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Testing half the population weekly with inexpensive, rapid-turnaround COVID-19 tests would drive the virus toward elimination within weeks—even if those tests are significantly less sensitive than gold-standard clinical tests, according to a new study published today by CU Boulder and Harvard University researchers.
Such a strategy could lead to "personalized stay-at-home orders" without shutting down restaurants, bars, retail stores and schools, the authors said.
"Our big picture finding is that, when it comes to public health, it's better to have a less sensitive test with results today than a more sensitive one with results tomorrow," said lead author Daniel Larremore, an assistant professor of computer science at CU Boulder. "Rather than telling everyone to stay home so you can be sure that one person who is sick doesn't spread it, we could give only the contagious people stay-at-home orders so everyone else can go about their lives."
[...] They then used mathematical modeling to forecast the impact of screening with different kinds of tests on three hypothetical scenarios: in 10,000 individuals; in a university-type setting of 20,000 people; and in a city of 8.4 million.
[...] When it came to curbing spread, they found that frequency and turnaround time are much more important than test sensitivity.
For instance, in one scenario in a large city, widespread twice-weekly testing with a rapid but less sensitive test reduced the degree of infectiousness, or R0 ("R naught"), of the virus by 80%. But twice-weekly testing with a more sensitive PCR (polymerase chain reaction) test, which takes up to 48 hours to return results, reduced infectiousness by only 58%. When the amount of testing was the same, the rapid test always reduced infectiousness better than the slower, more sensitive PCR test.
That's because about two-thirds of infected people have no symptoms and as they await their results, they continue to spread the virus.
"This paper is one of the first to show we should worry less about test sensitivity and, when it comes to public health, prioritize frequency and turnaround," said senior co-author Roy Parker, director of the BioFrontiers Institute and a Howard Hughes Medical Institute investigator.
Journal Reference:
Daniel B. Larremore, Bryan Wilder, Evan Lester, [et al]. Test sensitivity is secondary to frequency and turnaround time for COVID-19 screening. Science Advances, Nov. 20, 2020; DOI: 10.1126/sciadv.abd5393
(Score: 2, Interesting) by Rich on Sunday November 22 2020, @11:25AM (11 children)
The authors happily assume that a positive test has any effect. Deniers will ignore it, so will informal workers who want food on the table, religious nutcases will congretate to pray the disease away and certain parallel cultures will still measure social status in size of wedding gatherings.
The price of free (mis)information and free thought is that we'll end up with a solid amount of idiocy in the population. This is generally considered acceptable, because the benefits of freedom outweigh the damage by the idiocy. (Those liberals who whine loudest about maintaining freedoms out the front door are the first to monetize that idiocy out the back door, the more, the better).
I've come to the conclusion that there are three basic ways out of the misery, and, as the saying goes, "we have to die one death".
1.) A million deaths (per 100M). For those who value freedom over all. Far less lives than the Red Army lost when liberating Europe from un-freedom and therefore absolutely worth it. Give it all into private hands and responsibility. Unfortunately, there will be also a million cripples weighing down the economy. Infrastructure will collapse, the Chinese will buy everything and make sure option 3 is chosen the next time. Fast antigen tests are mandatory on private grounds for private gatherings of the elite. The extra $50 entrance fee for testing guarantees exclusivity. Positive tests end up on private lists and are correlated with tracking data from the internet, those tested positive need not apply for any more private gathering (unless they convince the correlators otherwise, with a large payment).
2.) Bankruptcy. For incumbent politicians. Do as little as possible. Lock down only when the situation becomes unbearable (rather than four weeks before, with a fraction of the damage) and loosen measures when the moaning of the idiots becomes too loud. Fast antigen tests let politicians pretend they can do something about the situation and win a bit time with the population anger. Eventually, a vaccine appears and helps somewhat, but too many anti-vaxxers run around for it to be reliable. In the end, the economy is broken, one year of education was lost, the Chinese buy everything and make sure option 3 is chosen the next time.
3.) Drop human rights. For those who want the "simple" solution. Close the borders. Immediately lock down with only essential business going on. Conscript those out of a job for the lockdown to handle tracing, checking, and supplying those in quarantine. Raise an extra tax (about as high as the service economy now does not get) to pay them. Have a mandatory smartphone app tracing all locations and all contacts with reliable ID. There's a checkpoint on every corner, evaders are shot. Back-trace every contact from a positive test, and hard-quarantine all contacts of the last two weeks. Quarantine-breakers would be easily detected on checkpoints, and interned. After four weeks the population is mostly clear, businesses can re-open, and a lighter tracing regime (still with the app) can be instated. Fast antigen tests can maybe cut that by 10 days. Borders open with a 2-week isolation period, including tests, on immigration. Unfortunately, you now have all components for a totalitarian regime in place that the most greedy and corrupt politicians will secure for them, and you end in a dystopian future.
There's also the variation of being on an island, or isolated peninsula, with traditionally strong anti-immigration measures, having a halfway reasonable population, and a government that understood what "exponential" means. People living there can consider themselves lucky. (Here in Germany you'll get looks as if you're the re-incarnation of Adolf Hitler and Walter Ulbricht combined, if you even raise the idea of a 14-day border internment, while all the trouble-free nations have that, or in the case of NZ even harder limitations).
