We can solve the coronavirus-test mess now if we want to | Hacker News Reader

We can solve the coronavirus-test mess now if we want to

newyorker.com

15 pointswintercarver17 comments

https://news.ycombinator.com/item?id=24359988 has

Everything about Paul Romer's plan (https://roadmap.paulromer.net/) makes sense and seems uncontroversial except Step 5: Let everybody get tested and if you get a negative result, you don't have to wear a mask. This permission not to wear a mask is also mentioned in the New Yorker article.

But I don't see any justification given for the no-mask part. I can see how it would be an incentive, but I'm not sure it wouldn't just erode the norm of wearing masks until everyone felt they could get away without wearing one.

A sobering and depressing read. What’s even more depressing is we’ll probably stumble through this, get past it (hopefully), and nothing significant will change before the next pandemic, which might be dramatically worse.

What should change?

The article presents the case much better than I could summarize, but effectively we need dramatically better coordination between government, public health organizations, and healthcare, and that coordination should be established before a crisis hits.

and not systematically de-funded right before the next crisis, unlike this time.

I wanted to avoid the political aspects, but yes.

reclaiming the term a little to be closer to the broader "pertaining to public affairs", it's hard to see how public health could be anything but.

I hope for, and am prepared to pivot my career in support of, a resurgence of public health work opportunities. (which atul gawande points out in an earlier column from april or so)

Some of the leading vaccines present their own logistical challenges. Some of the leading vaccines (Moderna, Pfizer) are quite fragile and are hard to transport and store. Moderna needs to be shipped and stored at -20C (-4F) this is tricky but not that hard, since it is in the range of commercial freezers. The Pfizer vaccine needs to be shipped and stored at -70C (-94F) which is outside the range of ordinary freezers (bio labs have them but doctors labs do not). Pfizer can be packed in dry ice to ship, but the ice needs to be replenished every 24 hours. https://twitter.com/LizSzabo/status/1298646754884300800

How does that compare to, say, flu vaccines? If these are hitherto unsolved problems at scale I’d be worried that a rush to deploy them will lead to no small number of failed vaccinations.

Flu vaccines are stable in household refrigerators. At the hospital I worked at, we stored roughly 10,000 doses in a 38°F fridge that wasn’t even on a dedicated backup. The benefits of decades of research...

*Edited to show F instead of a unitless 38º

38 degrees is the opposite of refridgeration, crazy!

Fahrenheit, which is ~3 degrees Celsius.

That's probably 38 degrees Fahrenheit (~3 degrees Celsius).

This seems like a well-researched article.

But I've read an article or two from the New Yorker before in my area of expertise-- music-- where I noticed logical flaws and spurious arguments. According to the well-known Gell-Mann Amnesia effect-- an effect which gets posted on HN like clockwork on any story wrt journalism (which I proudly continue here)-- I should therefore reject this article out of hand.

People who incessantly paste links to the Gell-Mann Amnesia effect-- am I generously interpretating the Gell-Mann Amnesia effect here? If not, what am I missing?

The strange thing about all this is that my experience has been completely opposite of how this is described. Fast, easy testing was available right away. The labs seem to have had this working perfectly from the beginning of the pandemic. Since April (with initial limited availability), anyone has been able to request a test from LabCorp on their website. They bill directly to insurance, send everything overnight with simple instructions and return packaging, and email results within a day of receiving it. The cost without insurance is just over $100, and governments were quick to offer coverage for the uninsured.

I'm not sure what their capacity has been, and this article states that they anticipate a lack of capacity going into flu season, but I didn't encounter any barriers, and it was the most seamless and polished experience I've had with any medical system. It made me wish I could always deal with labs directly instead of having to go through a hospital.

So it seems that everything was done very well, very quickly, but many problems occurred on on the layer of coordination at local testing sites which can more easily serve many people. It's strange that a seemingly inefficient system like direct mailing would be so efficient while something that would seem to be much easier like a central testing location would have so many difficulties.

So we already have the capacity to connect people with labs directly, but if everyone did it, it might overwhelm their capacity. I tend to agree with the sentiment in the article that we need to address this disconnection and work on removing layers of indirection between labs and people. I'm not sure what the best method of doing that would be, but the labs seem to have already figured out most of the logistics on their own, and they just need the resources to scale up.

It has always been true that "we" can solve any problem we put our minds towards.

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