- I think we need to know a LOT more about the sensitivity, specificity, and accuracy of every test that's being deployed right now. I am 100% willing to believe that "testing negative and then positive" means "you have a pretty low viral load and our tests suck more than we're willing to admit out loud right now".
- I think we need to be very clear that there are two kinds of tests: "you have an active SARS-CoV-2 infection right now, and also "you have once had a SARS-CoV-2 infection in the semi-recent past". One tells you who needs care, one tells you who is at least temporarily immune we hope.
The article mentions RNA implying that this is the PCR test not an Antibody test. False positives exist with the PCR test. Information I could find suggests the primary cause is sample contamination. So running the test multiple times through different labs and clinicians is an obvious workaround.
More likely sample degradation as well. Rna is notorious for being extremely fragile exactly when you need it not to be and extremely robust when you don't. Academic rna labs have a reputation for being clean freaks, and there was a spate of spurious observations when rt(rt)pcr became a thing ten or so years ago... I'm still not convinced of rt/rt results performed by run of the mill labs, generally speaking.
The capability for a highly sensitive and accurate test in no way guarantees that a randomly sampled administration of that test is going to meet the high standard that the test may be capable of.
I suspect it's because this virus is optimized to enter cells that line the lungs/respiratory tract, then also sheds back that same way. Meanwhile, cells in, and along, the bloodstream aren't infected – and are most-trafficked by the body's immune response, including virus-destroying antibodies.
(Why are rodents more prevalent in the walls/crawlspaces of a dwelling, rather than the hallways?)
Sure, but if an initially-infected respiratory cell releases its "baby coronaviruses" out to the respiratory linings, away from the blood, they'll find lots more of the respiratory cell surfaces they're optimized to infect, and maybe get a ride out to other hosts on sputum.
To the extent an infected cell releases its "baby coronaviruses" into the blood stream, they find a hot, chemically active environment – which is already inhospitable to their continued survival – plus a relative dearth of the respiratory cell-walls they're optimized to enter, plus a growing number of hostile antibodies.
(I don't know if a coronavirus-hijacked cell can direct its fresh viruses one way or the other, but it'd probably prefer to do that if it could, and I can understand why viruses wouldn't persist long in blood compared to respiratory-membranes.)
The coronaviruses are definitely active in mucosal surfaces, and carried by mucus. I haven't seen anything about, nor do I think any activity is necessarily implied, in other connective tissues.
As far as I know the route of SARS-Cov-2 spreading in the human body isn't known beyond the change in locality of symptomatic expression with progression of Covid-19 (upper respiratory tract to lower respiratory tract.)
Research has shown (1) the distribution of ACE2 protein, the functional receptor for SARS-Cov and SARS-Cov-2 (2), to include various human organs (oral and nasal mucosa, nasopharynx, lung, stomach, small intestine, colon, skin, lymph nodes, thymus, bone marrow, spleen, liver, kidney, and brain) along with arterial and venous endothelial cells and arterial smooth muscle cells in all organs studied. And ACE2 mRNA has been found in virtually all organs. So there is definitely the potential for cells in the circulatory system binding viruses.
What may be significant here is the concentration of ACE2 protein in cell membranes. One Chinese analysis of a group of 170 Covid-19 fatalities(3) found half of the cases suffered from hypertension. ACE inhibitors are a class of medication prescribed for lowering blood pressure and according to models they increase the concentration of ACE2 protein in lower respiratory tract cells. Given that fatality results from respiratory distress originating in the lower respiratory tract and that not all cases progress to the lower respiratory tract it seems possible that the spread of the virus within the body may be related to concentration of ACE2 protein in cells. The disease progression would also support mucosal transport of the virus within individuals the same as between them.
If you're looking for a chemical explaination, I don't know, but the virus can work it's way around quite fine using the lymphatic system, so there's no "fitness" reason that would make it need to hang out in the blood.
my longstanding argument against theranos, by the way (like, since 2005), was "look. if i go down to the beach with a bucket and take a bucket of water and put it in my super accurate shark detector van, it doesn't mean the beach is safe to swim at!"
They're highly sensitive to the presence of the target DNA or RNA sequence in the sample well. But they can't easily tell if the target sequence they amplified came from the patient's sample or from other potential sources of contamination in the lab (the test, after all, makes billions of copies of the target DNA sequence), whether from other positive tests or from positive controls.
They typically do one swab of the nasopharynx (upper back of the throat, up above the soft palate). You might have the virus elsewhere but not there.