(Score: 2) by legont on Sunday November 22 2020, @02:30PM (5 children)
Similar to driving, "walking in public is not a right, but a privilege". This simple change will solve all the issues, while straightening fascists system we already have.
Note that "showing your face in public privilege" is already implemented.
"Wealth is the relentless enemy of understanding" - John Kenneth Galbraith.
(Score: 2) by Rich on Sunday November 22 2020, @03:12PM (4 children)
The Chinese did exactly that. No green light on your phone app, no walking in public. Which I don't think is bad as such under pandemic conditions, but is horrible because of the surveillance infrastructure needed to implement it.
Yet as a result they now throw water park parties again in Wuhan, and, in total, the Chinese economy will effectively have gained a few years on the "old" economy once this is over.
Short of a miracle, we're effectively doomed (as far as "business as usual" goes, at least). Stomping feet or insulting the messenger doesn't help.
It is noteworthy that everyday surveillance in Singapore is even worse than anywhere in China, yet the Singaporeans do nothing about it, and some even welcome what's probably the purest implementation of fascism anywhere in the world right now.
(Score: 3, Interesting) by legont on Sunday November 22 2020, @04:26PM (3 children)
On the other hand Russians did exactly the opposite. They let people do as people pleased and are having mass parties as well. They just treat sick and develop vaccine as fast as they could.
"Wealth is the relentless enemy of understanding" - John Kenneth Galbraith.
(Score: 2) by Rich on Sunday November 22 2020, @08:39PM (1 child)
Well, the Russians are a bit tougher than the rest, and a bit more risk-friendly - as can be seen with their early vaccine deployment. And they drink a whole lot more, that leaves less elderly to die from disease (although I note their life expectancy has increased by almost 10 years in the last two decades), and eases any sufferings for the younger ones...
(Score: 0) by Anonymous Coward on Monday November 23 2020, @05:59AM
Most Russians have disinfectant running through their vascular system, seeping out their pores. Maybe not such a bad thing after all.
(Score: 0) by Anonymous Coward on Monday November 23 2020, @10:32PM
I can confirm that at least at one point Russia closed down due to Covid.
I work at a multinational, with a Russian branch. My Russian coworkers explained Covid was the reason that they were cancelling some meetings and said that the entire country was on lock-down.
(Score: 3, Troll) by shortscreen on Sunday November 22 2020, @05:10PM (3 children)
There are many examples of countries suffering casualties in a war that were far more dire than COVID's 99.xx% survival rate. In fact, if the enemy hit them with a biological weapon that was later found to have a survival rate of 99+% they would probably laugh it off. So I don't know how you got from there to "infrastructure will collapse." I mean, if you're talking about the USA then the infrastructure was already crumbling, so OK, but it won't be because of public health. How do I know that? We already have 200,000,000 people who are overweight and a substantial portion of them are or will be limping along with metabolic disorders, cardiovascular disease, and mobility issues. The amount of public will to do anything about this, let alone go full authoritarianism, has been zilch. On the contrary, it's a marketing opportunity for health care providers, food producers, and clothing retailers. Getting fat is not as scary as a virus.
Arguments from emotion are so pervasive that people are afraid to talk about it, but a disease that is only dangerous to the elderly and spares nearly all younger people is not an existential threat to any country. Try to prove me wrong. There are legal, economic, and moral arguments to be made here, but they are separate and need to be justified independently.
(Score: 2) by Rich on Sunday November 22 2020, @08:29PM (2 children)
First off, in this cynical scenario 1, the dead are actually a good thing, because they are mostly from population groups that consume much more than they contribute to the bottom line. I was making the assumption that if 2% of the workforce drop out with permanent damage (kids don't, and the elderly die) and draw up another 0.5%-1% of workforce for care-taking, that's enough damage done to an unguided western economy that it won't be able to recover from, especially with the competition from the totalitarian guided Asian economies, and the extra debt piled up. This is done under the assumption that the ruling class is as unable to set the economy back on course as it is to contain the disease. The ultra-libertarian approach to people incapacitated by the disease would be to let them suffer to death by the roadside ("they could have foreseen the risk and insured themselves..."), but that would likely spark riots on a scale that also crash the economy.
You make a very valid point about the damage done to the US population by overweightness, though. The medical damage done by that might well serve as a guideline what consequences to expect, and they might not be as dire as I wrote.
(Score: 3, Interesting) by shortscreen on Monday November 23 2020, @04:27AM (1 child)
Anyone who suffers serious lingering health problems after COVID would hopefully be able to qualify for social security disability. Just for the sake of some additional data points to consider, it seems there are currently 13 million people on SSD. This is bigger than 2% of the workforce but also much smaller than the number of retirees collecting social security. https://www.ssa.gov/policy/docs/quickfacts/stat_snapshot/ [ssa.gov]
(Score: 2) by Magic Oddball on Monday November 23 2020, @07:23AM
It's extremely difficult to convince the government to award SSD (or SSI), even if the person is completely disabled and has a specialty lawyer handling everything:
Quora: How Hard Is It To Get SSD? [quora.com] (best comprehensive source I could find)
(Score: 0) by Anonymous Coward on Sunday November 22 2020, @06:57PM
"Far less lives than the Red Army lost when liberating Europe from un-freedom and therefore absolutely worth it."
the Jewish "Murder Whitey For Standing Up For Himself" Army.