[no_gravity]

From what I read in this article and other sources, performing more tests seems to be a very promising approach to get this pandemic under control.

The number of positive tests and death rates are published every day on all channels. I wish the number of performed tests would be also published daily. What gets measured gets managed.

I wonder what limits the number of tests that can be performed. How much would it cost to ramp up testing capabilities so that every person with symptoms can be tested? How much to increase it to a level that everyone can be tested?

[Amygaz]

It's not a question of cost at this point. It's a question of availability of reagents and consumables, materials to make those, and time it takes to ramp up. The supply chain is like a supertanker.

At first we didn't have enough test, but that ramped up quickly, then we didn't have enough RNA extraction reagent, now we don't have enough swabs, and soon is the collection media that will be missing.

There has been a call for more protective equipement. But as the situation gets worst, beds space, ventilator, and then staff are going to be the bottleneck.

If you google you'll find stories of people helping their local hospital by 3D printing parts for for respirators, and swabs. There's nothing cost effective about that, it's not fast, but it gets the job done. If you were to scale that, you would be competing for the same materials than manufacturers using injection molding or plastic dipping are.

[ksrm]

> At first we didn't have enough test, but that ramped up quickly, then we didn't have enough RNA extraction reagent, now we don't have enough swabs, and soon is the collection media that will be missing.

Where are you getting this information from?

[icegreentea2]

For RNA extraction: https://cen.acs.org/analytical-chemistry/diagnostics/Shortag... for an example.

For swabs - here's an example in action up in Ontario Canada: https://www.ctvnews.ca/health/coronavirus/ontario-limits-who...

No one is out trying to actively hide this information, but its spread does seem a little uneven.

I also don't want this to be fearmongering. Capacity and supply will grow (hopefully fast enough). Alternative solutions will be validated. We will keep bumping into problems, and we'll keep solving them (cause we'll need to).

[tonetheman]

We do not have tests.

https://covidtracking.com/data/

We have tested 150K people.

We have 327M people in the US, we have tested 0.00046% of the population.

We do not have tests.

[sp332]

Yeah but about HALF of those tests were done in the last TWO days! Capacity is coming online very rapidly now and while we are starting from behind, we will not be so short on tests for long. Roche alone is shipping 400,000 tests per week and Abbot Labs is on track to perform one million tests per week in the next couple of weeks. https://arstechnica.com/tech-policy/2020/03/america-is-final...

[shalmanese]

The important number is the ratio of tests:true case count. You need ~1000 - 10,000X tests/case to do true contact tracing because you want to a) blanket the country with tests and test every single suspected case even if 99% of them end up not being COVID 19 and b) proactively quarantine every person that a positive person has come into contact with and then test each of those people every single day for 14 days until they come up negative. If a single of those people come up positive, then you want to proactively quarantine all the people THAT person came into contact with, rinse and repeat.

It's great that tests are finally ramping up but the growth in testing can never exceed the growth in cases if cases are doubling every finite number of days. The choices are a severe lockdown where R < 0.5 until the true case count drops to near 0, a non-severe lockdown where R ~1.2 - 1.8 (Hubei's lockdown had an R of 1.3 in the early days until they figured out centralized quarantine could bring it down to 0.4) and you just continue the lockdown indefinitely, or "herd immunity" where R stays at 2.4 until pretty much everyone in the country gets sick.

Once you get your true case load down below your test load, then you can think about using non-pharmaceutical interventions (universal masking, universal temperature screening, mandatory hand washing when entering into a gathering space etc.) along with rigorous contact tracing to ensure that any future outbreaks remain small and contained.

[sp332]

I agree with wanted to blanket the country in tests, but you don't need 1000 tests to do contact tracing for one person, even normally, let alone during social distancing.

You don't need to test people every day for 14 days.

[shalmanese]

You do because as soon as that person is confirmed positive, then you need to contact trace and quarantine that person's contacts. Every day that goes between a confirmed positive and a contact trace, the more that person's contacts are walking around, spreading it asymptomatically and making the cluster even more out of control.

[mjewkes]

0.046%

You didn’t multiply by 100 to change from per unit to per cent.

Still bad though.

[tonetheman]

awwwww man ... i suck at math. thanks!

[DennisP]

The FDA just approved an antibody test. One blood sample, results in fifteen minutes. The manufacturer thinks they can produce enough for 200K tests/day.

https://www.biospace.com/article/releases/20-20-bioresponse-...

[snewman]

This site shows the number of tests performed in each state in the US:

https://covidtracking.com/data/

[supportlocal4h]

That site demonstrates the erratic nature of current data. For instance, their source data for Nevada is https://app.powerbigov.us/view?r=eyJrIjoiMjA2ZThiOWUtM2FlNS0...