Saw reports that bronchoalveolar lavage (introducing and then suctioning out fluid from a branch of the lung) is better at picking up virus if it's present -- but it's much more time consuming, more invasive, and much less pleasant for the patient than sticking a swab up your nose. Not something you're going to do in a parking lot in a drive through testing center for someone only showing mild symptoms.
It depends on the time of the illness. Roughly my understanding is: 1st week - high virus load in the nasopharyngeal area. 2nd - almost no virus load in the nasopharyngeal area, high virus load in the lungs
Even a common well established test like a quick strep test has a significant (10% iirc) false negative rate. I'm sure that a rapidly developed test to an emerging target is going to have a significant error rate.
Suppose you get the disease and develop antibodies for it. Your body is pretty darn good at fighting the virus and won't get sick from it easily. But, you're in a place with a huge viral load exposure.
Wouldn't that imply there should be some of the virus in your lungs? Test accuracy aside, is the definition of "positive" even clear?
Favorite line from the article:
"In terms of those who retested positive, the official party line is that they have not been proven to be infectious. That is not the same as saying they are not infectious," one of the Wuhan doctors who tested positive twice told NPR [...] "If they really are not infectious," the doctor said, "then there would be no need to take them back to the hospitals again."
So why are the asymptomatic cases required to quarantine under medical observation for 14 days but not counted?
Sounds like a test from a single Chinese company and the results were closer to 30% accurate:
> The Chinese Embassy in Spain said that the Bioeasy tests were not part of China's medical donations and that the firm didn't have a license to sell its products.
Literally false positive and false negatives. In other words, if you test millions of people, there will be more people tested positive who DON'T have the disease vs. those who test positive and HAVE the disease.
Exactly! For any medical tests, there are 2 measurements: sensitivity and specificity, one to judge false positive and another judge the false negatives.
In the NYT article on Italy today, frontline medics were saying that clinical symptoms were anecdotally more reliable than the tests because there are too many false negatives. Not sure whose tests they're using but I've heard similar things about US PCR tests.
Yep! CT scans and clinician's experience is more reliable than any tests for COVID-19 diagnostics (which should only serving as a definitive confirmation). This also why I believe human doctors are still unbeatable by AI
I think that's missing the point, which is that the only way to get the necessary accuracy is to use multiple independent sources of information. It's not whether clinicians are better than tests or vice versa, but that no single datum is good enough.
No. The point is, COVID-19 testing kit is in extreme short supply everywhere in the world right now given most countries are locked down and the viral outbreak patients are growing at an exponential rate, the next reliable way to diagnose COVID-19 for clinicians without testing kits is to use CT (which gets results fast and inexpensive and the equipment is universally accessible in every hospital) scans and find some patterns, which is exactly what doctors in Wuhan did during the early phase of the outbreak[1].
Of course not! We've got half a million cases now, hundreds of thousands cases in hospitals, and hundreds of papers published in all the medical journals. So yeah, data is rich.
I was mainly referring to CT scan data. A symptomatic check should not require much experience, rather applying the knowledge in form of a simple decision tree.
Regarding CT scans .. machine learning will be so much better than humans in classifying those once enough data is available... it‘s completely out of question for me as an ML researcher.
I remember an article early in the outbreak that Chinese doctors found the most reliable diagnosis comes from CT scans. Test was merely the first filter. They tuned the settings to increase scan speed at the cost of resolution and setup a process to scan up to 200 patients a day per scanner. I wonder if this is still best practice that other countries aren't adopting. On the other hand I expect tests to have improved since the early days. There's also the consideration China simply had more CT scanners that could be mobilized to Wuhan which makes this less practical elsewhere.
My doctor friend who got the minutes of a call with a chinese doctor said they were also swabbing multiple areas of the body for PCR and doing an antibody screen as well (in addition to CT).
If you know the false positive and false negative rates, then you can predict how many in a sample size of millions will end up falsely identified in this way.
What I don't know and what the article doesn't seem to mention is if the false positive rates are known yet and if we have more or less than the expected number of 'reinfected'.
Nothing about Covid19 testing is statistical right now. Why? Because tests are scarce and are used by medical professionals to save lives. There will be time for rigorous statistical analysis after this epidemic is under control.
this kind of lazy thinking is probably no small contributor to the rest of the wider world squandering its 2 month advantage over this virus.
I don't disagree with you that there are many suspicious acts surrounding China and this pandemic, but a blanket statement like that is nevertheless unconstructive.
The Communist Party enjoys the luxury of dissent being a punishable offense. The media, the citizenry, the private sector are all held hostage by the absolute authority of the Party.
I'm not sure why, but the media seems so eager to accept the official CCP narrative and take the lack of clear dissent from within China to mean China should be held up as a model Nation worthy of praise while simultaneously ignoring all the restrictions and brutality that force silent those who otherwise might have much to complain about.
