Help me understand the need for testing and why that is critical to the reopening of businesses etc.

A few key facts:

• People are carriers for up to 2 weeks before they show symptoms. Therefore, someone can spread the virus to numerous people before they even know they have it.
• There is currently no cure or treatment. If you get sick, assume you have COVID as a test does not help you. Beside being sick, whether COVID or something else, you should still self isolate to avoid the spread of whatever it is. Assume you have it and contact trace to quarantine to potentially infected. Better than locking everyone down
• There are 328 Million people in the USA. At the current test rate of 150,000/day it will take 6 years to test everyone. We can expand testing, but why the focus and need on this and not something else.
• Testing takes a significant amount of people, PPE and other resources that could be used for other purposes

I understand that knowing if you have it offers some piece of mind, but until there is a treatment what are the benefits?

If we are serious about protecting the old then testing is how we possibly keep it out of the nursing homes. If the Drs cant find a series of treatments that improve survivability then flattening the curve and testing is a going to be less helpful. I am hopeful the Drs can find a treatment regimen and hopefully it can be available for the patients that end up with moderate to severe cases.

Your first example

Duncan Idaho said:

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the problem is we need to be a millions of tests a day. 200,000/day is just about as worthless as zero/day. The key is surveillance testing a d it has to be paired with contact tracing.

If you show up at the hospital and test positive, they move on to testing your household, co-workers and others that you have had direct contact. Everyone that test positive, immediately goes into enforced and monitored quarentine. Not "go home and rest" but medical jail/house arrest.


Testing is key to containment and monitoring of spread, not to managing treatment

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I dont think we need to be even close to a million per day. Keep it shut long enough and the number needing a test each day drops enough below capacity that you can open back up and not be worried

Thanks

Why can we not contact trace and quarantine based on assumed positive test? We are months away from being able to test enough people to know where the "hot spots" are. Add to that that all the people will need to be regularly tested as a negative test today may be positive tomorrow after going to the grocery store or gas station or wherever.

I still fail to see where testing helps. To be beneficial it has to be an instant test and even the yearly flu is not always correct on the instant test. And contact tracing has to be quick. Add to that that contact tracing is only partial as anyone that used the same gas pump in a 2 day period (more or less) will need to be identified, etc. Direct contact may be easy but social contact on where someone has been is not possible.

We have given up numerous freedoms already and having the government track my whereabouts is not going to happen.

Why is testing critical to opening back up? Why not lock down on assumed positive. We have started to inflate death totals to include assumed positive when not test was performed.

Marcus Aurelius said:

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Test everyone. Rapidly isolate positives and exposed to positives.

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How? Honest question...

If I expose dozens of people before I test positive, and those people expose dozens of people, and that happens in every community nation-wide....what does testing me do?

I am with the OP, and am having a hard time seeing what it will do, given this particular situation when you can be a carrier without knowing it.

From a surgery perspective, I expect all patients coming for elective surgery to be tested prior to having surgery. Those who test positive won't be allowed to have surgery.

Most other routine testing seems nothing more than satisfying a curiousity given our inefficient contact tracing methods.

AgGrad99 said:

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Marcus Aurelius said:

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Test everyone. Rapidly isolate positives and exposed to positives.

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How? Honest question...

If I expose dozens of people before I test positive, and those people expose dozens of people, and that happens in every community nation-wide....what does testing me do?

I am with the OP, and am having a hard time seeing what it will do, given this particular situation when you can be a carrier without knowing it.

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You make two leaps. 1 that everyone exposes dozens before they get tests and 2 that it happens nationwide

Testing and tracing, even without treatment, is just a way to keep a lid on things. There would still be flare ups, but most of the potential flare ups could be contained prior to becoming a wildfire and without widespread reimplementation of lockdown.

This assumes that the new normal of social distancing applies even with some loosening of restrictions. It wouldn't be normal; just a new normal. Some measure of social distancing would be critical for allowing testing and tracing to be effective. Otherwise, things could blow up too quickly to track.

That's the theory, anyway. We will see what reality looks like, probably with some examples in Europe before we start to roll out any loosening of restrictions in the US.

AgGrad99 said:

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Marcus Aurelius said:

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Test everyone. Rapidly isolate positives and exposed to positives.

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How? Honest question...

If I expose dozens of people before I test positive, and those people expose dozens of people, and that happens in every community nation-wide....what does testing me do?

I am with the OP, and am having a hard time seeing what it will do, given this particular situation when you can be a carrier without knowing it.

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Consider it in the reverse. In the same way your single infection can lead to "dozens" of additional infections, catching a single infection early enough prevents "dozens" of additional infections.

Yes, there will be overlap. Some of those dozens will get infected by someone else. Its not perfect. But, I hope you see the idea.

I don't see that as a leap personally, in 14 days I have filled up with gas twice, been to the drive through 15 times, been to the grocery store twice, Home Depot once, and the pharmacy once. If I had it during those 14 days, even keeping my distance I have potentially come in contact with 40-50 of whom I have no idea who they are or who else they came in contact with.

Now I don't believe it is that easy to transfer, ie the gas pump handle spreading it. But short of siting at home and having everything delivered to my door I can see dozens of exposed in a 2 week period.

Contact tracing is the most effective method the world has used to limit the spread. It's not 100% foolproof.

