The people misusing the CDC data are going to give me a fucking aneurysm.
COVID-19 Coronavirus Update: Wednesday/Thursday, September 2-3
New poll: Reality is sinking in for how long the pandemic is going to last.
Now: 44% of Americans think it will be 6+ months until things go back to normal. 27% say we'll never be back to normal.
In April, 55% believed the pandemic would be over by June.https://t.co/N2wEfZjtU4
— Drew Linzer (@DrewLinzer) September 2, 2020
A large majority of Americans, 58% see the U.S. government’s coronavirus response as worse than other countries.
But 58% of Republicans (and 67% of frequent Fox News viewers) think the U.S. government has done a *better* job than governments in other countries.
— Drew Linzer (@DrewLinzer) September 2, 2020
COVID-19 Coronavirus Update: Wednesday/Thursday, September 2-3Post + Comments (40)
Test types and payment policies
J. asked an awesome question yesterday about COVID testing:
I thought testing was covered by insurance. Can you please explain, David?
There are three different types/regulatory categories of testing for COVID. Each have their own quirks, desired technical specification and regulations that drive payment.
DIAGNOSTIC TESTING is testing done to give an individual a yea or nay on whether or not they are currently infected. Diagnostic testing is on the recommendation or supervision of a licensed medical professional. These tests are desired to be highly specific and highly sensitive. We really want to get the results right. These tests are overwhelmingly lab PCR tests with a sample coming from a swab stuck up your nose.
The CARES Act mandates that these tests are provided to individuals with no cost sharing. These are the “free” to the patient tests.
SCREENING TESTS are tests performed on people without clinical recommendation. My parents’ tests that I described yesterday are basically the epitome of this test archetype. A good analogy from a payment perspective is the company required drug screen as a condition to be hired. In that case, the company, not the insurer, pays as the test is not medically indicated but is part of a normal business practice. The NFL is a good example of mass, recurring screening tests being used with the intent of stomping on viral outbreaks at one, two or three cases instead of twenty, thirty, or forty cases. Here frequency of testing and rapid result reporting is more important than accuracy. A mediocre test done daily and reported within a cup of coffee is vastly superior to a perfect test done weekly with results coming back three days after the specimen was collected. Someone who has a presumed positive test today can get cleared with follow-up PCR diagnostic testing or by several days in a row of a negative screening result.
SURVEILLANCE TESTS: These tests are used to inform policy responses. Results are not reported back to any specific individual. For instance a pooled PCR test strategy for a college campus would allow for most dorms to be cleared at a point in time while saying that the 3rd Floor of East Rich Donor Tower is an emerging cluster. 3rd Floor ERDT would then be subject to a swarm of individually identifiable testing to figure out that there are five infected students in two suites that share an air conditioner and those individuals and their close contacts would be isolated and treated as appropriate.
Communities can also do non-individualized surveillance. Influenza Like Illness tracks the percentage of people who present to emergency rooms with symptoms that look like the flu. Covid Like Illness is a new metric that tries to do the same as ILI but for COVID. Communities that run their own sewage system are beginning to track virus levels in their waste water to identify background prevalence and hopefully isolate any sub-regional hotspots. This allows for more fine-grained strategic responses to the situation on the ground. These tests are also not paid for by insurers.
COVID-19 Coronavirus Updates: Tuesday/Wednesday, September 1-2
Warning: Upcoming Weekend Hiatus
I’ve been doing these aggregations every single night since late January — I don’t think any of us expected it to go on being necessary for so long. And I wouldn’t keep spending a couple of hours on it every day if I didn’t find it personally fulfilling, but I think we’re at a point where we could all use a break. So, barring some major change… since reporting tends to fall off over holiday weekends anyway, I’m planning to skip the Update this Saturday / Sunday / Monday. Just so y’all don’t have to think about firing up your news screens first thing in the morning, for a brief respite.
(I reserve the right to do a prime-time ‘longer read’ post or two, if I get the impulse to sort through some of the 85% of the material I’ve saved but never had the chance to share… )
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Trump is preventing the US from gaining access to promising vaccines developed abroad because he wants to scapegoat WHO for his own coronavirus failures. Hard to imagine a more reckless decision. https://t.co/mGxUjvg8mc
— Max Boot (@MaxBoot) September 2, 2020
Or, since Russia is recklessly pushing its own vaccine, good chance it’s because Putin told him to. https://t.co/H5afIQB40l
— Dana Houle (@DanaHoule) September 2, 2020
The U.S. has crossed the 6M #Covid19 infections mark. More than 183,600 people have died. @CDCgov is projecting that by Sept. 19, the death toll will be between 196,000 and 207,000.
