Without Mass Testing, the Coronavirus Pandemic Will Keep Spreading

[CousinIT]

https://foreignpolicy.com/2020/03/23/coronavirus-pandemic-south-korea-italy-mass-testing-covid19-will-keep-spreading/

. . . The key to South Korea’s success has been speed and an early push toward mass testing, rigorous contact tracing, and mandatory quarantine for anyone near a carrier of the virus.The key to South Korea’s success has been speed and an early push toward mass testing, rigorous contact tracing, and mandatory quarantine for anyone near a carrier of the virus. The country, with a population of 51 million, tests more than 20,000 people a day at more than 600 testing sites nationwide, while integrating apps that not only track individuals if they have tested positive, but also warn them if they might have been exposed to a known case.

Yet in the United States and the United Kingdom, there is a public and internal government debate over whether testing matters—particularly for those who are only having minor symptoms. As of March 20, South Korea’s rate of testing was 6,148 per million people, while the United Kingdom was testing only 960 people per million and the United States just 314. Why waste resources and time trying to identify who has the disease, these officials ask.

In fact, the U.K. government even took a strategic decision on March 12 to stop testing those who have mild symptoms, those coming into hospitals but not admitted, or even the country’s health workforce. This was a dangerous and shortsighted decision, as Prime Minister Boris Johnson’s U-turn less than a week later, when he committed to a goal of 25,000 tests per day, reveals.

. . .

There are five key reasons why testing matters.

First, people generally seem much more likely to isolate themselves if they are confirmed as a virus carrier. Government advice has been for individuals to isolate themselves for 7 or 14 days (depending on the country) in order not to spread the virus beyond their household. However, this is unrealistic for those who can only earn a living by showing up at work and depend on daily income, as well as those who wonder if they really have COVID-19 or are just having another of the seasonal viruses that circulate during the winter and early spring. As with HIV, knowing one’s status can ensure that people understand the ramifications of their actions and how they need to act responsibly to prevent further spread.

Given that presymptomatic transmission accounts for a large number of cases, testing is required to ensure that carriers of the coronavirus are not unknowingly passing it on to others.

Second, to break chains of transmission, public health officials need to know where the virus is and who has been exposed to it. Given that some studies estimate that presymptomatic transmission accounts for approximately 50 percent of cases, testing is required to ensure that carriers of the coronavirus are not unknowingly passing it on to others. In addition, close contacts of virus carriers must be informed so that they isolate themselves, meaning colleagues at work, people in the same apartment building, or those who have been in the same cafes, shops, trains, or planes. This is a classic public-health technique and one of the only ways to build a robust picture of who could have possibly been exposed to the virus and be carrying it.

Third, as local authorities scramble to allocate hospitals the right amount of personal protective equipment for staff, appropriate equipment such as ventilators and oxygen and beds, and even personnel, they need to predict how many people will be arriving in intensive care units in the coming days. By testing who has COVID-19 at an early stage, and by having existing data on what percentage of these people will require further care in hospitals, officials can make these decisions based on more precise and accurate data so that resources can flow appropriately.

Fourth, as China and South Korea have shown, certain parts of a country can become hot spots with a high number of cases. This is already happening in London, given the number of people arriving in hospital who are seriously ill with COVID-19. But rather than gauging this by looking at the number of people currently requiring hospital admission—which is actually a glimpse of past community transmission—by actively testing, public health authorities could see where new hot spots are emerging , and inside those hot spots, the role of superspreading events where numerous people become infected in one place, such as during church services or eating at restaurants.

It makes a huge difference if a country has 50, 500, or 50,000 cases. Without accurate numbers, governments and doctors are trying to fight a fire without knowing how large the blaze is, or where unseen embers are burning.

Finally, the World Health Organization is producing daily reports noting the number of confirmed cases per country in order to track the evolution of the outbreak, but the accuracy of these numbers is reliant on actually doing tests. Without widespread testing of all cases including those with mild symptoms or those who are asymptomatic virus carriers, no one knows how large the problem is. It makes a huge difference if a country has 50 cases, 500 cases, or 50,000 cases, and without accurate numbers, governments and doctors are trying to fight a fire without knowing how large the blaze is, or where unseen embers are burning

[Wounded Bear]

1. K & R...for truth...

Until we have mass testing, there is no way to know even how effective social distancing has been.



We also need the antibody testing to see who has really been "cured" of the virus and now have some degree of immunity.

[beachbumbob]

2. it is what it is and we will have this going on for 12-18 months until a vaccine is

put out and all get the shot.

[Iwasthere]

5. How effective will that shot be?

[beachbumbob]

8. be as effective as any vaccine and life will return mostly to normal

[Proud Liberal Dem]

3. This is the sort of thing that our officials here in the US *used* to be good at

We are, of course, dealing with a hollowed out system and exceptionally AWFUL leadership right now.

[uponit7771]

4. He knows this

[Igel]

6. So here's another take.

S Korea tested, as of 3/20, a bit more than 3% of its population. The other 97% was free to roam, and many of them could easily have been infectious. They didn't test everybody. They were lucky, they knew the group that was most likely affected and they tested *them*. All of them. And when they didn't get eager compliance and some names were withheld, they brought criminal charges for the group's omitting some names.

They tested those with symptoms not in that group, as well.

Then they traced contacts for each person. And had compliance from each person. That pointed them to who should be quarantined and tested. That helped them find asymptomatic cases. Having a newspaper and local news show say, for instance, "CousinIT has tested positive for COVID. Anybody who's had contact with CousinIT in the last 7 days should report for testing" may violate your HIPAA rights, it might get you threats from former friended or noxious neighbors, but that kind of publicizing names was done.

They did not have "stay home" orders, shoving those who might be infected in with those who weren't. In China that produced a lot of new infections. And they stopped it.

In both places if you were possibly infectious, you were pulled aside for a day or two until the test results came in. If you were infectious you were corralled and held with others who were infected already. Yes, large holding tanks. Separating families, mothers from children, children from parents. No, it wasn't optional. Protesting was deemed anti-social selfishness.

Taiwan was even more aggressive. They have universal health care. You see your GP with the sniffles, that day some bureaucrat in Taipei can see you had the sniffles. They looked at entry records/passport control, correlated it with health records, and had their first set of suspects. Test everybody. Look at housing records, who lives where--did they miss an occupant? Who did they work with? Check health records for those people *and* everybody in their household.

And use cell-phone GPS to locate people who aren't easy to find, and make sure those told to self-quarantine stay put. You don't like that? Why are you trying to kill people, why do you hate others, you're a bad person.


You don't do the last steps, testing just gives you data. But by 1/20 we probably already had it escape confinement, and even at the end of January media sources like Vox were still saying SARS-CoV-2 wasn't really a threat.

[uponit7771]

9. +1

[ffr]

7. Those were the first words out of Nancy Pelosi's mouth: Testing, testing, testing.

The formula isn't an unknown, this is the way.

But we have the republican experiment in the WH and lives are being lost unnecessarily.

[defacto7]

10. There are 3 legs that hold up a successful program,

Testing, Quarentine and Complete medical treatment. If any one of those legs are missing it all collapses.

[rocktivity]

11. I've been comparing the current social distancing to pulling up weeds

because it doesn't destroy the "root" of the problem: finding and quarantining the infected on the FRONT side of the "curve" who have infected others because they didn't KNOW they were sick.

In the absence of a vaccine, antidote, or cure, only mass testing could work because it would identify and allow for the quarantining of the infected on the FRONT end. Fortunately, a mass testing method has just been approved by the FDA.


rocktivity