Author: Gregor J. Rothfuss

COVID-19 Testing

Pooling is good:

If we look at this from the view of whole-population biosurveillance after the outbreak period is over and we have a 0.1% base infection rate, pools of 32 samples have an expected number of tests per person at 0.0628 or a 15.9x multiple on throughput/cost reduction.

Not even people dying left and right causes organizations to abandon the rules. Third world processes: Because of privacy concerns, the company’s call center does not leave voice messages. Its operators call back only 2x before moving to the next patient.
There’s also a lot of wishful thinking about serology tests:

There is no “serology test” – there are millions of possible serology tests, which need to be carefully compared and characterized to select ones that do more than just show you if some antibody against the virus is present. Reliable titres are going to be essential in the next phase of understanding this new viral infection – identifying who has protective immunity.

FDA delenda est

An innovative testing program in the Seattle area — promoted by the billionaire Bill Gates and local public health officials as a way of conducting wider surveillance on the invisible spread of the virus — has been ordered by the federal government to stop its work pending additional reviews.

Frequent, fast, and cheap is better than sensitive:

when you compare testing regimes it’s hard to come up with a scenario in which infrequent, slow, and expensive but very sensitive is better than frequent, fast, and cheap but less sensitive

Bill Gates is not impressed:

The majority of all US tests are completely garbage, wasted. If you don’t care how late the date is and you reimburse at the same level, of course they’re going to take every customer. Because they are making ridiculous money, and it’s mostly rich people that are getting access to that. You have to have the reimbursement system pay a little bit extra for 24 hours, pay the normal fee for 48 hours, and pay nothing And they will fix it overnight.

Economy freezer

Denmark is putting the economy into the freezer for 3 months. the government is paying companies for employees who are going home and not working. These workers are being paid a wage to do nothing. The government is saying: Lots of people are suddenly in danger of being fired. But if we have firing rounds, it will be very difficult to adapt later.

Titrating Quarantine

Last week I predicted that this might look like titrating quarantine levels – locking everything down, then trying to unlock it just enough to use available medical capacity, then locking things down more again if it looked like the number of cases was starting to get out of hand. This would eventually develop herd immunity without overwhelming the medical system. A paper argued for alternating periods of higher and lower quarantine levels based on how the medical system was doing:

A seesaw pattern of quarantine might work