I don’t read articles in the National Review very frequently but I’ve got to admit this one from Rich Lowry, presenting a very different story about COVID-19 testing than you’ve probably heard, completely flabbergasted me. I don’t know what to make of it other than to conclude that publicity works.
If they could just get him off twitter, they’d have the info stream locked down.
Fake News. The article doesn’t fit an OMB narrative, so the facts presented in it have to be be wrong. Yeah, I’m cynical this morning.
I think the article sounds legit, I was dismayed that this nation couldn’t overcome the mask shortage in a couple of weeks. But even a mask has different components which must be sourced, approved manufactured, transported, assembled, packaged, routed, financed, delivered, ect.
It’s just an example of how spoiled Americans have become, accustomed to having everything they desire for sale at numerous convenient locations to think that ramping up testing for a new disease doesn’t take time.
Nice attempt at trying to make a failure look good, but it’s a fail. So lets first stipulate that we have lots of tests now and that maybe people arent using them enough. However, we dont have much of an organized plan to do surveillance screening. That said, the real problem with testing is that it took us way too long to get any tests. Then when we finally got them it took so long to get results they were nearly useless. With early testing we could have known how rapidly it was spreading and where it was spreading. Look at this quote.
“The FDA worked to approve new tests and technologies as rapidly as possible, which was enormously important to nearly every aspect of testing.”
Absolute, complete BS. The FDA actually wouldnt let academic centers, which had the expertise, develop and use their own tests. Sure, later in March they approved lots of tests, and to be complete a lot of those were awful.
“For example, one manufacturer’s claim of 96.7 percent sensitivity for a test was found to only have 76.4 percent sensitivity at two weeks post symptoms. In 1,000 people who have antibodies, that means that it would miss 236 cases — even though the manufacturer listed sensitivity indicates it would miss only 33.”
https://thehill.com/opinion/healthcare/502566-trust-but-verify-the-us-government-needs-to-validate-antibody-tests
I said before that once they started taking this seriously they actually did OK, but that didnt start until sometime in late February/MArch. Even when governmental agencies were performing better the messaging was still awful. I was going to give this a D for effort, but since people seem to be buying into it I guess I should up that to a C.
Steve
As I said I don’t know what to make of it.
Not as long as the only testing being done was diagnostic testing.
is it raining or is somebody doing something on my back. The spin/counter spin/counter counter spin/ad nauseam makes me ponder if the last 2o years or so has been one long bad acid flash back.
Steve can always be counted on to be a naysayer about anything to do with Trump. Consequently, I read his comments with a grain of salt and a sense of reality as to his ideological configuration.
Trump was introduced to this virus like we all were – a new contagion blown up in it’s projections of fatality figures by various computer models. There were no immediate testing protocols, antivirals or PPE resources in place to get ahead of this virus. Mistakes were made, especially by the inflexible policies of the CDC and FDA, as well as by Trump initially waving off the seriousness this virus was presenting. However, the ever negative media, the obstructive democrats were of no assistance in helping to mitigate the presence and impact of COVID on this country. In fact, the hostile collaboration of the media and Dems has only played interference in finally getting to some semblance of understanding and treatment of COVID.
The BLM riots have also done nothing to add in getting a better handle on this pandemic, with testing centers being destroyed. Other testing sites, like in my area, are simply not frequented by people wanting to be tested – medical personnel are left standing around with no one in line waiting to participate in testing.
In the meantime, the IFR seem to be diminishing, as the media and presidential opponents highlight the increasing cases of COVID. But, nowhere is a widely reported differentiation being made about those dying because of the virus or simply being tested with it. Age and co-existing medical conditions are only a subset of the numbers attributed solely to the virus. Fear and continuing restrictive guidelines rule our lives, and will probably do so all the way to November.
Nazi farm tractor:
https://encrypted-tbn0.gstatic.com/images?q=tbn%3AANd9GcSvtNTe_iOyhLELqOoXeepKOa6KzFvdnf4w4YIu2JHT3fVAElWH&usqp=CAU
“With early testing we could have known how rapidly it was spreading and where it was spreading.â€
That’s odd. I correctly told everyone where to look day 1 and never even administered a single test: nursing homes and assisted living facilities.
That comment raises an interesting point. Have most of the deaths occurred in retirement homes, assisted living facilities, or skilled nursing facilities? It seems to me it would make a difference.
40-50%, but you can cut that number by transporting people to hospitals before death occurs.
We could probably extend life a little more by adding hospital intensive care units to nursing homes, but then there’s the cost thing again.
$$$ vs life.
I can now say that I personally know one person who has been infected, a native A. man in his thirties on the res. He’s home, but having a hard time shaking it off, every time he starts to feel better, the fever and chills come back, going on 3 weeks now. It’s just a very different disease, with symptoms and duration all over the map.
