Widespread testing? How does that help without any sort of transmission control measures?

What is up with this obsession with testing? We need to lower R0 and scale up medical infrastructure. Elimination at this point is a fantasy.

To be clear, testing is important. But to suggest that it should be the priority over isolation and distancing seems misguided.

I think that when there are calls for widespread testing it is a call for a system similar to what you see in S. Korea where there is a lot of testing, very quick contact tracing, and alerts about positive cases. This allows for lowering the R0 by isolating fewer people and letting more people continue to work.

FWIW, many of those countries that have been touted as testing+tracing success cases are now reporting patterns consistent with uncontrolled exponential growth of the virus in the past few days (although not in SK yet)

[1]: https://twitter.com/mattyglesias/status/1240740763752902670

It's a clear pattern of citizens returning with the virus when borders started to close.

Imagine you wake up in the morning, first thing you do is take a swab test. Ten minutes later you have your result, and if it's positive, you self-isolate. If it's negative, you go about your day.

No at-home test exists yet, and we surely aren't producing 300 million tests daily yet, but this should be the target.

Yes that sounds great. We do not have the capacity to make this happen before our hospitals overload and potentially 2.2 million die unless we take containment measures now.

Tests are good. We need containment now if we want them to be useful.

The tests require processing in complicated machines that have limited capacity. This isn’t happening.

It's clear everyone saying "a test for every American!" has never worked with PCR before.

>What is up with this obsession with testing?

Partially because of the idea that South Korea tested its way to safety. While its true that heavy testing was a key part of their containment plan, it also relied on a lot of investigative work, etc. It's also too late in the US since we already had uncontrolled and undetected community spread.

Partially because the US government screwed up the testing capacity. So people are overly valuing testing because its an easy way to assign blame. People love an oversimplified cause to a disaster because it makes life seem less random.

I agree with the obsession with the "test kits". The tests that are hard to come by, hard to process, and only detect active viruses.

Antibodies are what we need to be testing for. 10 minutes from blood to result. Works on formerly infected and currently infected.

It's important to know the difference between people who are still infectious and those that have completely recovered and have no virus in their body. An antibody test can't tell you that.

Lowering peak low enough for our medical system for long enough is the real fantasy. If you plug the numbers in the model you’ll see that it will take 10 years or until vaccines are ready which will also take years.

You need tests to backtrack and force isolate the sick. This waiting it out shit won’t cut it

Which is why I said "and scale up medical capacity" (and unspoken but of course: yes, there will be hundreds of thousands of deaths at the minimum, even with these measures)

> You need tests to backtrack and force isolate the sick. This waiting it out shit won’t cut it

You can only test and isolate if you first institute quarantine measures. Even after instituting quarantine measures, we still will unlikely be able to prevent an eventual resurgence of the disease.

From everything I've read, there's no path out of this that doesn't involve either:

a. shelter & scaling up critical care

b. at least a million people in the US dead

How are you going to train so many doctors in months? Total pipe dream to scale it more than 2x and then it will still take years.

Ofc you lock down then test everyone who comes in the hospital and then everyone who they came in contact with recursively until you stop finding any positives. Then you lock em all up for three weeks

Edit: and i dont mean self quarantine. I mean like the chinese did it

Okay, I'm glad we agree on the lockdown.

I agree that it is a pipe dream to suggest that we could scale up critical beds such that hospitals will not be overburdened. But I disagree that there is nothing to be done.

If we've bought time so that rather than 5 critical cases/bed we have 3, that is a huge improvement and still means potentially hundreds of thousands saved.

I am also skeptical that the primary or only shortage is labor.

The lockdown is just to slow it down so you can reasonably mount test and forced quarantine response. Realistically it will need military to step in or something like that. You can’t stop it with just lockdown. Currently US is barely doing the former and not doing the latter at all (unless you are celebrity). It is bad. My projection is at least 100k will die by the end of the year if nothing changes

if you have no reliable data you are shooting in the dark with mounting consequences

Sure, but we have more than enough evidence to show that emergency room visits are increasing and emergency room deaths are mounting. Control then test.