There are 38 comments.

1. Member
   Kozak

   @Kozak

   

   8:02 AM EST ⋅ Mar 7, 2020

   Rodin: So what does this all mean? When you are presented with a public health crisis the question is who do you test? People who are asymptomatic do not normally present themselves to a doctor for any testing. But it is important to test asymptomatic people in order to anticipate and control disease progress if you are dealing with an unknown illness of unknown virulence and consequence. Testing only symptomatic people is helpful in developing a treatment plan for that individual and documenting the history of the disease, but it doesn’t stop the spread of the disease. If you have a disease specific test that is accurate, easy to produce, easy to distribute, and easy to administer, the problem is simple. Just start rounding people up and test them. But is there such a thing for COVID-19, or is it a unicorn?

   Here’s what should have happened.

   We should have started with aggressive testing of all returning from China.  Followed by testing in China towns around the US.  Cities with large Asian populations.  Cities with direct air links to China.  Cities with lots of Chinese tourists.  Then expanded those to South Korea, Italy and Iran.  When positives showed up testing of family, contacts etc.  Testing of anyone symptomatic in surrounding areas. 

   Testing of a number of asymptomatic people in areas with a known outbreaks.  Finally random surveillance testing in other areas.

   Last I saw we have tested under 2000 people total in the US.  It’s been a complete shambles.  And I’m afraid there is going to be hell to pay for this screw up.

2. Member
   Rodin

   @Rodin

   Post author

   8:20 AM EST ⋅ Mar 7, 2020

   Kozak (View Comment):

   Rodin: So what does this all mean? When you are presented with a public health crisis the question is who do you test? People who are asymptomatic do not normally present themselves to a doctor for any testing. But it is important to test asymptomatic people in order to anticipate and control disease progress if you are dealing with an unknown illness of unknown virulence and consequence. Testing only symptomatic people is helpful in developing a treatment plan for that individual and documenting the history of the disease, but it doesn’t stop the spread of the disease. If you have a disease specific test that is accurate, easy to produce, easy to distribute, and easy to administer, the problem is simple. Just start rounding people up and test them. But is there such a thing for COVID-19, or is it a unicorn?

   Here’s what should have happened.

   We should have started with aggressive testing of all returning from China. Followed by testing in China towns around the US. Cities with large Asian populations. Cities with direct air links to China. Cities with lots of Chinese tourists. Then expanded those to South Korea, Italy and Iran. When positives showed up testing of family, contacts etc. Testing of anyone symptomatic in surrounding areas.

   Testing of a number of asymptomatic people in areas with a known outbreaks. Finally random surveillance testing in other areas.

   Last I saw we have tested under 2000 people total in the US. It’s been a complete shambles. And I’m afraid there is going to be hell to pay for this screw up.

   I don’t disagree, but the question for me remains: what test? I have read references to a “swab test” which I presume is collecting mucus or saliva from the nose or mouth. Presumably those swabs are sent somewhere for microscopic analysis by someone to detect the presence — in the sample — of the specific virus. I don’t know what the testing/results time cycle for that is and what people are supposed to do while awaiting results. I also don’t know the level of false negatives. 

3. Coolidge
   Roderic

   @rhfabian

   8:28 AM EST ⋅ Mar 7, 2020

   On the average in the US there are 16% more people infected each day.

   In Houston the VA hospital will start screening people who enter.   Staff who are not veterans who fail screening will be turned away and told to seek care and advice about being quarantined.  Veterans are sent to the ED if they fail screening.  There are now 8 cases in the Houston area, mostly travel related.  One is a staff member of Rice University.  They are in the process of tracking down all this person’s contacts and have sterilized the building where he or she works.

4. Member
   MarciN

   @MarciN

   9:19 AM EST ⋅ Mar 7, 2020

   Kozak (View Comment):

   Here’s what should have happened.

   We should have started with aggressive testing of all returning from China. Followed by testing in China towns around the US. Cities with large Asian populations. Cities with direct air links to China. Cities with lots of Chinese tourists. Then expanded those to South Korea, Italy and Iran. When positives showed up testing of family, contacts etc. Testing of anyone symptomatic in surrounding areas.

   Testing of a number of asymptomatic people in areas with a known outbreaks. Finally random surveillance testing in other areas.