Deference to China by naive journalists and other useful idiots must be checked.
> Please don't use Hacker News for political or ideological battle. That destroys the curiosity this site exists for.
> Eschew flamebait. Don't introduce flamewar topics unless you have something genuinely new to say. Avoid unrelated controversies and generic tangents.
There's CCP spread suggestions that coronavirus originated in the US (and was brought to China by the US army?). I don't think we're accepting all of CCP's narrative, because some of the ideas are quite obviously batshit crazy.
I don't many outside of China accepting everything the CCP is saying about coronavirus.
I do think it's probably worth waiting to evaluate until we have more real, verifiable numbers. Some of what people are saying is likely true. Some of it is likely not.
I don't understand this. I haven't seen "praise"? I have seen realistic assessments of the ultimate effectiveness, but I see this as vastly different from "praise".
I think the majority of people in the US that have observed how they handle it see their approach as overly harsh.
Secondly, Trump would break that news if it were fact. Hiding 10’s of thousands of deaths and 100’s of thousands of very ill is extremely difficult in the modern world when relatives live overseas.
Thirdly, I believe that China can effectively enforce social barriers, restricting the spread of Covid19. It seems reasonable to believe they can control it, even though freer countries struggle.
Of course you can always come up with some conspirational theory, and I keep my eyes open for lies, but common sense says that China is doing OK.
Whoever's downvoting this comment, how do you refute the point that export numbers are hard to fake? It would collusion from all of China and all of the importing countries.
They looked at the numbers, said "Ah, fuck it, this ain't that bad." and resumed production? It's not like the factories are full of 70+ year-old workers.
> how do you refute the point that export numbers are hard to fake?
By the fact that there are already reports of factories throughout the world that kept operating eventhough they were experiencing an outbreak of covid19 within their staff.
And let's be honest: no one places China in the top spots in rankings on safe working conditions and human rights.
Which is why I wrote: Secondly, Trump would break that news if it were fact. Hiding 10’s of thousands of deaths and 100’s of thousands of very ill is extremely difficult in the modern world when relatives live overseas.
> Thirdly, I believe that China can effectively enforce social barriers, restricting the spread of Covid19. It seems reasonable to believe they can control it, even though freer countries struggle.
This part is huge. When apartment complexes are already surrounded by walls with a couple gates, it's easier to control flow of people in and out. The infrastructure already in place (yes I know, hardy har har, chinese building walls, ok) actually helps a lot.
We've got family back on mainland who can't get in and out of their apartment complex without getting their temperature taken (both directions) and playing 20 questions with the guards about where they're going.
It's kind of how alarming raising Sinophobia and Chinese skepticism since the tradewar has made people unable to process reality when it comes to China. Millions of accessible posts on Chinese social media showing the conditions of lockdown from Wuhan to other cities. Thousands of expats stuck in China confirming the ground truth. Media reposted on twitter and youtube etc. But everything either gets downvoted out of view or dismissed as propaganda to the detriment of their own response. If everyone saw the measures being taken in China to contain COVID, then maybe they wouldn't have reacted so poorly.
b) liars are caught and Trump didn't caught the Chinese regime lying,
c) The Chinese regime enforced quarantined effectively.
From these points, only the third has any relation with and impact in the outbreak of covid19 within China.
However, as the virus is reported to have an asymptomatic incubation period that can be as long as 2 to 3 weeks, and as there are reports from within China that show that covid19 can be transmitted at over 4 meters, then, as we have seen in Italy and Spain, the impact of this measure would only start to show with that much of a lag.
I admit I am not an epidemiologist, but claiming that an epidemic was just stopped on it's tracks almost instantly has little to no credibility. For that to be even remotely realistic, there needed to be zero asymptomatic carriers from one day to another.
To add insult to injury, the Chinese government reported that the only new covid19 cases experienced within China came from foreigners who imported the disease.
I'm sure the measures imposed by the Chinese regime has a profound impact on the epidemic, but none of the official reports appear to have any credibility whatsoever. A disease with a 1 to 3 week incubation period does not stop spreading or killing people from one day to the other. What does stop immediately is how you chose to report the data, specially counting the dead.
its not the direct praise. its more like newspapers compare x-country to Chinas "80 000" infections and few thousands death. its false basis. there could 500 000 deaths for all we know in china. They wont tell the truth and should therefore be rejected from any statistics
I think it's been interesting wave. When the cases first started, China got blasted. As it hit the US, Administration political opponents have criticized the US response, but many have gone to the point of praising China's response and forgetting about China's actions in December/January.
