obvert
Posts: 14050
Joined: 1/17/2011 From: PDX (and now) London, UK Status: offline
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quote:
ORIGINAL: Chickenboy quote:
ORIGINAL: obvert quote:
ORIGINAL: Cap Mandrake Chickenboy is right. There are numerous obstacles to testing. When the CDC relinquished exclusive testing in the US and the private and university labs started to step up we set up expensive tents and outdoor heaters and paid a bunch of staff to gown up in face masks, and N-95 masks to collect the specimens...and then we ran out of viral transport media...and then when, after all effort we finally got the specimens to Quest it took 6-7 days to get a result...and then we had only 10% positive after selecting for the sickest appearing patients. And yet, more tests are what will get the country open again according to this. https://www.nytimes.com/interactive/2020/04/17/us/coronavirus-testing-states.html?action=click&module=Spotlight&pgtype=Homepage As some governors consider easing social distancing restrictions, new estimates by researchers at Harvard University suggest that the United States cannot safely reopen unless it conducts more than three times the number of coronavirus tests it is currently administering over the next month. An average of 146,000 people per day have been tested for the coronavirus nationally so far this month, according to the COVID Tracking Project, which on Friday reported 3.6 million total tests across the country. To reopen the United States by mid-May, the number of daily tests performed between now and then should be 500,000 to 700,000, according to the Harvard estimates. That level of testing is necessary to identify the majority of people who are infected and isolate them from people who are healthy, according to the researchers. About 20 percent of those tested so far were positive for the virus, a rate that the researchers say is too high. “If you have a very high positive rate, it means that there are probably a good number of people out there who have the disease who you haven’t tested,” said Ashish Jha, the director of the Harvard Global Health Institute. “You want to drive the positive rate down, because the fundamental element of keeping our economy open is making sure you’re identifying as many infected people as possible and isolating them.” The authors are advocating additional testing that may be necessary to identify positive people that are sick and their contacts. This is reasonable, based upon the testing rubric that most states have-the 'flow chart' testing process I provided as an example. This is not a call to random test the populace to identify asymptomatics. There are some states above 20% attack rate: New York, New Jersey, Massachusetts, Pennsylvania, Georgia, Illinois, Connecticut and Michigan. Louisiana is below that threshold of late. New York's and New Jersey's big numbers skew the national averages because of their outsized impact (~40% and nearly 50%(!) ARs respectively). The other states have known niduses of infection in cities that are well known. Governors of these states will probably have to take this into account and these states may have to remain under additional scrutiny until their attack rate drops. New York's numbers are improving and the attack rate is off by some 10% from its highs a couple weeks ago. Some states at or near this 20% rate may need to step up their game a bit in terms of testing numbers. Georgia's tests / M looks a little meager compared to the others with an attack rate circa 20%. But for the other big population states: California, Texas and Florida that are well below this 20% attack rate threshold, the governors should have some freedom to begin opening up the economies and getting people back to work. The granularity of this is important and I don't think the national averages have much bearing on state by state reopenings. The exceptions above (the few states >20%) may have to 'test out' of mitigation strategies. But the other 42 states can reasonably start getting things moving again. This article states that most states needs to improve testing in order to consider opening up. The 20% attack threshold is not a reasonable rate to begin opening. The WHO is advocating a 10% threshold. Also, many states which fall closer or even under this threshold are also those doing relatively little testing. The diagram in the article shows how far each state needs to go to reach the 152/100,000 residents each day. The diagram actually shows that EVERY state has a ways to go.
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"Success is the ability to go from one failure to another with no loss of enthusiasm." - Winston Churchill
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