Testing for the coronavirus might have stopped it. Now it's too late.

[SunSeeker]

By 

William Hanage 
William Hanage is an associate professor of epidemiology at the Center for Communicable Disease Dynamics at the Harvard T.H. Chan School of Public Health


The battle to keep covid-19 from becoming established in the United States is probably over without a single shot being fired. We were not outwitted, outpaced or outflanked. We knew what was coming. We just twiddled our thumbs as the coronavirus waltzed in.

The first thing officials need when responding to an infectious disease is a way to test for it — a way to tell who has it and who is at risk. Dozens of such test procedures have been produced in the scant weeks since covid-19 announced itself to the world by shutting down Wuhan, China, a city the size of New York. Public health agencies around the globe have generated huge amounts of data on how well these tests work and have rolled them out on a massive scale. South Korea alone has tested more than 100,000 of its citizens.

But the United States has lagged far behind the rest of the world in testing for the new coronavirus. As a result, outbreaks here are likely to be more numerous and more difficult to control than they would have been otherwise. I research infectious disease and how to fight it, so I know how important it is to detect outbreaks early. The covid-19 outbreak is the largest acute infectious-disease emergency most of us have experienced. And we may have let it go undetected here for too long.
...
Understanding this, in early February, Singapore authorities tested cases of respiratory disease that were negative for other viral pathogens, which meant they might have been the result of covid-19 transmission chains that had escaped detection. This aggressive testing almost immediately found four infections with no known contacts with other cases. Diligent contact tracing has managed to keep a lid on the outbreak, and, despite reporting its first case on Jan. 23, Singapore’s total as of Friday was only 130 cases, with no deaths (although seven people were in serious condition). This is a remarkable achievement.

https://www.washingtonpost.com/outlook/coronavirus-testing-united-states/2020/03/05/a6ced5aa-5f0f-11ea-9055-5fa12981bbbf_story.html

[napi21]

1. I believe this virus is going to do to DT what we all wanted to do to him. He will not be

re-elected because of him horrible failure in handling it. Something his money, his threats, and his BS can't save his a***!

[pat_k]

2. Detect, trace, quarantine, and other containment efforts are vital

We can't just say "it's too late" and shift all resources from containment efforts to building capacity to treat. Both "sides" need to be focused on: building capacity to treat and limiting spread.

Tracing, testing, quarantining, and monitoring those who have been exposed to know cases, even now, reduces the number infected. Don't let the perfect be the enemy of the good. So what if it is impossible to trace "everybody." You do what you can. The more people you take out of the "exponential" equation, the fewer the overall cases.

Given that asymptotic people pass on the pathogen, and given that those people will not be self-quarantining, every possible effort must be made to identify those who have had close contact with a known COVID positive. And all those people should be tested -- symptoms or not. Any who are positive, quarantine -- symptoms or not. If, based on time from exposure, a person who tests negative is still at risk for contracting COVID 19, line up a re-test.

Containment efforts were nil last month. We are paying with new cases mounting at a far higher rate than if we had acted last month.

If our efforts are nil this month, we will pay with new cases mounting at a far higher rate than if we had acted... on and on.

Here's a post that's part of a relevant discussion. It has thoughts on the need to, and possible ways to, trace contacts from Washington's long-term care "epicenter" -- even now -- as well as an approach to building capacity to carry out necessary testing.

[SunSeeker]

3. I agree. At a minimum we should be testing everyone wth pneumonia.

But what is too late is to be able to contain it like Singapore did. We screwed the pooch on that when Trump evacuated those folks from the cruise ship in Japan to the military bases in CA to be handled by untrained and unprotected HHS employees.

[pat_k]

6. I think we need to do more than that...

Perhaps the biggest problem is that asymptomatic people can pass on the virus (here's a case -- there are additional cases and evidence from China and elsewhere).

With all the warnings, a vast majority of people who have symptoms will self-quarantine. Even if positive, they are, in a sense, "dealt with."

But asymptomatic people don't self-quarantine -- they don't believe there is reason to. When a positive case is identified, tracing and testing contacts is vital. Any positives found must be quarantined, symptoms or not.

[SunSeeker]

5. Yup, like the 3,000 Trump killed by malevolent neglect in Puerto Rico. nt

[brer cat]

7. We have an administration living in a bubble

concerned only with trump's reelection and opportunities to grift off the tax payers. Sadly, if the virus gets totally out of control he may be thrown out, but at a horrid cost to people.