If China did in fact ship emergency medical supplies to Italy, that's a gesture worth recognizing and praising. "Carrying water" is a weird way of characterizing that recognition.
China also deserves criticism; its initial response was dysfunctional in some ways (albeit somewhat different ways than the United States dysfunctional response). Fortunately, as you say, it's been blasted in some discussion.
But recognition of ways in which its response has been respectable is less the mark of someone "carrying water" and more part of the process of learning things and having our political institutions learn things.
That tweet was referring to shipments from China to Italy, many of which were paid for and orders. Some were donated, but the articles present it as a grand gesture instead of Italy attempting to provision their own supplies on the market.
It’s a sad mix of propaganda and temporary faith in a shaky globally supply chain.
That's beyond recognition in that article. They're calling Beijing a "global leader." A response of purposeful coverup and suppressing dissenters is in no way showing leadership.
I've never seen the mainstream media question the veracity of the statistics about Covid that came out of China until the evidence is too obvious to ignore. There is plenty of proof that they regularly manipulate their statistics such as GDP.
Why should any respectable journalist quote their statistics about COVID and conclude how effective their response was without mentioning that they've been known to fabricate statistics? Let alone calling them a 'Global Leader' in response. I've not seen this qualification mentioned once with respect to China's stats on this virus.
Side note, they absolutely manipulate their financial numbers. "No one believes China's numbers," my financial broker uncle in Hong Kong once said.
No one really cared that much because manipulation, risk, and uncertainty is baked into financial equations no matter what the country or government. Now that we're talking about lives, it's harder to dismiss.
I don't see it frequently in writing, but the majority of TV and podcast reporting from news sites has the disclaimer. And there's enough China bad articles out there that I feel like this is implicitly assumed.
Either way, no one trusts Chinese stats, including the Chinese public themselves, and the Chinese government most of all. The ability to collect accurate statistics when there's so many different development levels country-wide simply isn't there. For example, China doesn't use GDP internally, they use LKI, LiKeQiang Index which aggregates a value from measurable indicators like freight cargo volume, electric consumption, bank loans. There's also TSF, Total Social Financing. They can still be gamed, but physically (running empty trains), but much harder to fake via submitting fake excel sheets to central government. Chinese GDP is basically a back of the napkin estimate to appease foreign investors, it's also used to set growth targets instead of reflecting it. Most of the mainstream western reporting on Chinese GDP does not understand this. It's well understood among China watchers. The most comprehensive study on Chinese GDP so far, by CSIS, suggested China was under reporting their GDP.
As for stacked urns in Wuhan, the city is still under quarantine so urns would not be picked up. Also necessary to account for other sources of death. The article quotes 56K cremations in Q4 2019, so a few thousands urns especially as restock doesn't seem atypical. Like LKI, it's an useful oblique indicator, but should be considered in other context. If there's mass death, enough to measurably affect hysterical people in quarantine, it would be on Chinese social media which would leak to China watchers. There's many expats and Chinese people with VPNs, things that affect the public on a mass scale inevitably leaps over the firewall, it's not opaque like politburo politics. People need to stop looking at Chinese numbers and instead extrapolate from oblique indicators. When expats in China talk about things returning to normal, when Chinese diaspora aren't mourning about sick or dead family members en-mass, then you can assume that reflects ground reality.
I don't read that tweet as praise for China at all, and I'm curious why you do. It seems pretty obviously a dig against the US administration that, when Italy needed help, we refused to provide it while China stepped up. It's an expression of shame at our national impotence.
Now, I suspect you wouldn't agree with that perspective either. But it's definitely not praise for China.
As far as the article to which it links... that's all factual stuff. The PRC absolutely has exported a ton of PPE equipment and assigned a bunch of well-documented medical personnel to hot regions. That's good, as far as it goes. It doesn't say anything about what they're doing inside the PRC, but it absolutely is helpful that they're doing it externally.
Not in the context presented, no. The article isn't talking about their "initial actions", it's talking about their international assistance work. China is absolutely a global leader in providing humanitarian assistance to other nations struct by COVID-19. In fact they're pretty much the only nation doing anything like this, at all.
And historically, that was always one of the core roles played by America. So in perspective it's sort of notable, no?
You're contracting yourself and just being argumentative. The whole context is their international assistance work, and there is nothing but praise in that article. Meanwhile the article just brushes aside their initial deceit which greatly magnified the problem.
Are you saying that merely reporting on the fact that China is providing international assistance is... praise?
I genuinely thought you were talking about the tweet about the article being the praise. The article was just facts. Facts, to borrow a phrase, don't care about your feelings.
