SARS CoV-2 coronavirus / Covid-19 (No tin foil hat silliness please)

Pogue Mahone said:
I think the point is that these are screening tests only. Any “positive “ would need to be confirmed by a PCR.

Obviously, a false negative would be problematic but, at a population level, mass screening like this would still identify many more cases than you would without these tests. The idea being that you’re testing people who wouldn’t be tested at all otherwise, so a false negative isn’t actually that harmful. If someone was sick enough that they would be tested using conventional means then, by all means, test them conventionally. What the screening would try and pick up is cases that would otherwise fly completely beneath the radar.

The aim is to complement the very expensive and time consuming (yet highly sensitive/specific) tests we already have, rather than replace them.
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The problem i could see is people who might have stayed at home because of mild symptoms (without getting tested) gets a false negative and then go out spreading it instead.
 
BootsyCollins said:
The problem i could see is people who might have stayed at home because of mild symptoms (without getting tested) gets a false negative and then go out spreading it instead.
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Yeah, that’s a risk. Although I don’t actually think many people are going to self isolate for two weeks without getting tested. I know that’s the guidance but it seems to me that, in reality, anyone who thinks they might have covid will get a test. If they’re convinced it’s not covid and just a head cold, they tend to get out and about as soon as they feel any better.

Let’s say out of 100 very mild cases like this who actually do have covid, the test will correctly identify 90 positives. That’s still a much better situation than the alternative, where they don’t get tested at all. The key here is about deciding who gets the screening test and who gets a “proper” test, based on symptoms/severity of illness.
 
Pogue Mahone said:
Yeah, that’s a risk. Although I don’t actually think many people are going to self isolate for two weeks without getting tested. I know that’s the guidance but it seems to me that, in reality, anyone who thinks they might have covid will get a test. If they’re convinced it’s not covid and just a head cold, they tend to get out and about as soon as they feel any better.

Let’s say out of 100 very mild cases like this who actually do have covid, the test will correctly identify 90 positives. That’s still a much better situation than the alternative, where they don’t get tested at all. The key here is about deciding who gets the screening test and who gets a “proper” test, based on symptoms/severity of illness.
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In the best of worlds people who is sick stay at home even if its not Covid. I am hoping after this the "i am sick but still goes to work because i am such a hard worker" get banished.

And i think i am pro mass testing also, as the rewards seems higher than the risk. At the moment at least and if its combined with, as you say, proper tests.
 
BootsyCollins said:
In the best of worlds people who is sick stay at home even if its not Covid. I am hoping after this the "i am sick but still goes to work because i am such a hard worker" get banished.

And i think i am pro mass testing also, as the rewards seems higher than the risk. At the moment at least and if its combined with, as you say, proper tests.
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Definitely. I’m mainly thinking of kids here, as it happens. There are loads of minor head colds doing the rounds amongst kids right now. So much so that we’ve tightened up the definition for covid testing to exclude kids who just have a snotty nose. It’s just not practical or possible to do a formal PCR test for every minor URTI. These kids aren’t being tested at all and go back to school as soon as they feel better (although they’re often still sniffling when they go back) If every one of them had a test that even picked up 90% of the covid cases amongst them we’d be a hell of a lot better off.

And that’s without even getting into the asymptomatic cases, in kids and adults, who would never be tested at all without some sort of screening test like this. It just doesn’t make sense to me to hold this sort of test to the same high standards we expect from the gold standard diagnostic tests.
 
Pogue Mahone said:
I think the point is that these are screening tests only. Any “positive “ would need to be confirmed by a PCR.

Obviously, a false negative would be problematic but, at a population level, mass screening like this would still identify many more cases than you would without these tests. The idea being that you’re testing people who wouldn’t be tested at all otherwise, so a false negative isn’t actually that harmful. If someone was sick enough that they would be tested using conventional means then, by all means, test them conventionally. What the screening would try and pick up is cases that would otherwise fly completely beneath the radar.

