Testing and Contact Tracing - What Do We Need?

[Birdman03]

No CDC labs have run only 800K, New York alone has run over 1.2 million..add Cali and those two states alone have run well over 2 million.

The US total is over 8 million. The latest data can be viewed at:
https://www.cdc.gov/covid-data-tracker/

 

[Birdman03]

Can we conclude anything from test results to date?

There seems to be an ongoing narrative that testing for COVID-19 has been, and continues to be, insufficient.

What is the threshold for testing (if any) where the general public can make a reasonable assessment of the infection rates where they live and the risk that they could contract the disease while going about their daily business?

The 20 states with the largest numbers of total tests have tested 1.8 to 6.2% of their total populations. The rates of positive tests vary over a large range from 4.2 to 32.9% (see attached table).

The more meaningful number to track is probably increase/decrease in positive tests, once some threshold portion of the population has been tested.

 

[Midpack]

All along the differences in hospitalization, serious cases or deaths have been orders of magnitude different for age groups. I can't get the same CDC data set I was tracking before, but 78% of deaths were 65+ and 92% of deaths were 55+. This CDC chart again suggests what's good for those under 50 is arguably significantly different than those older than 50. Even the most at risk 65+ group is at 160 hospitalizations per 100,000 population or 0.16%.

 

[tmm99]

Contact tracing (which will inevitably involve more and faster testing) is crucial going forward, and hopefully, we're ready to do that in some ways before more sectors open to the public. Just one person in South Korea recently infected over 100 people after visiting 5 night clubs, and without having a way to trace and isolate the infected (by testing) which S Korea does, the impact could be much more severe.

To me, releasing the information to the public as to where and what time the infected visited is part of contact tracing although I don't know what kind of legal ramification that may have. I live in a region in Ontario, Canada which started releasing that information to the public at one point and then stopped after just one day. One Italian restaurant and a membership club were mentioned along with the information on what date/time the infected visited those establishments. That information was however taken down the next day, and the health officials announced that they would no longer publish the information, saying that going forward, we need to assume that everyone is infected and we need to take social distancing precautions with everyone.

I don't know what kind of tracing can be possible/allowed in North America. We certainly do not want to infringe upon people's rights. Hopefully, the experts will put together a workable solution very very soon.

 

[Midpack]

There seems to be an ongoing narrative that testing for COVID-19 has been, and continues to be, insufficient.

What is the threshold for testing (if any) where the general public can make a reasonable assessment of the infection rates where they live and the risk that they could contract the disease while going about their daily business?

The 20 states with the largest numbers of total tests have tested 1.8 to 6.2% of their total populations. The rates of positive tests vary over a large range from 4.2 to 32.9% (see attached table).

The more meaningful number to track is probably increase/decrease in positive tests, once some threshold portion of the population has been tested.

Depends on how testing is deployed among other things. If testing is done strategically with contact tracing it's one number. If testing is random/arbitrary more testing will be required. Most countries seem to have a plan, I haven't seen one for the US - we just keep hearing we're running more and more tests each day. I've read some places are having to restrict testing, and others have excess capacity and they're starting to allow almost anyone...

 

[aiken]

Maybe listening to an expert would help us understand the issue....

 

[audreyh1]

OK - what’s the recap? Because that video is 55 mins long, and all sorts of different media like to trot out their expert.

 

[gwraigty]

All along the differences in hospitalization, serious cases or deaths have been orders of magnitude different for age groups. I can't get the same CDC data set I was tracking before, but 78% of deaths were 65+ and 92% of deaths were 55+. This CDC chart again suggests what's good for those under 50 is arguably significantly different than those older than 50. Even the most at risk 65+ group is at 160 hospitalizations per 100,000 population or 0.16%.

Thank for the update. It's been awhile since I checked Ohio's metrics. As of today, 51% of reported deaths were those 80+, 26% were 70-79, 14% were 60-69, 6% were 50-59, 2% were 40-49, 1% were 30-39, 3 deaths were 20-29, no deaths under 20. Condensing that a bit, 92% of deaths were people 60+, and 77% were people 70+.

Many deaths have been among those in LTC centers. As of May 6th, 499 deaths were from the LTC population. As of today, Ohio has 1436 deaths. That's about 34% of statewide deaths coming from the LTC population alone. Since the website is only reporting LTC cases from April 15th on, those numbers are definitely understated, as I said in a different post.

In my county, it was reported in the local news today that the youngest person who died was in their 30s, while the majority who died have been 80+. Yesterday twice as many people recovered as the number of new cases added, so that's a bit of welcome news.

