
CDC declined to test new coronavirus patient for days, California hospital says - pmoriarty
https://thehill.com/policy/healthcare/484903-cdc-declined-to-test-new-coronavirus-patient-for-days-california-hospital
======
m-i-l
Is there any particular reason the US is testing so few people? They've only
tested 445 people in the entire country so far[0], which is a tiny number for
such a large country (contrast e.g. with the much smaller UK which has tested
7,690 people[1])? Wasn't that one of the lessons from Italy - the numbers of
confirmed cases seemed to shoot up from 21 Feb mainly because that's when they
started testing.

[0] [https://www.cdc.gov/coronavirus/2019-ncov/cases-in-
us.html](https://www.cdc.gov/coronavirus/2019-ncov/cases-in-us.html)

[1] [https://www.gov.uk/guidance/coronavirus-
covid-19-information...](https://www.gov.uk/guidance/coronavirus-
covid-19-information-for-the-public)

~~~
devinhelton
The test-kit that the CDC sent to local labs had a faulty reagent, so all test
requests have to be sent back to the CDC.[0]

Local labs could develop or purchase their own test kits, but during an a
public health emergency, they must get FDA authorization before launching such
a test.[1]

This seems to me like a giant institutional and bureaucratic screw up.

Hopefully the FDA may be finally getting its act together and fast-tracking
approval of local tests:
[https://twitter.com/ScottGottliebMD/status/12330216819181936...](https://twitter.com/ScottGottliebMD/status/1233021681918193664)

[0] [https://www.politico.com/news/2020/02/20/cdc-
coronavirus-116...](https://www.politico.com/news/2020/02/20/cdc-
coronavirus-116529)

[1]
[https://threadreaderapp.com/thread/1231944326827081729.html](https://threadreaderapp.com/thread/1231944326827081729.html)

~~~
Reelin
In all seriousness, why should a non-invasive diagnostic test require any sort
of approval (particularly during an outbreak)? This is just RT-PCR if I
understand correctly - there's nothing particularly novel going on here. Just
publish the primer sequences and let the biotech industry handle things.

Edit: Oh hey they did publish an RT-PCR protocol [1] plus sequences, [2] along
with a disclaimer not to use them directly on human subjects. This is just
silly (IMO).

> These procedures and/or reagents derived thereof are intended to be used for
> the purposes of respiratory virus surveillance and research. The procedures
> and reagents derived thereof may not be used directly in human subjects.

[1] [https://www.cdc.gov/coronavirus/2019-ncov/lab/rt-pcr-
detecti...](https://www.cdc.gov/coronavirus/2019-ncov/lab/rt-pcr-detection-
instructions.html)

[2] [https://www.cdc.gov/coronavirus/2019-ncov/lab/rt-pcr-
panel-p...](https://www.cdc.gov/coronavirus/2019-ncov/lab/rt-pcr-panel-primer-
probes.html)

~~~
orblivion
Maybe false negatives or even false positives could be a liability issue?

~~~
oceanghost
Type-1 and Type-2 errors... :-)

[https://en.wikipedia.org/wiki/Type_I_and_type_II_errors](https://en.wikipedia.org/wiki/Type_I_and_type_II_errors)

Medical testing is very, very murky. There was a time a routine medical test
for me came back, indicating I possibly had Lupus. It turns out; this test has
a false positive rate of about 5%.

I am a white male, and the rate for lupus for my group is astronomically low.
The rate for the worst group (black females) is like 500 in 100,000. There's
some evidence the rate around white males might be six times lower.

Had I known any of this at the time, or had my doctor explained it, I wouldn't
have spent weeks worrying.

The fact is, medical tests just update the probability you're sick or well.
And this is why they have to be well understood.

~~~
magduf
I had a problem a couple years ago where my test showed that I had
hypothyroidism. My doctor wanted to immediately put me on sythetic thyroid
hormone to adjust this. The problem is that I'm thin, athletic, and have no
other indicators for risk of hypothyroidism.

I said no to the doctor, and had them do another test, which said I was just
fine.

~~~
cjbprime
The story is not so remarkable: there is no harm from taking synthetic thyroid
hormone, and your TSH is monitored while taking it such that I think the
mistake would have been discovered later.

~~~
magduf
>there is no harm from taking synthetic thyroid hormone

Where are you getting this crazy idea? Have you ever known anyone who took it?
I have two relatives (not biological) on synthroid and even small changes in
doses have massive effects on their metabolism, tiredness, etc. Taking thyroid
hormone when you don't need it is not harmless, just like any drug or hormone.