The journalists here haven't mentioned what kinds of tests each the 4 unnamed sources – 2 doctors, 2 citizens – had at each stage of their 'positive then negative then positive again' journey. They haven't mentioned if any of the individual tests were followed-up with multiple confirmatory tests of alternate methods.
To the extent they mention test types at all, it is quotes from "February" or "a professor... by email" – nothing about these persons' tests.
Yet, the tests in use have some level of false-positive and false-negative. Some variants have had quite high error rates – which may still be acceptable for mass-screening, but not for understanding the course of a single person's infection status.
So, among many millions of people tested in China, a handful have had alternating results not correlated with their symptoms? Not a surprise, even with tiny test error rates, unless each contributing result to the "+/-/+" pattern was reconfirmed by multiple-tests/multiple-methods.
(Note this also suggests many accounts of 'asymptomatic cases' may just be false-positives who never had Covid-19.)
False Positives. This would be the first time in history that a sizeable number of those "cured" of a virus where actually shedding live virus ? Depending on the type of test, it can read antibodies to the virus from those "cured", which gives a false positive.
This is entirely expected. Ex-positives develop antibodies, so that they are immune against further infections. Since the virus is so infectious it can easily lead to further infections, but the antibodies can contain it. Same happens with flu vaccination. The new PCR tests are so overly precise, that they can measure the new losing virus cells.
Big question is if the re-positives are infectious again. Doesn't seem to be plausible, but could be. It's a new virus with a different, stronger header.
The “stacks of urns” can almost be answered by the quote from the article: “There were 56,007 cremations in Wuhan in the fourth quarter of 2019”. (Edit: I shortened quote).
After a month of lockdown, the number of backlogged urns should be over 18000.
(More than) two months of lockdown, not one. So ~38000 cremations “normally”. Spread out to eight funeral homes, you’d expect 4k-5k at each location. (Since people were allegedly locked into apartments or at least apartment complexes, apparently they weren’t picking up ashes until now.) So “thousands” at each location tells us precious nothing.
Article is intentionally misleading, burying the “normal” stats that way.
Note: Bloomberg lowered number from 56,007 to 13,856 — see note at bottom “(Corrects characterization of 2018 and 2019 cremations data in story published March 27.)”
The reasons seem obvious. It's this the third pandemic for them in the past 10 years. SARS, Bird flu, Corvid-19 this is not a good trend if people start to notice
It's not a mystery. China is for sure not telling the truth. Remember this is a country with massive censorship issues and have even kicked out foreign reporters.
I'd like to know what the downvotes are? Because everything here is factually true.
Every test in the real world shows false positives and false negatives. I would expect that doing multiple tests on a massive number of people could show such results.
You've locked healthy people inside with sick people during the quarantine. Wouldn't that cause some reinfections? After your immune system got beat down the first time.
Catching a virus normally provides you immunity for some time frame from three months up to years or forever. We aren't expecting reinfection (yet) because we're expecting immunity, but might be wrong.
My key takeaway after reading this article is that I cannot blindly trust China's official figures.
NPR reports that "under its newest COVID-19 prevention guidelines, China does not include in its overall daily count for total and for new cases those who retest positive after being released from medical care. China also does not include asymptomatic cases in case counts" (emphasis mine).
One of the Wuhan doctors interviewed for this article told NPR that "I have no idea why the authorities choose not to count asymptomatic cases in the official case count. I am baffled."
All doctors and individuals in China who were interviewed for the article "requested anonymity when speaking with NPR because those who have challenged the government's handling of the outbreak have been detained."
122 comments
[ 3.6 ms ] story [ 174 ms ] thread- I think we need to know a LOT more about the sensitivity, specificity, and accuracy of every test that's being deployed right now. I am 100% willing to believe that "testing negative and then positive" means "you have a pretty low viral load and our tests suck more than we're willing to admit out loud right now".
- I think we need to be very clear that there are two kinds of tests: "you have an active SARS-CoV-2 infection right now, and also "you have once had a SARS-CoV-2 infection in the semi-recent past". One tells you who needs care, one tells you who is at least temporarily immune we hope.
That is, the patients were observed clinically to have caught and recovered from the virus, yet the test shows no trace of the viral infection.
Both are possible and either mess it all up.
(Edit) added in general above due to valid points in the comments below
- you do them right
- your reagents are good
- the kit was assembled properly
- there's no contamination in the machines
- you got a good sample
- ...
The capability for a highly sensitive and accurate test in no way guarantees that a randomly sampled administration of that test is going to meet the high standard that the test may be capable of.