   Your strategy is pretty much what this CEO did successfully in Germany that I wrote about yesterday from yesterday’s WSJ, “The Company That Fought the Coronavirus and Won“:

   STOCKDORF, Germany—The chief executive of a little-known local auto supplier had received an alarming email: One of his employees—who had just visited the company’s headquarters, shaking hands with management, including him—had tested positive for the novel coronavirus.

   This was how Europe’s first major Covid-19 outbreak started, but more impressive was how it ended. In slightly more than a month, the outbreak was successfully contained, and all 16 infected are now free of the pathogen.

   Company executives and health officials used detective work, rapid testing and isolation to limit the spread. The quick response is an example of how to contain a virus that remains little understood and has killed about 3,200 people world-wide, some 3% of all those known to be infected.

   “Managing a health crisis like this is something completely different than an economic crisis,” said Holger Engelmann, CEO of the company, Webasto SE, which makes sunroofs, electric-car chargers and air-conditioning systems. “It’s personal.”

   Before Mr. Engelmann opened that email Jan. 27, the virus seemed far away. “Then, all of a sudden, the virus was so close,” he told The Wall Street Journal.

   A Chinese employee had visited the company’s headquarters in the sleepy town of Stockdorf, near Munich, to attend a training seminar. She didn’t exhibit any symptoms in Germany as she met different co-workers, including Mr. Engelmann, who shook her hand. . . .

   The employee told the radio station that he went straight to the doctor and tested positive for the virus later that day.

   “At that point, we knew that something was about to hit us,” Mr. Engelmann said. He summoned a conference call and set up a crisis committee that Monday.

   [continued in comment 5]

5. Member
   MarciN

   @MarciN

   9:20 AM EST ⋅ Mar 7, 2020

   [continued from comment 4]

   The group included 17 active members and a shadow committee of the same size—the B-team in case executives on the front line fell ill. He also requested that Bavaria’s Infectious Diseases Task Force, a team of doctors and virologists, come to Stockdorf the next day and test the committee members.

   When the crisis committee reported to work Tuesday, they were met by Dr. Martin Hoch, leader of Bavaria’s disease task force, and three of his team, dressed in protective clothing and wearing face masks.

   They took DNA swabs from the executives and began the arduous detective task of identifying everyone who had had contact with the Chinese woman or any of the Stockdorf employees who had contracted the virus.

   The committee members all tested negative. . . .

   Around 1,500 employees at the Stockdorf headquarters were ordered to work from home that Tuesday. By the end of the day, three more Stockdorf employees, who had attended the training with the Chinese associate, tested positive.

   By then, little-known Webasto had become front-page news in and beyond Germany. Company officials decided to extend the home-office mandate for a week through Feb. 2.

   Initially, Bavarian health officials didn’t think it was necessary to shut down Webasto’s offices, but Mr. Engelmann ordered the closure to protect employees against the virus—an account confirmed by Bavarian officials.

   “The decision of the Webasto management to shut down and keep people home was a decisive factor in containing the spread of the virus,” Dr. Hoch said. “That allowed us to isolate those who had contact very early. We identified about 230 people.”

   Anyone who tested positive was treated at a hospital in Munich, even if their symptoms were mild.

   “It was clearly our policy to treat each case in hospital,” so as to keep a close check on the development of the unfamiliar disease, said Dr. Andreas Zapf, director of the Bavarian State Agency for Health and Food Security.

   On Feb. 3, the day Webasto had hoped to reopen its offices, Mr. Engelmann extended the shutdown for most of the 1,500 employees for another nine days. By now, seven Webasto employees had tested positive and around 122 examined in the previous week tested negative. All of the infections led back to the training seminar in January. The company extended the shutdown another week, keeping the office closed for a total of 14 days, the virus incubation period. . . .

   Next door, at Webasto, lights are burning in the offices again. This week, the company reported that the last employee had left the hospital, virus-free.

   [continued to comment 6]

6. Member
   MarciN

   @MarciN

   9:21 AM EST ⋅ Mar 7, 2020

   [continued from comment 5]

   The virus has since spread across Europe—and returned to Bavaria—from a separate outbreak in Italy, whose origin remains obscure. Still, Mr. Engelmann and his associates, in conjunction with the local health officials, managed to stop the Webasto outbreak within the company before it could infect the community.

