
We can solve the coronavirus-test mess now if we want to - wintercarver
https://www.newyorker.com/science/medical-dispatch/we-can-solve-the-coronavirus-test-mess-now-if-we-want-to
======
hprotagonist
[https://news.ycombinator.com/item?id=24359988](https://news.ycombinator.com/item?id=24359988)
has

[https://archive.is/5ceYd](https://archive.is/5ceYd)

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zestyping
Everything about Paul Romer's plan
([https://roadmap.paulromer.net/](https://roadmap.paulromer.net/)) makes sense
and seems uncontroversial except Step 5: Let everybody get tested and if you
get a negative result, you don't have to wear a mask. This permission not to
wear a mask is also mentioned in the New Yorker article.

But I don't see any justification given for the no-mask part. I can see how it
would be an incentive, but I'm not sure it wouldn't just erode the norm of
wearing masks until everyone felt they could get away without wearing one.

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macintux
A sobering and depressing read. What’s even more depressing is we’ll probably
stumble through this, get past it (hopefully), and nothing significant will
change before the next pandemic, which might be dramatically worse.

~~~
aantix
What should change?

~~~
macintux
The article presents the case much better than I could summarize, but
effectively we need dramatically better coordination between government,
public health organizations, and healthcare, and that coordination should be
established before a crisis hits.

~~~
hprotagonist
and not systematically de-funded right before the next crisis, unlike this
time.

~~~
macintux
I wanted to avoid the political aspects, but yes.

~~~
hprotagonist
reclaiming the term a little to be closer to the broader "pertaining to public
affairs", it's hard to see how public health could be anything but.

I hope for, and am prepared to pivot my career in support of, a resurgence of
public health work opportunities. (which atul gawande points out in an earlier
column from april or so)

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adtechperson
Some of the leading vaccines present their own logistical challenges. Some of
the leading vaccines (Moderna, Pfizer) are quite fragile and are hard to
transport and store. Moderna needs to be shipped and stored at -20C (-4F) this
is tricky but not that hard, since it is in the range of commercial freezers.
The Pfizer vaccine needs to be shipped and stored at -70C (-94F) which is
outside the range of ordinary freezers (bio labs have them but doctors labs do
not). Pfizer can be packed in dry ice to ship, but the ice needs to be
replenished every 24 hours.
[https://twitter.com/LizSzabo/status/1298646754884300800](https://twitter.com/LizSzabo/status/1298646754884300800)

~~~
macintux
How does that compare to, say, flu vaccines? If these are hitherto unsolved
problems at scale I’d be worried that a rush to deploy them will lead to no
small number of failed vaccinations.

~~~
mikeyouse
Flu vaccines are stable in household refrigerators. At the hospital I worked
at, we stored roughly 10,000 doses in a 38°F fridge that wasn’t even on a
dedicated backup. The benefits of decades of research...

*Edited to show F instead of a unitless 38º

~~~
crispyporkbites
38 degrees is the opposite of refridgeration, crazy!

~~~
tarlinian
That's probably 38 degrees Fahrenheit (~3 degrees Celsius).

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jancsika
This seems like a well-researched article.

But I've read an article or two from the New Yorker before in my area of
expertise-- music-- where I noticed logical flaws and spurious arguments.
According to the well-known Gell-Mann Amnesia effect-- an effect which gets
posted on HN like clockwork on any story wrt journalism (which I proudly
continue here)-- I should therefore reject this article out of hand.

People who incessantly paste links to the Gell-Mann Amnesia effect-- am I
generously interpretating the Gell-Mann Amnesia effect here? If not, what am I
missing?

~~~
ewzimm
The strange thing about all this is that my experience has been completely
opposite of how this is described. Fast, easy testing was available right
away. The labs seem to have had this working perfectly from the beginning of
the pandemic. Since April (with initial limited availability), anyone has been
able to request a test from LabCorp on their website. They bill directly to
insurance, send everything overnight with simple instructions and return
packaging, and email results within a day of receiving it. The cost without
insurance is just over $100, and governments were quick to offer coverage for
the uninsured.

I'm not sure what their capacity has been, and this article states that they
anticipate a lack of capacity going into flu season, but I didn't encounter
any barriers, and it was the most seamless and polished experience I've had
with any medical system. It made me wish I could always deal with labs
directly instead of having to go through a hospital.

So it seems that everything was done very well, very quickly, but many
problems occurred on on the layer of coordination at local testing sites which
can more easily serve many people. It's strange that a seemingly inefficient
system like direct mailing would be so efficient while something that would
seem to be much easier like a central testing location would have so many
difficulties.

So we already have the capacity to connect people with labs directly, but if
everyone did it, it might overwhelm their capacity. I tend to agree with the
sentiment in the article that we need to address this disconnection and work
on removing layers of indirection between labs and people. I'm not sure what
the best method of doing that would be, but the labs seem to have already
figured out most of the logistics on their own, and they just need the
resources to scale up.

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beamatronic
It has always been true that "we" can solve any problem we put our minds
towards.