In 205 patients with proven COVID-19 [...] bronchoalveolar lavage fluid was positive in 14/15 (93%), sputum 75/104 (72%), nasal swabs 5/8 (63%), brush biopsy 6/13 (46%), pharyngeal swabs 126/398 (32%), feces 44/153 (29%), blood 3/307 (1%), and urine 0/72 (0%).
https://www.jwatch.org/na51116/2020/03/17/pharyngeal-and-nas...
> blood 3/307 (1%)
Why isn't their blood rotten with virus?
(Why are rodents more prevalent in the walls/crawlspaces of a dwelling, rather than the hallways?)
So it's spreading mucosally or through connective tissue?
To the extent an infected cell releases its "baby coronaviruses" into the blood stream, they find a hot, chemically active environment – which is already inhospitable to their continued survival – plus a relative dearth of the respiratory cell-walls they're optimized to enter, plus a growing number of hostile antibodies.
(I don't know if a coronavirus-hijacked cell can direct its fresh viruses one way or the other, but it'd probably prefer to do that if it could, and I can understand why viruses wouldn't persist long in blood compared to respiratory-membranes.)
The coronaviruses are definitely active in mucosal surfaces, and carried by mucus. I haven't seen anything about, nor do I think any activity is necessarily implied, in other connective tissues.
Research has shown (1) the distribution of ACE2 protein, the functional receptor for SARS-Cov and SARS-Cov-2 (2), to include various human organs (oral and nasal mucosa, nasopharynx, lung, stomach, small intestine, colon, skin, lymph nodes, thymus, bone marrow, spleen, liver, kidney, and brain) along with arterial and venous endothelial cells and arterial smooth muscle cells in all organs studied. And ACE2 mRNA has been found in virtually all organs. So there is definitely the potential for cells in the circulatory system binding viruses.
What may be significant here is the concentration of ACE2 protein in cell membranes. One Chinese analysis of a group of 170 Covid-19 fatalities(3) found half of the cases suffered from hypertension. ACE inhibitors are a class of medication prescribed for lowering blood pressure and according to models they increase the concentration of ACE2 protein in lower respiratory tract cells. Given that fatality results from respiratory distress originating in the lower respiratory tract and that not all cases progress to the lower respiratory tract it seems possible that the spread of the virus within the body may be related to concentration of ACE2 protein in cells. The disease progression would also support mucosal transport of the virus within individuals the same as between them.
(1) Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis. https://www.ncbi.nlm.nih.gov/pubmed/15141377 (2) Structure, Function, and Antigenicity of the SARS-CoV-2 Spike Glycoprotein https://www.sciencedirect.com/science/article/pii/S009286742... (3) Controversial Study Links COVID-19 Severity to ACEIs and ARBs (Newsweek, March 24, 2020)
https://www.aim-med.org/hiv-rna-test/
Saw reports that bronchoalveolar lavage (introducing and then suctioning out fluid from a branch of the lung) is better at picking up virus if it's present -- but it's much more time consuming, more invasive, and much less pleasant for the patient than sticking a swab up your nose. Not something you're going to do in a parking lot in a drive through testing center for someone only showing mild symptoms.
There are always compromises.
Wouldn't that imply there should be some of the virus in your lungs? Test accuracy aside, is the definition of "positive" even clear?
So why are the asymptomatic cases required to quarantine under medical observation for 14 days but not counted?
Probably the same reason for mandatory 14 day quarantine for inbound travelers, China has the capacity to ere on the side of caution and enforce it.
I think DNA and RNA research is severely lacking in most countries. In a few years we will look at this year as 1960ies of computer engineering.
Edit: source https://www.irozhlas.cz/zpravy-domov/ostrava-rychlotesty-kor...
> The Chinese Embassy in Spain said that the Bioeasy tests were not part of China's medical donations and that the firm didn't have a license to sell its products.
https://en.wikipedia.org/wiki/Sensitivity_and_specificity
https://www.nytimes.com/interactive/2020/03/27/world/europe/...
[1]: https://www.ncbi.nlm.nih.gov/pubmed/32134681
Because you hypothesize that they can rapidly learn new, not very distinctive patterns without much data?
Of course not! We've got half a million cases now, hundreds of thousands cases in hospitals, and hundreds of papers published in all the medical journals. So yeah, data is rich.
Regarding CT scans .. machine learning will be so much better than humans in classifying those once enough data is available... it‘s completely out of question for me as an ML researcher.
What I don't know and what the article doesn't seem to mention is if the false positive rates are known yet and if we have more or less than the expected number of 'reinfected'.
I don't disagree with you that there are many suspicious acts surrounding China and this pandemic, but a blanket statement like that is nevertheless unconstructive.
Let me be very concise with this next statement: WAKE THE FUCK UP.
