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We’ve had some talk recently about false positive test results, but I couldn’t figure out the intended implications. In the New York Times, conservative columnist Ross Douthat recounts his tale of what sounds like a false negative diagnosis:

Falling Ill, Testing Negative
I had the symptoms. But did I have the coronavirus?

By Ross Douthat
Opinion Columnist

March 24, 2020, 5:01 a.m. ET

I traveled a lot in the weeks before America went into lockdown, promoting a book about (ah, irony) the decadence of the developed world. I was in New York, Washington, Boston, Los Angeles — then home to Connecticut, then back to New York and D.C. again.

I was planning to review Ross’s book on Decadence until the pandemic came along. I’d previously reviewed Adam Rutherford’s book How to Argue with a Racist: he came down with corona on his book tour too.

I thought of myself as woke to the coronavirus: I had followed reports from Wuhan via grainy Chinese videos and fringe alarmist Twitter, warned skeptical relatives to stock up and prepare to bunker down, and filled our basement shelves with rice and beans, paper towels, the works.

But I also felt, a bit idiotically, that if I was savvy enough I could stay one step ahead of the virus — giving up handshakes early, carrying Purell everywhere, projecting from the early case numbers to figure out how long I could safely travel, and when the virus would explode and the country would shut down.

My shutdown prediction was correct: I got home and started canceling future book events just before the lockdowns started. But the day after my return I felt achy and strange, and the following morning I woke up with a dry cough, tightness in my chest and pain across my lungs.

Then the rest of his family gets the symptoms. They finally find a drive-in testing center, but the test find Ross Negative, which would be bad: after all he suffered, he is formally still vulnerable to get the Big One. But in truth he’s like immune due to a false negative report.

So how many false negative tests are there?

 
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  1. dearieme says:

    What he really needs is an antibody test that will tell him whether he has had the disease. That too, though, will have false positives and negatives.

    Two of my extended family who live in the Orient think they may well have had it – picked up in Laos, if so – with one feeling seriously ill for several days and the other almost shrugging it off. They’d love to know whether they are now immune.

    • Replies: @NOTA
  2. UK says:

    I have/had the same symptoms, and can’t get tested where I am. Probability still says I have an unpleasant cold.

  3. Adam Rutherford, not Ferguson

  4. Sean says:

    The delay is getting the test kits out in sufficient numbers is being attributed to what sounds like worries about just that very issue. blockquote> <https://www.washingtonpost.com/business/2020/03/16/cdc-who-coronavirus-tests/

    FDA and CDC officials have attributed some of the testing delays to their determination to meet exacting scientific standards they said were needed to protect public health, the government effort was nevertheless marred by a widespread manufacturing problem that stalled U.S. testing for most of February.

  5. Doc Bob says:

    It’s 5% probably. qPCR is really good at detecting genes, and the paper I read recently had an AUC of 0.95.

    False negatives are also caused by not swabbing properly, which can be systemic to the swab technician.

    And it’s a matter of defining what a positive test IS, because you have to decide how much virus in the sample counts as infective. The more sensitively (lower) the threshold is set, the less specific the test and thus the more false positives. By the time Ross got the test his virus count may have been much lower. (Or more likely he was sick with not the new SARS), look up ROC curves if you want to find the trade offs.

  6. ic1000 says:

    Some general information.

    The current crop of PCR-based molecular diagnostics for the Covid-19 virus have analytical sensitivity of about 10 virus genomes. That means that in benchtop testing, a sample spiked with 10 virus’ worth of RNA will turn up positive 100% of the time.

    So, theoretically, it’s only possible to get about 3-fold greater sensitivity (look up “Poisson distribution”). There are claims that MDx approaches based on CRISPR/cas9 technology already do that; I haven’t checked.

    This is analytical sensitivity. What really matters is clinical performance. For instance, samples can include chemicals that inhibit key enzymes.

    An early Chinese report said that, from Covid-19 positive patients, broncheal lavage fluid was positive for 93% of them. Nasalpharyngeal swabs, about 70%. Mucus, a bit less. Fecal samples, less than a third. Urine and blood, basically none.

    Lavage fluid is not practical in most situations, or particularly safe for the test-givers. So swabs are used. Is the false-negative rate so high because nasal-oral secretions from infected people don’t contain very much shed virus? I think that’s likely… but maybe not. Is it something else?

    A related question: how much virus is shed by people who are infected-but-asymptomatic, compared to experiencing flu-like symptoms, shortness of breath, or ICU-level respiratory distress? It’s a key question when considering drive-through testing and mass surveillance. Maybe modest changes to analytical sensitivity or to testing procedures could yield big improvements in lowering the false-negative rate.

    These are critical studies; that Trump/CDC/FDA squandered the ~6 weeks we had for early development and deployment of tests, has meant that (AFAICT) they basically haven’t been done for the American context.

    Informed commenters, please supply links to studies.

  7. Art Deco says:

    Or, they had some other ailment.

  8. But in truth he’s like immune due to a false negative report

    .

    What makes you draw that conclusion?

    I read the article and find that to be the least likely of the three possible scenarios Ross mentions.

    Many other viral illnesses cause similar symptoms.

  9. If we’re not there on a vaccine by next flu season, at least an antibody test would be very helpful.

    (The Atlantic article says the Telluride couple’s test is an antibody test. Hence requires a blood draw, but then you’ve got a rough idea where you stand.)

    • Replies: @HA
    , @MEH 0910
  10. eric says:

    You are mainly concerned with false negatives, like most people, because the cost of false negative can be large as these people would infect others. But remember that there is always a trade-off in false negatives and false positives. Any practical test is imperfect, so minimizing false negatives maximizes the false positives.

    We all know the costs of false negatives–potential contamination–but there are costs to false positives. If we test everyone, the number of cases will skyrocket, just because we’ve never tested everyone for flu. Further, people at the end of life are often beset with infections of various sorts as their immune systems fail. These dying people are not dying of these infections per se, but if we define every dead person who also tested positive for corona as dying of corona, then corona deaths with spike even higher. These false positives will inflate the real risks of this flu, leading to a misallocation of our resources–time, money, etc.

    Given the media bias towards a crisis at all times, there will be large incentive to do this, just as current AIDS mortality data include anyone with HIV who dies regardless of the cause.

    • Replies: @Paul Jolliffe
  11. Anonymous[358] • Disclaimer says:

    Douthat was ahead of the game with the purell but he needed a mask to come off the travel tour unscathed. And most any mask will do because the mask prevents the facial touching. It would’ve been outrageous for him to do his whole tour in a mask including all the time he was behind a microphone but then again it would’ve gotten him more publicity.

    Surgical masks as good as respirators for flu and respiratory virus protection Date: September 3, 2019 Source: UT Southwestern Medical Center Summary:

    The study reported ‘no significant difference in the effectiveness’ of medical masks vs. N95 respirators for prevention of influenza or other viral respiratory illness

    https://www.sciencedaily.com/releases/2019/09/190903134732.htm

  12. Simon says:

    You misstated the name. The author of How to Argue with a Racist is Adam Rutherford.

  13. If the death rate is .5% then we can estimate 100,000 Americans were already infected by March first , since it takes 5 days to develop symptoms and another 18 days to succumb to This Coronavirus and the total deaths reached 500 yesterday.

    If 100,000 Americans were infected on March 1st, we must have had 200,000 infected by March fifth, 400,000 infected by March 10th and 800,000 infected by March 15 when they started closing down some schools…..must be at about 3 million Americans infected today. We should expect the number of deaths to reach 15,000 in 3 weeks.

    If the death rate is 1% , we can estimate that 50,000 Americans were infected by March 1st and we have just about 1.2 million Americans infected with Wahu Flu today.

    • Replies: @Buffalo Joe
    , @Anonymous
  14. ic1000 says:

    Serology tests are the critical companion to PCR-based tests that directly measure viral RNA. That they are not already in widespread use is to the further discredit of the US regulatory regime.

    The FDA is now trying to expedite deployment of this class of tests. At this writing, the FDA’s FAQ lists 12 kits that companies are offering for sale.

    After a person is infected with the n-CoV-SARS-2 virus, their immune system responds by creating antibodies, in particular antibodies to the spike protein, which circulate in the blood. This is part of an effective defense against the virus. The antibodies produced in the days after infection are known as “IgM”. Over the course of a few weeks, IgMs fade away, to be replaced by IgGs.

    It looks like, once a person has been infected, mounted a defense, gotten past symptoms of sickness, and tested negative for the virus — that they are indeed “cured”. Their body has cleared the virus, and they have immunity against re-infection. The immunity probably lasts months, and there is no guarantee that it is complete immunity against somewhat-different strains of coronavirus.

    But it should be good enough to let doctors, nurses, EMTs, etc. return to work without worry.

    AFAIK, the serology tests detect reactivity against coronavirus spike proteins, in general. This likely includes spike proteins of the coronaviruses that cause 20% of common colds.

    If this is correct, it will be important to distinguish IgM reactivity from IgG reactivity. You’d want to know that a recovering respiratory technician has high-titer IgM against spike protein, rather than only an IgG titer (which could merely mean that he got over a coronavirus cold, 6 months ago).

    Most of what’s known seems to have been learned in the aftermath of the SARS outbreak, quashed in 2003. As with the MDx tests, there’s a need for studies of the current Covid-19 virus, in the American context. I don’t know of any papers, either peer-reviewed or preprints. Links appreciated.

  15. @ic1000

    The test is theoretically very sensitive, but like everything else in life, garbage in, garbage out. If Douthats child’s test was inconclusive, that means there wasn’t enough human RNA in the sample (because the internal control for a regular human gene was negative). If a poorly trained or overworked technician wasn’t getting much material on the swabs that will reduce sensitivity.

    Also it’s quite possible Douthat had COVID but his test was a true negative. In mild/moderate cases people can start having negative swabs after 9-10 days and it sounds like he got it first and his family was sick for some time before he finally managed to get tested. It goes to show why we need widespread, rapid antibody testing that stays positive for survivors.