   By Feb. 14, the number of infections had peaked at 16, including nine Webasto employees in Germany, five of their relatives, and two company employees in China. A month after the first infection was discovered, the staff at Mr. Zapf’s agency are still studying the Webasto case to better understand which coronavirus patients can be kept at home and who should be treated in a hospital in the future.

   “We are trying to slow this thing down considerably,” said Dr. Zapf. “We want to slow it down and buy ourselves time to develop a vaccine.”

   Obviously there have to be accurate tests to make this strategy work.

   And strong executive leadership of a defined population unit–an island like Nantucket, a town, or company.

   I don’t understand why the CEO has the test we need and we don’t. It’s not like we are in Day 47 of this epidemic or something. Oh, wait . . . we are!

7. Coolidge
   EHerring

   @EHerring

   9:43 AM EST ⋅ Mar 7, 2020

   

   It is obvious the “test kits” are a Dem excuse to attack Trump on social media. I am not arguing their usefulness to doctors, but the reality they can’t stop the spread of a virus. Otherwise, flu would be contained since we test sick people in flu season. You would have to test 330,000,000 citizens plus immigrants weekly, symptomatic or not, to get the big picture. The screen shots I posted show the high volume of air and shipping traffic. The last two show just two cruise ship ports, on one day, each ship can carry 1800 to 5000 passengers plus crew. On Sunday, the scene will be repeated with a different batch of ships. Italy doesn’t have as many confirmed cases as there are passengers on the Allure of the Seas (and sister ships of that class). If people come in with sore throat and cough, the medical treatment will be the same unless it progresses into respiratory difficulty as the flu does. Tell all sick to stay home. Chasing down all who were in contact is time consuming. If they were infected, they probably have infected others who they can’t identify anyway. I expect this to spread just like the flu, some to die while most will recover, just like the flu, and labs will eventually figure out a vaccine to lesson the impact.   Dems will try to unfairly tarnish Trump while still fighting for open borders. Florida Dems will attack Matt Gaetz over masks while not wanting to close off ports, overseas travel, and amusement parks there for fear their economy will suffer.  Hysteria will run its course and summer will be normal.

8. Member
   Rodin

   @Rodin

   Post author

   9:53 AM EST ⋅ Mar 7, 2020

   MarciN (View Comment):

   Obviously there have to be accurate tests to make this strategy work.

   And strong executive leadership of a defined population unit–an island like Nantucket, a town, or company.

   I don’t understand why the CEO has the test we need and we don’t. It’s not like we are in Day 47 of this epidemic. :-)

   A couple of comments: (1) The CEO did a great (and commendable) job of containing one specific outbreak within a clearly defined population, and (2) people, including his employees, may get sick anyway from the propagation of the virus in Germany through other vectors over which the CEO has no control. 

   And regarding testing: I have been trying to understand what “testing” means in the various reports and accounts. The current gold standard test (CDC 2019-Novel Coronavirus (2019-nCoV) Real Time RT-PCR Diagnostic Panel) is described at https://www.fda.gov/media/134922/download.

   “PCR” stands for “Polymerase chain reaction (PCR) is a method widely used in molecular biology to rapidly make millions to billions of copies of a specific DNA sample allowing scientists to take a very small sample of DNA and amplify it to a large enough amount to study in detail.”

   I encourage you to skim through the link. This ain’t no “pee on the stick” pregnancy test. Here are some quotes from the link:

   

   

   

    

9. Member
   Rodin

   @Rodin

   Post author

   10:01 AM EST ⋅ Mar 7, 2020

   EHerring (View Comment):
   I expect this to spread just like the flu, some to die while most will recover, just like the flu, and labs will eventually figure out a vaccine to lesson the impact. Dems will try to unfairly tarnish Trump while still fighting for open borders.

   Just so, @eherring. Job #1 is to protect the health care system while dealing with the most acute cases. We have to expect some economic difficulties, but we must not make it worse through panic. Our free market system is better positioned than most to handle the shock although we have to work to get back some domestic capabilities that we off-shored. Government will hopefully not be stampeded into making things worse. (Compare Coolidge vs. Hoover-Roosevelt responses to economic shock.)

