
The explosion of new coronavirus tests that could help to end the pandemic - akbarnama
https://www.nature.com/articles/d41586-020-02140-8
======
pmoriarty
The most promising plan I've heard along these lines is detailed in a recent
episode of _This Week in Virology_.[1]

We could have this disease under control by the time school starts by giving
everyone (or at least everyone in highly affected areas) tests every day.

This is possible, practical, and affordable.

The technology for fast pregnancy-test style tests for COVID-19 exists right
now, and they could cost as little as $1 per test.

The reason these tests aren't being used yet is because of the FDA's misguided
requirements for extremely high sensitivity for COVID-19 tests. If these
requirements could be relaxed to allow lower-sensitivity tests, then these
tests could go out on the market... or, better yet, the government could take
over and ensure everyone gets tested with these tests every day for $1 a test.

Even a more limited plan of testing just all schoolkids every day for $1 a
test would be way better than what we've got now.

[1] - Starting at about 6'20" in to episode 640:
[https://www.microbe.tv/twiv/twiv-640/](https://www.microbe.tv/twiv/twiv-640/)

~~~
ISL
To put this idea in perspective, there are ~56 million students in the US. To
do this daily for an entire school year at $1/test would cost ~1% of the
trillion dollars allocated spent in the first relief bill.

Testing and contact tracing is a _bargain_ compared to continuing to pay
everyone to stay home. I don't understand why we're not seeing for-real
effective contact tracing from our governments yet.

~~~
xienze
> To put this idea in perspective, there are ~56 million students in the US.
> To do this daily for an entire school year at $1/test would cost ~1% of the
> trillion dollars allocated spent in the first relief bill.

Which $1 test currently in production would this be? And as a point of
context, there’s been nowhere near the ~10B tests (I assume you’re talking
about a 180 day school year) you’re proposing administered _worldwide_.
Furthermore, what factory produces and ships 56 million of anything on a daily
basis? I’ve said this before but I think HN readers suffer from thinking that
everything in the world works like AWS in that you can just spin up unlimited
“anything” on a moment’s notice.

~~~
pmoriarty
_" Which $1 test currently in production would this be?"_

The technology to make these tests currently exists, but the companies which
own the technology have chosen not to put them in to production because the
tests aren't sensitive enough to gain FDA approval under current regulations.

If the regulations were relaxed to allow these less sensitive (but perfectly
adequate) tests, then they could be put in to production.

So what's necessary for us to get $1 tests is to convince the FDA that these
less sensitive tests are adequate for use, which is what the _This Week in
Virology_ podcast and the _NYT_ article linked to earlier argue for.

 _" Furthermore, what factory produces and ships 56 million of anything on a
daily basis?"_

From the _TWiV_ podcast[1]:

 _" Take every manufacturing company that knows how to print paper, adapt
their tools to print monoclonal antibodies on to those sheets and just start
slicing it up and shipping it out. It's as easy as that, I mean, you know, I'm
simplifying it a bit, but..."_

[1] - from about 32'30" in to the podcast
[https://www.microbe.tv/twiv/twiv-640/](https://www.microbe.tv/twiv/twiv-640/)

------
ccvannorman
Some AI researchers[0] claim to be able to detect the virus by the sound of
your voice via speech signals. They took samples of youtube celebrities who
were recording videos at a time they were infected, but just before their
diagnosis, as part of their positive-case labeled data.

Maybe soon we'll have dogs that can smell Coronavirus too[1]!

[0] [http://news.mit.edu/2020/signs-covid-19-may-be-hidden-
speech...](http://news.mit.edu/2020/signs-covid-19-may-be-hidden-speech-
signals-0708)

[1] [https://www.ecowatch.com/dogs-smell-
covid-19-2646105814.html](https://www.ecowatch.com/dogs-smell-
covid-19-2646105814.html)

------
Barrin92
Testing is great but you can do all the testing in the world, if the
population is not compliant and superspreaders in particular simply ignore all
health guidelines and don't even show up for tests you've gained nothing.

The pandemic already is under control in most places and I'm not sure testing
had all that much to do with it. The successful strategy seems to be pretty
straight forward. Initial lockdowns if the country is hit badly to curb the
disease, then strong compliance with basic health guidelines and regional
lockdowns if necessary.

Japan has performed about 800k tests _in total_ on a population of ~120
million, which is lower than most other countries by a magnitude and about 50
times less than the US, but has had very few excess deaths.

At the end of the day the virus cares about behaviour, not testing.