  16. What right now is the contrast in treatment or “next steps” between someone who tests positive and someone who feels similarly sick but tests negative (aside from perhaps more tests for the negative person, as this is the less reliable of the two results)?

    If you’re a medical professional or caring for the elderly this could be a crucial distinction, but is it so crucial for members of the general public? To me some of the clamor over testing sounds driven by the need to assign blame or the urge to obtain spinnable statistics.

  17. Lugash says:

    Our elites seem to have some strange desire to be tested, even when it has negative consequences on their health. Ross does the same thing that special prosecutor Daniel Goldman did: drive around the northeast states with family in tow while exhibiting symptoms. They are risking their family’s health, their own health and that that of the health care workers. If they’re negative-negative they’re far more at risk to get it from the tester. If they’re positive they should be at home isolated and resting. In Goldman’s case it seems like he did it so he could shit on Trump in a Twitter thread. In Ross’s case it seems like he wanted a topic to write about.

    https://heavy.com/news/2020/03/daniel-goldman-coronavirus-trump-twitter/

    OT Political Idea: Any company that gets Bailout Bucks gives the government an equity stake equal to the stock buyback amount for the previous 10 years.

    Oh, and someone activate Tucker to go talk some sense into Trump about not easing up on the quarantine.

    • Agree: unit472
  18. Thomas says:

    Great. Meanwhile, the Wall Street mandarins and establishment cucks are pushing Trump to reopen everything while the spread of this thing as far as we can tell is still getting worse and at a faster rate. Now it turns out it’s getting worse than that still.

    Trump got elected more than anything because his voters had had it with being told they should be replaced for the good of the all-sacred economy. It’ll be a tragic irony if he winds up killing off a few hundred thousand (or a couple million) of his voters in sacrifice to Mammon.

  19. Jack D says:
    @ic1000

    Trump/CDC/FDA squandered the ~6 weeks we had for early development and deployment of tests

    First of all, Trump doesn’t develop tests so he didn’t squander anything. FDA/CDC are staffed with the same affirmative action hires that populate the rest of the Federal government. Testing was useful when we could still do contact tracing. We missed our chance. Now that the Chinese Virus is out in the community, testing is pointless – all we can do is lock everyone up and destroy the economy.

  20. Meanwhile, the NYT is covering the REAL Corona-crisis:

    Spit On, Yelled At, Attacked: Chinese-Americans Fear for Their Safety

    https://www.nytimes.com/2020/03/23/us/chinese-coronavirus-racist-attacks.html

  21. The false negatives for naso-sinal swipes samples are significantly higher than false negatives for sputum. Sputum is a superior sampling method but is more costly (time, supplies, safe handling) China bug basically heads straight for the lungs. This is a known known.

  22. dearieme says:

    Is it worthwhile trying to avoid overwhelming ICUs? Wuhan data say that 97% of patients die if they are so ill that they’re put on “invasive mechanical ventilation”.

    Table 2 in https://www.thelancet.com/action/showPdf?pii=S0140-6736(20)30566-3

    Hat tip to
    https://www.investmentwatchblog.com/lancet-medical-journal-24-fatality-rate-if-admitted-to-hospital-97-fatality-rate-if-requiring-mechanical-ventilation/

    I’m loathe to accept Chinese data uncritically but I can’t see any reason why they’d lie about this. But maybe medical people would like to add their views?

    • Replies: @Jack D
    , @epebble
    , @Johann Ricke
  23. unit472 says:

    Watching Cuomo doing his (presidential campaign?) press conferences is fascinating. He berates the Federal government for not turning over to New York its entire supply of medical equipment but doesn’t mention that New York had a Chinese New Year’s Parade on February 9th! Cuomo and de Blasio let the virus run amok due to this and other irresponsbile decisions that they made.

    This is redolent of the 1918 Spanish flu pandemic that is often cited today as an example of how St. Louis lowered its death toll by canceling parades and closing churches, bars etc. It was basic if primitive public health. They didn’t have RNA test kits or ventilators but they had common sense. Cuomo ignores his prior dereliction of duty and blames his woes on a lack of equipment he could have bought in February but didn’t. The math of infection rates was the same in February as it is in March if he or his public health officials had cared to look.

    • Agree: Coemgen, Chrisnonymous
    • Replies: @Chrisnonymous
  24. Bruno says:

    Is there data about ethnic % of positive/ICU/dead in NY ?

    In China, they saw that O blood had 20% less infection proportion, A 15% more and B average. It would be interesting to know …

  25. peterike says:
    @Jack D

    FDA/CDC are staffed with the same affirmative action hires that populate the rest of the Federal government.

    CDC Management political contributions, as per Open Secrets.

    2020 Dems 100% Republicans 0%
    2018 Dems 100% Republicans 0%
    2016 Dems 100% Republicans 0%
    2014 Dems 100% Republicans 0%
    2012 Dems 100% Republicans 0%
    2008 Dems 100% Republicans 0%

    Dept. of Health and Human Services contributions.

    2020 Dems 95% Republicans 5%
    2018 Dems 93% Republicans 7%
    2016 Dems 94% Republicans 6%
    2014 Dems 88% Republicans 12%
    2012 Dems 91% Republicans 9%

    • Replies: @anon
  26. MEH 0910 says:

    I’d previously reviewed Adam Ferguson’s book How to Argue with a Racist: he came down with corona on his book tour too.

    Heh, heh, heh. You mean Adam Rutherford.

  27. Whites account for 63% of all federal civilian employees,

    Not in the Boston-Washington axis of evil they don’t.

    https://www.cdc.gov/minorityhealth/diversityandinclusion/index.html

  28. SFG says:

    Wouldn’t Ross promoting his book be appropriate rather than ironic? I mean, our decadence has been quite intensely demonstrated over the past few weeks–East Asia flattening the curve while Italians and Spaniards choke to death in overcrowded emergency rooms (and we are likely next, having outsourced manufacturing to China).

    Now if Thomas Friedman had just promoted a book about the glories of globalization and had to stop because of the virus…that would be ironic.

    • Agree: epebble
  29. HA says:
    @AnotherDad

    “The Atlantic article says the Telluride couple’s test is an antibody test.”

    Note that it takes a couple of days for IgM antibodies to form. (I’m not sure how long it takes the virus to multiply so that it’s detectable in the bronchial or nasal mucus.) So if one suspects that a given restaurant gathering or airline flight might have led to an infection, one would need to wait a week (ideally, away from others) before being tested.

    Still, that’s a lot better than the long indefinite period people are having to endure now, and not that much worse than losing a week to ten days due to a cold, though if one expects to be tested several times a year, getting blood drawn each time is going to be a big problem (in comparison with, say, a nasal swab).

    IgM antibodies are typically detectable 5-7 days post symptom onset and frequently remain elevated for 2-4 months following infection.

  30. ic1000 says:
    @Jack D

    I haven’t dealt with the CDC, but industry people seem to be pretty unimpressed with the competence and work ethic of their in-house staff. FDA people I’ve dealt with have been very capable, though the organization is slow-moving.

    > Trump doesn’t develop tests so he didn’t squander anything.

    Really? You listened to Trump riffing about Korean Academy Award nominees etc. while the storm clouds were gathering in January and February, and thought, that’s leadership. Not everybody was left with that impression. Obama and Bush Jr. let a whole bunch of stuff happen too, do they get free passes, too?

    • Replies: @Thomas
    , @Adam Smith
  31. Anon[348] • Disclaimer says:

    I suspect a large number are false negatives. Seattle Times said that we are now testing 4,000 people a day, yet the number confirmed so far are at 2,221, with 11o deaths, incl. 225 new cases yesterday. They said that only 5 to 7% are testing positive, despite restricting testing to only those who show symptoms. They have a website where people could go request a home test kit, but only those currently with a cough and a fever can get one.

    NY seems to have a large number of positives. I think they are using different tests. WA state uses test kits developed by University of Washington Medicine.

    If the death rate is at 1%, then 110 deaths means at least 11,000 are infected in the area, not 2,221. If it’s 0.3% as in Germany, then 36,000+ are infected.

    • Replies: @Anonymous Jew
  32. @ic1000

    I know about the Poisson Distribution but I still don’t follow what you say about maximum sensitivity. Could you elaborate?

    • Replies: @ic1000
  33. @Jack D

    “First of all, Trump doesn’t develop tests so he didn’t squander anything.”

    Trump is the fucking boss.

    Ever worked for one of those?

    Boss tells you do to something, you do it.

    The FDA and the CDC all answer to The Boss.

    What about this shit do you NOT understand?

    Until March 9, Trump was minimizing this, casting shade, just flu, nothing to see here.

    You damned dipshit.

    • Replies: @WJ
    , @Whitey Whiteman III
  34. @Jack D

    FDA/CDC are staffed with the same affirmative action hires that populate the rest of the Federal government.

    It also didn’t help that the CDC distracted itself with “gun violence” and “climate change” as supposed public health issues.

    • Replies: @europeasant
  35. Thirdtwin says:
    @Jack D

    Not to put words in his mouth, but I think JackD is using AA as a catch-all for Peter Principle, patronage, nepotism and crony hires. AA is a melange of all of those things.

    But it would be interesting to see the percentage of whites in leadership positions in the federal bureaucracy. Do you think it would be higher or lower than white leadership in the private sector?

    • Agree: Jack D
  36. Anon7 says:
    @ic1000

    “Trump/CDC/FDA squandered the ~6 weeks we had for early development and deployment of tests…”

    Typical anti-Trump bias.

