if setting up a no-win situation for the USG is intentional, especially as their recommendations appear to be arbitrary.

Why is there such a force of propoganda surrounding Corona trying to make everyone feel like things are worse than they are? I've noticed it too.

We shut down the entire world and it killed over 100,000 in the US alone in 3 months. There's no suspicious conspiracy surrounding Covid19, it really is a very infectious and capable of killing a lot more than it already has.

Except that we DIDN'T shut down the world. That was the whole damn problem in the US.

The Northeastern states actually shut down. They're now under 50 new cases per day per 1 million people. Their deaths are mostly flat (just slightly increasing) at this point. And I suspect a lot of that is now being imported.

The Southeastern states didn't do crap. They're mostly all above 200 new cases per day per million.

Then you have states like California that kinda/sorta shutdown. They're scattered about 100 new cases per day per million.

We could have stopped this. We could have been flat in number of deaths as of June 1 like most of the European countries.

But we didn't.

Instead, we're on the same trajectory as "shithole" (to borrow the MAGA terminology) countries like Brazil, India, and Mexico.

And, now states like Louisiana, Mississippi, and Arizona are on a trajectory to cross over states like Rhode Island, Connecticut and Massachusetts in terms of number of deaths per million.

And the economy is in a shambles anyway. So, lots of people died, and we got nothing for it.

It's interesting that the NE states seem to now be lauded when actually NJ, NY, MA and CT have the highest per-capita death rates [0] in the WORLD [1] by far despite significant lockdowns, comprehensive & early mask mandates and fairly conservative reopening (e.g. NYC).

Although New England seems to be doing well since earlier in the summer, we did NOT do well overall. For example, MA at #3 has had 8831 deaths for 6.9M people. The average age of the dead is 82, 65% of all deaths from long term care homes [2] -- this was a failure to protect the vulnerable.

As for NE cases being imported, we saw a small uptick on Cape Cod with vacationers (resulting in Baker's recent travel order) but the back-to-school has only found a few dozen positive cases over the last few weeks despite massive and ongoing testing [3].

I'm not sure your comment about "most of the European countries" is correct. France is seeing near-record cases [4] Spain has seen a very significant surge [5] resulting in a lockdown of the Barcelona area and Germany is also seeing a worrying uptick in cases [6].

[0] https://www.statista.com/statistics/1109011/coronavirus-covi...

[1] https://www.statista.com/statistics/1104709/coronavirus-deat...

[2] https://www.mass.gov/doc/covid-19-dashboard-september-1-2020...

[3] https://old.reddit.com/r/CoronavirusMa/comments/ig1n1x/curre...

[4] https://www.worldometers.info/coronavirus/country/france/

[5] https://www.worldometers.info/coronavirus/country/spain/

[6] https://www.worldometers.info/coronavirus/country/germany/

> It's interesting that the NE states seem to now be lauded when actually NJ, NY, MA and CT have the highest per-capita death rates [0] in the WORLD [1] by far despite significant lockdowns, comprehensive & early mask mandates and fairly conservative reopening (e.g. NYC).

Back-modeling what happened in those states showed that the biggest problem those areas had is that (in New York, for example) when they thought they had Case Number 1 on March 1 they already had Case Number 10,000.

Even as late as March 15th, people in the New York mayor and governor's offices were screaming at each other because the data wasn't matching up and cases were appearing with no traceable cause--ie. general populace circulation was occurring.

The problem was that those areas needed to be locking down as of March 1 but because of poor data didn't get locked down until about 3 weeks later. This wasn't unusual: things like SXSW were still playing chicken with everybody until Austin pulled the plug on them--that was only like March 6th or so. And that's not a lockdown, that's just stopping an international travel event.

The sad part is that several states are about to surpass those per capita death numbers for RI, MA, and CT. That's inexcusable at this point.

And I really hope that no other state gets close to NY or NJ numbers. Sadly, unless a couple of those states do something NOW, they're going to.

This is nonsense. You completely disregard that the entire world's medical community has become vastly better at treating infectious people. In the early days, when NE states, Spain, Italy, etc. were hit hard, people who had to go to the hospital died at alarming rates. Since then, we have learned that prone position, dexamethasone, supplemental (non-intubated) oxygen, convalescent plasma, etc. contribute to vastly lower death rates. Of course per capita death rates are high in the NE states. We had no effective treatments then.

Minor note on Europe - Several European countries relaxed border travel restrictions and internal restrictions on dining / socializing in June in time for traditional summer holidays in July / August. Current surges are likely to be a result of relaxing of previous lockdown rules. For an early discussion of this see [1]

[1] https://fortune.com/2020/08/15/europe-covid-cases-second-wav...

Complete worldwide infections are 25 million that are known.

There's around a 40-50% asymptomatic number so the total estimated infections so far are around 40 million.

Total deaths is around 800,000.

.02 death rate on average and it drops drastically the younger a person is.

Depending on your risk tolerance, to many people, that's not worth destroying life as we know it.

Especially because the death rate of heart disease and cancer is higher than this and has easily targeted reasons with mountains of scientific evidence that could reduce the death rates.

It just seems like propaganda and we're making a bigger deal out of it than necessary.

Cancer and heart disease are not contagious like Covid-19 is, why is this ridiculous equating done so often? It’s apples to oranges...

Also, some studies seem to suggest we’re actually undercounting the death rate [0]. Combine that with likely under reported data in Russia, China, and other countries, it’s clearly a significant threat.

I think it’s kind of crazy to say preventing potentially 10s of millions of people from dying is not a big deal and propaganda. Seems like searching for a grand narrative in something that’s rather pretty cut and dry.

1. Death is not the only health problem caused by COVID-19. Patients who survive are also coming out with persistent lung damage and respiratory problems. Nobody knows the very long term (more than a year) health effects either.