Those numbers will soar if the US adopts a "let it burn" approach. https://t.co/PzGqMOx3EB pic.twitter.com/6pPvybzdgJ— Helen Branswell (@HelenBranswell) September 1, 2020
COVID-19 Coronavirus Updates: Tuesday/Wednesday, September 1-2Post + Comments (87)
Test to get out
Last week, my sister gave birth to her son.
Mom and son are doing well. He is adorable and asleep most of the time. His big sister is not 100% on board with the alien that her parents brought home.
My parents live about 45 minutes away from their newest grandchild. Both of my parents are at high risk of extremely negative consequences if they are infected with COVID. They have been extremely cautious about interactions and social engagement over the past six months. It helps that they live in Massachusetts where testing is common and community prevalence is low. Both of my parents were very determined to safely hold their grandson and play with their youngest granddaughter.
They had a plan.
On Saturday morning, they went to a walk-up testing clinic. They paid cash for a screening test. Things got stuck up their nose. Twenty minutes later, they were both cleared as unlikely to be positive and even less likely to be infectious. Three minutes later, they were both in the Kia and driving down 495. The testing cost them a good chunk of their discretionary funds for August but seeing their grandkids is highly valued.
An hour later, my dad was having a complicated tea party with his granddaughter and my mom was holding her grandson. A bit after that, my mom was in a parade with a dozen stuff animals and my dad was holding his grandson. My sister’s house was a bubble of confirmed no positives/no infectivity. There were hugs. There were dance parties led by an over-active three year old who knew exactly what she wanted even if the big people were not listening to her! There were cookies. It was a moment of near normality.
Testing is the way out. Massive, widespread, common and cheap testing that is accurate enough where we have a good deal of confidence that a negative is a true negative even if a positive is likely to be a positive is the way out. If people are able to test several times a week with results that are returned by the end of a cup of coffee, then 95% of normal, December 2019 expectations based, life can resume as long as people who don’t get negative results isolate until confirmatory diagnostic testing can sort false positives into true negatives and likely positives.
If we are confident that typical interactions of a day aren’t going to lead to infections of a disease that has immediate short run probabilities of high morbidity and mortality and significant unknown long run consequences, people will be out and about. Widespread testing is a way to achieve that goal even as we are also working on multiple separate tracks for vaccination, therapeutics and behavioral modifications such as masks.
COVID-19 Coronavirus Update: Monday/Tuesday, August 31-September 1
ICYMI:
Starting Tuesday, MIT is offering a weekly class to undergraduates **and the public** called “COVID-19, SARS-CoV-2 and the Pandemic.” An impressive lineup of guest speakers are coming. Livestream info here: https://t.co/b1F1sZICCt
— Carl Zimmer (@carlzimmer) August 30, 2020
In Fall 2020, all MIT students and the general public are welcome to join Professors Richard Young and Facundo Batista as they discuss the science of the pandemic during this new class. Special guest speakers include: Anthony Fauci, David Baltimore, Britt Glaunsinger, Bruce Walker, Eric Lander, Michel Nussenzweig, Akiko Iwasaki, Arlene Sharpe, Kizzmekia Corbett, and others. The class will run from September 1, 2020 through December 8, 2020 and begin each Tuesday at 11:30 a.m. ET. See the syllabus for lecture details…
The class is open to all MIT students, as well as any eligible cross-registered students. The live stream will be available to the public, but only registered students may ask questions during the Q&A. To view the live stream, click on this link and type in the password: mit-covid. Miss a class? You’ll be able to view a video of the lecture on this page.
US passes six million coronavirus cases – almost a quarter of the world's total https://t.co/ayJbcESWgZ
— BBC News (World) (@BBCWorld) August 31, 2020
COVID-19 Coronavirus Update: Monday/Tuesday, August 31-September 1Post + Comments (22)
Holy Motherforking Shirtballs
Thank you.
That is all I can really say right now.
Thank you.
You all have made life a bit easier for my niece and her parents.
I am overwhelmed and amazed and stunned at how generous you all are.
Thank you. I hope that I never have to come back and ask again as that will mean Claire is in remission and her and her parents will have only the normal worries of life. I knew all of you all are generous as fuck but I never counted on being able to put this ask out before my first cup of coffee and having you all pitch in by the time I finished my lunch.
WOW
Thank you!
Thank you,
Dave