   Keep Calm and Carry On.

    

10. Member
    MarciN

    @MarciN

    10:10 AM EST ⋅ Mar 7, 2020

    Rodin (View Comment):

    And regarding testing: I have been trying to understand what “testing” means in the various reports and accounts. The current gold standard test (CDC 2019-Novel Coronavirus (2019-nCoV) Real Time RT-PCR Diagnostic Panel) is described at https://www.fda.gov/media/134922/download.

    “PCR” stands for “Polymerase chain reaction (PCR) is a method widely used in molecular biology to rapidly make millions to billions of copies of a specific DNA sample allowing scientists to take a very small sample of DNA and amplify it to a large enough amount to study in detail.”

    I encourage you to skim through the link. This ain’t no “pee on the stick” pregnancy test. Here are some quotes from the link:

    I love this part under limitations: “This test cannot rule out diseases caused by other bacterial or viral pathogens.”

    Okay. So there is presently no definitive test for hospitals to work with.

    I remember when my kids were tested for strep throat. There were instant A tests that could be done in the doctor’s office and three-day B tests that went off to a lab. If the A test came back positive, the doctor put the kids on antibiotics and told them to stay home. Strep would have infected entire schools without those tests to identify the kids who had it and keep them home from school. Similarly, we have to have reliable metrics to combat the new infection.

    So I will add “accurate tests” to my prayer lists for “treatments” and ” vaccines.” :-)

    I also think we need new antibiotics. I’m betting that some of the deaths we are seeing are the result of treatable secondary infections. I understand the C-diff risks, so I understand why the doctors are hesitant to do this on a massive scale–not to mention the fact that our antibiotics come from China mostly. Using the antibiotics we now have would lead to the evolution of superbugs, use up whatever supplies we may still have on hand, and we would be simply exchanging one set of problems for another. But we need an aggressive antibiotic development program.

    A friend of my husband used to work for Merck. He traveled all over the world. He told us one night that his job when he wasn’t working in his sales function was to scoop up soil samples everywhere in the world he went to give them to the antibiotic development department. :-) He said antibiotics occur naturally in the environment. We just have to find them.

11. Member
    MarciN

    @MarciN

    11:02 AM EST ⋅ Mar 7, 2020
12. 🚫 Banned
    Valiuth

    @Valiuth

    11:02 AM EST ⋅ Mar 7, 2020

    I’d be curious to know what exactly these testing kits are and why they’ve been such a problem to implement and get out there. I work with plenty of virologists, and they all seem to be of the opinion that making a test for at least Corona Viruses in general (if not COVI-19 specifically) shouldn’t be that big an issue. IF the test is some sort of PCR reaction (and it sounds like it is) all you really need is a good set of primers. You don’t even have to make them just release the sequence and have hospitals order the primers from various private companies that supply them to labs. There are off the shelf kits that will extract DNA from samples, and once you have that there are literally hundreds of different PCR kits out there off the shelf that will work with any set of primers. 

    My gut tells me the CDC was over thinking this whole thing from a technical perspective, probably because this is how Government does its thing in general.  

13. Member
    Kozak

    @Kozak

    

    11:33 AM EST ⋅ Mar 7, 2020

    Rodin (View Comment):
    I don’t disagree, but the question for me remains: what test? I have read references to a “swab test” which I presume is collecting mucus or saliva from the nose or mouth.

    So most of the testing is to get nasal mucus  like a flu swab  or sputum, and it’s a PCR test for viral RNA.  

14. Member
    MarciN

    @MarciN

    11:37 AM EST ⋅ Mar 7, 2020
15. Member
    Kozak

    @Kozak

    

    11:39 AM EST ⋅ Mar 7, 2020

    EHerring (View Comment):
    It is obvious the “test kits” are a Dem excuse to attack Trump on social media. I am not arguing their usefulness to doctors, but the reality they can’t stop the spread of a virus. Otherwise, flu would be contained since we test sick people in flu season.

    Of course they would help.  You have 2 ways to stop an epidemic.  A vaccine , or social distancing, quarantine and contact tracing.  It’s worked well in those countries that used it aggressively, particularly Singapore and it’s helped in South Korea to slow the growth.  And slowing the growth is key if you want to keep the medical system from being overwhelmed. 