~~~
cjbprime
Hm, okay. Apologies for the misinformation.

------
pcr910303
As a South Korean citizen it is jarring that other countries including the US
and Japan isn't really trying to test people. Japan has people that died due
to COVID-19 and they don't know how it was spread - the US didn't even test
everyone that came from Diamond Princess! Why aren't those countries tracking
down how the viruses are being spread?

I don't like conspiracy theories, but seriously it looks like they are trying
to lessen the numbers on the paper instead of really trying to find the
patients. Compare the numbers that the countries are testing[0], US is less
than a thousand and Japan is about 1300.

Edit: Just for people who are curious in how things are working in South
Korea, we test everyone who has: pneumonia symptoms, or has been in the same
place with already discovered patients for free - and anyone who is concerned
can test with about $100 - which is refunded if one turns out to be positive.
We track every COVID-19 patient's routes and test everyone who was in the same
place; which means that the government (mostly) knows exactly how the virus is
being spread. Based on data that was announced 10 hours ago[1] (we announce
data and roadmap twice every day), we have tested 66,652 people with 1,766
cases found, and currently 25,568 tests are on-going. 1,727 people are being
quarantined, and 26 people have fully recovered from COVID-19.

Second Edit: Okay, I'm not really skilled in English; if this felt like
bragging how South Korea is well handling this situation, that is not my
intent - we have a lot of complaints of how the government should handle this.
My intent was asking why the US/Japan is not doing at least this much,
considering that both countries are much powerful & richer than Korea. Both
countries are basically the Korea's wannabe-countries; and everybody here is
pretty shocked (literally - there is a lot of news/SNS posts/internet memes on
how Japan/US is handling the situation) that they aren't doing well.

[0] [https://i.imgur.com/BAROczt.jpg](https://i.imgur.com/BAROczt.jpg)

[1]
[http://ncov.mohw.go.kr/tcmBoardView.do?brdId=&brdGubun=&data...](http://ncov.mohw.go.kr/tcmBoardView.do?brdId=&brdGubun=&dataGubun=&ncvContSeq=353203&contSeq=353203&board_id=&gubun=ALL)
(Korean, sorry :-()

~~~
ryanmercer
>As a South Korean citizen it is jarring that other countries including the US
and Japan isn't really trying to test people.

It's apparently quite expensive here. Federal minimum wage is $7.25 an hour,
while one reported cost [0] for the test is:

>$3,270 two weeks after his test. He will be responsible for $1,400 of that
bill.

That's almost 10% of my annual gross before insurance and I have almost 14
years at my job. For someone working a minimum wage job that's more than 11
week's gross income. I imagine they are limiting the number of tests on people
that could have any number of other things and waiting for symptoms to
strongly point towards the virus due to the simple fact that the tests cost so
much. If a patient can't pay, whatever hospital has to carry that cost for
potentially years before the patient can repay them (or not get paid at all if
it pushes someone to bankruptcy).

Until the government sets aside money to subsidize the tests, I imagine the
testing rates will remain low.

[0]
[https://www.independent.co.uk/news/world/americas/coronaviru...](https://www.independent.co.uk/news/world/americas/coronavirus-
test-medical-bill-china-us-miami-osmel-martinez-
azcue-a9358146.html?amp&utm_source=reddit.com)

~~~
pcr910303
Hmm, I’m not really familiar with US’s medical system... so some questions:

* Does that mean someone who gets minimum wage (which probably doesn’t have an additional health insurance except for a default one) needs to pay for $1400 to test? (If true, that’s insane - why does the government only take cares of $1700 and not something like $3000?)

* Does people who come from Wuhan/other places where COVID-19 is spreading (lets say an american that comes from Daegu - the district with the most patients in Korea) also have to pay the high price to be tested?

~~~
magduf
The US medical system is a complete disaster. Basically, the government
doesn't pay for anything; only private insurers do. And they try to avoid
paying for as much as they can get away with. On top of that, the actual cost
of care is far, far higher than in other developed nations for the same
procedures, due to many systemic problems.

~~~
pmoriarty
_" Basically, the government doesn't pay for anything; only private insurers
do."_

That's not true. Poor people can get Medicaid, old people can get Medicare,
and there are also various other ways of getting one's health care expenses
subsidized by the government if you're poor or have medical reasons for not
being able to work.

Just to be clear:

I'm for 100% state-funded medical care, but it's simply not true that _" the
government doesn't pay for anything; only private insurers do"_. The
government does pay for quite a lot, even if many people in the US don't
qualify for such aid.