The statistics of 40% of deaths (just let that sink in – 40%) is usually attributed to nursing homes. But I suspect that is just short hand for all three types you cite, simply because the most dominant risk variable – age – pertains to all three.
Note an MD, epidemiologist and former CEO of one of the Hopkins hospitals observes wrt the hyped increase in reported cases (in the face of stepped up testing):
“We see the disconnect between the number of daily cases and deaths in Florida. The state relaxed its stay-at-home orders in mid-May. Two weeks later, at the start of June—and about the time that one would expect to see increasing cases if the lifting of stay-at-home orders had an impact on transmission—the number of new cases started growing day-over-day. Since then, the number of daily cases has continued to grow; but over the same period, the number of daily deaths has dropped by more than half.”
Further:
“If the context has changed, what should our current policies on reopening the economy be? The data support moving forward with gradual reopening of commercial and social activities. As with all public policy, permitting normal life to resume will bring costs and benefits. Based on current conditions, the cost of limiting social and commercial activities outweighs the benefit of preventing further spread of the infection. This assumes that we continue to protect those most vulnerable for severe illness—the elderly and those with serious preexisting conditions—and closely monitor high-risk places such as prisons and long-term-care facilities.”
Note his usage of the term long term care facilities. I recall from earliest days commenting that concentrated institutional settings held the key to materially reducing the virus’ impact, especially institutions housing the aged.
I’m sure there are 4-6 first order risk factors in this disease. However, age, population density and co-morbidity seem to lead the pack. I’m sure variants of the virus, blood types etc can be factors, but I don’t think much is really controllable.
As a last point, even the Amazing Mr Fauci has recently said that the one size fits all mass shutdown was a “giant experiment.”
“That’s odd. I correctly told everyone where to look day 1 and never even administered a single test: nursing homes and assisted living facilities.”
Unfortunately, not many nursing home pts visited Italy or China. Nursing home pts tended to show up slightly later. And this is clearly just snark anyway since what we needed to know is what geographic areas were involved.
“Not as long as the only testing being done was diagnostic testing.”
Since testing was so limited we had to decide between surveillance testing vs diagnostic. In that situation I think it was hard to not choose diagnostic. Didnt have enough for meaningful surveillance anyway, so moot.
“Mistakes were made, especially by the inflexible policies of the CDC and FDA,”
One again, who is in charge of the CDC and FDA? Who appointed or approved their leadership? Who had the ability to demand that they change, to cut regulations? Your guy is in charge. You want to have the power but not the responsibility.
“but over the same period, the number of daily deaths has dropped by more than half.—
I still think deaths are a good metric, but you also need to monitor hospitalizations and ICU admissions. Remember that deaths from Covid usually occur 2-3 weeks after admission. So you can have increasing admissions while you are having decreasing deaths for a while with that long of a time lag.
The media likes to report total cases, and at some level that is important but it has a lot of variables going into it so its not very useful. Percentage of tests that are positive is much more meaningful.
Steve
Presumably, you mean “I still think deaths are not a good metric, etc.”
Note that the governor of Illinois’s position cannot be justified even on the basis you’ve suggested.
No, I think they are good metric but you have to understand the time lag and the demographics of the area involved.
Steve
No, its not snark. Its common sense. At it turns out to have been square on the money.
Ahh, then it is ignorance not snark. If we had adequate testing early and concentrated that in nursing homes we would have missed the early spread. The first cases on the West coast were people who traveled in China. The first in NYC those who traveled in Italy. W hat we needed was to do surveillance testing in the community. Doing it nursing homes also would’ve been a bonus, but since we didnt have adequate testing until after Covid was well established in the community and in nursing homes it is a wishful argument.
Steve
Are you really going to tell me, steve, that an engineer and private equity guy knew that long term care facilities were in the bullseye of this virus, and should be the focus of preventative measures, but a doctor didn’t know, without the benefit of testing?!? Seriously??
Can you say gross negligence? Profound ignorance. Unbelievable incompetence?
Park the politics, steve. I know you aren’t a fool, but you are behaving like one. Dogma needs a rest sometimes…….. Deep six the perceived opportunity to criticize Trump.
Nope, saying you are too far down the ideological rabbit hole to follow this. Covid was here for a month before it started showing up in nursing homes. IF, big if, we had testing early and we had enough we should have done general population testing to look for incidence in the community, and we should have been testing for people returning from China and Europe. That would have let us pick up spread and try to stop it in a focused manner if we wanted.
If someone had decided they wanted widespread testing in nursing homes then let us remember that well into April I couldn’t get testing for my staff and we couldnt test a lot of our pts since we didnt have enough tests. If we wanted to have meaningful testing programs in nursing homes it wouldnt have happened probably until sometime in May. By then we already knew it was prevalent in nursing homes. Could testing have been used to stop spread in nursing homes? Maybe. I still haven’t seen a realistic plan for reducing spread to nursing homes. I asked here and no one has offered one.
Steve