    Try this reporting:

    On February 5 the CDC began to send out coronavirus test kits, but many of the kits were soon found to have faulty negative controls (what shows up when coronavirus is absent), caused by contaminated reagents…

    The CDC’s kits are based on PCR testing, which makes millions or billions of copies of a DNA sample so that clinicians can easily identify and study it…

    The first thing to know is that PCR is a very sensitive test. You need extremely clean reagents, and the smallest contaminants can ruin it completely (as happened in this instance). A negative control that detects the wrong viral genome and raises a false positive is practically a worst-case scenario, because it calls into question all the other results in the run—you don’t know if samples are truly positive or if they are positive because of the contamination…

    …the biggest limitation in diagnostics is not the technology, but rather the regulatory approval process for new tests and platforms.

    FDA rules initially prevented state and commercial labs from developing their own coronavirus diagnostic tests, even if they could develop coronavirus PCR primers on their own. So when the only available test suddenly turned out to be bunk, no one could actually say what primer sets worked.

    The CDC and FDA reversed course and lifted this rule on February 29, and commercial and academic labs are now allowed to participate.

    https://www.technologyreview.com/s/615323/why-the-cdc-botched-its-coronavirus-testing/

  37. Thomas says:
    @ic1000

    FDA people I’ve dealt with have been very capable, though the organization is slow-moving.

    From what I’ve read, the FDA’s glacial process on approving tests for coronavirus was a major reason why the opportunity to contain it was lost.

    https://www.nytimes.com/2020/03/10/us/coronavirus-testing-delays.html

    The FDA is something of the crown jewel and the last remaining accomplishment of the early-20th century Progressive movement. That was something that Progressives and modern gentry liberals (their descendants) were very proud of, that we got clean food and drugs and no more hucksters selling snake oil or rat meat in the hot dogs and such.

    Unfortunately though, the FDA has probably become a case of bureaucratic overshoot. Their process is taken to be so important and carries with it such a very high and exacting standard of proving safety and efficacy that it can’t adapt to an actual health crisis on its own.

    • Replies: @Jack D
  38. ic1000 says:
    @International Jew

    If a test can detect 10 viral genomes in a test tube with 100% accuracy, you can see that it can’t be improved to be a hundredfold more sensitive. That would mean detecting 0.1 viral genomes, but there is no such thing — a virus is a discrete entity.

    A test that’s tenfold better would detect 1 viral genome, which would be “perfect.” However, the Poisson distribution means that, while most test tubes would get one viral genome, by chance, some would get none, and some would get two (a few would get three, etc.). I’m sure some online calculator can tell you the theoretical upper limit to sensitivity on this basis, IIRC it’s something like 80%.

    This does get back to two real-world questions. One is, what’s the sensitivity that’s required to identify infected people? The second is, what’s the sensitivity that’s required to identify contagious people (e.g. those who can spread disease by coughing, sneezing, talking, licking their finger and pressing an elevator button)?

    10 viral genomes seems awfully sensitive already. But, with a ~30% false-negative rate for nasal swabs, perhaps it’s not sensitive enough?

    • Replies: @Jack D
    , @Kratoklastes
  39. Jack D says:
    @Art Deco

    We’ve had this discussion before.

    First of all, it shouldn’t be equal to the population representation in the 1st place in any agency that requires g loaded tasks. It should be equal to the IQ adjusted population representation for those occupations. If whites were represented in the NBA according to their population representation due to AA, would the NBA function at the current level of play?

    2nd, white representation in the Fed gov is lumpy. At the Dept. of Ed in DC, it’s majority black. Park rangers in S. Dakota – mostly white. CDC is in Atlanta which is sort of white collar heaven for blacks so it wouldn’t surprise me to see them over represented there. Most blacks with college degrees are AA products who are not really qualified to do the jobs that they are in.

    • Agree: Thirdtwin
    • Replies: @Art Deco
  40. Jack D says:
    @ic1000

    But, with a ~30% false-negative rate for nasal swabs, perhaps it’s not sensitive enough?

    For the same reasons you give, even if the threshold was 1 viral genome, there would still be false negatives. The virus seems to live mostly lower down in the respiratory tract so maybe in 20% of throat swabs you get 0 virus genomes even though they are present.

    The solution is probably repeated testing. Instead of 1 swab you get 3 swabs on successive days. Even if the test is only 80% accurate on 1 try , on 3 tries it might be 99% accurate. But we can barely get people tested once let alone 3 times.

  41. There are probably enough false negatives for this thing to hang around in the population for quite a while, picking off the occasional genetically susceptible victim.

    If baffles me that we are not seeing more discussion of genetic susceptibility. I assume we are keeping samples of the genome of every patient. If not, that is the height of incompetence. Indications that there are “10 or 15” genes involved in cytokine storms means we ought to be data mining like crazy to identify which genes are responsible.

    Once we have identified the susceptible (assuming we do) then life will go on for the rest. Right now it is fear of the unknown that is driving our reactions.

    I imagine that there are few of us whose behavior would not be adjusted by the knowledge of susceptibility or the lack thereof.

    • Replies: @anon
    , @res
  42. @Jack D

    all we can do is lock everyone up and destroy the economy.

    We must destroy America to save America!

    USA #1

  43. Anonymous[570] • Disclaimer says:

    Isn’t it Adam *Rutherford*?

  44. MEH 0910 says:
    @AnotherDad

    Thread:

    • Replies: @MEH 0910
  45. Jack D says:
    @Thomas

    The FDA has a mandate to allow only drugs (and “medical devices” such as tests) that are BOTH safe and effective. This was a reaction to quack devices and medicines which (while sometimes harmless, sometimes not) did absolutely nothing and so were a form of consumer fraud – crooks were wasting people’s money. So if you want to market a drug or medical device, not only do you have to prove that it doesn’t harm anyone but you also have to prove to the FDA by means of extensive controlled trials that the product does what you claim it does.

    Now in normal times this makes a lot of sense, but we are not in normal times. I saw an interview yesterday with a guy who was trying to bring in Covid tests from China to sell to medical professionals as “quick and dirty” instant tests for people who come in exhibiting symptoms. These are not quack tests. They are the same tests that the Chinese are using on their own people. They have an accuracy of maybe 80%, which is better than nothing. But the FDA standard is not “better than nothing” – it has to be “perfect”. Maybe there’s a worldwide pandemic and people are dying like flies, but rules are rules. So they sent him a cease and desist letter telling him to stop selling these tests. So now instead of an 80% good test, people have NO test.

    Bureaucracies are pretty good at certain things but they tend to be very rigid. They are like trains that go down a certain track. As long as the conditions on the track are the normal conditions, the train does very well at what it is designed to do. But if there is a sudden change in conditions, the train itself doesn’t now how to react (other than stop). You need to bring in external forces to get the train back onto the track and going in the right direction. But it’s not easy to get a locomotive to change direction.

  46. M_Young says:

    As late as Jan 29 NYC officials were downplaying the virus, at least according to the Times of that fair city.

    “City health officials have urged New Yorkers to go about their lives. They say there is no reason for healthy people to shy away from public gatherings — even those who recently returned from Wuhan, where the virus is believed to have originated.”

    https://www.nytimes.com/2020/01/29/nyregion/coronavirus-nyc.html

    • Replies: @MEH 0910
  47. @ic1000

    Obama and Bush Jr. let a whole bunch of stuff happen too, do they get free passes, too?

    It’s great how Bush has been held responsible for lying the U.S. into the forever wars. I know the people of Iraq are happy that the man who launched the invasion of their country is not walking around as a free man.

    It’s equally impressive how Obama was prosecuted for drone assassinating Americans and escalating the forever wars. I know the Libyans are relieved that the man who ordered the destruction of their country has been punished.

    It’s amazing how they’ve been held accountable for all the lives they destroyed and all the treasure they squandered. So glad their victims have been made whole.

    I sleep well knowing they’re in prison where they belong and didn’t get free passes, my faith in justice restored.

    • Replies: @Art Deco
  48. In Italy (of course) they miscounted cases. If they had counted right, their mortality from the virus statistics would be in line with other countries.

    https://off-guardian.org/2020/03/23/italy-only-12-of-covid19-deaths-list-covid19-as-cause/

    • Thanks: Kratoklastes
  49. @Lugash

    OT Political Idea: Any company that gets Bailout Bucks gives the government an equity stake equal to the stock buyback amount for the previous 10 years.

    No, they should be required to re-issue shares in the markets to raise a dollar volume equal to their prior repurchases. This is, of course, after executives buy sizeable equity stakes and agree to take most of their pay in restricted stock with a five-year lockup, which will of course be painfully diluted by any new issuance. The capital markets should be the first place the oligarch parasite class should be forced to turn. Oh, and since buybacks are little more than an evasion of taxes on dividends, they should once again be outlawed.

  50. Anon[407] • Disclaimer says:

    OT

    Re ventilators, if the hardware and software is all that tricky, couldn’t the Feds appropriate/nationalize the IP, maybe along with some employees, and give it to several other, larger companies to manufacture? And if the manufacturing machinery is hard to make, take over those companies also. Materials and components difficult to source? Same thing, or confiscate inventory from other companies. If this is really war, more ass needs to be kicked.

    As a bonus, the squeals from the companies involved, the Democrats, and the “national injunction” courts will only play to Trump’s favor.

  51. A couple of thoughts. Wyoming County, NY, which is one county over from here, just had their first COVID “related” death. The victim, an unidentified 82 year old resident of a nursing home. Biopsy? Autopsy? I also Googled “Why doesn’t the CDC report influenza deaths in those over 65?” Lots to read, but basically there are many contributing factors to infuenza deaths, such as pneumonia, COPD, congestive heart failure, and the virus can only be detected for a few days so basically, why blame the flu. So, how many people in the USA actually die from the flu each year? The answer is determined by mathematical models and estimates.

    • Replies: @Buzz Mohawk
    , @MBlanc46
  52. @International Jew

    “It also didn’t help that the CDC distracted itself with “gun violence” and “climate change” as supposed public health issues”.

    I think they also busied themselves with the greatest health issue of our day. About how racism affects American’s health. The turible, turible “Toll” that Racism inflicts on our brothers.