At the moment of this comment that data says that ~2500 tests have been performed and ~2700 people have been tested. Perhaps those numbers were transposed. Maybe there is a simple, explainable mistake. But all the numbers everywhere are so full of errors, it makes casual statistical analysis just a fancy form of home entertainment at the moment.

[DoreenMichele]

I think testing mostly matters to prove to people this is real, but tests don't actually stop the disease. They aren't a cure.

I don't know how to get there from here, but I would like to see a great deal more focus on best practices and cultural change. That's how this pandemic will be stopped and prevented from recurring. Tests will only elucidate how bad it is, but aren't actual treatment.

Stop touching your face.

Stop touching everything.

Stop shaking hands. Maybe adopt bowing instead as a respectful greeting.

Wash your hands.

Be more supportive of remote work.

Design more services that help make flexible remote work a good thing for workers. (I like the Textbroker model. I've tried to promote that previously. No one cared or thought it mattered. Now, maybe people will pay attention.)

Light one small candle rather than curse the dark. Focus on promoting solutions. We don't do enough of that.

[DennisP]

Testing helps a lot more than that, because it helps you catch infected people before they spread it further. This was a key factor in China and South Korea getting the disease under control.

[DoreenMichele]

If we have cultural practices in place that more universally reduce or halt the spread of disease, it matters less to know who has it.

Of course, then people will say "we were just lucky" or the threat was never real.

But in terms of actual germ control, I would like to see more focus on shifting the culture to one of higher levels of germ control permanently.

But I don't need convincing. I already know this stuff is serious and makes a difference because of my medical situation.

[masonic]

   it helps you catch infected people

It helps you know that infected people exist, but in a "free" state, that's all. Unless you both require verifiable ID and have the power to quarantine someone against her will, you haven't "caught" anybody.

[mynegation]

I agree with you on almost all points, but testing does help to stop the disease. They are not a cure but an ability to test infected and recovered people en masse would help immensely to (a) isolate contagious people as soon as possible (b) confirm that the virus is cleared and the person can go back to the productive work with at least some assurance of immunity.

[DoreenMichele]

Let me try to put that another way:

Tests are information. I think we have enough information to try to err on the side of "Let's just assume everyone is a danger. Let's just globally reduce our cavalier, casual exposure to germs as a matter of course."

To me, it's crazy to insist we need to keep testing and we need to know who has it to protect people.

Social distancing and good hygiene are effective whether the person has been identified or not. I wish we would just go with that and stop acting like "a return to normal" is the goal and just around the corner for most people, if only we can identify the parties guilty of being infected and Target them.

It kind of doesn't matter. Just stop touching your face, among other things.

[mynegation]

Good idea in theory, not so much in practice, especially over longer periods of time. First, people are fallible and many of them who don’t know if they have it or not, may not take it seriously. Having a positive test (even if asymptomatic right now) would put them in a different mindset. The ability of quickly confirm recovery would put the people in critical roles back to their occupation. Medical professionals, police, truck drivers, water treatment plant workers, utility workers are all going to get sick in droves and it is not going to be pretty.

[DoreenMichele]

not so much in practice, especially over longer periods of time.

Everything I've read suggests that older, densely populated cultures pretty universally have adopted bowing over shaking hands, eat spicier foods, etc.

My belief is that over longer periods of time, cultural change is a much more reliable and effective means to combat disease.

"An ounce of prevention is worth a pound of cure."

[bamboozled]

Which is scary because Japan seems to have had the virus for a long time and is hardly testing at all. Really makes me wonder how the Olympics will or won't look.

[nkrisc]

Not cancelling or postponing the Olympics is massively irresponsible. That said, those who would still choose to attend are beyond help and a risk to their communities.

[Frost1x]

"We're virus free! Our strategy of extensively not testing has eliminated cases of the disease! Come to the 2020 Olympics, stay long, and please spend money here."

[bamboozled]

It’s a joke and everyone in Japan knows it too. The sooner they cancel or postpone and get on with solutions, the better.

[mynegation]

Ontario publishes this statistic and updates it twice daily [1]. It was just under 2% but started to creep up. To understand the numbers better it helps to know that currently there is about a 6 day wait on the test results. Until very recently criteria for testing were very stringent (2+ symptoms, recent travel), and even then only 2% were found to have it, which - in my understanding - disqualifies the idea that virus was already around for a while.

[1] https://www.ontario.ca/page/2019-novel-coronavirus