[BostonCard]

Just to be clear, there were six million motor vehicle collisions in the US last year.  Most people involved in a motor vehicle collision survive, regardless of whether they wear a seatbelt.  The chances of dying are about 9% for people not wearing a seatbelt, and about 5% for those wearing a seatbelt.  The fact that 9 in 10 people who don’t wear a seatbelt survive is no reason not to take the reasonable precaution of wearing one.  Thankfully 6 in 7 people involved in a car accident do wear a seatbelt, so the overall mortality is 6%.

BC

[BostonCard]

Just to be clear, there were six million motor vehicle collisions in the US last year.  Most people involved in a motor vehicle collision survive, regardless of whether they wear a seatbelt.  The chances of dying are about 9% for people not wearing a seatbelt, and about 5% for those wearing a seatbelt.  The fact that 9 in 10 people who don’t wear a seatbelt survive is no reason not to take the reasonable precaution of wearing one.  Thankfully 6 in 7 people involved in a car accident do wear a seatbelt, so the overall mortality is 6%.

BC

[pefloresjr]

  Pence having tested negative completely ignores the science that he could have become infected and contagious before it shows up in a test. 

Cheers,
Pete F.

Thank you, thank you, thank you for so clearly making the case for why this monomaniacal focus on testing, testing, testing is so ridiculous.  It will never be possible to test everyone literally at the same time, nor to get all test results back instantaneously [and at the same time], nor to enforce a mandatory fourteen day quarantine of everyone so that the negative testers have no possible way of coming in contact with the positive testers.  Accordingly, insisting on testing as the solution [and using it as the rationale for continuing to impose a drastic lockdown] "completely ignores the science that [someone who has tested negative] could have become infected and contagious before it shows up in a test."  

I have yet to see anyone explain why someone without symptoms would benefit in any manner -- or, apparently, be permitted to change his/her behavior in any manner even in the event of a negative test  -- from taking a test.  According to scientists, this may even be true with respect to antibody tests, since it hasn't been shown yet that the existence of antibodies is also evidence of immunity from reinfection.

I'm not against testing. It provides data, and more data is always better than less.  In fact, I certainly hope some group of scientists is doing whatever they can to get tests of all the folks on the beaches in Southern California or at those demonstrations, or at that Hassidic funeral in New York City -- all of those places where, presumably, massive hot spots are about to break out as a result of the highly criticized behavior ove rthe past few days.  If [hopefully] that doesn't happen, that would be very helpful to know.  As things stand right now, based on what the "scientists" say, we should expect to see a spike.

In fact, everyone who came in contact with VP Pence at the Mayo Clinic should be watched and, if no one develops COVID that can be traced to him, then will you be willing to admit he put no one in danger?

Not sure if this is all directed to me for a response but I can answer your last question.  If Pence didn't infect anyone at the Mayo Clinic, I would absolutely admit that he put no one in direct danger.  However, that could only be knowable in retrospect and would be meaningless regarding any future contacts he were to have with others.  Saying he did no direct harm on one visit has absolutely no relation to whether he might be doing harm in other visits, so I'm not sure of what the point of that question is.  

The question of direct harm also ignores the potential great harm caused by our leaders undermining even the simplest of actions that Americans can take everyday to help limit the risk posed to themselves and others.  Wearing a mask isn't costing people jobs or causing anything beyond a minor annoyance for most.  (For me it steams up my glasses when I'm walking my dog, others with breathing difficulties have a different calculus, but Pence doesn't have either of those issues, serious or negligible.)  That is what bothers me most about his decision to not wear a mask in a hospital.  Whatever his motivations, I find it terrible that he was unwilling to take the smallest of measures to provide leadership to Americans as we try to find ways to deal with this.  

As for the testing, it is not all the same.  The testing I care most about at this point, is the ability to quickly test those with symptoms to find out if they have COVID19.  I think that will be crucial in keeping the outbreak levels within normal (not the recent deferral of nearly all other medical services) healthcare capacity.  If we have enough testing, we can use the contact tracing and two week quarantine to try to limit and mitigate hot spots.  Long term more data will be needed to know our level of herd immunity or lack thereof along with the success of potential vaccines.  

I think it is really important for those from the many perspectives here (and there really are many perspectives) to acknowledge that the scientists are making their best projections based on what we know so far.  I am fine with policy makers being conservative with regard to potential loss of lives and resulting economic damage until the information shows we can ease up on the conservative precautions.  The scientists and policy makers I try to pay most attention to are those who are regularly adjusting their models based on the evidence and who have not staked out a strong public position that they refuse to alter.  

Cheers,
Pete F.

[pefloresjr]

  Pence having tested negative completely ignores the science that he could have become infected and contagious before it shows up in a test. 

Cheers,
Pete F.

Thank you, thank you, thank you for so clearly making the case for why this monomaniacal focus on testing, testing, testing is so ridiculous.  It will never be possible to test everyone literally at the same time, nor to get all test results back instantaneously [and at the same time], nor to enforce a mandatory fourteen day quarantine of everyone so that the negative testers have no possible way of coming in contact with the positive testers.  Accordingly, insisting on testing as the solution [and using it as the rationale for continuing to impose a drastic lockdown] "completely ignores the science that [someone who has tested negative] could have become infected and contagious before it shows up in a test."  

I have yet to see anyone explain why someone without symptoms would benefit in any manner -- or, apparently, be permitted to change his/her behavior in any manner even in the event of a negative test  -- from taking a test.  According to scientists, this may even be true with respect to antibody tests, since it hasn't been shown yet that the existence of antibodies is also evidence of immunity from reinfection.