  53. Travis says:

    this is why we need to get more people testing for antibodies to the Wahu Flu.

    New blood tests for antibodies could show true scale of coronavirus pandemic. How many COVID-19 cases have gone undetected? And are those who had mild cases of the disease—perhaps so mild they dismissed it as a cold or allergies—immune to new infections? Answering those questions is crucial to managing the pandemic and forecasting its course. But the answers won’t come from the RNA-based diagnostic tests now being given by the tens of thousands. Scientists need to test a person’s blood for antibodies to the new corona virus. Such tests can detect active infections, too, but more importantly, they can tell whether a person has been infected in the past because the body retains antibodies against pathogens it has already overcome.

    The test can identify those who have already had COVID-19 and likely acquired at immunity. And that means thousands of doctors, paramedics, nurses, and other workers who have been identified as immune might be able to take the lead in the fight on the ground against the virus with no worry for their safety, even if the shortage of personal protective equipment continues.

    • Agree: ic1000
  54. Anon[665] • Disclaimer says:

    A study just published says that yes, active smokers and those persons with COPD do have more ACE 2 expression in their small airway tissue. Covid-19 targets ACE 2 receptors.

    https://www.medrxiv.org/content/10.1101/2020.03.18.20038455v1

    Smokers, you have to quit.

  55. anon[104] • Disclaimer says:
    @another fred

    If baffles me that we are not seeing more discussion of genetic susceptibility.

    • Replies: @Anonymous Jew
  56. anonymous[198] • Disclaimer says:
    @Jack D

    Commenter exhibits the opposite of Trump Derangement Syndrome.

    Trump Bootlicker Syndrome.

    • Replies: @Coemgen
  57. MEH 0910 says:
    @M_Young

    David Pinsen Retweeted:

    • Thanks: ic1000
    • LOL: Redneck farmer
    • Replies: @res
    , @MEH 0910
  58. Potentially a huge number of false negatives. Depends on your assumption of the true infection rate in a population.

    Check out this YouTube video going through the arithmetic.

  59. @The Wild Geese Howard

    I’d hate to be a Chinese-American right now — racists want to slug you and liberals want to hug you.

  60. @The Wild Geese Howard

    If the Coronacrisis has reached Corona itself, it’s unlikely trey’re being spit on (or spat upon, whatever) by Becky and Karen:

    Corona

    The racial makeup of the neighborhood was 8.4% (4,851) White, 13.6% (7,845) African American, 0.2% (130) Native American, 12.7% (7,346) Asian, 0% (9) Pacific Islander, 0.5% (280) from other races, and 1.3% (723) from two or more races. Hispanic or Latino of any race were 63.3% (36,474) of the population.

    https://en.m.wikipedia.org/wiki/Corona,_Queens

    The chick in the article is in San Francisco. Where being s*it upon is a problem, for sure, but not saliva.

  61. Anon[665] • Disclaimer says:

    New York City has over 14K cases of active Covid-19. That’s almost 1/3rd of all the cases in the US. With a population of over 10 million, they’re going to be Wuhan redux. They’re about where Wuhan was on February 2.

  62. WJ says:
    @Jane Plain

    Hey dipshit, Trump closed the China connection on January 31st and was still called a racist xenophobe by the deplorable little shit head school girls in our media. The CDC are Democratic dominated lethargic pos government organization. Trump had nothing to do with their incompetence. Maybe Rod Rosenstain’s sister did though.

    • Replies: @Jane Plain
  63. res says:
    @another fred

    If baffles me that we are not seeing more discussion of genetic susceptibility.

    Here is a paper discussing this in relation to SARS-CoV and MERS-CoV. Not sure how relevant this is to SARS-CoV-2/COVID-19
    Molecular immune pathogenesis and diagnosis of COVID-19
    https://www.sciencedirect.com/science/article/pii/S2095177920302045

    3.2. Antigen presentation in coronavirus infection
    While the virus enters the cells, its antigen will be presented to the antigen presentation cells(APC), which is a central part of the body’s anti-viral immunity. Antigenic peptides are presented by major histocompatibility complex (MHC; or human leukocyte antigen (HLA) in humans) and then recognized by virus-specific cytotoxic T lymphocytes (CTLs). Hence, the understanding of antigen presentation of SARS-CoV-2 will help our comprehension of COVID-19 pathogenesis. Unfortunately, there is still lack of any report about it, and we can only get some information from previous researches on SARS-CoV and MERS-CoV. The antigen presentation of SARS-CoV mainly depends on MHC I molecules [24], but MHC II also contributes to its presentation. Previous research shows numerous HLA polymorphisms correlate to the susceptibility of SARS-CoV, such as HLA-B∗4601, HLA-B∗0703, HLA-DR B1∗1202 [25] and HLA-Cw∗0801 [26], whereas the HLA-DR0301, HLA-Cw1502 and HLA-A∗0201 alleles are related to the protection from SARS infection [27]. In MERS-CoV infection, MHC II molecules, such as HLA-DRB1∗11:01 and HLA-DQB1∗02:0, are associated with the susceptibility to MERS-CoV infection [28]. Besides, gene polymorphisms of MBL (mannose-binding lectin) associated with antigen presentation are related to the risk of SARS-CoV infection [29]. These researches will provide valuable clues for the prevention, treatment, and mechanism of COVID-19.

    Some discussion of what should be done.
    COVID-19 infection: the perspectives on immune responses
    https://www.nature.com/articles/s41418-020-0530-3

    HLA haplotypes and SARS-CoV-2 infection
    The major-histocompatibility-complex antigen loci (HLA) are the prototypical candidates for genetic susceptibility to infectious diseases [8, 9]. Haplotype HLA-loci variability results from selective pressure during co-evolution with pathogens. Immunologists have found that T-cell antigen receptors, on CD4+ or CD8+ T cells recognize the conformational structure of the antigen-binding-grove together with the associated antigen peptides. Therefore, different HLA haplotypes are associated with distinct disease susceptibilities. The repertoire of the HLA molecules composing a haplotype determines the survival during evolution. Accordingly, it seems advantageous to have HLA molecules with increased binding specificities to the SARS-CoV-2 virus peptides on the cell surface of antigen-presenting cells. Indeed, the susceptibility to various infectious diseases such as tuberculosis, leprosy, HIV, hepatitis B, and influenza is associated with specific HLA haplotypes. Particular murine MHC class II haplotypes are associated with the susceptibility to influenza. In man, HLA class I is also associated with H1N1 infections: HLA-A*11, HLA-B*35, and HLA-DRB1*10 confers susceptibility to influenza A(H1N1)pdm09 infection [10]. Therefore, it is imperative to study whether specific HLA loci are associated with the development of anti-SARS-CoV-2 immunity and, if so, to identify the alleles, either class I or II, that demonstrate induction of protective immunity. Once the dominant alleles are identified, simple detection kits can be developed. Such information is critical for (1) strategic clinical management; (2) evaluation of the efficacy of vaccination in different individuals in the general population; (3) assignment of clinical professional and managerial teams amid interactions with COVID-19 patients.

    Another tidbit from that paper.

    Lung damage is a major hurdle to recovery in those severe patients. Through producing various growth factors, MSCs may help repair of the damaged lung tissue. It is important to mention that various studies have shown that in animal models with bleomycin-induced lung injury, vitamin B3 (niacin or nicotinamide) is highly effective in preventing lung tissue damage [7]. It might be a wise approach to supply this food supplement to the COVID-19 patients.

    • Thanks: another fred
    • Replies: @Altai
    , @Altai
  64. Art Deco says:
    @Jack D

    First of all, it shouldn’t be equal to the population representation in the 1st place in any agency that requires g loaded tasks.

    1. Any agency will have support staff

    2. The ‘should’ implies similar venue preferences across all racial groups which is not true.

    3. The ‘should’ implies similar occupational preferences across all racial groups, which isn’t true either.

    We’ve had this discussion before.

    Yes. You say something unreasonable. I tell you why. You huff and puff and wave your hands. We’ve had the discussion again and again.

  65. Altai says:
    @res

    IFITM3 variants might be a clue. At least they’re described. Attempts were made to get some GWAS hits for ACE2 receptor expression but it seems like there are too many environmental factors to easily match case and controls.

    One explanation that has been put forward is both the larger share of the population living in a warmer climate but also the population frequencies of certain IFITM3 variants. These variants are speculated to confer protection from dengue fever, yellow fever and possibly malaria but confer risk towards influenza and coronaviruses. This is somewhat debated in terms of how much of an impact the variants identified so far have but it is clear if such variants exist that they would be in the IFIT genes and the identification of them in those genes is suggestive. The variants identified aren’t causative but may be in high linkage with ones which are.

    IFITM3: How genetics influence influenza infection demographically
    https://www.sciencedirect.com/science/article/pii/S2319417018305675
    The role of host genetics in influenza infection is unclear despite decades of interest. Confounding factors such as age, sex, ethnicity and environmental factors have made it difficult to assess the role of genetics without influence. In recent years a single nucleotide polymorphism, interferon-induced transmembrane protein 3 (IFITM3) rs12252, has been shown to alter the severity of influenza infection in Asian populations.

    The variants aren’t a part of many of the arrays used to genotype world populations yet so most of this is estimated using the fairy restricted choices in the 1KG samples and through imputation.