2. “Destroying life as we know it” is a pretty dramatic way of saying “Stay home, wear a mask when you have to go out, and wait until things are better to get your nails done.” Plus, lots of people are not even doing that! They’re out horsing around anyway, putting more people at risk and further extending the crisis.

The math based on your figured is .02 as in 2%, not 0.02%, and that would indeed be pretty bad but there's a dramatic amount of undercounting of the survivors so your numbers are a bit pointless. (Also if to be fair we're lacking a lot of deaths particular in Russia, China, Iran etc.)

Comparing death rates doesn't mean much if the number infected for covid is orders of magnitude higher. Even if it turns out to be about .02%, we are looking at a death toll like the world has never seen if everyone gets infected. And that's not taking into account hospitals becoming overwhelmed and causing deaths to skyrocket.

It's the third leading cause of death behind heart disease and cancer.

And no one has ever shut down a fast food restaurant to prevent the propagation of heart disease.

It's bad but it's being severely over exaggerated.

Nice job repeating snappy talking points but this comparison is malicious, unfounded and indicates a bad faith argument.

You're personally attacking someone for making a genuine argument, as is clear from both its content and that person's messages elsewhere in this thread.

You may not like the comparison but to call it "malicious" is not OK. Play the ball, not the man.

Just doesn't make sense to me that we dont ban cigarettes, we don't ban fast food restaurants... Yet we shut down the entire economy and all of human life as we know it for something with less of the death rate than both of those illnesses.

And there's mountains of scientific evidence supporting those directly lead to their respective ailments.

How many of those factors spread on accident vs personal choice? ~300,000,00 in the US ~2% death rate .. 6,000,000? Is that enough bodies?

Where are you getting a 2% death rate or expectancy that 100% of the population will be infected?

The numbers I've seen are 0.66% death rate, with an average remaining life expectancy of about 10 years among those who die, and estimates that between 15% and 70% of the population would be infected.

70% of 0.66% of 328M is 1.5M deaths, or 15M years of life lost. That is indeed a big number.

Smoking has been estimated to reduce life expectancy by 13 years for heavy smokers. There are about 34M smokers in the US. I don't have the exact stats on number of heavy smokers and how long people smoke for, but assume that the average smoker smokes for 20 years and loses 5 years of life expectancy over that time. That's about 850,000 years of life lost _every single year_ to smoking alone.

I think the question of "would it be worth 5% of the current COVID-19 measures to stop smoking entirely for 1 year" is a valid one.

It would be if smoking was an infectious disease.

This activity smoking causes a disease.

Leaving quarantine causes a disease.

It's personal choice to do either activity and corona is the only disease where it's somehow the rest of the worlds responsibility for people making poor choices.

It's personal choice to leave quarantine but for some reason corona is the only disease where it's somehow the rest of the worlds responsibility for people making poor choices.

You act like there's an alternative. The only way out is through, it's all just delaying otherwise.

Because there's an election in just over two months. And if the US blew handling Covid, that reflects badly on the president. So you have insane levels of propaganda (from both sides, plus foreign meddling), trying to influence how you see Trump's performance as a leader.

Or it could be because US has 4% of the world population but 25% of the coronavirus cases? With supposedly the best brain trust and the biggest economy of the world, we were maybe expected to do better but landed up performing worse than other developed nations that have at least used this time to establish the infrastructure to conduct limited local openings or closings as needed? Maybe we really blew handling covid because of excessive political interference and amplification of fringe conspiracy theories?

Yeah, that's one of the other standard lines being pushed by the press to convince everyone that the US is uniquely failing. It's a very effective talking point. The trouble is, it makes no sense to compare those two numbers because most of the world's population is in places that don't have widespread access to medical care or coronavirus testing, and we know that there have been major outbreaks in pretty much all of those areas. (For instance, antibody testing on a sample of residents suggests about half the population of Mumbai's main slums had caught Covid-19 as of a couple of months or so ago. That's quite a lot of people which really weren't captured by the official case count - and there have also been outbreaks throughout India, including more recently in rural areas, in Africa, South America, Mexico...)

The other problem is that even within Europe, the really major outbreaks happened in countries which also didn't have widespread coronavirus testing at the time. For the most part they were usually only testing people who ended up being hospitalized. So the total death counts are probably reasonably accurate, but case counts are basically meaningless even for those outbreaks. (Which causes some problems when comparing the current, somewhat alarming case counts in many European countries with the initial wave.)

I'm not going to defend US policy in terms of COVID handling, but comparing positive test numbers in the US to positive test numbers in the rest of the world mostly tells you about testing rates.

The US has 22% of the total (verified) global COVID-19 deaths. Most deaths occur in those aged 65 or above. 9% of the global population (702M people) is over 65. 17% of the US population (56M people) is over 65.

So the US has 8% of the population over 65 but 22% of the COVID deaths - it's still almost a factor of 3, so definitely not just reporting artifacts, but it's not a factor of 6+ either in terms of how the US is doing vs how you would expect.

That could be true. But it doesn't answer why there is such a force of propaganda surrounding Covid. If what you said is true, it should be plainly reported and clearly understood (fringe conspiracy theories aside). Instead, we've got this blizzard of people trying to make it very hard to see anything objectively. Why? (Which, restated, is nickthemagicman's question.)

I've noticed it especially on small Reddit communities for cities where constant narrative shifting has occurred: from flattening the curve and potential high death rates to we don't know the side effects of the virus and potential future complications.

> we don't know the side effects of the virus and potential future complications

It’s fun to see the rhetorical positions nowadays: pick an argument that doesn’t require evidence and can’t be disproved. You’re always right!

It’s also a wet dream for people with anxiety and hypochondria - say the side effects are a complete wildcard and people assume the worst case scenario.