It's time to clear up the issues about testing. So I've put together a #COVID19 thread on spread.
Addressing the Super-spreaders, Spreaders, and the essentiality of testing
Addressing the Super-spreaders, Spreaders, and the essentiality of testing
Let's start in China where the 1st cases were manifest.
A @ScienceMagazine yesterday provided elegant modeling from real data to show that 79% of the spread was from people without #COVID19 detection.
A @ScienceMagazine yesterday provided elegant modeling from real data to show that 79% of the spread was from people without #COVID19 detection.
Now Singapore, which dealt with 3 clusters by having tight surveillance of pneumonia, testing immediately and tracing all the contacts
thelancet.com/journals/lance… @TheLancet
thelancet.com/journals/lance… @TheLancet
And to South Korea where broad testing was conducted that picked up on the high rate of young people who were infected but without symptoms or very mild symptoms. You can see KOR (S. Korea) very different from Italy
So far in this thread we know most of the spread is from people who are not detected, asymptomatic. And they are most likely to be young. So I've replaced the lead diagram with this one. To emphasize that kids/young are the main spreaders, the unwitting vectors of the pandemic.
Now let's go to the US and look at one example patient of likely 1000s. This patient was admitted w/pneumonia on Feb 26 w/o known contacts.
nypost.com/2020/03/16/bel…
Only on March 9th was he tested, it came back + on March 13, and he died March 16th.
nypost.com/2020/03/16/bel…
Only on March 9th was he tested, it came back + on March 13, and he died March 16th.
We're way behind in testing in the US, since we went over 50 days from the 1st case here until we started ramping up. And the testing is still very restrictive, mainly reserved for people w/symptoms.
It's the wrong approach & small-minded compared with what we could still learn👇
It's the wrong approach & small-minded compared with what we could still learn👇
Yes, we're damn late, taking 50 days from the 1st US case to ramp up testing and it's still very restrictive.
The smart approach would be to get these tests, now w/ more rapid turnaround, broadly used. Like every #healthcare worker, repeated later if negative, to prevent spread.
The smart approach would be to get these tests, now w/ more rapid turnaround, broadly used. Like every #healthcare worker, repeated later if negative, to prevent spread.
We can still make a difference in the US by broad use of testing, a large random sample, w/ genome sequencing. #COVID19 will be with us for a long time and the more we understand it now, the better. And set a template for the future; this won't be the last pandemic. --End
And Trevor's @trvb thread which not only supports extensive ("a huge rollout")testing but also provides creative ways be which that can be achieved at scale. Agree 💯 👇