 

[aiken]

OK - what’s the recap? Because that video is 55 mins long, and all sorts of different media like to trot out their expert.

Well, I'd recommend watching it...he's a Stanford Medical Professor who's been on the cutting edge of antibody testing. His MLB study yielded less than 1% infected based on antibody testing, which is less than other studies.

--He doesn't believe large scale contact tracing is feasible given the fact millions are already infected...and it's infectious, do you test people every week? He also felt their were HIPPA issues with that level of invasive testing.
--He believes in aggressively testing 1) Nursing home workers and patients...2) All medical personnel with patient contact...3) People who present with symptoms.
--He is bearish on a vaccine. Pointed out we still don't have an HIV vaccine, nor have any coronavirus vaccines been successful. He believes the government should undertake a vast data mining of the people who have become seriously ill/died, and try and determine what makes them more susceptible so we can devise better treatment interventions.

--He believes it's a false choice between "lives vs. the economy" He says it's likely more lives may be lost in a continued lockdown scenario, more suicides, deaths from other medical conditions that aren't being treated, and the fact that economic collapses and related poverty are correlated with poor health and incremental deaths.

--He says lockdowns work to a certain extent, but they just delay the inevitable. Says it's critical to protect the most vulnerable, obviously the elderly and those with serious underlying health problems. Doesn't believe most young/healthy people should be locked down.
--Says most of the transmission appears to be done in crowded, indoor events. He's not bullish on sports reopening with fans, concerts, etc. Outdoor activities are significantly less dangerous he believes, but not 100% safe.



He's a reasonable guy who makes it clear he doesn't have all the answers...seems to go where the data takes him.

 

[statsman]

Well, I'd recommend watching it...he's a Stanford Medical Professor who's been on the cutting edge of antibody testing. His MLB study yielded less than 1% infected based on antibody testing, which is less than other studies.

--He doesn't believe large scale contact tracing is feasible given the fact millions are already infected...and it's infectious, do you test people every week? He also felt their were HIPPA issues with that level of invasive testing.
--He believes in aggressively testing 1) Nursing home workers and patients...2) All medical personnel with patient contact...3) People who present with symptoms.
--He is bearish on a vaccine. Pointed out we still don't have an HIV vaccine, nor have any coronavirus vaccines been successful. He believes the government should undertake a vast data mining of the people who have become seriously ill/died, and try and determine what makes them more susceptible so we can devise better treatment interventions.
--He believes it's a false choice between "lives vs. the economy" He says it's likely more lives may be lost in a continued lockdown scenario, more suicides, deaths from other medical conditions that aren't being treated, and the fact that economic collapses and related poverty are correlated with poor health and incremental deaths.
--He says lockdowns work to a certain extent, but they just delay the inevitable. Says it's critical to protect the most vulnerable, obviously the elderly and those with serious underlying health problems. Doesn't believe most young/healthy people should be locked down.
--Says most of the transmission appears to be done in crowded, indoor events. He's not bullish on sports reopening with fans, concerts, etc. Outdoor activities are significantly less dangerous he believes, but not 100% safe.

He's a reasonable guy who makes it clear he doesn't have all the answers...seems to go where the data takes him.

Some interesting points here, and I think I am in agreement with him on most of it, especially the part I highlighted. But I leave it to others to cherry-pick and argue the countering points.

 

[Midpack]

Well, I'd recommend watching it...he's a Stanford Medical Professor who's been on the cutting edge of antibody testing. His MLB study yielded less than 1% infected based on antibody testing, which is less than other studies.

--He doesn't believe large scale contact tracing is feasible given the fact millions are already infected...and it's infectious, do you test people every week? He also felt their were HIPPA issues with that level of invasive testing.
--He believes in aggressively testing 1) Nursing home workers and patients...2) All medical personnel with patient contact...3) People who present with symptoms.
--He is bearish on a vaccine. Pointed out we still don't have an HIV vaccine, nor have any coronavirus vaccines been successful. He believes the government should undertake a vast data mining of the people who have become seriously ill/died, and try and determine what makes them more susceptible so we can devise better treatment interventions.

--He believes it's a false choice between "lives vs. the economy" He says it's likely more lives may be lost in a continued lockdown scenario, more suicides, deaths from other medical conditions that aren't being treated, and the fact that economic collapses and related poverty are correlated with poor health and incremental deaths.

