News Worldwide impact of the novel coronavirus (covid-19)

[Sideways]

Let's get those wide-scale antibody tests rolling!

This is rock solid advice...in theory.

Unfortunately the problem with any testing is the same for most places atm. Even with enough testing kits, there isn't the PPE required to conduct it safely.

For testing clinic, if it's set up so that it can function at 5 star levels, where intake and exit procedures can be done at a 2m distance, and/or with shielding in place between staff and public, and only one practitioner is swabbing? That's still a change of PPE for at least one staff member for every test. And most places simply don't have the PPE (let alone sufficient testing kits, or facilities set up to test from). Because you're aiming to conduct thousands of tests every day at each facility.

In places where there is evidence of high community contagion already (and "high" is relative - the percentage of population will be low, but given how quickly this virus spreads, each percentage point counts), testing becomes less realistic, like there's a tipping point where physical distancing measures become critical.

If you're to take a test case like New York, for example. They clearly reached a point where testing was a waste of resources that they could no longer afford, and in situations like that? I reckon you get to a point where you either enforce lockdowns or accept a high mortality rate. Testing becomes important again once medical facilities are operating well again.

Where testing kits, facilities and PPE is available and positive cases are still low? Testing as many people as possible seems to be definitely the way to go. But so many places have missed the boat on that.

Testing will come back into relevance, but not while medical facilities aren't able to cope.

 

[siniang]

@Sideways I tried to read you post multiple times and I'm still fighting a major headache, so please bear with me, there's a good chance I might be just missing something completely...

but.... I think you might be mixing up the two different types of tests?

Antibody tests will become extremely important to identify asymptomatic cases and verify recovered cases -- both which will be important to identify the true prevalence of the virus in the population (and hence model the epidemic's progression more accurately) and potentially step-wise re-open the economy.

I can see your concerns with lack of PPE, but at least here, even for normal testing, I don't think they actually chance for every case during our drive-through tests. Might be wrong, though.

 

[user27357]

I laugh a lot these days, sometimes at my own stupid, sometimes at national level broadcasts, but laughing. A lot.

I fully expect todays daily briefing, from my nations whitehouse press room, the one that is there to serve us and disseminate knowledge to the people through the press (who are protected by the first amendment), the workplace where those people are insulted daily and face what has to be legally a hostile workplace, to be a 100% crap fest

OK, I was wrong. He stuck to the script and didn't answer any questions. Laughing at my own foolish insistence that I can make sense of this resident.

 

[Sideways]

I can see your concerns with lack of PPE, but at least here, even for normal testing, I don't think they actually chance for every case during our drive-through tests.

Yeah, and in some places, it's worth the risk. Because everywhere is basically in its own unique situation right now - where they're at in terms of infection, how effective their testing is, how dense their population is, how wealthy they are - the list of factors to consider goes on and on.

So, for a place that's in a position like Germany where they seem to be getting past the peak, they're relatively wealthy and well-resourced, and they've had strong public distancing rules (being effectively enforced) for some time now, their population is dense? That makes good sense.

Only one of those factors needs to change, and other alternatives become more important. For example, somewhere that is exactly like Germany, but the population is sparsely populated, as an example. Drive-through testing makes less sense, and nailing your contact-tracing becomes the pivotal management key.

At the other extreme, places that are so densely populated that most people don't have a car (eg New York, London, Tokyo, Beijing, etc) setting up a testing clinic means people are out on the street getting to, and then waiting at, those clinics in person. And that? Needs to be handled with extra care.

But ideally, for every test, you're changing your PPE. Because, that person may have been infected, and not changing your PPE means that you're about to infect the poor bugger who happens to be next in line.

Places that are doing a lot of testing, have testing numbers in the tens of thousands every day. Which is a lot of PPE to dedicate just to testing facilities.

I'm totally behind getting testing of as much of the population as possible. Just, in some places, it's not feasible. It can't be done safely. Or they aren't at a point where large-scale testing is the key element of their management strategy at this point in time (for a whole range of potential reasons).

TLDR: I'm pretty sure we're agreeing with each other:)

 

[blackemerald1]

But ideally, for every test, you're changing your PPE. Because, that person may have been infected, and not changing your PPE means that you're about to infect the poor bugger who happens to be next in line.

^Ideally I guess?? But a change of PPE is a methodical procedure that takes time and done incorrectly could contaminate the health worker and everyone else I suppose.

Think about it. The only part of the chain of contact that is being shared with anyone else is the swab. It's at the end of gloves. I don't think they change an entire PPE set per test in a field testing unit. Maybe the gloves but idk..

