Is it akin to testing people for the bacteria that causes meningitis (which seems commonplace) and finding it in a person with no symptoms and saying they have meningitis
Their issue seems to be presymptomatic people. The delays and lags with this virus is the issue. The studies are all over the shop on whether these two groups infect others.
Youâd wonder if testing people with no symptoms using a test that does not detect if there is live virus was a massive waste of time.
It was the made driver for the FDA to make the code of federal regulations what they are today.
From a surveillance perspective, I think it has resulted in a lot of the bungled policy. I think it is leading to decisions made on restrictions that are already out of date.
The Zoe app in the UK has been far more consistent in calling outbreaks.
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Iâm not sure I follow you here. The test for meningitis involves a spinal tap (taken from a completely sterile environment) versus a nasal swab (not a sterile environment). Plus, youâd only really test someone for meningitis if theyâre showing clinical signs. People are being tested (using an inappropriate test) for Covid-19 willy-nilly. Itâs genuinely pure and unadulterated madness.
But is the bacteria that causes meningitis not on everyoneâs skin?
The main issue with the PCR test is the amplification factor that is used to try and detect the virus. At high amplification rates which are used in the US at least, a small fragment of the virus will give a positive result. The estimates from credible sources are that as high as 90% of positive tests are from people who do not have much or maybe no active virus, and certainly not enough to develop disease or transmit a disease. This means for every 5,000 that test positive, there are 500 to be concerned about as they could be spreaders or develop disease.
But we treat all 5,000 of them the same, itâs madness.
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so youâre saying the virus is deadlier than it looks? If a miniscule percentage of cases are actually cases then it is actually a pretty dangerous virus for those that get it?
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No, what that data says is that for the great majority of people who are exposed to the virus it doesnât develop into anything worth worrying about. Miniscule amounts of live virus or fragments of virus would be normal in people who were exposed but their immune systems did what they are designed to do.
you think 10% of positive tests actually developed the disease, in which case the virus is worryingly dangerous
you would imagine with tony advising yesterday to assume all flu like symptoms in the community currently are covid , that there is no point testing anyone outside those getting to hospital due to illness.
Youâre right in that the test is so sensitive that it picks up inconsequential tiny amounts of virus RNA and refers to the test subject as âpositiveâ. But thatâs only one of the issues.
Ultimately, the phenomenal volume of PCR tests that are being carried out on people all over the globe provide no information about critical factors such illness, infection, contagion/transmission.
PCR does not distinguish between dead or live virus though. A tiny fragment of degraded virus RNA would be sufficient to return a âpositiveâ. It does not mean the person is sick, infectious, etc.
Japans strategy can be summed up as follows; if you donât bother testing people it turns out thereâs no crisis at all
WHEN Diamond princess , a cruise ship suffering from a covid-19 epidemic, arrived in Japan in February, it seemed like a stroke of bad luck. A small floating Petri dish threatened to turn the Japanese archipelago into a large one. In retrospect, however, the early exposure taught authorities lessons that helped make Japanâs epidemic the mildest of any major economies in the world, despite a recent spike in infections. A total of 2,487 people have died from the coronavirus in Japan, just over half the number in China and fewer people than on a single day in America several times over the past week. Japan has suffered just 18 deaths per million population, a higher rate than in China, but by far the lowest in g7, a club of large industrialized democracies. (Germany comes in second, with 239.) Most strikingly, Japan has achieved this success without strict restrictions or mass testing â the main weapons in the battle against covid-19 elsewhere.
âFrom the start, we did not seek to contain it,â says Oshitani Hitoshi, a virologist who sits on a panel of experts advising the government. This would require identifying all possible cases, which is not feasible in a country the size of Japan when the majority of infections produce mild or no symptoms, argues Oshitani: âEven if you test everyone once a week you will always run out. âJapan performs the fewest tests in the g7: an average of 270 per day for every million people, compared to around 4,000 in America and Great Britain (see graph).