--He says lockdowns work to a certain extent, but they just delay the inevitable. Says it's critical to protect the most vulnerable, obviously the elderly and those with serious underlying health problems. Doesn't believe most young/healthy people should be locked down.
--Says most of the transmission appears to be done in crowded, indoor events. He's not bullish on sports reopening with fans, concerts, etc. Outdoor activities are significantly less dangerous he believes, but not 100% safe.



He's a reasonable guy who makes it clear he doesn't have all the answers...seems to go where the data takes him.

Thanks for the recap. Those are all items that have been discussed here, but it’s nice to have them all together.

 

[martyp]

Well, I'd recommend watching it...he's a Stanford Medical Professor who's been on the cutting edge of antibody testing. His MLB study yielded less than 1% infected based on antibody testing, which is less than other studies.

--He doesn't believe large scale contact tracing is feasible given the fact millions are already infected...and it's infectious, do you test people every week? He also felt their were HIPPA issues with that level of invasive testing.
--He believes in aggressively testing 1) Nursing home workers and patients...2) All medical personnel with patient contact...3) People who present with symptoms.
--He is bearish on a vaccine. Pointed out we still don't have an HIV vaccine, nor have any coronavirus vaccines been successful. He believes the government should undertake a vast data mining of the people who have become seriously ill/died, and try and determine what makes them more susceptible so we can devise better treatment interventions.

--He believes it's a false choice between "lives vs. the economy" He says it's likely more lives may be lost in a continued lockdown scenario, more suicides, deaths from other medical conditions that aren't being treated, and the fact that economic collapses and related poverty are correlated with poor health and incremental deaths.

--He says lockdowns work to a certain extent, but they just delay the inevitable. Says it's critical to protect the most vulnerable, obviously the elderly and those with serious underlying health problems. Doesn't believe most young/healthy people should be locked down.
--Says most of the transmission appears to be done in crowded, indoor events. He's not bullish on sports reopening with fans, concerts, etc. Outdoor activities are significantly less dangerous he believes, but not 100% safe.



He's a reasonable guy who makes it clear he doesn't have all the answers...seems to go where the data takes him.

I would agree with all of this.

Update: OK. I watched the whole video. I generally agree with his point of view. There is about 10 minutes in the middle where he is asked to play emperor for a day and talk about lockdown policy. That is outside his expertise and wasn't interesting to me.

However, he makes a quick comment at 47:00 minutes into the video where he is incorrect. He is asked about frequent workplace testing. He is expressing concern about patient privacy and your employer "having your DNA". That is not correct. The PCR test does not sequence your DNA. It doesn't even sequence the virus DNA. No one has your DNA sequence. What your employer has is information about whether you are infected with the Coronavirus at the time you were tested. That is all. This is something but not at all what he said. I just caution people getting the wrong impression from this quick comment in the video.

However, in general it is an interesting 1 hour interview and I recommend others to view it. After all, we all seem to have a bit of time on our hands these days.

 

[Jeffman52]

They are talking about loading a contact tracing app on peoples cell phones. If that is voluntary, I will NOT be loading it. If it is not, I am going to turn off my smart phone and buy a cheap flip phone.

 

[braumeister]

They are talking about loading a contact tracing app on peoples cell phones. If that is voluntary, I will NOT be loading it. If it is not, I am going to turn off my smart phone and buy a cheap flip phone.

I'm taking it a step farther.

Harry Potter Quill & Ink Wizard's Writing Bundle with Parchment Paper & Owl Sealing Wax Seal Stamp

 

[gwraigty]

I'm taking it a step farther.

Harry Potter Quill & Ink Wizard's Writing Bundle with Parchment Paper & Owl Sealing Wax Seal Stamp

Won't you also have to buy an owl?

 

[Gumby]

They are talking about loading a contact tracing app on peoples cell phones. If that is voluntary, I will NOT be loading it. If it is not, I am going to turn off my smart phone and buy a cheap flip phone.

Don't worry. Your private life is just not that interesting.

 

[Chuckanut]

--Says most of the transmission appears to be done in crowded, indoor events. He's not bullish on sports reopening with fans, concerts, etc. Outdoor activities are significantly less dangerous he believes, but not 100% safe.

Peter Attia interviewed an epidemic expert who said a similar thing. He mentioned that if a 2nd wave strikes with a vengeance it won't be because two people had dinner together at a restaurant. It will be because of mass events than bring people together from geographically different areas, gets them infected, and then sends them back where they came from. Spain had the problem of the International Woman's day events where tens of thousands visited a certain town, crowded together inside and outside, and then went back home. Northern Italy had a big soccer game with a Spanish team.