Additionally, the fact that so many people have to quarantine based on the assumption they have the virus is why this economy cannot get revved up without testing. Let's take a hypothetical business where 1 person comes down with the CV. Now, in the situation where we don't have enough testing to check asymptomatic people who were in close contact with known carriers, all of those people have to stay home for two weeks and effectively shut down the business. However, in a situation with sufficient testing, those people who have been exposed can all go out and get tests. Even if they have to wait a day or two, they could be back to work much sooner.

Someone already mentioned the impact to health care, but that same logic would apply to a lot of things.

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You make two leaps. 1 that everyone exposes dozens before they get tests and 2 that it happens nationwide

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But we're talking about how the tests change/improve the status quo.

So as is...those that will infect dozens of people nationwide, will continue to do so, even if we test....because the test wont come until after symptoms show.

How is that different? Once I show symptoms, Im going to get tested, and isolate myself.

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Consider it in the reverse. In the same way your single infection can lead to "dozens" of additional infections, catching a single infection early enough prevents "dozens" of additional infections.

Yes, there will be overlap. Some of those dozens will get infected by someone else. Its not perfect. But, I hope you see the idea.

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Yes. I understand how identifying someone who has tested positive, and isolating them will help. But that's what we're already doing, no? People experience symptoms, they test/isolate.

I think testing would make a difference if we catch asymptomatic people and isolate them very early. That would require Widespread testing for everyone (showing symptoms or not)...but that doesn't seen feasible given the numbers of people and lack of tests available.

AgGrad99 said:

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You make two leaps. 1 that everyone exposes dozens before they get tests and 2 that it happens nationwide

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But we're talking about how the tests change the current status quo.

So as is...those that will infect dozens of people nationwide, will continue to do so, even if we test....because the test wont come until after symptoms show.

How is that different than now? Once I show symptoms, Im going to get tested, and isolate myself.

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Self selecting for testing after you decide that you are sick is worthless. Never mind how insanely stupid telling someone who is sick to "well go home and stay there" is. Hell the first set of quarantined people in San Antonio went to the ****ing mall.

No one thinks that increasing the testing we are doing now (I.e. sick people ) is going to matter.

Testing has to be pervasive, proactive and integrated with contact tracing and supported by spread mitigation techniques (masks, hygiene, social distancing)

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Yes. I understand how identifying someone who has tested positive, and isolating them will help. But that's what we're already doing, no? People experience symptoms, they test/isolate.

I think testing would make a difference if we catch asymptomatic people and isolate them very early. That would require Widespread testing for everyone (showing symptoms or not)...but that doesn't seen feasible given the numbers of people and lack of tests available.

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Not only widespread testing...but widespread repeated testing. You would pretty much have to keep testing the negative results (daily/weekly) until they do test positive. Then isolate them.

The percentage of people who are asymptomatic but infectious is undetermined, but thought to be substantial. Contract tracing would get you tested, and you might find out you are an asymptomatic carrier and quarantine, where you otherwise might not have.

AgGrad99 said:

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Consider it in the reverse. In the same way your single infection can lead to "dozens" of additional infections, catching a single infection early enough prevents "dozens" of additional infections.

Yes, there will be overlap. Some of those dozens will get infected by someone else. Its not perfect. But, I hope you see the idea.

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Yes. I understand how identifying someone who has tested positive, and isolating them will help. But that's what we're already doing, no? People experience symptoms, they test/isolate.

I think testing would make a difference if we catch asymptomatic people and isolate them very early. That would require Widespread testing for everyone (showing symptoms or not)...but that doesn't seen feasible given the numbers of people and lack of tests available.

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This is what you should be pissed at. We have squandered these last few months. The second thing that should have happened after restricting flights from China was mass production and distribution of South Korean designed test kits. Mirrored by the development of US improved tests.
The first thing should have been invoke "P" and make ppe

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Not only widespread testing...but widespread repeated testing. You would pretty much have to keep testing the negative results (daily/weekly) until they do test positive. Then isolate them.

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Makes sense...But how?

We have 330 million people. We dont have the ability to test everyone repeatedly.

Test everyone in the US?
Statistically speaking I dont think you need a population size anywhere that large to make an informed medical decision. Besides, even if we could create 330 million tests, it would take roughly 9.5 years to test everyone assuming we could test one person, per second continuously.

edit: bad math, it should be roughly 10.5 years but I'll leave it anyways

AgGrad99 said:

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Consider it in the reverse. In the same way your single infection can lead to "dozens" of additional infections, catching a single infection early enough prevents "dozens" of additional infections.

Yes, there will be overlap. Some of those dozens will get infected by someone else. Its not perfect. But, I hope you see the idea.

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Yes. I understand how identifying someone who has tested positive, and isolating them will help. But that's what we're already doing, no? People experience symptoms, they test/isolate.

I think testing would make a difference if we catch asymptomatic people and isolate them very early. That would require Widespread testing for everyone (showing symptoms or not)...but that doesn't seen feasible given the numbers of people and lack of tests available.

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Tests are becoming more and more available by the day. Did you know we are up over 3.2m tested in the US?

Capacity will continue to build over the next two weeks. We will be getting close to what we need to be able to conduct widespread surveillance testing soon.

Contact tracing and then testing of contacts will greatly help in keeping a lid on things.

tysker said:

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Test everyone in the US?
Statistically speaking I dont think you need a population size anywhere that large to make an informed medical decision. Besides, even if we could create 330 million tests, it would take roughly 9.5 years to test everyone assuming we could test one person, per second continuously.

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