~~~
perl4ever
>The pandemic already is under control in most places

This is an interesting claim. I think it's potentially misleading, and
possibly motivated by a need to portray places where it isn't under control as
isolated.

I suppose it might be technically correct if you count a list of "places" and
divide the number where it is growing rapidly by the number where it isn't.
However, the results you get are very dependent on how you define a "place".

If you divide the world into Europe, North America, Asia, South America,
Africa, and Oceania, the only one that definitely seems to be under control
right now is Oceania. Africa and Europe are growing much slower than the
others, but not obviously "under control", and Asia notably is seeing over
60,000 new cases per day even though it previously seemed to be under control
until India started reporting large increases.

If you count countries, you could claim that about 3/4 of them have it under
control, but that might not be permanent. Considering Brazil (which I think
people would generally consider to have a serious problem right now) and
everywhere the epidemic is growing faster, it is a minority of _countries_ ,
but very near half of the world _population_.

Source (as usual) is
[https://www.worldometers.info/coronavirus/](https://www.worldometers.info/coronavirus/)

------
paulie_a
The article says new tests, is that a test for a new person. Or simply a test
in a certain time frame

I assume it is the latter, which means the stats can be skwed somewhat. I
can't say what degree it would be but I've had 8 tests. Which means I show up
in the testing stats 8 times. My situation is somewhat unique, but I'm not
alone. Hence the distinction I am curious about.

------
pragnesh
[https://youtu.be/857B7u_vUBc](https://youtu.be/857B7u_vUBc) indian company
developed automatic test machine

------
ggm
The pooled sample testing method looks tractable.

~~~
lps41
Yes, but it’s only more efficient than testing everybody if you are unlikely
to get a positive result. So, in places where covid is not widely spreading.

~~~
lern_too_spel
The method described in the article isn't a traditional pooled test. Each
sample is marked, and it tests and reports on all samples at once.

------
aaron695
I would say, testing being the solution is one thing that wasn't pushed in
January or even pre C19 that I saw.

It wasn't mentioned in "Contagion" for instance.

A vaccination or cure was always known as not possible but the media pushed
these false hopes.

In part I suspect this is the usual medial malpractice of doctors keeping
their profession wealthy and keeping everything they can tied up and
regulated.

I'd be interested to look at HIV and testing in the 80/90s to see whether at
home tests were stopped by doctors or technology.

~~~
lazyasciiart
No, a vaccination was not always known as not possible. It still isn't, in
fact. And amazing amounts of effort are being spent to make the administration
of tests easier. The first tests required trained research technicians. Today
tests are still not widespread because they require specialized machinery or
other materials. If it were possible to pee on a stick as a self test,
everyone would be ecstatic - but it's not, so far.

The pandemic planning stuff I've read from before this year seems to suffer
from a number of assumptions that were violated by covid, from asymptomatic
transmission to the long lead time. E.g in MERS or Ebola or even flu, the
infectious but asymptomatic period is more like Contagion. You don't have to
worry about infected people wandering around town for a week or two.

Most planning mentions the need for having tests, and quickly gathering
materials etc, and then moves on to tactics for containment and vaccine
development. Where testing is focused on, it's as a way to differentiate
between people who have symptoms but are actually infected with a non-panfemic
disease, so that resources aren't wasted quarantining them. I haven't yet
found a scenario studied with a long lead time and possible low level or
asymptomatic presentation as standard.

~~~
pmoriarty
_" If it were possible to pee on a stick as a self test, everyone would be
ecstatic - but it's not, so far."_

It is possible.

Listen to episode 640 of _This Week in Virology_ [1] for details.

[1] - Starting at about 6'20" \-
[https://www.microbe.tv/twiv/twiv-640/](https://www.microbe.tv/twiv/twiv-640/)

~~~
lazyasciiart
Audio doesn't work for me, but if you have a written source I would be curious
to see it.

~~~
pmoriarty
No, I don't have a transcript, but you could give this direct link to an mp3
version of the show a try:

[http://traffic.libsyn.com/twiv/TWiV640.mp3](http://traffic.libsyn.com/twiv/TWiV640.mp3)

It should play in any media player.

~~~
lazyasciiart
Sorry - I didn't mean technically, I meant I can't listen to voices easily.