 

[donheff]

Peter Attia interviewed an epidemic expert who said a similar thing. He mentioned that if a 2nd wave strikes with a vengeance it won't be because two people had dinner together at a restaurant. It will be because of mass events than bring people together from geographically different areas, gets them infected, and then sends them back where they came from. Spain had the problem of the International Woman's day events where tens of thousands visited a certain town, crowded together inside and outside, and then went back home. Northern Italy had a big soccer game with a Spanish team.

National political conventions. I think I’d phone in.

 

[Chuckanut]

National political conventions. I think I’d phone in.

You seem like a nice person, so please phone in.

OTOH, since my wishes for the current crop of politicians is "A plague on both their houses" let us take advantage CV19 and get them all together in one or two big indoor event centers. OK, I'm not being nice. I know.

 

[aiken]

Don't worry. Your private life is just not that interesting.

Facebook, Google, and lots of government agencies would disagree with you.

 

[RAE]

Looks like there is pretty strong evidence now that those that have been infected with COVID-19 do develop strong antibodies that should protect them from reinfection.........at least for a period of time.


Nearly everyone who recovers from COVID-19 makes coronavirus antibodies, a recent study in Nature Medicine reported. Antibodies are blood proteins produced by the immune system to fight viruses, and may help to ward off future attacks by those same invaders, Dr. Francis Collins, director of the NIH, wrote in a blog post. The study took blood from 285 people hospitalized with severe COVID-19 and found that all had developed SARS-CoV-2 specific antibodies within two to three weeks of the first symptoms showing. Although more research is needed to determine just how protective these antibodies are and for how long, Collins said these findings suggest that the immune systems of people who survive COVID-19 have been be primed to recognize SARS-CoV-2 and possibly thwart a second infection.

 

[RobbieB]

I'll load the app on my phone and leave the phone at home.

Like I do now.

 

[martyp]

Looks like there is pretty strong evidence now that those that have been infected with COVID-19 do develop strong antibodies that should protect them from reinfection.........at least for a period of time.


Nearly everyone who recovers from COVID-19 makes coronavirus antibodies, a recent study in Nature Medicine reported. Antibodies are blood proteins produced by the immune system to fight viruses, and may help to ward off future attacks by those same invaders, Dr. Francis Collins, director of the NIH, wrote in a blog post. The study took blood from 285 people hospitalized with severe COVID-19 and found that all had developed SARS-CoV-2 specific antibodies within two to three weeks of the first symptoms showing. Although more research is needed to determine just how protective these antibodies are and for how long, Collins said these findings suggest that the immune systems of people who survive COVID-19 have been be primed to recognize SARS-CoV-2 and possibly thwart a second infection.

I think the follow up is to see what the anti-body levels are for the asymptomatic people. It is hardly surprising that those with a severe infection have antibodies. We will have to wait to see what level of anti-bodies confers immunity and how much.

 

[Bongleur]

The study took blood from 285 people hospitalized with severe COVID-19 and found that all had developed SARS-CoV-2 specific antibodies within two to three weeks of the first symptoms showing. .

What about people with less severe infections?

>
Specifically, the researchers determined that nearly all of the 285 patients studied produced a type of antibody called IgM, which is the first antibody that the body makes when fighting an infection. Though only about 40 percent produced IgM in the first week after onset of COVID-19, that number increased steadily to almost 95 percent two weeks later. All of these patients also produced a type of antibody called IgG. While IgG often appears a little later after acute infection, it has the potential to confer sustained immunity.
>

What is the timeline for other infections? Is the body significantly slower to respond to COVID-19?

 

[Birdman03]

All along the differences in hospitalization, serious cases or deaths have been orders of magnitude different for age groups. I can't get the same CDC data set I was tracking before, but 78% of deaths were 65+ and 92% of deaths were 55+. This CDC chart again suggests what's good for those under 50 is arguably significantly different than those older than 50. Even the most at risk 65+ group is at 160 hospitalizations per 100,000 population or 0.16%.

This post illustrates that the COVID-19 pandemic is highly concentrated in selected age groups, populations, and geographic locations. For example, just 30 counties in the US account for 50% of all confirmed cases and 57% of all deaths:

https://www.heritage.org/public-health/commentary/over-half-us-counties-have-had-no-covid-19-deaths

Experts will continue to advise everyone everywhere to stay home. That advice will never be wrong, at least from the infection risk standpoint. However the average healthy person will need to use facts and unbiased information in order to decide how much infection risk they are willing to undertake while returning to daily life.