The aim is to complement the very expensive and time consuming (yet highly sensitive/specific) tests we already have, rather than replace them.
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I'm not against the idea of mass testing for epidemiological purpose (depends on which exact kit we're talking about), what I argue is that negative results from these kits shouldn't be regarded as safe passes (as suggested in #43426) and we can't simply neglect sensitivity and specificity just because it's faster and cheaper (as suggested in #43481).

In Hong Kong we are actually carrying out city-wide testing using PCR.
 
I think my biggest worry about the "false negative" idea is that the result might change the behaviour of some people. Good test result in the morning = pub crawl in the evening!

That said, if they had no test at all would they do the same thing, because that's just who they are anyway. A brutal mass psychology experiment as well as an epidemiological one.

Still, without it, a lot of things are happening blind. Schools and colleges are reopening. Planes are still flying with no/minimal tests or mitigation etc beyond a request to "sanitise your hands" and "wear a mask" with mixed compliance results.
 
Pogue Mahone said:
Definitely. I’m mainly thinking of kids here, as it happens. There are loads of minor head colds doing the rounds amongst kids right now. So much so that we’ve tightened up the definition for covid testing to exclude kids who just have a snotty nose. It’s just not practical or possible to do a formal PCR test for every minor URTI. These kids aren’t being tested at all and go back to school as soon as they feel better (although they’re often still sniffling when they go back) If every one of them had a test that even picked up 90% of the covid cases amongst them we’d be a hell of a lot better off.

And that’s without even getting into the asymptomatic cases, in kids and adults, who would never be tested at all without some sort of screening test like this. It just doesn’t make sense to me to hold this sort of test to the same high standards we expect from the gold standard diagnostic tests.
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I see you keep mentioning 90% but tbh it's a long shot. According to CDC, the sensitivity of rapid kits only ranges from 50%-70% even for well-established flu viruses.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7240272/
 
BootsyCollins said:
In the best of worlds people who is sick stay at home even if its not Covid. I am hoping after this the "i am sick but still goes to work because i am such a hard worker" get banished.

And i think i am pro mass testing also, as the rewards seems higher than the risk. At the moment at least and if its combined with, as you say, proper tests.
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I think it's more a case of I am sick but still go to work cos I'm skint and got bills to pay for most people.
 
djembatheking said:
I think it's more a case of I am sick but still go to work cos I'm skint and got bills to pay for most people.
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Off course it is for many, but i can only speak for where im from and where i worked and in both Sweden and Norway its no problem staying home when you are sick.

I understand thats its not the same anywhere though.

Edit : Thought about it and figured it might sound a little wrong. Norway and Sweden also has many people who might be unable to take a day off because of their situation. What i am trying to say that thru my whole working life it has not gone a week without somebody (who absolutley dont need to) comming in to work sick because that was the norm. And thats what i hope going away, that we have a bigger understanding for people staying home while sick that again makes it easier for people to stay at home when they are and dont feel the "have to" go work.

To make that work companies has to make changes to, and make it easier for people to work from home f.ex. And make sick leaves more accessible and reasonable.
 
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hmchan said:
I'm not against the idea of mass testing for epidemiological purpose (depends on which exact kit we're talking about), what I argue is that negative results from these kits shouldn't be regarded as safe passes (as suggested in #43426) and we can't simply neglect sensitivity and specificity just because it's faster and cheaper (as suggested in #43481).

In Hong Kong we are actually carrying out city-wide testing using PCR.
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Pogues addressed the point exactly. The false negatives from these tests are mostly people who aren’t even getting tested today. You’d use it in a staggered manner obviously and complement the current testing regime.

Even if you use rapid tests for an otherwise low risk population for whom you’d have done the more accurate tests, it is fine if there are false negatives as you’d measure the success of this on a population level. The percentage of true positives getting picked up would be still higher. It doesn’t matter if they had a cough or not if they weren’t going to get severe disease.
 
zing said:
Pogues addressed the point exactly. The false negatives from these tests are mostly people who aren’t even getting tested today. You’d use it in a staggered manner obviously and complement the current testing regime.