    IFITM Genes, Variants, and Their Roles in the Control and Pathogenesis of Viral Infections
    https://www.frontiersin.org/articles/10.3389/fmicb.2018.03228/full

    IFITM3 protects the heart during influenza virus infection
    https://www.pnas.org/content/116/37/18607

    Distinct Patterns of IFITM-Mediated Restriction of Filoviruses, SARS Coronavirus, and Influenza A Virus
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3017121/

    SNP-mediated disruption of CTCF binding at the IFITM3 promoter is associated with severe influenza risk in humans
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5702558/

    High Level Antibody Response to Pandemic Influenza H1N1/09 Virus Is Associated With Interferon-Induced Transmembrane Protein-3 rs12252-CC in Young Adults
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5962690/

    Back to the Future: Lessons Learned From the 1918 Influenza Pandemic
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6187080/

    deCode in Iceland has just finished the first wave of it’s large-scale population testing for the virus and they estimate that about 1% of the population has been infected. This would amount to about 3,200 people but they so far only have 13 hospitalisations and 3 deaths. (I think the deaths are inclusive so 10 other cases serious enough for hospital)

    https://nordiclifescience.org/covid-19-first-results-of-the-voluntary-screening-on-iceland/

    A large scale testing of general population in Iceland has begun, and the first results of the voluntary screening indicate that about 1% of all Icelanders have the novel coronavirus.

    The results of the additional tests performed by deCode have given an indication that efforts to limit the spread of the virus have been effective so far, states the government. In Iceland, these measures have focused on testing, contact tracing of infections, social distancing, public efforts to increase basic awareness of hand sanitation, voluntary self-quarantine measures (currently about 5 448 individuals), and strict measures at healthcare institutions, nursing homes and the likes. Of the 473 cases identified 13 are individuals over age 70, considered to be the most at-risk group.

    • Thanks: Smithsonian_6
  66. Art Deco says:
    @Adam Smith

    It’s great how Bush has been held responsible for lying the U.S. into the forever wars. I know the people of Iraq are happy that the man who launched the invasion of their country is not walking around as a free man.

    The overwhelming bulk of American troops were withdrawn from Iraq 8 years ago. You need to keep up. There is no war in Iraq. There are security problems caused by various and sundry criminal / political gangs and, lately, rioters.

  67. Jack D says:
    @dearieme

    Is it worthwhile trying to avoid overwhelming ICUs?

    Probably not – maybe your chance of dying on the ventilator is 97% (hopefully lower in the US) but your chances of dying without it if you are not getting enough oxygen in your bloodstream is probably close to 100% so you as an individual have little to lose.

    The real question is the societal one – is it worth spending vast medical resources to save 3 out of 100 patients? The natural reaction (and financial incentive) of our medical system is to do everything possible regardless of cost (because they are not paying the cost – the government or insurers are). People feel the same way when the subject in question is themselves or a loved one (and they are not footing the bill). So everyone has their foot on the (cost) accelerator and no one has their foot on the brake. You’ll note that all of the politicians and reporters screaming for more ventilators have not mentioned the 97% death rate – this is the 1st I’ve heard of it.

    And it’s not just money. The medical personnel manning the ventilators are at risk of getting sick and could be helping others. The resources that are being wasted on building thousands of ventilators could be spent on more useful public health measures or drug trials so that people wouldn’t get to the point of needing ventilation that probably isn’t going to work anyway.

  68. res says:
    @MEH 0910

    Interesting how the embedded tweet renders differently from the Twitter version. The original NYC tweet was made on February 9th.

    Contrast that with what she tweeted three days ago.

    The replies to that tweet are filled with references to her 2/9 tweet.

    Here is an article about this.
    https://summit.news/2020/03/23/new-york-health-officials-told-residents-to-congregate-in-huge-crowds-in-defiance-of-coronavirus/

    • Replies: @Reg Cæsar
  69. Glastonbery has been cancelled. What are Miley Cyrus and Ariana Grande going to do?

    One result of this foofaraw might be an attenuation of trash culture. The NBA is totally hosed for the year and MLB and maybe even the NFL could follow behind. Would it not be amazing if Las Vegas just shriveled up into a little shell of itself?

    NO BAILOUTS FOR THE SHOW BUSINESS PARASITES!!!!!!!

  70. Just heard new figures that the rate of “positive” test results is 8 percent in CT, 20 percent in NY and 13 percent nationally. Those might seem surprisingly low if you assume that the people motivated to get tested have symptoms or are at-risk in some way.

  71. Altai says:
    @res

    Should also mention that though no hard genetic variants were identified in the GWAS attempts for ACE2 receptors expressed on cell surfaces the 2:1 ratio of serious male to female cases is very interesting given that the ACE2 gene is on the X chromosome and that looks like a classic x-linked distribution indicative of some recessive variant.

    Could those variants also differ in their population distribution? Who knows since we don’t know if they even exist. But certainly blood pressure does differ between populations and so too must ACE2 receptors expression then.

    • Replies: @Jane Plain
  72. @Art Deco

    I’m just happy he’s in prison where he belongs.

  73. @Known Fact

    No good reason to get tested , if you are sick you should stay home. It could be Swine flu or the Wahu Flu , or a regular cold….either way you should not be going to work to infect others when you are sick. The treatments are the same , so testing offers little benefit. I certainly will not drive to the testing site and wait 3 hours to get tested if I become sick.

    One benefit of knowing you have the Wahu Flu , if you get better you will probably have immunity for a few months. Then You would no longer need to wear a mask when going to the store to buy groceries.

  74. Altai says:

    Also seems like there a very high completely asymptomatic cohort on the basis of the earliest runs of the Iceland study over a week ago. (Though the population there is quite young for a developed Western country due to a continuing cultural practice of starting families very young. Even if the lifetime fertility is the same, a shorter generation time will make society younger at all times and tends to ameloirate baby booms and busts)

    They are saying 50% totally asymptomatic. Though given the relatively long course of the disease, this may be an over-estimate.

    https://www.government.is/news/article/2020/03/15/Large-scale-testing-of-general-population-in-Iceland-underway/

    Also previous advice that very mild cold symptoms like a runny nose not being related to Covid-19 is seemingly being revised.

    https://www.theguardian.com/us-news/2020/mar/23/have-i-already-had-covid19-coronavirus

    Coronavirus is actually quite a significant spectrum of symptoms, from people who are entirely asymptomatic and would have no idea that they have it to people with very mild, cold-like symptoms – runny nose, congestion, sore throat – to people with more flu-like symptoms – high fevers, muscle aches, shortness of breath and cough. All the way up to people with severe illness, who we’re seeing in the hospital with respiratory failure, requiring ICU care. (Editor’s note: recent reports suggest that loss of smell and taste are also signs of Covid-19 infection.)

    Though the same article also states.

    There’s not been any evidence that anyone’s gotten it more than once. Someone with a normal immune system that can react to the virus and get better should have immunity for quite some time, at least a year, if not lifelong.

    Which is a bit much. There is no reason to suspect lifetime immunity! And there is evidence of people being reinfected among the doctors (Many of the youngest deaths were doctors in Wuhan) and other individuals who displayed 20-28 day incubation periods that may well represent a second infection.

    • Replies: @Jack D
    , @HA
  75. epebble says:
    @dearieme

    I think the optimal policy would be to triage the intake so that only those who are likely to benefit by taking them to ICU by surviving (and do so fairly fast). But, there is no use in keeping an ICU empty because a particular person may not benefit from it. The difficult problem is when the ICU’s are full with people who may not survive and there are people waiting who may benefit from being in ICU. I think there is no mechanism to give up on a hopeless case and use the resources for a hopeful case.

  76. @eric

    You are 100% correct- the MSM has a huge incentive to maximize this.

    I have previously argued that politicians at all levels also have that same incentive, especially those who bet their political futures locking down their states.

    Those governors will never admit that they overreacted, no matter how this turns out.

    I believe we ought to enact an amendment at both the state and federal level: any executive, judicial or legislative authority that order’s policies which throws out of work tens (hundreds)of millions of Americans will lose their own job.
    If their policy of massive sacrifice for the rest of us is truly required at the time, truly the only one, then they must lead by example – they are the first ones to lose their jobs.

  77. Tulip trees abloom
    Stock marquette aboom
    My girlfriend’s such a fine teen
    Covid who? What is he, a basketball player?

  78. @res

    Oxiris is not to be confused with oxalis, that giant fake shamrock often employed in years which, unlike this one, have a St Patrick’s Day.

    Of course, an Irishman would have held Mz Barbot’s position in years past. So in a way she’s a fake shamrock herself.

    Barbot, by the way, sounds like a mermaid doll from Mattel.

  79. Jack D says:
    @Altai

    There is no reason to suspect lifetime immunity! And there is evidence of people being reinfected among the doctors (Many of the youngest deaths were doctors in Wuhan) and other individuals who displayed 20-28 day incubation periods that may well represent a second infection.

    The norm with viral diseases is that you DO get lifetime immunity. The exceptions are viruses that mutate frequently but if this is true, most typically the virus mutates toward something less deadly. The doctors who died were probably infected with a massive amount of virus that overwhelmed their immune system or triggered a cytokine storm. If there were any 2nd infections, it was probably from a different strain.

  80. anon[225] • Disclaimer says:
    @peterike

    Unfortunately, that is a common pattern. “Intellectuals” are generally liberal.

  81. @WJ

    The one good thing he did.

    But you didn’t answer the question – have you ever worked for a boss?

    I didn’t think so, unless it was flipping burgers or washing cars.

  82. Don’t look now, but Corona-chan got Scoldilocks too!

    Greta Thunberg says she may have coronavirus and is isolating with her father after displaying symptoms

    https://www.dailymail.co.uk/news/breaking_news/article-8147765/Greta-Thunberg-says-coronavirus-isolating-father.html

  83. @Art Deco

    You don’t need to respond to every single post if you don’t want to. 484 comments this year and we’re not even out of Q1. Try to calm down old woman.

  84. Coemgen says:
    @anonymous

    I think you mean anti-Globalism Syndrome.

    If only the U.S. had a tightly controlled border and made our own stuff (other than airplanes etc).

    We would be in much better circumstances now.

    In other words, if the Democrats had adopted some of Trump’s anti-globalist philosophy, we’d be in much better circumstances now.

    No boots involved. Most boots are probably made in the PRC now anyways.