They absolutely _should_ qualify for such aid, in my view, but my opinion
doesn't change anything. Some people qualify, some don't, and the government
_does_ pay for some, and private insurance does not pay for absolutely
everything in the US. These are just facts.

~~~
barretts
You're focused on the trees, not the forest. The prior commenter is right:
Unless you are very poor (and get Medicaid) or old (and get Medicare), most
Americans receive no government assistance for healthcare.

------
deweller
I can only imagine that there is a large amount of requests for COVID-19 tests
from hospitals across the country right now. Without some kind of guidelines,
the request for tests would overwhelm the current capacity and the most likely
subjects would not be identified as soon. There has to be priorities.

I expect the CDC will update their testing criteria when it makes sense.

~~~
missosoup
There aren't any meaningful criteria. The symptoms look exactly like those of
the regular flu, they just have a worse distribution of outcomes which
manifest long into the infection.

Just like China, the rest of the world does not have the capacity to test
anywhere close to every suspected case. This is also why even good-faith stats
are guaranteed to be underestimates. There are no easy answers here,
individuals should look after their own wellbeing.

~~~
gnulinux
> individuals should look after their own wellbeing.

I don't understand how I'm supposed to look after my wellbeing when I'm
employed and need to go to work and need to be in close contact with hundreds
of people. CDC should advise businesses and should advise everyone to WFH if
they can. My boss didn't even hear about this at all, think about that for a
second.

~~~
graeme
Many best practices can be done in that context:

1\. Wash your hands frequently

2\. Especially wash your hands before eating

3\. Practice not touching your face. In particular eyes, mouth, nose

4\. Keep distance from people. Aim for 1.5 feet. Double that if person
coughing or sneezing

5\. Don’t shake hands

6\. Avoid large gatherings

7\. If sick, take sick days

8\. Watch out for objects many touch but which are infrequently cleaned.
Doorknobs, pens, elevator buttons, etc. Using your elbow or sleeve is better
than your hand. Once community spread starts, wear gloves.

More here. If everyone did the above the R0 would drop.

[https://foreignpolicy.com/2020/01/25/wuhan-coronavirus-
safet...](https://foreignpolicy.com/2020/01/25/wuhan-coronavirus-safety-
china/)

~~~
unlinked_dll
One problem I suspect we'll see is that the sick people most exposed to others
won't take sick days, because they don't get paid sick leave.

There are a lot of hourly workers in the service economy that don't get sick
time, and they still need to pay their bills. I'm not personally worried about
the people in my office since I can avoid close contact. I'm worried about the
people stocking shelves at grocery stores and pharmacies, working checkout
counters and the like.

~~~
graeme
It’s a real concern. But keeping your distance, washing your hands, and not
touching your face will nonetheless greatly reduce risk.

Maintaining a decent (though not extreme) amount of supplies at home will also
help you avoid shopping at time of greatest spread.

I say “not extreme” as hoarding can cause problems on its own. Basically just
forward your own purchases a couple weeks.

------
pmoriarty
South Korea tested more people for COVID-19 in one day than all the testing
the CDC has done to date.

~~~
DyslexicAtheist
+4000 tests within a couple of hours in which they identified another 70
cases:
[https://twitter.com/DrEricDing/status/1231972534612119557](https://twitter.com/DrEricDing/status/1231972534612119557)

US total tests so far: 445 (source:
[https://www.cdc.gov/coronavirus/2019-ncov/cases-in-
us.html](https://www.cdc.gov/coronavirus/2019-ncov/cases-in-us.html))

~~~
jbattle
The numbers on that page are over a month old

> * This table represents cases detected and tested in the United States
> through U.S. public health surveillance systems since January 21, 2020.

~~~
DyslexicAtheist
no. right above the table the report says:

    
    
       Updated February 26, 2020
    

and it clearly says the data is _/ since/_ Jan 21st.

see archive how their numbers evolved over time:
[https://web.archive.org/web/*/https://www.cdc.gov/coronaviru...](https://web.archive.org/web/*/https://www.cdc.gov/coronavirus/2019-ncov/cases-
in-us.html)

there are also inconsistencies/errors in the report (e.g. 21st Feb they
claimed 479 total tests):
[https://web.archive.org/web/20200221040933/https://www.cdc.g...](https://web.archive.org/web/20200221040933/https://www.cdc.gov/coronavirus/2019-ncov/cases-
in-us.html)

------
tlobes
Flying into LAX from Asia last week, I had expected to spend a few hours at
the airport before officially entering, but alas, it was worryingly expedient
only being asked “did I travel to China in the last weeks?”