I'm not against testing. It provides data, and more data is always better than less.  In fact, I certainly hope some group of scientists is doing whatever they can to get tests of all the folks on the beaches in Southern California or at those demonstrations, or at that Hassidic funeral in New York City -- all of those places where, presumably, massive hot spots are about to break out as a result of the highly criticized behavior ove rthe past few days.  If [hopefully] that doesn't happen, that would be very helpful to know.  As things stand right now, based on what the "scientists" say, we should expect to see a spike.

In fact, everyone who came in contact with VP Pence at the Mayo Clinic should be watched and, if no one develops COVID that can be traced to him, then will you be willing to admit he put no one in danger?

Not sure if this is all directed to me for a response but I can answer your last question.  If Pence didn't infect anyone at the Mayo Clinic, I would absolutely admit that he put no one in direct danger.  However, that could only be knowable in retrospect and would be meaningless regarding any future contacts he were to have with others.  Saying he did no direct harm on one visit has absolutely no relation to whether he might be doing harm in other visits, so I'm not sure of what the point of that question is.  

The question of direct harm also ignores the potential great harm caused by our leaders undermining even the simplest of actions that Americans can take everyday to help limit the risk posed to themselves and others.  Wearing a mask isn't costing people jobs or causing anything beyond a minor annoyance for most.  (For me it steams up my glasses when I'm walking my dog, others with breathing difficulties have a different calculus, but Pence doesn't have either of those issues, serious or negligible.)  That is what bothers me most about his decision to not wear a mask in a hospital.  Whatever his motivations, I find it terrible that he was unwilling to take the smallest of measures to provide leadership to Americans as we try to find ways to deal with this.  

As for the testing, it is not all the same.  The testing I care most about at this point, is the ability to quickly test those with symptoms to find out if they have COVID19.  I think that will be crucial in keeping the outbreak levels within normal (not the recent deferral of nearly all other medical services) healthcare capacity.  If we have enough testing, we can use the contact tracing and two week quarantine to try to limit and mitigate hot spots.  Long term more data will be needed to know our level of herd immunity or lack thereof along with the success of potential vaccines.  

I think it is really important for those from the many perspectives here (and there really are many perspectives) to acknowledge that the scientists are making their best projections based on what we know so far.  I am fine with policy makers being conservative with regard to potential loss of lives and resulting economic damage until the information shows we can ease up on the conservative precautions.  The scientists and policy makers I try to pay most attention to are those who are regularly adjusting their models based on the evidence and who have not staked out a strong public position that they refuse to alter.  

Cheers,
Pete F.

[76lsjumb]

Yeah, but if Pence did test positive, his behavior certainly would have changed.

I agree asymptomatic patients without high risk for exposure have no need to be tested. But if you have symptoms, any symptom, getting a test that comes back positive will change your behavior and likely reduce the number of people you go on to further expose particularly if your symptoms are mild. The more tests we run, the more cases we can prevent.

I have no doubt whatsoever that, if Pence had tested positive, he wouldn't have gone to Mayo Clinic.  I also agree that anyone having symptoms that come anywhere close to resembling COVID should stay home, act as if they very well might have it, and get tested.

But Pence didn't fall into that category.  And, since folks under S-i-P Orders are now essentially required by law to act as if if they're infected even when they aren't, I still don't understand why having more testing available will change anything.

[76lsjumb]

Yeah, but if Pence did test positive, his behavior certainly would have changed.

I agree asymptomatic patients without high risk for exposure have no need to be tested. But if you have symptoms, any symptom, getting a test that comes back positive will change your behavior and likely reduce the number of people you go on to further expose particularly if your symptoms are mild. The more tests we run, the more cases we can prevent.

I have no doubt whatsoever that, if Pence had tested positive, he wouldn't have gone to Mayo Clinic.  I also agree that anyone having symptoms that come anywhere close to resembling COVID should stay home, act as if they very well might have it, and get tested.

But Pence didn't fall into that category.  And, since folks under S-i-P Orders are now essentially required by law to act as if if they're infected even when they aren't, I still don't understand why having more testing available will change anything.

[dabigv13]

Well, hopefully we can start to relax those SIP orders at some point in the near future. Having the mechanism in place to test quickly and widely will be really important in realizing that possibility without having to do a big general shutdown again.

[dabigv13]

Well, hopefully we can start to relax those SIP orders at some point in the near future. Having the mechanism in place to test quickly and widely will be really important in realizing that possibility without having to do a big general shutdown again.

[magnus]

As for the testing, it is not all the same.  The testing I care most about at this point, is the ability to quickly test those with symptoms to find out if they have COVID19.

Even these tests may not be close to 0% false negative due to the sensitivity of the sampling method.  As has been mentioned before, deep nasal swabs may not be anywhere close to 100% (maybe not even 70%) sensitive...and that's done by trained healthcare workers.  If instead your average layperson is taking that sample, that percentage may drop even more.

[magnus]

As for the testing, it is not all the same.  The testing I care most about at this point, is the ability to quickly test those with symptoms to find out if they have COVID19.

Even these tests may not be close to 0% false negative due to the sensitivity of the sampling method.  As has been mentioned before, deep nasal swabs may not be anywhere close to 100% (maybe not even 70%) sensitive...and that's done by trained healthcare workers.  If instead your average layperson is taking that sample, that percentage may drop even more.