    We don’t do that for the flu because we know it’s not worth the effort.  Very few people need to be hospitalized for the flu, and less then 0.1% of people die from the flu every year.  Cost > Benefit.

16. Coolidge
    DonG (skeptic)

    @DonG

    1:30 PM EST ⋅ Mar 7, 2020

    Rodin: 1 in Ontario: a person who traveled to Las Vegas for an international conference [source]

    OK.  This got my attention.  I was in Vegas last year for March Madness.  It was packed with lots of people from all over (most folks were wearing a school shirt)–crowded around tables and TVs for a 3 hour game all shouting and high fiving.  Many people just circulating and waiting in line for restaurants and buffets and shows.  It seems like a place tailor made to share and widely distribute a contagion. 

17. Coolidge
    ctlaw

    @ctlaw

    1:50 PM EST ⋅ Mar 7, 2020

    DonG (skeptic) (View Comment):

    Rodin: 1 in Ontario: a person who traveled to Las Vegas for an international conference [source]

    OK. This got my attention. I was in Vegas last year for March Madness. It was packed with lots of people from all over (most folks were wearing a school shirt)–crowded around tables and TVs for a 3 hour game all shouting and high fiving. Many people just circulating and waiting in line for restaurants and buffets and shows. It seems like a place tailor made to share and widely distribute a contagion.

    The source said nothing of the conference.

18. Coolidge
    Gumby Mark (R-Meth Lab of Demo…

    @GumbyMark

    3:44 PM EST ⋅ Mar 7, 2020

    CDC just advised everyone over 60 to stay at home as much as possible.

    EDIT: This is not exactly correct.  CDC issued guidance on Thursday suggesting older adults in communities where an outbreak is occurring should stay at home as much as possible.  Shame on me for relying on CNN summary!  Of course, most metro areas at this point have an outbreak.  Just had our first community case in Phoenix yesterday.

19. Member
    Rodin

    @Rodin

    Post author

    5:30 PM EST ⋅ Mar 7, 2020

    Gumby Mark (R-Meth Lab of Demo… (View Comment):

    CDC just advised everyone over 60 to stay at home as much as possible.

    EDIT: This is not exactly correct. CDC issued guidance on Thursday suggesting older adults in communities where an outbreak is occurring should stay at home as much as possible. Shame on me for relying on CNN summary! Of course, most metro areas at this point have an outbreak. Just had our first community case in Phoenix yesterday.

    And I think it is important to also emphasize a point Dr Fauci made in the press conference with Vice President Pence: a lot of older people have “underlying health issues”, but not all health issues represent a risk for COVID-19. For example, controlled hypertension does not make you more at risk with COVID-19, while COPD would. The focus is on lung, heart and kidney disease, not arthritis or cataracts.

20. Member
    MarciN

    @MarciN

    6:28 PM EST ⋅ Mar 7, 2020

    Gumby Mark (R-Meth Lab of Demo… (View Comment):

    CDC just advised everyone over 60 to stay at home as much as possible.

    EDIT: This is not exactly correct. CDC issued guidance on Thursday suggesting older adults in communities where an outbreak is occurring should stay at home as much as possible. Shame on me for relying on CNN summary! Of course, most metro areas at this point have an outbreak. Just had our first community case in Phoenix yesterday.

    What the CDC is suggesting is very reasonable advice. I like it. :-)

21. Coolidge
    Gumby Mark (R-Meth Lab of Demo…

    @GumbyMark

    6:39 PM EST ⋅ Mar 7, 2020

    Rodin (View Comment):

    Gumby Mark (R-Meth Lab of Demo… (View Comment):

    CDC just advised everyone over 60 to stay at home as much as possible.

    EDIT: This is not exactly correct. CDC issued guidance on Thursday suggesting older adults in communities where an outbreak is occurring should stay at home as much as possible. Shame on me for relying on CNN summary! Of course, most metro areas at this point have an outbreak. Just had our first community case in Phoenix yesterday.

