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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: 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)