The entire world economy is fucked right now because the Chinese lied their little asses off to save face.
We need to be more hesitant to praise their pandemic response
I'm not sure why, but the media seems so eager to accept the official CCP narrative and take the lack of clear dissent from within China to mean China should be held up as a model Nation worthy of praise while simultaneously ignoring all the restrictions and brutality that force silent those who otherwise might have much to complain about.
Deference to China by naive journalists and other useful idiots must be checked.
> Eschew flamebait. Don't introduce flamewar topics unless you have something genuinely new to say. Avoid unrelated controversies and generic tangents.
I don't many outside of China accepting everything the CCP is saying about coronavirus.
I do think it's probably worth waiting to evaluate until we have more real, verifiable numbers. Some of what people are saying is likely true. Some of it is likely not.
I think the majority of people in the US that have observed how they handle it see their approach as overly harsh.
I'm afraid we only see the chinese government's report and data on how the epidemic is spreading within China.
Firstly, exports are hard to lie about. Order something from alibaba yourself, or here’s some graphs: https://www.plex.com/blogs/china-potential-model-for-post-co...
Secondly, Trump would break that news if it were fact. Hiding 10’s of thousands of deaths and 100’s of thousands of very ill is extremely difficult in the modern world when relatives live overseas.
Thirdly, I believe that China can effectively enforce social barriers, restricting the spread of Covid19. It seems reasonable to believe they can control it, even though freer countries struggle.
Of course you can always come up with some conspirational theory, and I keep my eyes open for lies, but common sense says that China is doing OK.
By the fact that there are already reports of factories throughout the world that kept operating eventhough they were experiencing an outbreak of covid19 within their staff.
And let's be honest: no one places China in the top spots in rankings on safe working conditions and human rights.
Which is why I wrote: Secondly, Trump would break that news if it were fact. Hiding 10’s of thousands of deaths and 100’s of thousands of very ill is extremely difficult in the modern world when relatives live overseas.
This part is huge. When apartment complexes are already surrounded by walls with a couple gates, it's easier to control flow of people in and out. The infrastructure already in place (yes I know, hardy har har, chinese building walls, ok) actually helps a lot.
We've got family back on mainland who can't get in and out of their apartment complex without getting their temperature taken (both directions) and playing 20 questions with the guards about where they're going.
a) China keeps on exporting,
b) liars are caught and Trump didn't caught the Chinese regime lying,
c) The Chinese regime enforced quarantined effectively.
From these points, only the third has any relation with and impact in the outbreak of covid19 within China.
However, as the virus is reported to have an asymptomatic incubation period that can be as long as 2 to 3 weeks, and as there are reports from within China that show that covid19 can be transmitted at over 4 meters, then, as we have seen in Italy and Spain, the impact of this measure would only start to show with that much of a lag.
I admit I am not an epidemiologist, but claiming that an epidemic was just stopped on it's tracks almost instantly has little to no credibility. For that to be even remotely realistic, there needed to be zero asymptomatic carriers from one day to another.
To add insult to injury, the Chinese government reported that the only new covid19 cases experienced within China came from foreigners who imported the disease.
I'm sure the measures imposed by the Chinese regime has a profound impact on the epidemic, but none of the official reports appear to have any credibility whatsoever. A disease with a 1 to 3 week incubation period does not stop spreading or killing people from one day to the other. What does stop immediately is how you chose to report the data, specially counting the dead.
https://twitter.com/KenDilanianNBC/status/124324375891486310...
I think it's been interesting wave. When the cases first started, China got blasted. As it hit the US, Administration political opponents have criticized the US response, but many have gone to the point of praising China's response and forgetting about China's actions in December/January.
China also deserves criticism; its initial response was dysfunctional in some ways (albeit somewhat different ways than the United States dysfunctional response). Fortunately, as you say, it's been blasted in some discussion.
But recognition of ways in which its response has been respectable is less the mark of someone "carrying water" and more part of the process of learning things and having our political institutions learn things.
It’s a sad mix of propaganda and temporary faith in a shaky globally supply chain.
https://www.bloomberg.com/news/articles/2019-03-08/china-s-g...
https://time.com/5811222/wuhan-coronavirus-death-toll/
etc
Why should any respectable journalist quote their statistics about COVID and conclude how effective their response was without mentioning that they've been known to fabricate statistics? Let alone calling them a 'Global Leader' in response. I've not seen this qualification mentioned once with respect to China's stats on this virus.
No one really cared that much because manipulation, risk, and uncertainty is baked into financial equations no matter what the country or government. Now that we're talking about lives, it's harder to dismiss.