[76lsjumb]

I think it is really important for those from the many perspectives here (and there really are many perspectives) to acknowledge that the scientists are making their best projections based on what we know so far.  I am fine with policy makers being conservative with regard to potential loss of lives and resulting economic damage until the information shows we can ease up on the conservative precautions.  The scientists and policy makers I try to pay most attention to are those who are regularly adjusting their models based on the evidence and who have not staked out a strong public position that they refuse to alter.  

Cheers,
Pete F.

This is certainly a reasonable approach, but do you believe determining when "the information shows we can ease up on the conservative precautions" is a scientific or, for lack of a better term, a "political" question?  I think that's a political question, not a scientific one.  I also think many [although I readily admit I have no idea if you are among those folks] brand that a scientific question in order to make their answer appear more "factual," when in reality, it is simply a different risk analysis than that of someone who, for example, favors fewer restrictions.

[76lsjumb]

I think it is really important for those from the many perspectives here (and there really are many perspectives) to acknowledge that the scientists are making their best projections based on what we know so far.  I am fine with policy makers being conservative with regard to potential loss of lives and resulting economic damage until the information shows we can ease up on the conservative precautions.  The scientists and policy makers I try to pay most attention to are those who are regularly adjusting their models based on the evidence and who have not staked out a strong public position that they refuse to alter.  

Cheers,
Pete F.

This is certainly a reasonable approach, but do you believe determining when "the information shows we can ease up on the conservative precautions" is a scientific or, for lack of a better term, a "political" question?  I think that's a political question, not a scientific one.  I also think many [although I readily admit I have no idea if you are among those folks] brand that a scientific question in order to make their answer appear more "factual," when in reality, it is simply a different risk analysis than that of someone who, for example, favors fewer restrictions.

[pefloresjr]

Any of these type of risk analyses are hybrid political/scientific decisions.  You can't make a rational risk analysis of a health related issue without good science behind it.  Of course "science" isn't always clear, that is why I think it is critical that scientists and policy makers be open to information that is evolving.  In fact, they should expect it and tell the public that they should expect it.  I would feel much better if all of the leaders in the political chain of command I live under did so.  I think most Americans can handle the hard truth, including uncertainty, if the leaders lay out plans to increase certainty and show a willingness to act on the true information.  

I cut policy makers slack in being conservative toward public safety at the outset (taking actions to stop the worst case scenario until we have information that the likelihood of that is low) because I work in an area where public safety is part of my overall duties.  Even though some would dismissively categorize me as a bureaucrat, I take that responsibility to heart and it is serious to me.  Making the wrong decision and failing to protect public safety is what keeps me up at night.  I am very in favor of the Trump administration's guidelines for re-opening the country and economy because they seem to be based on scientific information for when we can control the virus sufficiently to limit the health and economic impacts.  

Cheers,
Pete F.

[pefloresjr]

Any of these type of risk analyses are hybrid political/scientific decisions.  You can't make a rational risk analysis of a health related issue without good science behind it.  Of course "science" isn't always clear, that is why I think it is critical that scientists and policy makers be open to information that is evolving.  In fact, they should expect it and tell the public that they should expect it.  I would feel much better if all of the leaders in the political chain of command I live under did so.  I think most Americans can handle the hard truth, including uncertainty, if the leaders lay out plans to increase certainty and show a willingness to act on the true information.  

I cut policy makers slack in being conservative toward public safety at the outset (taking actions to stop the worst case scenario until we have information that the likelihood of that is low) because I work in an area where public safety is part of my overall duties.  Even though some would dismissively categorize me as a bureaucrat, I take that responsibility to heart and it is serious to me.  Making the wrong decision and failing to protect public safety is what keeps me up at night.  I am very in favor of the Trump administration's guidelines for re-opening the country and economy because they seem to be based on scientific information for when we can control the virus sufficiently to limit the health and economic impacts.  

Cheers,
Pete F.

[76lsjumb]

Any of these type of risk analyses are hybrid political/scientific decisions.  You can't make a rational risk analysis of a health related issue without good science behind it.  Of course "science" isn't always clear, that is why I think it is critical that scientists and policy makers be open to information that is evolving.  In fact, they should expect it and tell the public that they should expect it.  I would feel much better if all of the leaders in the political chain of command I live under did so.  I think most Americans can handle the hard truth, including uncertainty, if the leaders lay out plans to increase certainty and show a willingness to act on the true information.  

I cut policy makers slack in being conservative toward public safety at the outset (taking actions to stop the worst case scenario until we have information that the likelihood of that is low) because I work in an area where public safety is part of my overall duties.  Even though some would dismissively categorize me as a bureaucrat, I take that responsibility to heart and it is serious to me.  Making the wrong decision and failing to protect the public safety is what keeps me up at night.  I am very in favor of the Trump administration's guidelines for re-opening the country and economy because they seem to be based on scientific information for when we can control the virus sufficiently to limit the health and economic impacts.  

Cheers,
Pete F.

Sounds reasonable to me.  Indeed, much more so than a lot of the discussion I’ve seen. Thanks for that.

[76lsjumb]

Any of these type of risk analyses are hybrid political/scientific decisions.  You can't make a rational risk analysis of a health related issue without good science behind it.  Of course "science" isn't always clear, that is why I think it is critical that scientists and policy makers be open to information that is evolving.  In fact, they should expect it and tell the public that they should expect it.  I would feel much better if all of the leaders in the political chain of command I live under did so.  I think most Americans can handle the hard truth, including uncertainty, if the leaders lay out plans to increase certainty and show a willingness to act on the true information.  