~~~
soared
I came japan -> SF on 2/1 (prior to major outbreaks) but they didn’t have
temperature scanners, no one asked if I’d been to China, and with the mobile
passport app I was through immigration in <30 seconds. Kind of crazy.

~~~
companyhen
What's the mobile passport app called? I have a global entry card, but just
got it so I'm not too familiar with my options.

~~~
turrican
“Mobile Pass”, blue and white icon. Takes maybe 10 minutes to configure the
first time, but is really useful.

~~~
companyhen
Thanks, do you just use the free version? Looks like there's some subscription
plans inside.

~~~
turrican
I personally have only used the free one. To me it isn’t even entirely clear
what the paid version gets you.

------
shakna
> “Since the patient did not fit the existing CDC criteria for COVID-19, a
> test was not immediately administered,” the statement added. “UC Davis
> Health does not control the testing process.”

That seems fair enough to me - testing is currently limited, and likely under
high load.

The concern, rather, is this:

> Experts raised concern that the CDC's narrow testing criteria could mean
> that there are more cases circulating among the general public that have not
> been identified.

The narrowed testing criteria hasn't managed to just exclude false positives
(the intent) - it is now excluding positives that need to be caught.

~~~
bilekas
> testing is currently limited, and likely under high load.

How can it be high load if its not being tested ?

approx 400 tests nationwide ? If thats high load, the CDC is in for a big
shock soon I think.

~~~
shakna
They've distributed around 200 test kits, that can each run 700-800 individual
tests. [0]

Unfortunately, a number of these kits have turned out to be faulty, a
discovery only widely noticed a few days ago. [1]

It'll take time for them to redistribute the kits.

[0] [https://www.cdc.gov/media/releases/2020/p0206-coronavirus-
di...](https://www.cdc.gov/media/releases/2020/p0206-coronavirus-diagnostic-
test-kits.html)

[1] [https://www.washingtonpost.com/health/2020/02/25/cdc-
coronav...](https://www.washingtonpost.com/health/2020/02/25/cdc-coronavirus-
test/)

~~~
Reelin
I'm actually a bit puzzled by this. This is RT-PCR based, so why can't off the
shelf lab supplies be used? Oligo synthesis commonly has next day turnaround
at this point, so primers can't be the issue... Is this purely a regulatory
bottleneck?

Edit: It's purely a regulatory bottleneck, they've published a protocol along
with the primers and probes.
([https://www.cdc.gov/coronavirus/2019-ncov/lab/rt-pcr-
panel-p...](https://www.cdc.gov/coronavirus/2019-ncov/lab/rt-pcr-panel-primer-
probes.html)) FFS how are we this incompetent.

~~~
ggreer
It's an unintended side effect of FDA regulation. This thread by the previous
FDA commissioner explains it.[1]

1\.
[https://twitter.com/ScottGottliebMD/status/12319443268270817...](https://twitter.com/ScottGottliebMD/status/1231944326827081729)

~~~
Reelin
Interesting read. It doesn't explain though why "the people in charge" haven't
issued a blanket authorization by now for basic RT-PCR based diagnostics using
a particular primer sequence at facilities meeting some minimum criteria.

Other countries have managed to authorize and implement drive-thru testing
stations [1] by now; it really seems like we're demonstrating our ineptitude
here.

[1]
[https://twitter.com/ianbremmer/status/1232685500806225922](https://twitter.com/ianbremmer/status/1232685500806225922)

~~~
ggreer
The FDA is a big slow bureaucracy. Also, all of their incentives are to block
new things. If they approve a new medical treatment or diagnostic that ends up
harming people, they'll get tons of bad publicity and the individuals who
approved it could lose their jobs. If they block things, few seem to notice
(see everyone in this thread talking about CDC funding being cut).