I don't see it frequently in writing, but the majority of TV and podcast reporting from news sites has the disclaimer. And there's enough China bad articles out there that I feel like this is implicitly assumed.
Either way, no one trusts Chinese stats, including the Chinese public themselves, and the Chinese government most of all. The ability to collect accurate statistics when there's so many different development levels country-wide simply isn't there. For example, China doesn't use GDP internally, they use LKI, LiKeQiang Index which aggregates a value from measurable indicators like freight cargo volume, electric consumption, bank loans. There's also TSF, Total Social Financing. They can still be gamed, but physically (running empty trains), but much harder to fake via submitting fake excel sheets to central government. Chinese GDP is basically a back of the napkin estimate to appease foreign investors, it's also used to set growth targets instead of reflecting it. Most of the mainstream western reporting on Chinese GDP does not understand this. It's well understood among China watchers. The most comprehensive study on Chinese GDP so far, by CSIS, suggested China was under reporting their GDP.
As for stacked urns in Wuhan, the city is still under quarantine so urns would not be picked up. Also necessary to account for other sources of death. The article quotes 56K cremations in Q4 2019, so a few thousands urns especially as restock doesn't seem atypical. Like LKI, it's an useful oblique indicator, but should be considered in other context. If there's mass death, enough to measurably affect hysterical people in quarantine, it would be on Chinese social media which would leak to China watchers. There's many expats and Chinese people with VPNs, things that affect the public on a mass scale inevitably leaps over the firewall, it's not opaque like politburo politics. People need to stop looking at Chinese numbers and instead extrapolate from oblique indicators. When expats in China talk about things returning to normal, when Chinese diaspora aren't mourning about sick or dead family members en-mass, then you can assume that reflects ground reality.
Fully agreed on that particular point, that is commendable
Now, I suspect you wouldn't agree with that perspective either. But it's definitely not praise for China.
As far as the article to which it links... that's all factual stuff. The PRC absolutely has exported a ton of PPE equipment and assigned a bunch of well-documented medical personnel to hot regions. That's good, as far as it goes. It doesn't say anything about what they're doing inside the PRC, but it absolutely is helpful that they're doing it externally.
And historically, that was always one of the core roles played by America. So in perspective it's sort of notable, no?
You're contracting yourself and just being argumentative. The whole context is their international assistance work, and there is nothing but praise in that article. Meanwhile the article just brushes aside their initial deceit which greatly magnified the problem.
I genuinely thought you were talking about the tweet about the article being the praise. The article was just facts. Facts, to borrow a phrase, don't care about your feelings.
To the extent they mention test types at all, it is quotes from "February" or "a professor... by email" – nothing about these persons' tests.
Yet, the tests in use have some level of false-positive and false-negative. Some variants have had quite high error rates – which may still be acceptable for mass-screening, but not for understanding the course of a single person's infection status.
So, among many millions of people tested in China, a handful have had alternating results not correlated with their symptoms? Not a surprise, even with tiny test error rates, unless each contributing result to the "+/-/+" pattern was reconfirmed by multiple-tests/multiple-methods.
(Note this also suggests many accounts of 'asymptomatic cases' may just be false-positives who never had Covid-19.)
More importantly, it would seem that premature lifting of restrictions is done at our peril.
re-positive report: http://www.bjnews.com.cn/feature/2020/03/05/699575.html (2020/03/05)
expert stance: http://www.bjnews.com.cn/news/2020/03/12/702870.html (2020/03/12)
it's about lives and I don't think anyone believe in govt. lightly. so do you.
Big question is if the re-positives are infectious again. Doesn't seem to be plausible, but could be. It's a new virus with a different, stronger header.
https://www.bloomberg.com/news/articles/2020-03-27/stacks-of...
China is likely hiding the real numbers for unknown reasons
After a month of lockdown, the number of backlogged urns should be over 18000.
Article is intentionally misleading, burying the “normal” stats that way.
Original here: https://archive.md/g1BDx#selection-2503.0-2507.171
I'd like to know what the downvotes are? Because everything here is factually true.
NPR reports that "under its newest COVID-19 prevention guidelines, China does not include in its overall daily count for total and for new cases those who retest positive after being released from medical care. China also does not include asymptomatic cases in case counts" (emphasis mine).
One of the Wuhan doctors interviewed for this article told NPR that "I have no idea why the authorities choose not to count asymptomatic cases in the official case count. I am baffled."
All doctors and individuals in China who were interviewed for the article "requested anonymity when speaking with NPR because those who have challenged the government's handling of the outbreak have been detained."
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See also: https://www.theguardian.com/film/2020/mar/27/china-re-closes...
I think it's just false negatives.