I cut policy makers slack in being conservative toward public safety at the outset (taking actions to stop the worst case scenario until we have information that the likelihood of that is low) because I work in an area where public safety is part of my overall duties.  Even though some would dismissively categorize me as a bureaucrat, I take that responsibility to heart and it is serious to me.  Making the wrong decision and failing to protect the public safety is what keeps me up at night.  I am very in favor of the Trump administration's guidelines for re-opening the country and economy because they seem to be based on scientific information for when we can control the virus sufficiently to limit the health and economic impacts.  

Cheers,
Pete F.

Sounds reasonable to me.  Indeed, much more so than a lot of the discussion I’ve seen. Thanks for that.

[M T]

I agree asymptomatic patients without high risk for exposure have no need to be tested. ...

This statement struck me as odd, so I'm trying to figure it out.  Maybe that sentence just didn't come out right and you meant something entirely different.

Assuming it was more or less what you meant, is this about
(1) a theoretical person (not a "patient") who has COVID-19 without symptoms or high risk of exposure and has not been tested
(2) a guy in the hospital for a gall bladder operation, that has no COVID-19 symptoms and no high risk for exposure before going to the hospital
(3) something else that I didn't comprehend

If #1, if someone is asymptomatic, that doesn't mean that are not infectious.  Indeed, the very first I saw suggesting a large (= size of symptomatic) group of asymptomatic cases was in regard to spread in China.  The models of the spread only worked if there were asymptomatic individuals (and, IIRC, that excluded presymptomatic as they would be detected in China once they became symptomatic).

If someone came out with an easy, cheap test (say a toothpaste that turned bright blue in presence of the virus), and we could each test every day, wouldn't that be a way to reduce infections and reduce all the negative outcomes?


If #2, shouldn't this person be tested to inform the healthcare workers whether they have to treat him with negative pressure rooms and all the other extra protections they go to for COVID-19 patients, for the protection of other patients & healthcare workers?

[M T]

I agree asymptomatic patients without high risk for exposure have no need to be tested. ...

This statement struck me as odd, so I'm trying to figure it out.  Maybe that sentence just didn't come out right and you meant something entirely different.

Assuming it was more or less what you meant, is this about
(1) a theoretical person (not a "patient") who has COVID-19 without symptoms or high risk of exposure and has not been tested
(2) a guy in the hospital for a gall bladder operation, that has no COVID-19 symptoms and no high risk for exposure before going to the hospital
(3) something else that I didn't comprehend

If #1, if someone is asymptomatic, that doesn't mean that are not infectious.  Indeed, the very first I saw suggesting a large (= size of symptomatic) group of asymptomatic cases was in regard to spread in China.  The models of the spread only worked if there were asymptomatic individuals (and, IIRC, that excluded presymptomatic as they would be detected in China once they became symptomatic).

If someone came out with an easy, cheap test (say a toothpaste that turned bright blue in presence of the virus), and we could each test every day, wouldn't that be a way to reduce infections and reduce all the negative outcomes?


If #2, shouldn't this person be tested to inform the healthcare workers whether they have to treat him with negative pressure rooms and all the other extra protections they go to for COVID-19 patients, for the protection of other patients & healthcare workers?

[akiddoc]

  Pence having tested negative completely ignores the science that he could have become infected and contagious before it shows up in a test. 

Cheers,
Pete F.

Thank you, thank you, thank you for so clearly making the case for why this monomaniacal focus on testing, testing, testing is so ridiculous.  It will never be possible to test everyone literally at the same time, nor to get all test results back instantaneously [and at the same time], nor to enforce a mandatory fourteen day quarantine of everyone so that the negative testers have no possible way of coming in contact with the positive testers.  Accordingly, insisting on testing as the solution [and using it as the rationale for continuing to impose a drastic lockdown] "completely ignores the science that [someone who has tested negative] could have become infected and contagious before it shows up in a test."  

I have yet to see anyone explain why someone without symptoms would benefit in any manner -- or, apparently, be permitted to change his/her behavior in any manner even in the event of a negative test  -- from taking a test.  According to scientists, this may even be true with respect to antibody tests, since it hasn't been shown yet that the existence of antibodies is also evidence of immunity from reinfection.

I'm not against testing. It provides data, and more data is always better than less.  In fact, I certainly hope some group of scientists is doing whatever they can to get tests of all the folks on the beaches in Southern California or at those demonstrations, or at that Hassidic funeral in New York City -- all of those places where, presumably, massive hot spots are about to break out as a result of the highly criticized behavior ove rthe past few days.  If [hopefully] that doesn't happen, that would be very helpful to know.  As things stand right now, based on what the "scientists" say, we should expect to see a spike.

In fact, everyone who came in contact with VP Pence at the Mayo Clinic should be watched and, if no one develops COVID that can be traced to him, then will you be willing to admit he put no one in danger?

Actually, we will likely have a 15 minute test before the year is out. We have a 15 minute influenza test. The issues of course will center around sensitivity and specificity. We may be able to supplement that with rapid IgM testing. It isn't practical to do all of that on the entire population, but when tracking down infected people in hot spots we might do okay. IgG testing is not useful in those situations. 

Saying that Pence put no one in danger if no one gets sick over the next whatever number of days completely misses the point. He's playing Russian roulette.

[akiddoc]

  Pence having tested negative completely ignores the science that he could have become infected and contagious before it shows up in a test. 

Cheers,
Pete F.

Thank you, thank you, thank you for so clearly making the case for why this monomaniacal focus on testing, testing, testing is so ridiculous.  It will never be possible to test everyone literally at the same time, nor to get all test results back instantaneously [and at the same time], nor to enforce a mandatory fourteen day quarantine of everyone so that the negative testers have no possible way of coming in contact with the positive testers.  Accordingly, insisting on testing as the solution [and using it as the rationale for continuing to impose a drastic lockdown] "completely ignores the science that [someone who has tested negative] could have become infected and contagious before it shows up in a test."  