Even if you use rapid tests for an otherwise low risk population for whom you’d have done the more accurate tests, it is fine if there are false negatives as you’d measure the success of this on a population level. The percentage of true positives getting picked up would be still higher. It doesn’t matter if they had a cough or not if they weren’t going to get severe disease.
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In addition to that you'll also have people who regard these false negative results as safe passes and give up social distancing; you'll also have people who try to replace conventional testing with these rapid kits even if they are eligible, etc.

Of course you'd always pick up more positive cases by offering these rapid tests on a large scale, even if they have a sensitivity of 1%. My point is that it would be much more worthwhile to invest the same resources in expanding the conventional testing capacity, which also aims at testing people who are ineligible previously.

The goal of epidemiology is not just "looking for" positive cases blindly, but to have an accurate picture about the pandemic. There is a reason why few biotechnology companies develop rapid antigen kits, and why few authorities adopt these kits as one of their measures.
 
hmchan said:
In addition to that you'll also have people who regard these false negative results as safe passes and give up social distancing; you'll also have people who try to replace conventional testing with these rapid kits even if they are eligible, etc.

Of course you'd always pick up more positive cases by offering these rapid tests on a large scale, even if they have a sensitivity of 1%. My point is that it would be much more worthwhile to invest the same resources in expanding the conventional testing capacity, which also aims at testing people who are ineligible previously.

The goal of epidemiology is not just "looking for" positive cases blindly, but to have an accurate picture about the pandemic. There is a reason why few biotechnology companies develop rapid antigen kits, and why few authorities adopt these kits as one of their measures.
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All I am saying is that a cheap, rapid diagnostic test at scale can help as it would capture a higher percentage of true positives and you can optimize it so that you lose none of the diagnostic capabilities of the existing testing regime.

I don't understand the part in bold. I don't know what 'positive cases blindly' means. Admittedly, positive cases with higher mobility will be worse than positive cases with lower mobility, but rapid diagnostics aren't going to discriminate and look for ones with lower R so your statement isn't relevant.

If you're interested, you can read this: https://marginalrevolution.com/marginalrevolution/2020/08/rapid-tests.html and https://marginalrevolution.com/marg...ich-time-lags-matter-for-testing-regimes.html

(It's from economists - but I don't agree with your basic assertion that economists aren't the right people to say this. This is an optimization problem. It doesn't matter what degree someone holds if their proposal results in fewer deaths.).
 
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As an aside, I'm working as a GP registrar in inner city Leicester and its appalling regarding the shortages of tests, no slots available for drive through for miles and for many days. No home tests available as well. Hearing from other GPs that its a national problem in various areas.

Patients understandably angry as affecting work etc. I wouldn't personally trust this government to handle or be able to deliver anything logistically challenging like mass testing which needs competence.
 
zing said:
All I am saying is that a cheap, rapid diagnostic test at scale can help as it would capture a higher percentage of true positives and you can optimize it so that you lose none of the diagnostic capabilities of the existing testing regime.

I don't understand the part in bold. I don't know what 'positive cases blindly' means. Admittedly, positive cases with higher mobility will be worse than positive cases with lower mobility, but rapid diagnostics aren't going to discriminate and look for ones with lower R so your statement isn't relevant.

If you're interested, you can read this: https://marginalrevolution.com/marginalrevolution/2020/08/rapid-tests.html and https://marginalrevolution.com/marg...ich-time-lags-matter-for-testing-regimes.html

(It's from economists - but I don't agree with your basic assertion that economists aren't the right people to say this. This is an optimization problem. It doesn't matter what degree someone holds if their proposal results in fewer deaths.).
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Theoretically yes, but in reality there's no such ideal diagnostic test (even for the well-established flu A/B) or else we'd have been using it for years instead of the labor-intensive, time-consuming conventional tests. Rapid kits also require confirmation by the gold standard PCR (as suggested by others above) and this inevitably loses some extent of the capabilities of the existing testing regime. That's why expanding the conventional testing capabilities is the most sensible and direct way given the resources.