Instead, the government tried to apply the lessons of the Diamond princess . After quarantine officers and trained nurses were infected aboard the ship, despite protocols followed for viruses that spread by droplets, Mr. Oshitaniâs team concluded that the virus was spreading through the air. As early as March, Japanese authorities began warning citizens to avoid the san-mitsu or â3VSs â: closed spaces, crowded places and places of close contact. The phrase was broadcast on traditional and social media. Spring surveys found that a large majority avoided 3VS settings. Jiyukokuminsha Publishing House recently declared it âBuzzword of the Yearâ for 2020.
the Diamond princess also inspired an early focus on clusters. The government established a cluster control task force in March.
This information has allowed authorities to make granular distinctions about risk, opting for targeted restrictions rather than oscillating between the extremes of strict lockdowns and free openings for all. Nishimura Yasutoshi, the minister overseeing the governmentâs response to covid-19, wears a device that monitors carbon dioxide to measure the quality of ventilation during his meetings. (The room where he and your correspondent meet registers 506 parts per million, safely below the 1000 ppm threshold which indicates poor air circulation. The interview takes place on a large table, behind plastic screens. and with masks.)
The researchers deployed Fugaku, the worldâs fastest supercomputer, to model different situations. Crowded subways pose little risk, if the windows are open and passengers are wearing masks, Nishimura insists. Sitting diagonally, rather than directly across from each other, can reduce the risk of infection by 75%. Movie theaters are safe, âeven if viewers eat popcorn and hot dogs,â Nishimura says. While most cinemas in the West are closed, âDemon Slayer,â a new anime film, played in full swing in Japan, becoming the second highest grossing film in the country. In addition to the 3VSs, the Japanese government warns of five more specific dangers: dinners with alcohol; drink and eat in groups of more than four; speak without a mask up close; live in dormitories and other small shared spaces; and use changing rooms or rest rooms.
Of course, these ideas would have been in vain if ordinary people had ignored them. But the Japanese heeded the governmentâs advice to stay home and quarantine if they showed symptoms of the coronavirus, even though those warnings had no legal force. âSometimes we are criticized for being too homogeneous a society, but I think it played a positive role this time,â says Nishimura. And already, Japan has become even more picky when it comes to hygiene. As Americans argued over whether face covers were an attack on personal freedom, the Japanese lined up in front of Uniqlo for the release of its new line of masks. In the first ten weeks of the flu season this fall, Japan recorded just 148 cases of the common flu, less than 1% of the five-year average for the same period (17,000).
Best of all, while Japanâs population is disproportionately old, and therefore potentially more vulnerable to covid-19, they are also in very good health. Only 4.2% of Japanese adults are obese, a condition known to make the disease more deadly. This is the lowest rate of OECD and a tenth of America. Japan also has a good health care system, with universal coverage and many well-equipped hospitals. He even had many contact tracers already trained, part of a public health network established since the 1930s.
These advantages clearly have their limits. The virus has spread rapidly in recent weeks, reaching record levels in terms of daily cases and daily deaths. The government had to send medical personnel from the self-defense forces to consolidate hospitals in the worst affected areas. But at the same time, he has discouraged caution with a program that subsidizes indoor tourism and outdoor dining, in an effort to help the economy. While this appears to have contributed to the recent spread of covid-19, the government is only curbing it rather than suppressing it. And the cold now pushes people into 3VS spaces, as in the northern hemisphere. But in Japan, at least, the recent growth in the number of cases has started from a considerably lower base. â
Editorâs Note: Some of our covid-19 coverage is free for readers of The economist today , our daily newsletter. For more stories and our pandemic tracker, check out our hub
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Youâre missing the point. The point is that public policy is being decided on the rate of positive tests, when 90% of those positives are not going to develop disease and more importantly not infect others. The focus in terms of containment and isolation surely should have been on those that have a high enough viral load to transmit the virus? This can be accomplished simply by changing the amplification factor of the test.
The disease is worryingly dangerous for some people, and not dangerous for most. This was established in February 2020. The focus in terms of protection should have been on those who are most vulnerable, something almost all governments failed spectacularly at.
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Itâs actually worse
Understatement of the year.
Itâs all about Japan now, the Sweden lads need to keep up.
As well as vaccines thereâs treatments coming too âŚmight not be as good as vaccine but will cut down the amount of people ending up in ICUâŚboth will help give people more confidence âŚ