I have yet to see anyone explain why someone without symptoms would benefit in any manner -- or, apparently, be permitted to change his/her behavior in any manner even in the event of a negative test  -- from taking a test.  According to scientists, this may even be true with respect to antibody tests, since it hasn't been shown yet that the existence of antibodies is also evidence of immunity from reinfection.

I'm not against testing. It provides data, and more data is always better than less.  In fact, I certainly hope some group of scientists is doing whatever they can to get tests of all the folks on the beaches in Southern California or at those demonstrations, or at that Hassidic funeral in New York City -- all of those places where, presumably, massive hot spots are about to break out as a result of the highly criticized behavior ove rthe past few days.  If [hopefully] that doesn't happen, that would be very helpful to know.  As things stand right now, based on what the "scientists" say, we should expect to see a spike.

In fact, everyone who came in contact with VP Pence at the Mayo Clinic should be watched and, if no one develops COVID that can be traced to him, then will you be willing to admit he put no one in danger?

Actually, we will likely have a 15 minute test before the year is out. We have a 15 minute influenza test. The issues of course will center around sensitivity and specificity. We may be able to supplement that with rapid IgM testing. It isn't practical to do all of that on the entire population, but when tracking down infected people in hot spots we might do okay. IgG testing is not useful in those situations. 

Saying that Pence put no one in danger if no one gets sick over the next whatever number of days completely misses the point. He's playing Russian roulette.

[M T]

By the way, has anyone considered that Pence and other key officials might be getting daily testing? 

I could see why it would be done (to avoid the spread of the disease even when pre-symptomatic to key US officials).  (Indeed, now that I think of it, I think it would be stupid if they aren't testing every day or two for the heads of the three branches of the government and top military leaders.  I think such testing ought to be extended to the state level too.)
I could see why it wouldn't be talked about.  (See recent grumbling here over the assertions that the first vaccines would go to the rich & famous.  Also the optics would be bad if the country is still struggling to do enough testing.)
I could see why Mayo Clinic would then let him in without the mask

[M T]

By the way, has anyone considered that Pence and other key officials might be getting daily testing? 

I could see why it would be done (to avoid the spread of the disease even when pre-symptomatic to key US officials).  (Indeed, now that I think of it, I think it would be stupid if they aren't testing every day or two for the heads of the three branches of the government and top military leaders.  I think such testing ought to be extended to the state level too.)
I could see why it wouldn't be talked about.  (See recent grumbling here over the assertions that the first vaccines would go to the rich & famous.  Also the optics would be bad if the country is still struggling to do enough testing.)
I could see why Mayo Clinic would then let him in without the mask

[akiddoc]

By the way, has anyone considered that Pence and other key officials might be getting daily testing? 

I could see why it would be done (to avoid the spread of the disease even when pre-symptomatic to key US officials).  (Indeed, now that I think of it, I think it would be stupid if they aren't testing every day or two for the heads of the three branches of the government and top military leaders.  I think such testing ought to be extended to the state level too.)
I could see why it wouldn't be talked about.  (See recent grumbling here over the assertions that the first vaccines would go to the rich & famous.  Also the optics would be bad if the country is still struggling to do enough testing.)
I could see why Mayo Clinic would then let him in without the mask

I think it is assumed that he is being tested frequently. The Mayo wouldn't change their rule because of that. Doctors who return to work after a negative test aren't given a pass for the next 2 days.

[akiddoc]

By the way, has anyone considered that Pence and other key officials might be getting daily testing? 

I could see why it would be done (to avoid the spread of the disease even when pre-symptomatic to key US officials).  (Indeed, now that I think of it, I think it would be stupid if they aren't testing every day or two for the heads of the three branches of the government and top military leaders.  I think such testing ought to be extended to the state level too.)
I could see why it wouldn't be talked about.  (See recent grumbling here over the assertions that the first vaccines would go to the rich & famous.  Also the optics would be bad if the country is still struggling to do enough testing.)
I could see why Mayo Clinic would then let him in without the mask

I think it is assumed that he is being tested frequently. The Mayo wouldn't change their rule because of that. Doctors who return to work after a negative test aren't given a pass for the next 2 days.

[JustAnotherFan]

In fact, everyone who came in contact with VP Pence at the Mayo Clinic should be watched and, if no one develops COVID that can be traced to him, then will you be willing to admit he put no one in danger?

That's not how it works. Just because no one dies doesn't mean no one was put in danger. For example, someone having sex without a condom. Just because they later are found to be clean on STDs doesn't mean we should admit that they never put their partner at risk. The fact is that even if Pence got tested the day before he still could have been shedding. He should have worn the mask. No excuses.

Also, this Medium article does a nice job of breaking down the various benefits of testing with nice graphics as well. Not sure if it is perfect, but I consider it good enough to share to get people to see value in testing (like we did when we were trying to explain why we should flatten the curve even though the heavy focus on staying below medical capacity led people to ignore the value of reducing infections well beyond the benefit of people not dying in hallways). https://medium.com/@tomaspueyo/coronavir...e85b64072e

[JustAnotherFan]

In fact, everyone who came in contact with VP Pence at the Mayo Clinic should be watched and, if no one develops COVID that can be traced to him, then will you be willing to admit he put no one in danger?