  85. Forbes says:
    @Lugash

    Oh, and someone activate Tucker to go talk some sense into Trump about not easing up on the quarantine.

    Presumably, what’s implied is the quarantine for those infected/testing positive, or ill with symptoms (irrespective of test result). If you have the common cold or the flu, stay home–that’s contagious too.

    Or is it now policy to quarantine healthy persons? Why shouldn’t the healthy get back to work ASAP?

    If grocery store clerks work because they’re necessary, why not others who have nothing like the hundreds of person-to-person contact as does a retail store clerk?

  86. indocon says:

    Regardless all this crazy year ends, let me nominate in advance the iSteve story of the year:

  87. eD says:

    False positives are more an issue.

    https://blog.nomorefakenews.com/2020/03/24/heres-what-the-cdc-says-about-the-test-for-the-coronavirus/#comments

    OK, its a tin foil hat site, though I thought those were OK in Unzland. But most of the post is quoting what the CDC has to say directly:

    ‘“Positive [test] results are indicative of active infection with 2019-nCoV but do not rule out bacterial infection or co-infection with other viruses. The agent detected may not be the definite cause of disease. Laboratories within the United States and its territories are required to report all positive results to the appropriate public health authorities.””

    To be fair, here its not so much that the test might say you have the virus when you don’t, as its perfectly possible to have the virus and it not make you sick. But regardless there is a risk of at best, tying up medical resources that could better go elsewhere, and worse, subjecting yourself to treatments and drugs that actually make you sick when you are not, in fact, sick.

    This is an issue with all infections and one reason why just testing everyone is not a good idea and medical authorities usually avoid doing that.

    By the way, the issue of false positives vs false negatives was covered very early when I studied statistics. Without going through the whole examples, in the real world generally with medical tests a false positive is more likely and they really try to reduce the number of false positives before releasing the tests to the public.

  88. black sea says:
    @Art Deco

    There is no war in Iraq.

    A former Marine colonel urges you to “keep up.”

    https://www.militarytimes.com/opinion/commentary/2020/03/18/the-iraq-war-is-not-yet-over/

    • Replies: @Art Deco
  89. Art Deco says:
    @black sea

    There is no war in Iraq. There’s a great deal of political violence in Iraq (currently, about 170 civilian deaths a month on average), but there is no war. No front lines, no organized insurgency, just a mess of gangs shooting people and setting off bombs.

  90. eD says:

    From the same site as in my earlier post quoting the CDC again:

    ““Negative results do not preclude 2019-nCoV infection and should not be used as the sole basis for treatment or other patient management decisions. Negative results must be combined with clinical
    observations, patient history, and epidemiological information.”

    More OT. Tests are useful, its just their usefulness is limited.

  91. HA says:
    @Altai

    “There is no reason to suspect lifetime immunity!”

    Indeed. That would make this virus especially unusual: The immunity to the plain-old coronaviruses that are in the grab-bag of diseases known as the “common cold” lasts one to two years, though, if your immune system is compromised, you could get reinfected with one of them even earlier.

    So all this talk about herd immunity assumes that we’ll have a vaccine in place before the next time the virus comes around. If the immunity associated with this new viruses is similar to the other ones, then if enough people get infected (i.e. if herd immunity is significant), that won’t be for another year or two, but after that, assuming no vaccine, the virus can just sweep through again, and take out as many as it did the first time. And then that residual herd immunity will last only another year or two as well. So, even if the probability of winding up with some permanent damage (e.g. scarring in the lungs, diminished lung capacity — any of which means you’re in that category of patients “with earlier complications” whose deaths we can presumably just brush off, according to many of the comments here) is low, it can accrue into something significant if the virus can take several bites of the apple.

    (That being said, the immunity for this new virus may be different than what we’ve seen with earlier coronaviruses. We just don’t know.)

  92. ATBOTL says:

    Most Americans have had a bad cold or a flu like illness this year, just like they do this by this time every year.

  93. vhrm says:

    https://www.mercurynews.com/2020/03/19/coronavirus-false-test-results-with-the-push-to-screen-come-questions-of-accuracy/

    According to the anecdotes in that article of people testing negative then positive then negative in various orders, there’s definitely reason to wonder. I was surprised to read:

    In its official rules for testing, Santa Clara County’s Department of Public Health notes that “It is important to note that the test is not validated for use in asymptomatic individuals, and testing those without symptoms may give falsely reassuring negative results and lead to missed infections or inaccurate safety recommendations.”

    The U.S. Centers for Disease Control and Prevention has not disclosed how sensitive its test is to detect very low levels of the virus.

    When Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, was asked about it in a recent interview with the Journal of the American Medical Association, he hedged.

    “If (the test is) positive, you absolutely can make a decision,” he said.

    That suggests to me that clinical false negatives are pretty high especially in mild cases. And it’s straight from the horse’s mouth. I was reading some armchair speculation that it could be more than half, but can’t find a link to that at the moment.

    Given how/where the samples are collected vs where the virus reproduces… it doesn’t seem unreasonable. (but of course this is the kind of thing that “reasoning about” is mostly bs and you just have to test it)

    • Replies: @Kratoklastes
  94. Anonymous[408] • Disclaimer says:

    Steve,

    Any thoughts on Trump’s probable new policy of asking Americans to die in service to the stock market? It is similar to Boris Johnson’s original plan which was quickly abandoned due to sheer outrage.

    I believe modern America is a spiritually awful place, and I won’t die or kill my grandparents to keep the elites in New York and DC fat and happy. Trump ran on reforming this place. He failed. He thinks he can appeal to our sense of patriotism to keep the status quo? Hilarious. I am rooting for an economic reset. What a monster we elected.

    • Replies: @anon
    , @Jack Armstrong
  95. Anon[665] • Disclaimer says:

    Liberals are suddenly crying about conditions on Rikers Island:

    I find it odd that they’re saying people are sleeping very close together. Bunks are built into the wall. You can’t move them so that they’re close together. Since they removed some prisoners, they should have more space to relieve any inmate crowding, and any staff who is choosing to stay overnight could use the extra space themselves. As for being served food on dirty dishes, I find it odd that they’ve suddenly lost the ability to wash their own dishes. They say there’s only 1 toilet for every 29 people. Why? Every prison cell has a toilet. With some inmates gone, there should be extras free. Get in there with some industrial strength cleaner and the toilets and cells will be sanitized of Covid-19.

    Liberals are lying and trying to manufacture a crisis.

    • Replies: @Kratoklastes
  96. UK says:

    China was saved by a weather change. High humidity and high temperature are crucial factors in lowering transmission of Wuhan Flu. Europe will benefit from similar, but we can all expect round 2 in October unless a vaccine is found.

    http://www.accuweather.com/en/health-wellness/new-study-says-high-temperature-and-high-relative-humidity-significantly-reduce-spread-of-covid-19/703418/amp

  97. Anon87 says:

    Related health question…… dying from coronavirus sounds painful and awful and I wish it on no one.

    When people die of the regular flu, I imagine it’s no picnic either. Lungs struggling, feel like your drowning, organs failing, etc. You’re dying!!

    So I am curious if it is a “worse” death, and also maybe we should all be a bit more cautious next year and the year after during flu season when hopefully things are more normal.

    I am afraid we are too vain to wear masks, which would go a long way to keeping the numbers small. But Americans aren’t great at any sort of sacrifices anymore, no matter how minor.

  98. @Hernan Pizzaro del Blanco

    Herman, first, I think we would see fewer sick days in America if people stayed home from work, or school or church or shopping when they feel sick. The flu often closes schools and offices, but without this dread. I read The Plains Dealer (Cleveland.com) online and the banner headline is “564 cases in Ohio, 8 deaths.” Ohio has a population in excess of 11,660,000. You do the math and tell me how close this comes to infuenza with 3 million cases, 350K hospitalization and 18,000 deaths (although the CDC has their own way of recording deaths.) All this and the economy, or life in general is never shut down. I am concerned for my loved ones but I still want to know WTF is going on.

    • Replies: @Anon87
  99. @Altai

    “e ACE2 gene is on the X chromosome and that looks like a classic x-linked distribution indicative of some recessive variant.”

    How does it being X-linked indicate recessive variance?

    • Replies: @Altai
  100. @Anon

    Depends on who’s being infected. In Korea the infections have skewed disproportionately young and female. Many of the Seattle area deaths came from a single nursing home. Obviously as more people become infected these effects will have a tendency to even out, but you still need to account for demographics (eg Italy is a lot older than Korea).

  101. Neoconned says:

    I caught”the crud” a lot from 2015 thru 2018…..sometimes once every 3 weeks….i was glad when after spending the entire 1st half of 2016 sick i found myslef getting sick less often and the symptoms were more annoying than bad w each successive cold.

    I’m hoping my immune system has built an immunity good enough to this sh-t…..and in a way i hope i get it soon so i can build-up my immunity….

  102. @anon

    I don’t think the data is there yet, but you can speculate on ACE2 expression et al. Such comparisons are hampered by the fact that you’re not comparing apples to apples in terms of age, smoking, (under-)counting infected and co-morbidity etc. For example Korea has a very low death rate for reasons that seem attributable mostly to age of infected.

    Also suspect the first strains in China were stronger. Milder strains usually spread faster and out compete the lethal ones. It’s anecdotal, but a 25 year old White Brit who was teaching in Wuhan got it early and gave an account of his experience. If I recall he was extremely sick/bedridden for a month.

    Also think the biggest immune differences would not be within Eurasia because diseases have always crossed the land mass and gone from Whites to Asians and visa versa (eg plague, flu, tuberculosis etc).

  103. anon[321] • Disclaimer says:
    @Anonymous

    Any thoughts on Trump’s probable new policy of asking Americans to die in service to the stock market?

    • LOL: vhrm
  104. Glaivester says: • Website
    @Lugash

    I think that Trump realizes that it is going to be very hard to sell a six-week or eight-week quarantine. However, a two-week quarantine is sellable, and a second two-week quarantine is sellable…

    basically, if we are to have a longer lock-down, it will be easier to sell it in pieces than as one big chunk.