    And I think it is important to also emphasize a point Dr Fauci made in the press conference with Vice President Pence: a lot of older people have “underlying health issues”, but not all health issues represent a risk for COVID-19. For example, controlled hypertension does not make you more at risk with COVID-19, while COPD would. The focus is on lung, heart and kidney disease, not arthritis or cataracts.

    The specific language on the CDC website refers to “Older adults and people who have severe chronic medical conditions”.

22. Coolidge
    DonG (skeptic)

    @DonG

    7:08 PM EST ⋅ Mar 7, 2020

    Valiuth (View Comment):
    My gut tells me the CDC was over thinking this whole thing from a technical perspective, probably because this is how Government does its thing in general.

    I watched a little bit of the Trump press conference from CDC on Friday.  Lots of questions about testing.  One guy said the first test was developed rapidly after sequencing.  Probably as fast as WHO or Europe countries.  The problem was getting samples shipped to CDC.  So they sent the test kits to regional labs, but regional labs were not getting good results.  They figured out it was too unreliable to test for 3 criteria and switch to 2 criteria, which the regional labs had better quality.  Makes sense to me.  It feels like the media are expecting the government to detect all and prevent all infections, which is probably good for ratings and a handy stick for Trump bashing.  The real goal and it will be a challenge, is to use social distancing to keep the number of infected people from overwhelming the healthcare system in any city.

     

23. Member
    Kozak

    @Kozak

    

    4:35 AM EDT ⋅ Mar 8, 2020

    DonG (skeptic) (View Comment):

    Valiuth (View Comment):
    My gut tells me the CDC was over thinking this whole thing from a technical perspective, probably because this is how Government does its thing in general.

    I watched a little bit of the Trump press conference from CDC on Friday. Lots of questions about testing. One guy said the first test was developed rapidly after sequencing. Probably as fast as WHO or Europe countries. The problem was getting samples shipped to CDC. So they sent the test kits to regional labs, but regional labs were not getting good results. They figured out it was too unreliable to test for 3 criteria and switch to 2 criteria, which the regional labs had better quality. Makes sense to me. It feels like the media are expecting the government to detect all and prevent all infections, which is probably good for ratings and a handy stick for Trump bashing. The real goal and it will be a challenge, is to use social distancing to keep the number of infected people from overwhelming the healthcare system in any city.

     

    I think the problem was the CDC stepped in and took complete control, and stopped any universities or health departments from developing their own tests.  They then in classic Big Government fashion proceeded to bungle and fail spectacularly.  One article I read yesterday stated a reason for the failure of the CDC test was they trie to construct a “cadillac” test that also tested for MERS and SARS as well the current virus.  It was too complex and proved unreliable.  In the meantime we lost at least a month of testing.  To put that in perspective Italy, 14 days ago had 20 cases.  Look where they are today.

24. Coolidge
    Gumby Mark (R-Meth Lab of Demo…

    @GumbyMark

    8:13 AM EDT ⋅ Mar 8, 2020

    DonG (skeptic) (View Comment):

    Valiuth (View Comment):
    My gut tells me the CDC was over thinking this whole thing from a technical perspective, probably because this is how Government does its thing in general.

    I watched a little bit of the Trump press conference from CDC on Friday. Lots of questions about testing. One guy said the first test was developed rapidly after sequencing. Probably as fast as WHO or Europe countries. The problem was getting samples shipped to CDC. So they sent the test kits to regional labs, but regional labs were not getting good results. They figured out it was too unreliable to test for 3 criteria and switch to 2 criteria, which the regional labs had better quality. Makes sense to me. It feels like the media are expecting the government to detect all and prevent all infections, which is probably good for ratings and a handy stick for Trump bashing. The real goal and it will be a challenge, is to use social distancing to keep the number of infected people from overwhelming the healthcare system in any city.

    I think the President could set an example here by cancelling his rallies for the next two months and urging other politicians to do the same.  This would trigger additional actions by others to cancel large meetings and events.  Covid is going to spread but the degree and speed with which it does is important in its ultimate impact.  We now have enough examples to show that measures taken early on can be effective but if you wait too long much less so. 

25. Coolidge
    ctlaw

    @ctlaw

    8:44 AM EDT ⋅ Mar 8, 2020

    Gumby Mark (R-Meth Lab of Demo… (View Comment):

    DonG (skeptic) (View Comment):

    Valiuth (View Comment):
    My gut tells me the CDC was over thinking this whole thing from a technical perspective, probably because this is how Government does its thing in general.