That's not how it works. Just because no one dies doesn't mean no one was put in danger. For example, someone having sex without a condom. Just because they later are found to be clean on STDs doesn't mean we should admit that they never put their partner at risk. The fact is that even if Pence got tested the day before he still could have been shedding. He should have worn the mask. No excuses.

Also, this Medium article does a nice job of breaking down the various benefits of testing with nice graphics as well. Not sure if it is perfect, but I consider it good enough to share to get people to see value in testing (like we did when we were trying to explain why we should flatten the curve even though the heavy focus on staying below medical capacity led people to ignore the value of reducing infections well beyond the benefit of people not dying in hallways). https://medium.com/@tomaspueyo/coronavir...e85b64072e

[stupac2]

We get it. You two DGAF. You can go golfing now, brighten up.

Yeah, that's it, Dabig . . . I don't give a *****.  
Never mind that people might say the same thing about you and your cohorts re: all those out of jobs, those with mental health issues whose situations are being exacerbated by lockdown, etc.

But you keep painting your little moral high ground picture in your mind, if it makes you feel better.
For me, I'll try harder to see "the light" being shone in these parts.    

P.S.  Not much of a golfer - maybe 2x/year.  But if I were, then I would definitely try to get out there.  I'm looking for reasons to get out and about; unlike The Enlightened in these parts, who are looking for reasons to stay inside.  And btw, on that front, no one is forcing you to go outside - and that will be true today, tomorrow, and well . . . forever (even after the SiP restrictions are lifted).  So no worries for you guys - you can hunker down and bunker in all the way till Kingdom Come.  Woo hoo!!

Did you look at the polling thread I started? Fully 2/3 of Americans agree that people shouldn't go back to work in our current state. The percentage is basically identical between people making <$50k and >$50k.

Did you read the article I linked titled "Reopening the economy won't save the economy"? Because I've never see you or Mick or any other SiP doubter engage with the arguments and explain why removing SiP would meaningfully help the economy. But basically, right now people are afraid. When people are afraid, they're not going to spend money on unnecessary purchases, and that virtually guarantees a recession of some form.

It's also perverse to expect people who are afraid of exposure to show up to jobs that virtually guarantee it, providing them meager healthcare, while exempting the business owners from liability. That situation is barbaric.

I think that the majority of us on here see SiP as an extremely unfortunate necessity, because we need to avoid turning into Lombardy or NYC, perhaps not at all costs, but at high cost (although I think the cost is less than you think it is, given the realities about what people will spend if SiP were lifted). We also think that the government at various levels should do whatever they can to ameliorate the situation for those most affected (some governments are doing this more effectively than others). No one is happy about this situation, and your continued characterization of people who aren't champing at the bit to remove SiP as eager to "hunker down until kingdom come" is asinine. I may as well say that you're just sociopathically eager to build your bank account over the skeletons of the poor. I don't think, and dearly hope, that's not true.

[stupac2]

We get it. You two DGAF. You can go golfing now, brighten up.

Yeah, that's it, Dabig . . . I don't give a *****.  
Never mind that people might say the same thing about you and your cohorts re: all those out of jobs, those with mental health issues whose situations are being exacerbated by lockdown, etc.

But you keep painting your little moral high ground picture in your mind, if it makes you feel better.
For me, I'll try harder to see "the light" being shone in these parts.    

P.S.  Not much of a golfer - maybe 2x/year.  But if I were, then I would definitely try to get out there.  I'm looking for reasons to get out and about; unlike The Enlightened in these parts, who are looking for reasons to stay inside.  And btw, on that front, no one is forcing you to go outside - and that will be true today, tomorrow, and well . . . forever (even after the SiP restrictions are lifted).  So no worries for you guys - you can hunker down and bunker in all the way till Kingdom Come.  Woo hoo!!

Did you look at the polling thread I started? Fully 2/3 of Americans agree that people shouldn't go back to work in our current state. The percentage is basically identical between people making <$50k and >$50k.

Did you read the article I linked titled "Reopening the economy won't save the economy"? Because I've never see you or Mick or any other SiP doubter engage with the arguments and explain why removing SiP would meaningfully help the economy. But basically, right now people are afraid. When people are afraid, they're not going to spend money on unnecessary purchases, and that virtually guarantees a recession of some form.

It's also perverse to expect people who are afraid of exposure to show up to jobs that virtually guarantee it, providing them meager healthcare, while exempting the business owners from liability. That situation is barbaric.

I think that the majority of us on here see SiP as an extremely unfortunate necessity, because we need to avoid turning into Lombardy or NYC, perhaps not at all costs, but at high cost (although I think the cost is less than you think it is, given the realities about what people will spend if SiP were lifted). We also think that the government at various levels should do whatever they can to ameliorate the situation for those most affected (some governments are doing this more effectively than others). No one is happy about this situation, and your continued characterization of people who aren't champing at the bit to remove SiP as eager to "hunker down until kingdom come" is asinine. I may as well say that you're just sociopathically eager to build your bank account over the skeletons of the poor. I don't think, and dearly hope, that's not true.

[dabigv13]

I agree asymptomatic patients without high risk for exposure have no need to be tested. ...

This statement struck me as odd, so I'm trying to figure it out.  Maybe that sentence just didn't come out right and you meant something entirely different.

Assuming it was more or less what you meant, is this about
(1) a theoretical person (not a "patient") who has COVID-19 without symptoms or high risk of exposure and has not been tested
(2) a guy in the hospital for a gall bladder operation, that has no COVID-19 symptoms and no high risk for exposure before going to the hospital
(3) something else that I didn't comprehend

If #1, if someone is asymptomatic, that doesn't mean that are not infectious.  Indeed, the very first I saw suggesting a large (= size of symptomatic) group of asymptomatic cases was in regard to spread in China.  The models of the spread only worked if there were asymptomatic individuals (and, IIRC, that excluded presymptomatic as they would be detected in China once they became symptomatic).

