A week? Two weeks tops? Once we have the viral genome sequence, which we've had for a looooong time, it's really easy to make a test.

Testing a new virus is not the difficulty! We've had all the info we needed for months, and the bottlenecks are not anything specific to SARS-COV-2. IDT, TWIST, and others can produce the specifics for this virus in no time.

What we are seeing is a massive logistical and organizational failure, driven right from the top of all of the organizations.

I dunno, how long did it take in South Korea?

South Korea and the US found their first covid positive case on the same day[0]. I can't understand how the richest nation in the world failed this hard at containing and controlling covid.

[0]https://www.reuters.com/article/us-health-coronavirus-testin...

If you look at South Korea's population, they have 1/7th the pop of the United States but yet have 1/3rd the number of deaths. They are doing almost twice as bad as the U.S. in terms of deaths per million people.

There are so many ways to slice the raw data, each giving a different sound of how alarming it is. For example, if you look at just Washington state, it has roughly the same number of deaths of South Korea, with one seventh the population.

Exactly. It’s already done. Why there isn’t more or even any public outcry regarding the US/FDA refusing to use their testing kits/system is beyond me.

For those reading who may be reminded of a recent news story - There was never any refusal of purportedly offered test kits. The WHO confirmed that there was never such an offer or even availability and that the rumor was false.

https://www.politifact.com/factchecks/2020/mar/16/joe-biden/...

I’m not sure when the WHO reported that it did not have kits to offer, though they did state that many countries develop their own kits.

It still makes sense to ask why FDA only allowed CDC to develop a test, vs allowing all extant, validated tests and/or allowing private US tests.

This is not the same story or question. This is a derailing statement and should be removed.

Looks like they were on the ball and started developing their tests way back in January, when the virus's gene was first sequenced. I haven't been able to find a detailed timeline of their test production, though: https://www.aljazeera.com/news/2020/03/south-korea-coronavir...

SK reformed their pandemic response in 2015.

They were ready long before Covid-19 showed up.

https://www.propublica.org/article/how-south-korea-scaled-co...

How were their false negatives?

(Edit: typo: just noticed I accidentally wrote false positives instead of false negatives.)

Seems not to matter much given that they were able to get their cases under control

How have they established this has been due to testing rather than something else?

Testing and tracing are core parts of both SK's and Singapore's strategies who had cases in their countries and seem to have beaten it. I don't think we'll ever be able to proof with 100% certainty that their strategies worked because and it wasn't good luck or some other unknown factor, however it seems highly likely given the same strategy is working out well on two different places.

South Korean foreign minister believes it's testing that was key: https://www.bbc.com/news/av/world-asia-51897979/coronavirus-...

Singapore was hit hard by SARS. They adjusted their strategy and are successful with COVID-19. paper: https://academic.oup.com/jtm/advance-article/doi/10.1093/jtm...

Maybe they were just lucky, but if it was my decision, I'd put my money on the strategy that worked in those two countries and minimized cost in lives and economic impact.

Thanks for the links! To be clear, I'm not suggesting they had good luck or anything like that. I'm not even saying testing would be unhelpful (obviously it'd be helpful at least in some cases). I'm trying to figure out if there's more to the story, and if the effect testing itself is really as big as people imagine. Note that in the video she says testing is important because it minimizes further spread and quickly treats those found with the virus. But, for example, I'm hearing many Americans aren't exactly heeding the shelter-at-home orders. Would testing change that? And is there no other way to already change that without testing? Or for example, I'm hearing the US is running low on masks (not sure about other supplies) which I presume would harm patients' treatment. Would testing change that in any way? And like I mentioned elsewhere, the US can't legally just collect GPS data on everyone, and if we tried to put known cases on a map for everyone to look at, I'm not sure how well it would fly here. So are these going to be bigger obstacles to tracing even if we test people? Is testing really our biggest obstacle here?

I find these “devil’s advocate” perspectives a bit trying at times - yes testing would lead people to stay at home (since we could simply post a cop outside), yes testing would reduce PPE use (we would reduce transmission before a new case ever could walk in the ER door). You don’t need GPS data to do contact tracing.

Really, there’s no excuse for the abysmal US testing regime. We’re beyond a point where contact tracing is feasible, but there is no reason we had to get to this point.

Maybe instead of looking for excuses we should look at what they have done that can be applied to the US and Europe.

That's literally what I'm asking. What else did they do besides testing? My understanding is they've been aggressively quarantining people and tracing their contacts via phone GPS tracking, credit card data, and video surveillance [1], which is what really matters. Whereas in the US, they're telling people that testing them wouldn't change the health provider's response, which would be that the patient should self-quarantine if able. Now I don't like this fact, but I don't see why they would be lying about it. And if we assume they're not lying, then testing really would seem pointless. The problem here (as far as I can tell) seems to not be the presence or lack of testing, but the inability and/or unwillingness to provide the same kind of response in the US as in South Korea.

[1] https://www.businessinsider.com/coronavirus-south-korea-spre...

I think the problem is bigger. We can't do now what SK is doing. They are tracing cases and aggressively quarantining everyone who tests positive. Obviously you cannot do that if you cannot test enough people to get a complete enough picture of the invected population. We also probably now have too many infected to make that strategy workable at this point, even if we had the tests, tracing probably would be the new bottleneck.

This great write-up suggests to shut everything down to get cases back to a manageable level and then move to the SK and Singaporean model: https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-th...

Strongly recommend the read.

I don't really think we disagree on the overall picture to be honest. I realize they're probably doing something (or I should say multiple things) right, and I realize the US has had organizational failures and such. I'm just not clear on what exactly having testing capability would let the US do that it otherwise cannot do right now, and I've yet to see a direct answer to this. If healthcare providers are saying that they'd just tell anyone who might have the disease stay home, then how does testing change the picture? Can't they do it already? Or is the idea that people would only obey this if they actually tested positive? And for tracing, can the US even use GPS etc. data the way South Korea can to trace their contacts, and invade people's privacy just like that? Would testing make that noticeably easier, compared to (I don't know, just thinking aloud) making medical providers report those that call about an illness so their contacts can be traced? etc.

I'm not so sure the tests are really the issue here. Were talking about breathing equipment for sick folks (anesthesiologists have proposed repurposing some of the equipment to aid in the shortage). We're talking about personal protective equipment, and the time/energy of the healthcare providers. At least in the case of simply having enough general use equipment for a pandemic, it's something that can be prepared for well in advance.

One Germany company managed in January https://www.bloomberg.com/news/articles/2020-03-12/a-berlin-...