Can somebody on the forum @Chris-duck - can you please advise - because I've watched them on the telly & there's no change of PPE happening but I might well have missed something?

I think these only two kinds of tests. The swab & deep cough looking for genetic material and then the drop of blood one where it's a finger print. Not counting the one where you are put under a local to get a sample from the lung.

I just wanted to add. To anyone contemplating getting their tests online? The online buying is being swamped by dodgy tests - mostly from China. So not a good idea.

 

[blackemerald1]

That is not how natural selection works, by the way. But still, hopefully people don’t do anything stupid.

^But doesn't it? Nature tends to kill off stupid eventually? :hilarious: :) :sneaky:

 

[Sideways]

The swab & deep cough looking for genetic material and then the drop of blood one where it's a finger print.

Yeah, but put aside the usual casual swipe of the mouth that they do on your average cop show looking for DNA.

The swab testing they're using here in the Sunshine state they take 2 swabs. The first cotton bud goes up your nose, right to the very back, as far as it can go.

The second one, they're sticking in your mouth. So you open wide, and instead of just swiping the side of your mouth, they have to take the sample from the back of your throat, right back where your gag reflex is.

The person whose doing that test on me? I'd like them to be using clean PPE please! Because if they're getting that far back in my mouth while I'm sitting there in a fever clinic, potentially surrounded by infected people? I'd like them to not give me Covid in the process please:laugh:

 

[blackemerald1]

The swab testing they're using here in the Sunshine state they take 2 swabs. The first cotton bud goes up your nose, right to the very back, as far as it can go

^I know the tests you're referring to. I've had one before covid19 came into our lives? I've had four respiratory infections in about six months since taking some particular meds. My doctor did it & though unpleasant done efficiently it's over within seconds.

The nose one is no problem - get mucous from well inside each nasal passage & return to the vial so very easy.

The throat one is the most unpleasant but not outrageously so. There's no digging around & yeah avoiding the gag reflex when swabbing near the tonsils needs practice. Being fast is the key lol...

But overall - done in seconds & no need for a change in PPE as far as I know. Well not unless the patient sputters and coughs all over the tester. :)

 

[blackemerald1]

went digging... here ya go about the UV stuff.

^Thanks but I'm not sure why me? :hilarious:

 

[DharmaGirl]

At the end of the day, it may actually be better for him to be where he is now.

Right, the discharge planner is trying to find a place for rehab when it is time. With his last rehab, he went to the hospital rehab bed near his home, but now they won't take him at any time without a neg test. The planner also told my mom that if he doesn't get up and walk, medicare won't pay, which is also not true. I was an RN case manager/discharge planner. He could barely walk before he broke his good hip.

The alternative is that he has a 'community acquired' pneumonia. A viral one.

Community acquired means you got it outside a hospital. Nosocomial means you got it inside a hospital. It doesn't mean viral or bacterial. He has bacterial pneumonia now.

All due respect to both of you, I don't think I explained it very well. He won't be moved right away, but he will have to be moved. He can't go home, since my 82 year old mom can't lift him. With the last hip, he was 45 days in rehab. He also has a blood cancer, heart failure, a bedsore, and COPD. My mother doesn't want me to talk to the discharge planner, since she thinks they will take it out on my stepfather, even though threatening my mother with a hospital bill if he doesn't walk when he couldn't before is horrid.

 

[Sideways]

Sorry @DharmaGirl - was just trying to say that testing him for Covid probably doesn't change his treatment plan at all. I'm really sorry. I do hope they're at least able to keep him comfortable while he recovers from his surgery, and hopefully the pneumonia is treatable.

 

[Muttly]

So what are the choices Muttly?

Don't do tests at all?
Do tests and don't believe them?
Or.
When sick just stay home unless you really do need medical assistance.
Not sure I'd be thinking I've got covid19 if I tested negative. If I was that sick & they idk just needed to know what the hell was going on with me? I guess do the test again.

from the articles I read, the positive results are very accurate. So it's worth testing because if you get a positive then you know. If you get a negative and are sick, a lot of doctors are still treating you as if you have covid.

For me, since I wasn't able to get the test when first symptomatic, my doctor says it's not worth getting the test. It will probably come up negative. But based on my exposure to covid and symptoms I'm presumed positive. And basically I'm just supposed to ride it out. If my symptoms go past 6 weeks she then wants me to get the antibody test to be sure it's covid and that the current treatment plan is current. ETA- she'd probably have me do the antibody test sooner if it was more readily available. It's only in 1 city near me and it's not close.