
When can we test everyone? - jeremyw
https://whencanwetesteveryone.org/
======
nostromo
What we need now is antibody testing, not testing for Covid-19.

All the antibody studies in the US so far are showing that antibodies are
present in at least an order of magnitude greater number of people than the
official number of people with Covid-19.

This has huge implications for our response. Given this new data, LA is
suggesting [1] that ~5% of the population of LA has already developed
antibodies, which would mean the fatality rate may be as low as 0.10-0.20%.
(For comparison, the seasonal flu is 0.05%-0.10%.)

Knowing if this is really the case for the entire nation would have huge
implications for our response.

1\.
[https://www.facebook.com/countyofla/videos/537241533852930/](https://www.facebook.com/countyofla/videos/537241533852930/)

~~~
throwawayiionqz
Number of deaths in NYC divided by total population is 15,000/8,000,000. This
already puts the fatality rate at at least 0.2.

But the consequences are far from over and the number of deaths will keep
climbing, so your "fatality rate may be as low as 0.10-0.20%" is completely
off the mark.

edit: I am sorry if my tone was interpreted as confrontational. I otherwise
agree with the parent's post that we need much more antibody testing.

~~~
nostromo
Feel free to take it up with the Stanford researchers and the LA county health
commissioner. I'm simply sharing their reports.

~~~
throwawayiionqz
I am simply trying to slow the spread of non-sensical numbers. The total
population divided by number of deaths provide a factual lower bound and
arguing against that is not sensible.

Flaws in the Stanford study has already been highlighted extensively, see for
instance [https://statmodeling.stat.columbia.edu/2020/04/19/fatal-
flaw...](https://statmodeling.stat.columbia.edu/2020/04/19/fatal-flaws-in-
stanford-study-of-coronavirus-prevalence/) and the insightful comments. The
issue is not to take it up with the authors but whether the authors might
listen and take back what they claimed on popular political TV shows. [1]

[1]:
[https://www.youtube.com/watch?v=6NjCitwKJSQ](https://www.youtube.com/watch?v=6NjCitwKJSQ)

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jameslevy
Are there different tests for antibodies vs. active infections? Or is it just
that if you have symptoms and antibodies, that means you have an active
infection? For example, many of us who want to see family, etc. at some point
may want to test to make sure we're not currently contagious, even if we don't
have any symptoms. If we have antibodies and no symptoms, that doesn't
necessarily imply that we're not currently contagious.

~~~
maxerickson
Yes, the tests are different.

The tests that look for the virus are probably more accurate than the antibody
tests, at least right now.

~~~
dba7dba
I have read that S. Korea's disease control center has not approved antibody
tests because antibody tests are not accurate enough.

Multiple S. Korean companies submitted test kits for coronavirus for approval,
and not all were approved because of insufficient accuracy.

Mainly antibody tests.

------
ltbarcly3
Testing is only really useful for a handful of things:

\- Identifying people who are carriers so they can be isolated

\- Contact tracing (pointless at the moment, there are hundreds of thousands
of people in the US who are infected)

\- Ruling out other diseases or conditions that are treatable

Testing basically doesn't help anyone who has covid, it helps the people they
would have spread it to if you can prevent that spread. There is no treatment
for covid whatsoever, knowing you have it doesn't help you live longer or
become healthy sooner. Knowing you don't have it, if you are already sick,
might help if that lets them invest in further testing or treatments for
other, non-covid, conditions.

Testing is easy to point at, but at the moment more testing would have limited
impact. Even if we were to test everyone in the US, it would have to be done
in a relatively short window of time to allow for a significant impact, and
it's unlikely that there will be enough testing capacity to use this strategy
before we reach saturation levels of infection. If they test me today and I'm
negative, then they test you in 6 weeks, what does that get you and me? I was
very likely infected in the meantime. This could be used socially like an
negative AIDS test, except instead of a few months or years the validity of a
test as a social currency is about a week, making it more or less useless as a
way to avoid being infected.

~~~
didericis
The biggest benefit would come from antibody testing.

If we could end social isolation for people who have antibodies, which is
probably a very large number of people, that’d be a big win.

~~~
dawnerd
That could be dangerous - especially if things like theme parks open up.
People without antibodies might risk getting infected just so they can go out
and "have fun".

~~~
didericis
That risk already exists.

I think we need to be realistic about containment. A full lockdown until a
vaccine is released is the safest option, but it isn’t a sustainable strategy.

The main thing we should focus on is keeping high risk people away from people
likely to have active infections, determining hotspots/where to
increase/maintain blanket lockdowns, and detecting people with active
infections early/getting them to self isolate when they’re just getting sick.

If someone really wants to expose themselves, there isn’t much you can do to
stop them short of martial law, which starts a feedback loop of escalating
civil unrest. I think you’re likely to have more success keeping people
worried about being infected away from people who either don’t care or have
antibodies than keeping all the people that want to go out indoors for a year.

------
ttcbj
FWIW, I think this is a useful idea. But I think it would be more helpful if
you clearly explained why you choose those stats and rethought what you are
trying to say. I personally care about "When can I feel safe going out?"
Testing is just a means to that end.

* I would lead with the % of the population tested (not the total) and make it in the last 7 days, since I really care how likely they are to detect a current outbreak.

* I think to be really useful, it needs to be localized by county, since what I really care about is how likely I am to get infected, and that means I are about testing in my area.

* I would go with the positive rate in the last 7 days. It's important to explain that a high positive rate indicates they are probably only testing people with symptoms, and so they are probably missing lots of infectious asymptomatic cases.

* Then, I think I would drop the recent growth rate in testing, because I suspect that the growth rate is not going to grow consistently, and also that testing growth will be unevenly distributed. I am skeptical that it is meaningful to try to predict when testing will achieve specific milestones.

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klipt
Why would you want to test "everyone"?

For epidemiological purposes, you only need a statistically valid sample,
which is much smaller than "everyone".

For medical purposes, you only need to test people who are sick, which is
hopefully also much smaller than "everyone".

~~~
alistairSH
For medical purposes, you don't even need to test the sick. We don't have
treatments available at this time, so the course of treatment doesn't current
vary. IE, if you have COVID-like symptoms and are moved to the ICU, the course
of treatment is the same with or without a positive test.

I've seen it argued that instead of testing the sick (as we currently do), we
should be testing individuals who are "high touch" and likely to infect others
(even lacking symptoms). Medical staff, first responders. Pharmacy and grocery
employees. Bus drivers. Etc. I don't know enough to argue this is a better
approach.

~~~
smacktoward
Since an infected person can be contagious for days before showing any
symptoms, it'd be ideal if we could regularly test everybody, regardless of
whether or not they are currently symptomatic. That way we could get them
isolated early, which would prevent them from infecting X other people before
they even realize they're sick, as well as cutting down on the number of
contacts they've had that would need to be traced.

------
JohnTHaller
We don't have anywhere near enough tests. We also don't know how many tests
are actually available or will become available as the administration has
repeatedly thrown out incorrect numbers without coming anywhere close to them.

------
bhobs
>everyone

In the us.

Nice.

~~~
ecmascript
As a european I immedietly suspected this before clicking the link. Was not
disappointed.

This is very funny.

~~~
davidw
OTOH, most of Europe is probably ahead of the US. Italy and Germany are
certainly doing a lot more tests per capita. So I guess it's not so bad...

~~~
RandallBrown
And parts of the US are ahead of Italy and Germany.