If someone came out with an easy, cheap test (say a toothpaste that turned bright blue in presence of the virus), and we could each test every day, wouldn't that be a way to reduce infections and reduce all the negative outcomes?


If #2, shouldn't this person be tested to inform the healthcare workers whether they have to treat him with negative pressure rooms and all the other extra protections they go to for COVID-19 patients, for the protection of other patients & healthcare workers?

I should have used "people" instead of "patients". If you don't have symptoms, and you haven't been exposed to people with covid or are in a job or situation where that is very likely, don't bother with a one off PCR test because it's only a single snapshot.

Regarding your #2, at this time, if you are going for surgery, you are getting preop covid testing. If you are pregnant, you get a covid test. Would not be surprised if soon all inpatients get tested. False negatives are a problem though, one were still trying to quantify.

[dabigv13]

I agree asymptomatic patients without high risk for exposure have no need to be tested. ...

This statement struck me as odd, so I'm trying to figure it out.  Maybe that sentence just didn't come out right and you meant something entirely different.

Assuming it was more or less what you meant, is this about
(1) a theoretical person (not a "patient") who has COVID-19 without symptoms or high risk of exposure and has not been tested
(2) a guy in the hospital for a gall bladder operation, that has no COVID-19 symptoms and no high risk for exposure before going to the hospital
(3) something else that I didn't comprehend

If #1, if someone is asymptomatic, that doesn't mean that are not infectious.  Indeed, the very first I saw suggesting a large (= size of symptomatic) group of asymptomatic cases was in regard to spread in China.  The models of the spread only worked if there were asymptomatic individuals (and, IIRC, that excluded presymptomatic as they would be detected in China once they became symptomatic).

If someone came out with an easy, cheap test (say a toothpaste that turned bright blue in presence of the virus), and we could each test every day, wouldn't that be a way to reduce infections and reduce all the negative outcomes?


If #2, shouldn't this person be tested to inform the healthcare workers whether they have to treat him with negative pressure rooms and all the other extra protections they go to for COVID-19 patients, for the protection of other patients & healthcare workers?

I should have used "people" instead of "patients". If you don't have symptoms, and you haven't been exposed to people with covid or are in a job or situation where that is very likely, don't bother with a one off PCR test because it's only a single snapshot.

Regarding your #2, at this time, if you are going for surgery, you are getting preop covid testing. If you are pregnant, you get a covid test. Would not be surprised if soon all inpatients get tested. False negatives are a problem though, one were still trying to quantify.

[Goose]

Thank you, thank you, thank you for so clearly making the case for why this monomaniacal focus on testing, testing, testing is so ridiculous.  It will never be possible to test everyone literally at the same time, nor to get all test results back instantaneously [and at the same time],

To this point of your argument, I totally agree.

nor to enforce a mandatory fourteen day quarantine of everyone so that the negative testers have no possible way of coming in contact with the positive testers.

As I understand it, the purpose of contact tracing is to prevent people who have known exposure  to people who are known positive from coming into contact with  people who are presumed (or actually tested) negative. We "only" need to test those people who have symptoms or have a known exposure to someone who is positive. We need enough testing to do that. We also need a mandatory quarantine of people who have known exposure to positive testers. I think that much lower standard is possible. All quarantines "leak" a bit. Several other nations have made this work, although it is tricky. Do you believe this is not possible here in the US?

In fact, everyone who came in contact with VP Pence at the Mayo Clinic should be watched and, if no one develops COVID that can be traced to him, then will you be willing to admit he put no one in danger?

I would in fact admit he put no one in danger, retrospectively. However, I would also say that prospectively he did, because he may have had COVID-19, and that is an  irresponsible action. I am sure others have pointed out false negatives, disease progression, etc. Do I think that wearing a mask is a "big" deal in terms of increased risk to others? In each individual case, probably not. However the summation of all those very small increased risks over our society adds up to something our CDC has decided is not negligible. I have to honor that determination and comply. I don't get to independently decide. Neither does the vice-president nor the president. The fact they don't comply says they must either believe their own CDC is in error or that they are for some good reason "exempt" from compliance. Which it is needs to be explained IMHO.

[Goose]

Thank you, thank you, thank you for so clearly making the case for why this monomaniacal focus on testing, testing, testing is so ridiculous.  It will never be possible to test everyone literally at the same time, nor to get all test results back instantaneously [and at the same time],

To this point of your argument, I totally agree.

nor to enforce a mandatory fourteen day quarantine of everyone so that the negative testers have no possible way of coming in contact with the positive testers.

As I understand it, the purpose of contact tracing is to prevent people who have known exposure  to people who are known positive from coming into contact with  people who are presumed (or actually tested) negative. We "only" need to test those people who have symptoms or have a known exposure to someone who is positive. We need enough testing to do that. We also need a mandatory quarantine of people who have known exposure to positive testers. I think that much lower standard is possible. All quarantines "leak" a bit. Several other nations have made this work, although it is tricky. Do you believe this is not possible here in the US?

In fact, everyone who came in contact with VP Pence at the Mayo Clinic should be watched and, if no one develops COVID that can be traced to him, then will you be willing to admit he put no one in danger?