    I watched a little bit of the Trump press conference from CDC on Friday. Lots of questions about testing. One guy said the first test was developed rapidly after sequencing. Probably as fast as WHO or Europe countries. The problem was getting samples shipped to CDC. So they sent the test kits to regional labs, but regional labs were not getting good results. They figured out it was too unreliable to test for 3 criteria and switch to 2 criteria, which the regional labs had better quality. Makes sense to me. It feels like the media are expecting the government to detect all and prevent all infections, which is probably good for ratings and a handy stick for Trump bashing. The real goal and it will be a challenge, is to use social distancing to keep the number of infected people from overwhelming the healthcare system in any city.

    I think the President could set an example here by cancelling his rallies for the next two months and urging other politicians to do the same. This would trigger additional actions by others to cancel large meetings and events. Covid is going to spread but the degree and speed with which it does is important in its ultimate impact. We now have enough examples to show that measures taken early on can be effective but if you wait too long much less so.

    He should stay at home, make YouTube videos., and wait for them to be shadowbanned.

26. 🚫 Banned
    Valiuth

    @Valiuth

    9:56 AM EDT ⋅ Mar 8, 2020

    DonG (skeptic) (View Comment):
    Probably as fast as WHO or Europe countries. The problem was getting samples shipped to CDC. So they sent the test kits to regional labs, but regional labs were not getting good results. They figured out it was too unreliable to test for 3 criteria and switch to 2 criteria, which the regional labs had better quality. Makes sense to me. It feels like the media are expecting the government to detect all and prevent all infections, which is probably good for ratings and a handy stick for Trump bashing. The real goal and it will be a challenge, is to use social distancing to keep the number of infected people from overwhelming the healthcare system in any city.

    Hm… well that makes sense it seems to me though that trying to centralize the process didn’t really work for them, and in a way there was no need to centralize it at first. This is a project for which crowd sourcing is an ideal solution. Labs in the US, Europe, and Asia could each have come up with different tests. The CDC serving as an information and resource sharing hub would have been more useful. Once you have a few working tests they can serve to disseminate the information. Like I said nothing about these tests is anything that can’t be bought off the shelf by individual hospitals/labs. If they had issue getting positive sample from China or Korea to use as positive controls that would certainly slow things down, and that is where good international organizations (again acting as clearing houses for such resources) would come into play. 

    I think if they have a working set of primers now, just release the sequences so that any lab can do the test, just to get capacity up. It is literally a process that costs a few dollars per reaction, where everything can be bought off the shelf. 

    I think it would definitely be prudent to encourage at least all old people (60+) to avoid unnecessary public gatherings for now. They are the most at risk group and so should take extra precautions. 

27. Inactive
    Jules PA

    @JulesPA

    6:37 PM EDT ⋅ Mar 8, 2020

    https://www.japantimes.co.jp/news/2020/03/08/national/7-eleven-yamanashi-coronavirus/#.XmWNBdApB-F

    A young 20-something in Japan, has now contracted SARS-2-CoV and also meningitis.

    In UK, they are talking about rationing care.

    Don’t mess around. It’s not the flu.

    “The technical note spells out how patients with coronavirus experience a severe infection in all of their lungs, requiring major ventilation support. It also reveals the effect of the virus, which affects blood pressure, the heart, kidneys and liver with patients needing sustained treatment.

    Dr Nattino said: “A week ago we opened a six-bed ICU for Covid-19 critically ill patients. In two days our unit filled up and we extended it to 10 beds on 3 March which filled up during the same afternoon. Now we’re planning to merge the cardio and general ICUS to use the general ICU beds for 10 more Covid-19 patients.”

    In an alarming development, Dr Nattino said younger patients were being affected, saying the ages of patients ranged from 46 to 83 with only a small number having important underlying conditions.”

    https://www.independent.co.uk/news/health/coronavirus-italy-doctors-intensive-care-deaths-a9384356.html

28. 🚫 Banned
    Unsk

    @Unsk

    6:52 PM EDT ⋅ Mar 8, 2020

    ” I think the problem was the CDC stepped in and took complete control, and stopped any universities or health departments from developing their own tests. They then in classic Big Government fashion proceeded to bungle and fail spectacularly. One article I read yesterday stated a reason for the failure of the CDC test was they trie to construct a “cadillac” test that also tested for MERS and SARS as well the current virus.”