    • Replies: @George
  105. @ic1000

    As you say, the gap between the ‘analytical’ PPV/NPV and the clinical PPV/NPV can be very wide.

    The other day I posted a link to Zhuang et al (only the abstract: the original paper is still in Chinkie-squiggles), which was made available a few days ago.

    They got a point estimate of the clinical PPV of 0.197 – i.e., a false positive rate of 80.3%.

    They did a nice multifactorial sensitivity analysis – something I have been OCD about for 25 years: it was the central guts of my PhD (and a big part of the reason I abandoned it). Their sensitivity analysis found that 75% of the probability mass was above a false-positive rate of 47%.

    A little over a month ago I gave my conservative point-guess at the false-positive rate – 60% – based on the survey literature for clinical sensitivity of SARS tests (references below), and giving the clinical specificity of the test the benefit of the doubt (setting it at 99%).

    I guessed a prevalence of 1%, based on the fact that nowhere near enough Chinese were dying by the time they imposed their crackdown (I built a SEIR model over a month ago; China ought to have had tens of millions of cases by mid-January, and many many more deaths).

    Also…

    If you build a distribution of PPV – calculating PPV using random tuples of [prevalence, clinical specificity, clinical sensitivity] drawn from plausible ranges, with each draw having an estimated probability from the joint CDF of the three… 60% is a much better estimate for false positive rate, than either 47% or 80%.

    If you update prevalence based on the Australian prevalence numbers from tests (1.3% positive in over 130,000 tests) and put central guesses about clinical sensitivity and specificity into the NPV formula, you’ll get a false-negative rate of 51%.

    As I said at the time – worse than a coin toss. Which raises the question (which I pose tongue-in-cheek, because I am on record as saying this is a nothingburger[1]:

    Should a ‘negative’ test mean that the person ought to be left free to roam around?.

    [1] Note that some guy who won the 2013 Nobel Prize in Chemistry is saying approximately the same thing, albeit in linguistic pabulum with a sugar-cube for the mouth-breathers: ‘We’re going to be fine’.

    I could have told everyone that a month ago
    : at that point in time, if this pissweak pathogen actually had an R[0] of 2-2.5 and had started infecting people with patient zero in mid-December 2019, there would already have been millions of asymptomatic-infected wandering around by mid-Feb 2020 (Chinese lockdown started on Feb 5, but only in 3 cities).

    Between Jan and early-March when everyone started to shut the stable gate, hundreds (perhaps thousands) of asymptomatic people from ‘hotspots’ arrived in the West (not just 1) – and all the ‘social distancing’ malarkey didn’t start in earnest until March.

    References

    Zhuang et al (too many co-authors to bother with), “Potential false-positive rate among the ‘asymptomatic infected individuals’ in close contacts of COVID-19 patients” (link is to English abstract)

    SARS stuff from 2003 (gives a lot of detail about clinical sensitivity of early-stage tests).

    Richardson, S. E., Tellier, R., & Mahony, J. (2004), The laboratory diagnosis of severe acute respiratory syndrome: emerging laboratory tests for an emerging pathogen.The Clinical Biochemistry Review, 25(2), 133–141.

    Peiris JS, Lai ST, Poon LL, Guan Y, Yam LY, Lim W, Nicholls J, Yee WK, Yan WW, Cheung MT, Cheng VC, Chan KH, Tsang DN, Yung RW, Ng TK, Yuen KY, SARS study group, Coronavirus as a possible cause of severe acute respiratory syndrome. Lancet 2003 Apr 19; 361(9366):1319-25.

    • Thanks: vhrm
    • Replies: @Philip Owen
  106. @Anon

    You’re being pretty blasé given that Rikers holds a lot of people who are canonically innocent (i.e., they are awaiting trial): it’s primarily a jail, not a prison or a penitentiary.

    It would be ethically wrong for me to hope that you were jailed for several months due to inability to post an economically-ruinous bail for a victimless non-violent ‘crime’… so I will leave that for others.

    • Replies: @Anon
    , @Jack D
  107. @vhrm

    When Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, was asked about it in a recent interview with the Journal of the American Medical Association, he hedged.

    “If (the test is) positive, you absolutely can make a decision,” he said.

    Fauci is bullshitting, or talking in that ’embedded asterisk’ way common to late-night advertorials.

    “You absolutely can make a decision”*

    [*: so long as you don’t give a fuck if it’s a correct decision]).

    There is now plenty of evidence that the false positive rate is far higher than the false-negative rate.

    Fuckbags in political sinecures have an incentive to fling propaganda to make people focus on false negatives, because it helps explain why there is so little problem being detected – even in self-selected (biased) samples.

    If the test is positive and the patient is asymptomatic, there is a very high probability (60-80%) that the test is a false positive.

    If the test is negative and the patient is asymptomatic, it’s pretty much a coin toss as to whether it’s a false negative.

    It is unlikely that we ever determine the false-positive and false-negative rates for tests of people who are symptomatic, because the records being kept are unbelievably shoddy.

    As usual, I’ll give the most useful reference to date about the estimate for false positives…

    Zhuang et al (2020), “Potential false-positive rate among the ‘asymptomatic infected individuals’ in close contacts of COVID-19 patients” (link is to English abstract)

  108. @Buffalo Joe

    Joe’s back. We like it.

    • Replies: @Jack Armstrong
  109. Anon[231] • Disclaimer says:
    @Kratoklastes

    By far the vast majority of people who get arrested are guilty. They’re no great loss.

  110. George says:
    @Lugash

    ” Bailout Bucks ” It’s not a bailout. Fed Gov made it impossible for them to do business and now demands a huge chunk of the company to be permitted to open again. It’s more of a shakedown.

  111. George says:
    @Glaivester

    Constantly changing the quarantine schedule will create even more opportunities for government insiders do profit from their knowledge.

  112. Altai says:
    @Jane Plain

    Women have two X chromosomes, men only have one. For any variant outside the pseudo-autosomal regions on the X chromosome, a male is homozygous.

    • Replies: @Jane Plain
  113. @dearieme

    Is it worthwhile trying to avoid overwhelming ICUs? Wuhan data say that 97% of patients die if they are so ill that they’re put on “invasive mechanical ventilation”.

    Invasive means they stick a tube down your throat. Not everyone on a ventilator requires intubation.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1116024/

    The takeaway here is that anyone who needs that tube should be saying his goodbyes.

  114. Negatives may mean you have already had it. A new model from Oxford University suggests that 68% of the UK population and 805 in Lombardy have already been infected and mostly not noticed.

    https://www.dropbox.com/s/oxmu2rwsnhi9j9c/Draft-COVID-19-Model%20%2813%29.pdf?dl=0

    Bear in mind that the Imperial College model was predicting a continuing Apocalypse (using data from flu).

    • Replies: @Steve Sailer
  115. Jack D says:
    @Kratoklastes

    I once had this explained to me very eloquently by a NY judge (much better than I am doing right now). You are presumed innocent ONLY for purposes of the jury determining your guilt or innocence at trial – it is the burden of the state to prove your guilt in that setting. In other respects, if you are being held in jail, there must be considerable evidence of your guilt or the judge would have released you already. Doesn’t meant that you will be convicted (although the vast majority of people held in jail either plead guilty or are convicted at trial) but if we really really thought you were innocent we wouldn’t be holding you in the first place.

    Now some % of those who are jailed are not convicted, but even among those, the % that truly “dindu nuthin” is very tiny. Wrongful convictions happen now and then, but not very often and usually to guys who have committed plenty of other crimes.

    • Agree: Johann Ricke
    • Replies: @Kratoklastes
  116. MBlanc46 says:
    @Buffalo Joe

    Welcome back. You were missed.

  117. Anon87 says:
    @Buffalo Joe

    WTF is the sad culmination of decades of ineptitude. Our leaders in government and business are pure hacks, and all it took was a little panic to expose them completely and catastrophically. Not picking sides or playing politics, there is plenty of blame to go around here, and it goes way back. Not a serious country, or “clown world” as some like to say.

    I’m still surprised by the areas with and without high death rates. Italy I kind of get, maybe Spain, but I’m surprised France isn’t much worse off. They smoke quite a bit, heavy diets, kisses as greetings, Chinese tourists, and poor hygeine and dirty cities. Perfect storm, but not much yet. I can’t say Russia is a well run country, but they are dead serious and locked it down fast. Malaria drugs are the only explanation why a Chinese-filled basketcase Africa hasn’t been wholloped.

    I wonder how much introspection there will be once this blows over? Was the panic worth it? “What have we learned”??

    And any guesses on what we flip out over next? The presidential election or a potential new war is too old fashioned. There has to be something *really* idiotic coming.

  118. @ic1000

    One is, what’s the sensitivity that’s required to identify infected people?

    If the aim is to identify infected people with certainty, and to reduce false negatives to zero, then what’s required is a test specificity of 1 (i.e., 100%) and a sensitivity of 1 (i.e., 100%).

    You’re basically looking for a test with perfect PPV, and perfect NPV. Substitute ‘acceptably high’ in place of ‘perfect’ if you’re willing to accept some non-zero ‘misses’… but if you get misses on one, you’re guaranteed to get misses on the other.

    It just comes down to the forumlae for PPV and NPV:

    There’s an interaction between
    • σ – sensitivity (detecting something when it’s there);
    • S – specificity (detecting a particular thing when it’s there); and
    • π – prevalence (proportion of the population expected to have the thing being tested.

    S, σ, π all ∈ (0,1).

    Now to the formulae… (no MathJav/MathML so this won’t be pretty)

    PPV = σπ/(σπ + (1-S)(1-π))

    NPV = S(1-π)/(π(1-σ) + S(1-π))

    For PPV to simplify to 1 requires S = 1: the test must be perfectly specific. σ (sensitivity) is irrelevant if S = 1.