Everyone is entitled to have their opinions on the pandemic. Scientists, economists, politicians all have their concerns and I fully respect their views. But with all due respect, a layman may lack some of the professional knowledge and experience in the biomedical field, and some of the suggestions are really too impractical. If you're interested, here's one of the most popular pregnancy-test-like flu A/B rapid kits and look how much it costs, it's comparable to a conventional PCR: https://www.fishersci.com/shop/products/xpect-flu-a-b-test/r24600
 
djembatheking said:
I think it's more a case of I am sick but still go to work cos I'm skint and got bills to pay for most people.
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Definitely an issue in the US, where people get strict (and tiny) allowances for holiday and sick days. In more developed countries they actually just pay you if you are off sick. Nor do they try to make you take the day as holiday.
 
Pogue Mahone said:
Definitely. I’m mainly thinking of kids here, as it happens. There are loads of minor head colds doing the rounds amongst kids right now. So much so that we’ve tightened up the definition for covid testing to exclude kids who just have a snotty nose. It’s just not practical or possible to do a formal PCR test for every minor URTI. These kids aren’t being tested at all and go back to school as soon as they feel better (although they’re often still sniffling when they go back) If every one of them had a test that even picked up 90% of the covid cases amongst them we’d be a hell of a lot better off.

And that’s without even getting into the asymptomatic cases, in kids and adults, who would never be tested at all without some sort of screening test like this. It just doesn’t make sense to me to hold this sort of test to the same high standards we expect from the gold standard diagnostic tests.
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Was meant to go in for a medical procedure this week but had sniffles so called them up to get advise. They said checklist was upgraded so that people with sniffles shouldn’t come in
 
In Italy the mean age of death was actually rising all the way up to July. It's now declining but still stands at 78 and 3 years higher than it was at the start of the outbreak, although the hospitalisation and ICU figures are creeping back up.

There have also been 4 deaths of otherwise healthy under 40s since April, with none in the last couple of months. Young people may be catching it now but they are not dying from it.
 
decorativeed said:
Definitely an issue in the US, where people get strict (and tiny) allowances for holiday and sick days. In more developed countries they actually just pay you if you are off sick. Nor do they try to make you take the day as holiday.
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There are a lot of self employed and zero hours contract workers in the UK too that don`t want to take time off .There are a hell of a lot of people that get nothing if they don`t work.
 
An age breakdown of the current outbreak here in NZ.
Under 10, 22 people.
Age 10-20, 35 people.
Age 20-30, 29 people.
Age 30-40, 26 people.
Age 40-50, 25 people.
Age 50-60, 22 people.
Age 60-70, 8 people.
Age 70+ 6 people.
 
djembatheking said:
There are a lot of self employed and zero hours contract workers in the UK too that don`t want to take time off .There are a hell of a lot of people that get nothing if they don`t work.
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True enough. Far too familiar with this as until recently had to cobble a living together from three zero hour contract jobs. I was just being flippant.
 
Bad news in France with nearly 10,000 new daily infections

Good new from Australia with Victoria with only 43 new infections, down from over 700 a day a few weeks ago. NSW only had 10 new infections, with 6 in quarantine after arriving from overseas and the other 4 in known clusters, and NZ only had 1 new infection. NT have also announced they will open up to NSW/Sydney residents very soon as they have controlled covid so well.

I also read somewhere that the Oxford vaccine trial wasn't paused for Transverse Myelitis (although I guess it could just be not confirmed but still a possibility) and that we don't know if they got the placebo. Which isn't bad news at least.
 
Stack said:
An age breakdown of the current outbreak here in NZ.
Under 10, 22 people.
Age 10-20, 35 people.
Age 20-30, 29 people.
Age 30-40, 26 people.
Age 40-50, 25 people.
Age 50-60, 22 people.
Age 60-70, 8 people.
Age 70+ 6 people.
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That is a lot of under 10's
 
Wibble said:
Bad news in France with nearly 10,000 new daily infections

Good new from Australia with Victoria with only 43 new infections, down from over 700 a day a few weeks ago. NSW only had 10 new infections, with 6 in quarantine after arriving from overseas and the other 4 in known clusters, and NZ only had 1 new infection. NT have also announced they will open up to NSW/Sydney residents very soon as they have controlled covid so well.

I also read somewhere that the Oxford vaccine trial wasn't paused for Transverse Myelitis (although I guess it could just be not confirmed but still a possibility) and that we don't know if they got the placebo. Which isn't bad news at least.
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Where did you read this?
 