    The simple fact is that the CDC and FDA  have way too much authority.  Multiple approaches was always the way to go, and to stop Universities and Laboratories from developing their own tests makes absolutely no sense, and is perhaps a violation of their rights. 

    I am an architect. If I design a building and a person gets hurt or dies due to some negligent part of my design, I may  be criminally liable and could potentially  be sent away for manslaughter.  In my work I have to check out every potential flaw, whether or not some less than official authority says it’s okay. or not.  That is why I am so appalled at all these commenters who are so afraid of talking about various pieces of information that do not come what they think are official “authorized :sources, if there is even such a thing anymore. In my job, I have to check it all out and deal with the worst case scenario. Always. 

    But that is not what the CDC and FDA have done.  They have been grossly negligent in their approach and have not considered from my point of view, the worst case scenarios that could happen with this pandemic. 

    Similarly, the CDC and FDA have taken a “by the book” slow as molasses approach to this pandemic, which has a great potential of causing  a great many to die. In my book, if people start to die in droves then the upper management of the CDC and FDA should be held criminally responsible for their deaths for their response has  been worse than GAWDAWFUL.  

     

29. Inactive
    Ontheleftcoast

    @Ontheleftcoast

    7:10 PM EDT ⋅ Mar 8, 2020

    Coming soon: a home test kit for 2019-NCoV

    Testing for the novel coronavirus in the Seattle area will get a huge boost in the coming weeks as a project funded by Bill Gates and his foundation begins offering home-testing kits that will allow people who fear they may be infected to swab their noses and send the samples back for analysis.

    Results, which should be available in one to two days, will be shared with local health officials who will notify those who test positive. Via online forms, infected people can answer questions about their movements and contacts, making it easier for health officials to locate others who may need to be tested or quarantined, as well as to track the virus’ spread and identify possible hot spots.

    Initially, the lab will be able to conduct about 400 tests a day, eventually expanding to thousands of tests a day, said Scott Dowell, leader of coronavirus response at the Bill & Melinda Gates Foundation. The project is ramping up as quickly as possible, but it’s not clear exactly when it will launch, he added. Among other things, software needs to be upgraded to handle the expected crush of requests, and a detailed questionnaire finalized for people who request tests.

    “Although there’s a lot to be worked out, this has enormous potential to turn the tide of the epidemic,” Dowell said.

    While Public Health – Seattle & King County has confirmed 71 cases and 15 deaths as of Saturday,  modeling by Trevor Bedford, a computational biologist at Fred Hutchinson Cancer Research Center, estimated on Wednesday that the actual number of cases in the Seattle area was about 600. Unchecked, that could theoretically increase to 30,000 by the end of March, Dowell said. But steps to slow transmission can significantly reduce the number of new infections, underscoring the importance of acting quickly to protect people from the virus.

30. Inactive
    Ontheleftcoast

    @Ontheleftcoast

    8:11 PM EDT ⋅ Mar 8, 2020

    Aaaand then there are the idiots who should be locked up. Except somebody would have to look after them.

    There was a confirmed COVID-19 case in St. Louis, a 20 year old woman who was studying in Italy. She was sent home from the hospital. She and her parents were told to “self-quarantine” at home.

    But they went to a preparty and then the school father-daughter dance.

    The whole school is now closed.

    The St. Louis Post-Dispatch reported:

    Villa Duchesne and Oak Hill School will close Monday after administrators learned that a St. Louis County woman infected with the coronavirus is the older sister of a Villa Duchesne student.

    Moreover, a message from the schools to parents, circulating on social media, warns that the father and sister of the infected patient attended a school father-daughter dance Saturday night at the Ritz-Carlton in Clayton. They also apparently attended a pre-dance gathering at the house of a Villa student.

    St. Louis County Executive Sam Page said Sunday that the patient’s family had been told on Thursday to self quarantine at their home in Ladue. Page said the patient’s father had not followed health department instructions.

    Ya think?