    PPV then simplifies to σπ/σπ which equals 1… 100% PPV (and therefore zero false positives).

    .

    For NPV to simplify to 1 requires that σ = 1: the test must be perfectly sensitive. S (specificity) is irrelevant if σ = 1.

    .

    If S = 1 and σ < 1,

    PPV = 1
    NPV = (1-π)/(π(1-σ) + (1-π)), which simplifies to (1-π)/(1-σπ) which is < 1

    So if the test produces no false positives, it will still produce false negatives unless it’s perfectly sensitive.

    For imperfect tests – i.e., tests taken under real-world clinical conditions – the real key is prevalence.

    If π is small, then the derivatives of PPV and NPV with respect to σ and S are very large.

    If prevalence is only 1%, then even a 99% sensitive, 99% specific test will produce 50% false positives and 50.1% false negatives.

    In a clinical environment, it’s not sensible to assume that analytical specificity is relevant. Tests that give perfection in the lab during development, will not do so in the face of vagaries in sample collection and handling, small changes in reagent quality, unknowable differences in the patient’s time since exposure and so forth.

    For SARS, tests that had 85% analytical sensitivity at 21 days, had 30% clinical sensitivity in the real world at 7-14 days.

    85% a week after the patient is symptomatic, is not very useful as a quarantine screening tool.

    • Replies: @res
  119. @Jack D

    if you are being held in jail, there must be considerable evidence of your guilt or the judge would have released you already

    I know you’re being slightly tongue-in-cheek.

    It does sound like the sort of self-interested horse-shit that a judge would say: even in jurisdictions where judges are lawyers first and foremost, they’re generally not good lawyers. With very few exceptions[1], good lawyers don’t go to the Bench.

    And where judges are elected (and may not even be lawyers) they will just make shit up as it suits them. This is a problem in Tribunals, and to a lesser extent in Magistrate’s Courts, in common law jurisdictions: they never actually say “I don’t give a fuck what the law says“, but they may as well.

    Anyone who has seen the criminal process up close, knows that it bears no relationship whatsoever to the textbook version. Prosecutors withhold exculpatory evidence all the time; public defenders are overworked beyond endurance; judges have a pro-State bias (i.e., they have corn pone opinions) and invariably have only looked at a summary of the facts prepared by their associate (if they do any prep at all).

    So the idea that a judge would order the released of a remanded accused based on a pre-trial review of the case, is preposterous on its face.

    Rumpole of the Bailey” gets judges about right: authoritarian egomaniac blowhards who were second-rate advocates. No surprise given that John Mortimer was a half-decent barrister in his day.

    .

    [1] I only say ‘with very few exceptions’ these days, because an old Uni mate was a very good advocate, and was given a red robe (Supreme Court, in Vic, Oz).

    My conclusion is that the ‘elevation’ happened – at least in part – to “take him off the board”.

    That’s because while defending one client he had exposed a procedural failure in the swearing of warrants that made the warrant invalid. Under examination, the police gave evidence that the same process had been ongoing for 30 years. Problem there is that all evidence arising from invalidly-sworn warrants is inadmissible.

    This risked invalidating thousands of convictions – including many people currently in chokey.

    Once Michael had his new Little Red Riding Judge costume on, the government enacted retrospective legislation to ‘legitimise’ the historical, invalid, warrant-swearing process. The entire Bar learned – as if by osmosis – that challenging the constitutionality of the new legislation would be career death (ditto for the criminal bar, if they tried to use it as part of a defence).

  120. @The Wild Geese Howard

    Not a word in that long article about the ‘bigots’ doing the harassing. They’re all ‘a man’ ‘men’ ‘bullies’, etc.

    The one quoted description is clearly aimed at implicating Chad (and Becky):

    “That person didn’t look strange or angry or anything, you know?” she said of her tormentor. “He just looked like a normal person.”

  121. Anonymous[768] • Disclaimer says:
    @ic1000

    Is the false-negative rate so high because nasal-oral secretions from infected people don’t contain very much shed virus? I think that’s likely… but maybe not.

    The conventional wisdom at this point is that the virus primarily infects lung cells. Thus, wouldn’t nasal-oral secretions contain relatively little, especially in people who don’t have the cough symptom?

    A related question: how much virus is shed by people who are infected-but-asymptomatic, compared to experiencing flu-like symptoms, shortness of breath, or ICU-level respiratory distress?

    If the virus resides primarily in the lungs, how effectively can it spread without the aid of a cough?

    • Replies: @Chrisnonymous
  122. Anonymous[768] • Disclaimer says:
    @Hernan Pizzaro del Blanco

    If 100,000 Americans were infected on March 1st, we must have had 200,000 infected by March fifth, 400,000 infected by March 10th and 800,000 infected by March 15 when they started closing down some schools…..must be at about 3 million Americans infected today. We should expect the number of deaths to reach 15,000 in 3 weeks.

    Dr. Birx said that 1 in 1000 New York City region individuals are infected. Your numbers don’t add up.

    • Replies: @Travis
  123. res says:
    @Kratoklastes

    Thanks for the detailed explanation. One nitpick, don’t you mean
    S, σ, π all ∈ [0,1]
    https://en.wikipedia.org/wiki/Interval_(mathematics)#Including_or_excluding_endpoints

    For those new to these equations, a good way to think about this is the square:
    https://online.stat.psu.edu/stat507/node/71/

    To match up the notations:

    σ = A/(A+C) – sensitivity (detecting something when it’s there);
    S = D/(D+B) – specificity (detecting a particular thing when it’s there, res: not sure about this description of yours); and
    π = Tdisease/ Total = (A + C) / (A + B + C + D) – prevalence (proportion of the population expected to have the thing being tested.

    PPV = σπ/(σπ + (1-S)(1-π)) = A/(A+B)
    NPV = S(1-π)/(π(1-σ) + S(1-π)) = D/(D+C)

    Note that in the equations above S, σ, π, PPV, NPV are ∈ [0,1] while in the page I linked they are expressed as percentages (hence all the x 100 in the equations at the link).

    Looking at those equations we also see (the * Total cancel out in the equations above).
    A = σπ * Total — True Positives
    B = (1-S)(1-π) * Total — False Positives
    C = π(1-σ) * Total — False Negatives
    D = S(1-π) * Total — True Negatives

    Also notice:
    Tdisease = A + C = π * Total
    Tnondisease = B + D = (1-π) * Total

    Rendering things in a square like that can be very helpful for thinking through examples. I think it is a good example of “natural frequencies” being a good way to think about probabilistic concepts. This is something Gerd Gigerenzer (I highly recommend his books on this topic) talks about. Some discussion in this paper:
    Simple tools for understanding risks: from innumeracy to insight
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC200816/

    • Thanks: vhrm
    • Replies: @anon
  124. @Philip Owen

    OK, it would be great if a huge proportion of the population already had it and were immune, at least until next fall. How much evidence is there for that optimistic scenario?

  125. Travis says:
    @Anonymous

    if the death rate is 1% and 200 New Yorkers have died this week then simple math indicates we had ~20,000 New Yorkers infected 25 days ago. Since it takes 18-22 days to die from COVID-19 we can calculate how many are infected 25 days ago. It takes about 3-14 days to show symptoms and then another 18 days to succumb to the virus. Those dying today had the first symptoms 18 days ago on average and they were infected 21-31 days ago.

    if the death rate is just .5% then there were 40,000 New Yorkers infected 25 days ago. Since the number of infected doubles every 5 days, we would expect over 1,200,000 New Yorkers are infected today, so we should expect ~6,000 deaths in New York by April 24th.

    200 New Yorkers Died this week so far…we should expect the number of deaths to double next week if the number infected doubled from March 1st to March 6th.

  126. @unit472

    It was basic if primitive public health. They didn’t have RNA test kits or ventilators but they had common sense.

    Indeed. The testing boner people have is from the Orange Man Bad porn on MSM.

  127. @Anonymous

    If the virus resides primarily in the lungs, how effectively can it spread without the aid of a cough?

    When alveoli degas, they create little suspensions. Imagine making bubbles as a kid by dipping a circle in soapy water and then blowing through it. Something like that. Can you smell garlic, spices, or booze on people’s breath? That’s not from lungs expelling CO2. TB can be spread by breathing and it’s much bigger than virus.

  128. anon[399] • Disclaimer says:
    @res

    Very good string of comments, in fact the most useful and intelligent comments on this thread.

  129. @Altai

    I know this. I still don’t understand the “recessive variance” part.

    It could as easily be dominant, no?

    • Replies: @Altai
  130. @Whitey Whiteman III

    Typical alt-right turd.

    Here is your Il Duce:

    demonstrating numeracy:

    and this gem:

    Christ, you guys are even dumber than I imagined.

  131. @Whitey Whiteman III

    dipshit

    dipshit

    dipshit

    dipshit

  132. Altai says:
    @Jane Plain

    Because a dominant X-linked trait will always be expressed, a recessive one will only be expressed if you have no alternative variants.

    Since males only have one X chrom they will always express the phenotype if they inherit the recessive variant. Thus the frequency of males with the trait will be higher.

    https://en.wikipedia.org/wiki/X-linked_recessive_inheritance#Sex_differences_in_phenotype/genotypes_and_frequency

    You could have some difference with dominant traits from things like deactivation of one X chrom in women but this isn’t fully understood or apparent.

  133. NOTA says:
    @dearieme

    The antibody test will just need a blood draw, not a swabbing. My guess is that messing up the swabbing causes a fair number of false negatives.

  134. MEH 0910 says:
    @MEH 0910

    Thread:

    • Replies: @MEH 0910
  135. MEH 0910 says:

  136. MEH 0910 says:
    @MEH 0910

  137. MEH 0910 says:
    @MEH 0910

    • Replies: @MEH 0910
  138. MEH 0910 says:
    @MEH 0910

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