For example: The FDA took a decade longer than the rest of the world to
approve the first beta-blocker (timolol). That caused around 100,000 deaths.
The FDA is also the reason why epipens are so expensive (along with countless
other generic drugs).[1]

That said, it looks like they'll approve a standard covid19 test soon.[2]

1\. [https://slatestarcodex.com/2016/08/29/reverse-
voxsplaining-d...](https://slatestarcodex.com/2016/08/29/reverse-voxsplaining-
drugs-vs-chairs/)

2\.
[https://twitter.com/davidalim/status/1233032552056807426](https://twitter.com/davidalim/status/1233032552056807426)

------
the_watcher
Perhaps a basic question, but what is actually required to test for COVID-19?
I've seen mentions of "testing kits", but what's actually in them? For
comparison, US medical facilities regularly test for any number of viruses and
can essentially turn them around indefinitely. Is this because they _know_
they'll continue to need to test for them, so they are well-stocked in the
test kits?

~~~
singularity2001
The most sensitive test is polymerase chain reaction PCR, which multiplies
tiny remnants of DNA of the virus

It can take up to a day to get results, a team of four can only do roughly
about 100 tests per day

Then you have serology test, which checks for antibodies against the virus,
The signal is strongest after the peak of the disease

The Koreans are working on tests which can be applied at home but I don’t know
details

~~~
usaar333
nit, but it's an actually amplifying the RNA (it's an RNA, not DNA based
virus), using RT-PCR (which basically converts the RNA into complementary DNA
-- and then amplifying DNA)

I'm not sure per se what the CDC does, but here's a good overview of a testing
method:
[https://www.broadinstitute.org/files/publications/special/CO...](https://www.broadinstitute.org/files/publications/special/COVID-19%20detection%20\(updated\).pdf)

------
moultano
Folks, I think it's time for as many bay area workers as possible to WFH.
Let's get ahead of this.

~~~
dguaraglia
I've been turning this around in my head for the past few days. If things keep
getting worse (and there's no signs they'll get _better_ soon) I'll bring it
up with my co-founders. Seems silly to worry too much, but on the other hand,
what is the upside if we are all on our computers 99.99% of the time anyway?

------
remote_phone
Everyone involved in the decision not to test the person should be removed
from their position. End of story.

In a time of crisis we need the best people in control of important decisions
not bureaucrats.

------
refurb
_The Centers for Disease Control and Prevention (CDC) initially declined to
test a California patient for coronavirus because of narrow testing criteria,
delaying the identification of a new possibly pivotal case, according to
officials at the hospital treating the patient._

Seems pretty reasonable to me.

There are limited resources for doing the Corona virus test. If the CDC tested
everyone who got a fever, they'd have a massive backlog.

The risk is reasonable if any suspected case is quarantined.

~~~
jmull
> If the CDC tested everyone who got a fever, they'd have a massive backlog.

The problem with that argument is that's not what anyone was asking for. The
patient went through an extensive triage before doctors identified a
significant risk of coronavirus and requested a test. The CDC overrode that
judgement.

Note that amount of CDC resources directed toward coronavirus so far is
minuscule, so we should be no where near their capacity to respond.

In the face of a burgeoning pandemic where there are many cases with uncertain
origins, it doesn't make sense to override the medical judgement of the
doctors on the ground because the case has an uncertain origin.

~~~
refurb
The point is, the CDC came up with guidelines on when it’s appropriate to test
a patient and this patient didn’t qualify until 4 days later.

That shouldn’t surprise anyone that they do this.

~~~
jmull
Guidelines would be ok but these weren't guidelines so much as inflexible
rules.

Surprise doesn't really have anything to do with it. We want the CDC to take
the coronavirus seriously and disregarding doctors working directly with
coronavirus patients is not taking it seriously.

------
ctww
No offense, but I remember couple weeks ago, people in here are keep mention
that China gov lying about the truth/numbers etc. By saying that, I am not
argue fro the China gov. The Wuhan gov actually tried to hide something in the
very early days, until the central gov noticed this.

I just feel this's interesting.. \--- Disclaimer: I am Chinese work in US. I
don't agree everything China is doing, but also don't like people blindly hate
it.

------
chrononaut
It has been mentioned in a number of threads that there are likely a
significant number of underreported cases, e.g. John Hopkins study. However,
if cases are underreported and it is implied that these are more mild cases,
would that mean that these more mild cases are less likely to infect others? I
ask this because if there's a hidden but significant fraction of cases, it
seems to be beyond the scope of nearly every quarantine (i.e. asymptomatic
people going about their day) and if the transmission rate is equal I would
think we would see a lot of uncontrolled spreading. Perhaps Italy and South
Korea are an example of this, although I would've imagined far more Western
countries with deep distributed infections if are so many high transmission,
light or asymptomatic carriers around.