Can't get a test for love nor money , just get told none available. GP can't sort it out. Also , how accurate is a home test on an 8 year old ? I think the numbers in the UK would be higher if you could actually get tested when ill.
 
Wibble said:
Bad news in France with nearly 10,000 new daily infections

Good new from Australia with Victoria with only 43 new infections, down from over 700 a day a few weeks ago. NSW only had 10 new infections, with 6 in quarantine after arriving from overseas and the other 4 in known clusters, and NZ only had 1 new infection. NT have also announced they will open up to NSW/Sydney residents very soon as they have controlled covid so well.

I also read somewhere that the Oxford vaccine trial wasn't paused for Transverse Myelitis (although I guess it could just be not confirmed but still a possibility) and that we don't know if they got the placebo. Which isn't bad news at least.
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The CEO confirmed they were given the vaccine. However the person was expected to be discharged Wednesday and it hasn’t been confirmed that it was Tranverse Myelitis, it was just initially suspected.

https://www.statnews.com/2020/09/09/astrazeneca-covid19-vaccine-trial-hold-patient-report/

Incidentally the trials in India have also now been paused.
 
djembatheking said:
Can't get a test for love nor money , just get told none available. GP can't sort it out. Also , how accurate is a home test on an 8 year old ? I think the numbers in the UK would be higher if you could actually get tested when ill.
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I really enjoyed Michael Deacon’s column regarding the bumbling meddling idiots running the UK and how everything, including lack of available testing is in fact the public’s fault.

I can’t believe people in the UK aren’t marching on Westminster regarding this being an actual fecking law. Unreal.
 
Regulus Arcturus Black said:
I really enjoyed Michael Deacon’s column regarding the bumbling meddling idiots running the UK and how everything, including lack of available testing is in fact the public’s fault.

I can’t believe people in the UK aren’t marching on Westminster regarding this being an actual fecking law. Unreal.
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It's a joke mate. My grandson is full of cold, snotty and coughing and bit of a temp He's been like that since Wednesday , a bit better now but as he hasn't been tested he or his brother couldn't go back to school on Thursday and they have all just been told to isolate , daughter has got a month old baby in the house too. But hey, we are on top of testing.
 
djembatheking said:
It's a joke mate. My grandson is full of cold, snotty and coughing and bit of a temp He's been like that since Wednesday , a bit better now but as he hasn't been tested he or his brother couldn't go back to school on Thursday and they have all just been told to isolate , daughter has got a month old baby in the house too. But hey, we are on top of testing.
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It's going to get much worse over the winter months when you have the normal seasonal flu's and cold's all over the place.
 
Regulus Arcturus Black said:
The evidence from March and April 2020 suggests we are likely in for the mildest flu season in decades.
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Many people who have a heavy cold think it's flu. It's people's understanding of what flu actually is that is flawed and is what will cause an increase in un-necessary testing putting more pressure on the system.
 
balaks said:
Many people who have a heavy cold think it's flu. It's people's understanding of what flu actually is that is flawed and is what will cause an increase in un-necessary testing putting more pressure on the system.
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Considering the milder symptoms of flu, cold, covid-19 are so similar, and the message has been “got symptoms, get tested”, yeah, that is bound to result in even more people wanting to get tested. Absolutely.
 
massi83 said:
The peak deaths were around 1.000 a day, so of course peak infections were around 100.000 a day. This has been known for months already.
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Weren't the boffins only saying a month or back they believed only 5% of the U.K population had been impacted? If it really was 100k cases a day during April you reach 6m in that timespan so already 10% of the population.

I can't believe we've been through all we have in the last six months for a tiny percentage to be affected. There was a report yesterday that covid 19 was on death certificate for 84 year old who died in Kent on December 29th so I've always suspected it was here in some form in December-January rather than magically floating onto these forms in mid Feb.

Wuhan games took place in October for Athletes around the world and many of them fell ill with nausea and so they could've been the first super spreaders.
 
Coronavirus app being launched. Whatever happened to the Isle of Wight experiment in June, I assume it wasn't a great success.
 
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