I would in fact admit he put no one in danger, retrospectively. However, I would also say that prospectively he did, because he may have had COVID-19, and that is an  irresponsible action. I am sure others have pointed out false negatives, disease progression, etc. Do I think that wearing a mask is a "big" deal in terms of increased risk to others? In each individual case, probably not. However the summation of all those very small increased risks over our society adds up to something our CDC has decided is not negligible. I have to honor that determination and comply. I don't get to independently decide. Neither does the vice-president nor the president. The fact they don't comply says they must either believe their own CDC is in error or that they are for some good reason "exempt" from compliance. Which it is needs to be explained IMHO.

[BostonCard]

There is also the issue of modelling behavior.  The message that Pence sends to the American people is don't wear a mask if you don't want to.  Now, maybe (probably) he's tested frequently and is negative and no one is in danger due to his actions. But that may not be the case for your average American who might have seen Pence and concluded that face masks aren't necessary, thereby unknowingly transmitting the virus to someone who is susceptible, thereby triggering an outbreak or killing someone.

BC

[BostonCard]

There is also the issue of modelling behavior.  The message that Pence sends to the American people is don't wear a mask if you don't want to.  Now, maybe (probably) he's tested frequently and is negative and no one is in danger due to his actions. But that may not be the case for your average American who might have seen Pence and concluded that face masks aren't necessary, thereby unknowingly transmitting the virus to someone who is susceptible, thereby triggering an outbreak or killing someone.

BC

[2006alum]

Is there any good argument for not wearing a mask other than that it might piss off Our Elected Leader? And Mother's excuse that he wasn't told is so fatuous: 
[tweet]https://twitter.com/thehill/status/1255865761375059968?s=20[/tweet]

Anyone who is even vaguely socially aware would notice that literally every other person in that institution had a mask, and ask for one. 

It pains me that we're even on the second page of a thread discussing this.

[2006alum]

Is there any good argument for not wearing a mask other than that it might piss off Our Elected Leader? And Mother's excuse that he wasn't told is so fatuous: 
[tweet]https://twitter.com/thehill/status/1255865761375059968?s=20[/tweet]

Anyone who is even vaguely socially aware would notice that literally every other person in that institution had a mask, and ask for one. 

It pains me that we're even on the second page of a thread discussing this.

[Mick]

Some folks have to endanger themselves and their families daily in the face of this virus. You two obviously don't. I could really care less about your opinions about this pandemic, even though you make them clear in most every thread. Moral high ground, hilarious. It sucks you have to fire some people, I have to put on a spacesuit and put breathing tubes in covid patients airways and hope that I did every step right so as not to expose myself or my family to a disease that I hear killing people on a regular basis (code blue in the ICU means one thing these days).

Waiting to hear that you GAF about 30 million+ and rising unemployed.  Very impressed how you slur the unemployed and my having to let people go.  Can't imagine why they say MD's have God complexes...

Current ratio of unemployed:coronavirus dead is 483:1.  Add the 2x people who depend on those unemployed for food, rent, etc.; that's about 1,300:1.  But yeah, you keep your moral low ground.

---

Is there any good argument for not wearing a mask other than that it might piss off Our Elected Leader? And Mother's excuse that he wasn't told is so fatuous: 
[tweet]https://twitter.com/thehill/status/1255865761375059968?s=20[/tweet]

Anyone who is even vaguely socially aware would notice that literally every other person in that institution had a mask, and ask for one. 

It pains me that we're even on the second page of a thread discussing this.

No good argument at all. It is reprehensible that he doesn't wear a mask.

[Mick]

Some folks have to endanger themselves and their families daily in the face of this virus. You two obviously don't. I could really care less about your opinions about this pandemic, even though you make them clear in most every thread. Moral high ground, hilarious. It sucks you have to fire some people, I have to put on a spacesuit and put breathing tubes in covid patients airways and hope that I did every step right so as not to expose myself or my family to a disease that I hear killing people on a regular basis (code blue in the ICU means one thing these days).

Waiting to hear that you GAF about 30 million+ and rising unemployed.  Very impressed how you slur the unemployed and my having to let people go.  Can't imagine why they say MD's have God complexes...

Current ratio of unemployed:coronavirus dead is 483:1.  Add the 2x people who depend on those unemployed for food, rent, etc.; that's about 1,300:1.  But yeah, you keep your moral low ground.

---

Is there any good argument for not wearing a mask other than that it might piss off Our Elected Leader? And Mother's excuse that he wasn't told is so fatuous: 
[tweet]https://twitter.com/thehill/status/1255865761375059968?s=20[/tweet]

Anyone who is even vaguely socially aware would notice that literally every other person in that institution had a mask, and ask for one. 

It pains me that we're even on the second page of a thread discussing this.

No good argument at all. It is reprehensible that he doesn't wear a mask.

[dabigv13]

I care more saving lives than the economy. You got me figured.

But as has been said by me and many others, its a false choice. You don't accept that. You would prefer to call me an asshole with a God complex. I'll be your Doctor bogeyman crushing your economy. I can live with that on my moral high ground. But it's really sad that people think the scientists and doctors are the enemy, not the most lethal pandemic virus in our lifetime. I'll be adding you to the ignore list for now because you don't add anything to this forum for me. I'd welcome you to do the same.

[dabigv13]

I care more saving lives than the economy. You got me figured.

But as has been said by me and many others, its a false choice. You don't accept that. You would prefer to call me an asshole with a God complex. I'll be your Doctor bogeyman crushing your economy. I can live with that on my moral high ground. But it's really sad that people think the scientists and doctors are the enemy, not the most lethal pandemic virus in our lifetime. I'll be adding you to the ignore list for now because you don't add anything to this forum for me. I'd welcome you to do the same.