Concurrent to this, I am surprised the original dozen set of infections in the
US seemed to have not infected nearly anyone else, assuming close contacts
were appropriately monitored.

~~~
pmoriarty
In China, where the overwhelming amount of cases in the John Hopkins study
came from, deaths were also likely to have been underreported or
miscategorized as not being caused by COVID-19.

We're not sure to what extent that has happened, but it could also alter
estimates of disease mortality rates for the worse.

------
8bitsrule
UC Davis is 20 minutes from the capital of California, the largest state in
the union. Davis Medical, one of the top-5 hospitals in the state, has
specialists in 150 fields, and is the referral center for 33 counties. It took
them 3 days to get a Covid test.

How long 'til we get serious?

------
ajross
And we thought only China was suppressing disease counts

I see from the downvotes that everyone thinks this is just a glib cheap shot.
But the point is profound: no one wants to admit to this happening. Everyone
in power[1], everywhere, still thinks this is "probably not going to be a big
deal". So they deliberately avoid looking for those early cases, because
they're sure they're just rare outliers. And that makes the eventual outbreak
inevitable.

And it's happening here too.

[1] Also a lot of people not in power, like a distressingly large cohort of
posters here who seem to be taking their cues from political sources.

~~~
throw44342
It’s fascinating how universal “saving face” is.

------
spyckie2
Here's the appropriate level of threat response to the virus, as seen by other
countries:

0-30 cases/day (covid is being imported in via travel)

\- put temperature detection check points at airports for all passengers on
international flights

\- voluntary or enforced self-quarantine measures for those who have fever

\- tighten or ban travel from certain areas of the world

30-100 cases/day (you've isolated individuals with covid in your population)

\- put areas with confirmed COVID cases on high alert - hospitals in those
areas should be required to check fever for COVID virus

\- Follow up with patients who have COVID by tracking down and checking their
recent social circles

100+ cases / day (containment, not prevention, becomes the main goal. There's
groups who contracted the virus / the virus cannot be traced to an entry
point)

\- Put the entire region on high alert via policy - mandated work from home
and limited social gatherings

\- Suspend school and other high traffic institutions

\- limit travel, request everyone to stay at home. Put up temperature checks /
road blocks in major crowded areas.

\- ask population to take extreme precautions with their health by washing
hands and wearing masks. Wearing masks is an amazing marketing tool to get
people to treat the pandemic seriously, even if it doesn't actually help limit
the spread that much.

1000+ cases/day (treatment is the prioritization to limit deaths)

\- build makeshift hospitals to anticipate the increase in load

\- remove as much red tape as possible to allow immediate treatment of
critical condition patients (approve funding, get the right tests, mobilize
health professionals, allocate hazmat suits / quarantine spaces)

This implies that you are testing patients that have suspected corona symptoms
and reporting them upwards.

The US should have been taking border protection more seriously, but it's
probably already too late for that. COVID is likely to spread regardless of
how much effort you put into border control now.

------
bilekas
What the hell is wrong with the CDC right now ?

[s]It just seems to be ran like a startup or something. Jesus.[/s]

How can more people not be outraged by the govmnt lack of readiness?

~~~
tristanj
The Trump admin fired much of the CDC pandemic response team in 2018 to cut
costs. [https://www.snopes.com/fact-check/trump-fire-pandemic-
team/](https://www.snopes.com/fact-check/trump-fire-pandemic-team/)

> _In 2018, the Trump administration fired the government’s entire pandemic
> response chain of command, including the White House management
> infrastructure._ [https://foreignpolicy.com/2020/01/31/coronavirus-china-
> trump...](https://foreignpolicy.com/2020/01/31/coronavirus-china-trump-
> united-states-public-health-emergency-response/)

CDC to cut by 80 percent efforts to prevent global disease outbreak (2018):
[https://www.washingtonpost.com/news/to-your-
health/wp/2018/0...](https://www.washingtonpost.com/news/to-your-
health/wp/2018/02/01/cdc-to-cut-by-80-percent-efforts-to-prevent-global-
disease-outbreak/)

~~~
creaghpatr
This is partisan misinformation:
[https://apnews.com/d36d6c4de29f4d04beda3db00cb46104](https://apnews.com/d36d6c4de29f4d04beda3db00cb46104)

~~~
tristanj
I strongly disagree. The articles I linked talk about _2018_ budget cuts and
eliminations that went through. The article you linked talk about proposed
_2020_ budget cuts, and how they came up at this week's democratic debate.

They are not the same issue. Taken from the FP article linked above:

> _In the spring of 2018, the White House pushed Congress to cut funding for
> Obama-era disease security programs, proposing to eliminate $252 million in
> previously committed resources for rebuilding health systems in Ebola-
> ravaged Liberia, Sierra Leone, and Guinea. Under fire from both sides of the
> aisle, President Donald Trump dropped the proposal to eliminate Ebola funds
> a month later. But other White House efforts included reducing $15 billion
> in national health spending and cutting the global disease-fighting
> operational budgets of the CDC, NSC, DHS, and HHS. And the government’s $30
> million Complex Crises Fund was eliminated._

> _In May 2018, Trump ordered the NSC’s entire global health security unit
> shut down, calling for reassignment of Rear Adm. Timothy Ziemer and
> dissolution of his team inside the agency. The month before, then-White
> House National Security Advisor John Bolton pressured Ziemer’s DHS
> counterpart, Tom Bossert, to resign along with his team. Neither the NSC nor
> DHS epidemic teams have been replaced. The global health section of the CDC
> was so drastically cut in 2018 that much of its staff was laid off and the
> number of countries it was working in was reduced from 49 to merely 10.
> Meanwhile, throughout 2018, the U.S. Agency for International Development
> and its director, Mark Green, came repeatedly under fire from both the White
> House and Secretary of State Mike Pompeo. And though Congress has so far
> managed to block Trump administration plans to cut the U.S. Public Health
> Service Commissioned Corps by 40 percent, the disease-fighting cadres have
> steadily eroded as retiring officers go unreplaced._

In 2018, 80% of the staff working at the CDC global health section were let go
because of Trump budget cuts.

------
mrandish
I'm wondering if confirming COVID-19 with a test now matters much from the
perspective of a patient and doctor. At this point, with public-to-public
transmission known to be occurring, if an MD assesses a symptomatic patient
and suspects COVID-19, they'd likely isolate the patient immediately.

Does the treatment regimen differ much between severe flu and COVID-19?

------
randyrand
I’ve read that as a respiratory disease such as the flu it should die down in
spring naturally. Is that true?

~~~
gdubs
Well, I’d keep an eye on Singapore which has cases and is currently 88 degrees
Fahrenheit and 70 miles from the equator.

------
jfoster
If any given country is declining to test for whatever reason, but the virus
kills ~2% of those infected, wouldn't the mortality rate seem much higher than
2% in those countries?

(assuming testing uncovers cases post-homously and numbers are not suppressed
outright)

~~~
heavyset_go
I'm not aware of any country doing posthumous testing while there are many
orders of magnitude more living and symptomatic people who need the tests.

------
A4ET8a8uTh0
I wonder sometimes about the future of the human species. I can't find an
apparent reason for it other than cost and even that should not be an issue in
this case. Ignorance is bliss and no one wants to cause panic?

------
acoderhasnoname
the test result shows it is flu, why panic

------
bilekas
I've heard there are budget cuts being done, they've completely gutted the
staff of the CDC.

Morons in charge seems to be a leading factor.

~~~
bluGill
It is an election year. One says says Trump cut needless dead weight and there
is still plenty of staff. The other side is going to play this crisis and call
it a gutting.

~~~
jethro_tell
There's no sides here, and the particular reason for failure doesn't matter.
This is a disease that will kill people. Letting people go untested out into
the wild is not going to help.

People fuck up, that's what people do, leaders catch and acknowledge failure
early and try to fix it. Unfortunately, at this point, people will die that
didn't have to. And that's going to be because:

1\. Tons of people weren't tested that should have been.

2\. People can't afford to get a test because of the health insurance
situation in this country.

Aggressive no cost testing would help, I'm sure trump is going to announce
that here any minute for a problem that he doesn't think is real.

~~~
s1artibartfast
I find your post really interesting and am having trouble unpacking it. It
seems to me that there are many contradictions, but perhaps I missunderstood.

You say that there are no sides, but end by railing on trump.

You say that the reason for failure doesn't matter, but provide a list of
reasons.

You claim that health insurance is the cause of no testing, when the article
stated that the CDC refused to conduct or approve testing.

If you sentiment is that this is not the time to focus on partisanship, I
wholeheartedly agree. If you sentiment is we should be solution minded, I
wholeheartedly agree.

The focus should be on determining what we can do NOW to save the most lives.
There will be plenty of time later to assign blame and discuss long term
fixes.

~~~
hanniabu
> You say that there are no sides, but end by railing on trump.

He means it's not a partisan thing. Trump is still the person calling the
shots.

> You say that the reason for failure doesn't matter, but provide a list of
> reasons.

I think you're misunderstanding here on what the reasons he's referring to,
which are why we're in this situation - those don't matter. The reasons that
he provided are the reasons why this is an issue.

------
iagovar
As european, don't count on Europe neither. Italians are already backing up in
their statements as they clearly see they are the only fools that were willing
to make any sacrifice to try to contain it.

Another instance of pathethic european leadership.

~~~
dang
We detached this subthread from
[https://news.ycombinator.com/item?id=22434997](https://news.ycombinator.com/item?id=22434997).

------
acoderhasnoname
The corona virus has to be tariffed before get into united state

------
stanski
Something something the blindness of a non-authoritarianism (Chinese version
of The Atlantic).

~~~
netheril96
China’s response in the beginning was exactly the same. Only people who had
been to Wuhan seafood market and had fever got tested and we had testing kits
shortages too.

But US have the advantage of hindsight. Why they are repeating Wuhan’s mistake
is beyond me.

------
justinzollars
We have had the sequence of the COVID-19 for over a month. Are you guys, on
hackernews, are telling me there isn't a single startup - not one - that could
develop a more effective test to fill this gap? The virus when it comes, will
not discriminate between Republican and Democrat. But developing a better test
could save lives.

~~~
CamelCaseName
There are plenty of startups giving this a shot. There's a huge amount of
money in being the first to develop a test or vaccine. Just look at the
unbelievable growth in $CODX, $NVAX, $GILD, $MRNA, over the past week.

A quick Google shows:

Feb 16 - Israel races to find solutions for coronavirus [0]

Feb 17 - Corporate Japan rushes to devise quick coronavirus tests [1]

Feb 25 - Nanotechnology Startup Develops Quick-response Lateral-flow Test for
Coronavirus [2]

Feb 26 - Biotech company Moderna says its coronavirus vaccine is ready for
first tests [3]

Feb 26 - Novavax to Begin Clinical Testing of Coronavirus Vaccine by Late
Spring [4]

Feb 27 - Drug companies race to test coronavirus vaccines

[0] [https://www.israel21c.org/israel-races-to-find-solutions-
for...](https://www.israel21c.org/israel-races-to-find-solutions-for-
coronavirus/)

[1] [https://asia.nikkei.com/Spotlight/Coronavirus/Corporate-
Japa...](https://asia.nikkei.com/Spotlight/Coronavirus/Corporate-Japan-rushes-
to-devise-quick-coronavirus-tests)

[2] [https://statnano.com/news/67501/Nanotechnology-Startup-
Devel...](https://statnano.com/news/67501/Nanotechnology-Startup-Develops-
Quick-response-Lateral-flow-Test-for-Coronavirus)

[3] [https://www.cnn.com/2020/02/25/business/moderna-
coronavirus-...](https://www.cnn.com/2020/02/25/business/moderna-coronavirus-
vaccine/index.html)

[4] [https://www.fool.com/investing/2020/02/26/novavax-plans-
clin...](https://www.fool.com/investing/2020/02/26/novavax-plans-clinical-
trial-coronavirus-vaccine.aspx)

[5] [https://www.cnn.com/2020/02/27/investing/coronavirus-
vaccine...](https://www.cnn.com/2020/02/27/investing/coronavirus-
vaccine/index.html)

~~~
justinzollars
Thank you for this list! This is great

------
DonHopkins
They were too busy sending their thoughts and prayers to perform any
scientific evidence based tests.

~~~
derefr
Are you suggesting that the people in their PR department should be doing the
tests?

Or, do you think that they shouldn’t _have_ a PR department, and be solely
composed of doctors? When a large point of their organization is to talk the
public into doing things for their own safety?

Without sarcasm, now: people need to stop thinking of organizations as
amorphous talent pools of generalist ubermenschen, where a “trivial” task
would distract one of these do-it-all people from doing an “important” task.
Maybe on HN, people forget that not everything’s a startup and not everyone’s
a cofounder.

Big organizations like the CDC are composed of departments; each department is
a separate talent pool. The PR department making (trite) announcements is not
“getting in the way” of anyone receiving a shot. Likewise, the management of
an organization changing hands doesn’t _usually_ † “get in the way” of boots-
on-the-ground doing their day-to-day jobs.

† Management can explicitly interfere by introducing hindering policies.
But—especially with doctors—it’s been found many times that the people doing
the work will just _ignore_ dumb executive policies if they get in the way of
treating patients. This is why there’s not much point in a “private hospital”
attempting to run at a profit by cutting costs: the doctors won’t cooperate,
and will just treat patients the way they would in a public hospital, using
all the same interventions they were taught were best-practices in med school.

~~~
jefurii
I think the grandparent was referring to GOP politicians who tweet their
"hopes and prayers" after every mass shooting instead of doing something
effective to stop the epidemic of gun violence.

