What is the expectation people will actually get the swab far enough back to collect a meaningful sample? Having been on the receiving end of a nasal collected flu test, it was a pretty deep probing. I’m kind of doubtful most people can do it to themself properly without some prompting to ‘go deeper’.
There's evidence that for Covid-19 it's not necessary to go as far back as people have been going. There's also evidence that self-collection works well. The FDA has acknowledged this before and allowed self-collection with physician oversight before they allowed this test.
Where is this evidence? How does this square with the evidence that RT-PCR tests are already coming back falsely negative, probably due to missing the virus while swabbing? Pardon me for being skeptical, but this is all from the same people who have bungled this every step of the way.
I'm having trouble finding the actual study, but UnitedHealth Group, working with the Bill & Melinda Gates Foundation, Quest Diagnostics, and the University of Washington did a study on the efficacy of self-swabbing.
I found the paper. I haven't read through it so I can't say if it is actually any good, but it is good enough that the FDA changed their recommendations because of it (that might not mean much, of course).
Thanks for tracking it down. Doesn't seem to be any problem with accepting their results that it's almost as good as a nasopharyngeal swab, so you won't see me complaining about it again.
Prompting to 'go deeper' could potentially be done over a video call. I hope LabCorp does some sort of beta testing to know how well people do with instructions.
Put a mark on the swab, put a rubber band around the mark on the swab and say it has to go back that far. Have a test for adults and another for children.
But, the video from the actual labcorp website someone else posted shows it does not actually have to go very deep.
It was my understanding, that its easy to get false negatives with this kind of test because the virus moves down the respiratory track as time goes on. Too early, its not sensitive enough. Too late, nothing there. It has to be in a specific window of opportunity. Can somebody jump in and correct me if I am wrong?
It is now thought that the virus can also infect cells in the nose. Cough and nasal discharge could also bring virus from deeper parts of the body to the nasal passage.
It does move down the respiratory tract, but nasal epithelial tissue can still contain/produce the virus for awhile even after it "moves". For me, I was able to physically feel the inflammation move down from my throat to lungs to abdomen, but that was 5 weeks ago, and I just tested positive on a deep nose swab rtPCR given yesterday. A lot of people are testing positive for surprisingly long time.
I wouldn't be surprised if a light nasal swab like being discussed here doesn't pick up anything post-symptoms, whereas PCR with the deep nasal swab may still be detectable for a longer time after primary symptoms have faded.
I think they're just assuming you will pay 119USD (Plus tax and shipping) for a box because coronavirus. What you do with it after your transaction clears really isn't their concern...
As a childhood sufferer of semi-regular strep throat infections, I have a hard time believing people are going to willingly jam the swab back to where it needs to go. To me, it seems like this will just generate false negatives.
I'm sure it will come, but it looks like the FDA is waiting until the big companies ask for an EUA because they don't trust the startups (or the startups aren't able to do what LabCorp does?)
That seems very odd considering the SFGate article was published yesterday, and I presume they asked the lab how much it costs. I sent the lab an email to clarify. Let's see what they send back.
While this is walk in, the actual test likely requires an NPI number. There's likely a physician (or mid-level that can prescribe - don't know CA law) that's pretty much there to "check the boxes".
We are working on this. I can’t share more here but if you are interested and want to help, let me know how at zen[at]rapidcov[dot]com (dev, design, marketing, medical, partnerships, etc). We have our core team in place but we are planning to be bring on more people in the next few weeks.
What would make you different from the many many EUA antibody tests already on the market? How are you going to get yours approved for OTC at-home use?
Originally, we tried to bring the existing antibody tests that can only be sold to medical practitioners. During that process, we engaged in conversations with the FDA to get approval and we asked them what their concerns are with at-home antibody test kits. Once they explained us, we went back to the drawing board and worked on a solution that would allow us to mitigate the FDA’s concerns.
We then proceeded to present our solution to the FDA. They were positive so we filed for our pre-EUA and now we are working with an FDA reviewer.
I’m not going to pretend that our solution will end being approved. I have no idea since none of us (the three founders) have medical device experience. Nonetheless, we are willing to take a huge risk in terms of money and time, and at least know at the end that we gave it our best shot.
Thanks for taking risks to try and make a difference. I hope you are successful! These tests are pretty simple to administer so there really should be an at-home version.
This is really the direction we need to go. If there was a cheap and quick test, you could monitor your population over time. Relax restrictions with testing prior to restarting activities.
It would go a long way in managing the epidemic while reducing the impact on the economy.
It's no more risky than anything else an already infected person may ship, which is why the parcel delivery companies likely already have sufficient mitigation efforts in place.
$119 [0], since it's not mentioned in the article.
Also, not yet available to the masses:
> With limited quantities of kits available, Pixel by LabCorp is currently prioritizing healthcare workers and first responders, consistent with guidance from the CDC. We plan to make kits more broadly available soon so please check back.
Maybe, maybe not. Their other tests have almost no demand right now due to coronavirus. How much of a killing they make will depend on which tests have better margins.
I believe LabCorp's Men's Health Test is relatively popular amongst guys looking to check their testosterone levels. The results can be taken to a "men's health physician", or a "bio-identical hormone physician", or whatever else they are called and used to justify legal hormone therapies (typically testosterone injections and/or estrogen-blockers). Common for bodybuilders, or even just dudes closing in on 60 who want to stay good at golf.
Likely not "at cost", since a for-profit company should be expected to be making a profit, but probably close, considering the herculean effort to get these things to market, despite the red tape.
Lab techs will spend at maximum a couple minutes on each test, if they are manually preparing and pipetting samples, as the majority of the test is automated on a PCR thermocycler. At $30/hr that's $1/test in labor at most.
Edit: This isn't a total cost analysis, just labor like the person asked.
This price includes Fedex shipping both ways, mail handling and controls (which are CRITICAL for this type of testing), R&D, validation, hoopjumping for the FDA and much more (buildings, accounting, payroll, HR, PR, attrys).
This is a very low price. Plenty of business would be $150/test TODAY to test huge numbers of employees, and $250/test TODAY to test employees they were worried might be sick. Someone comes in with a fever, have them do this fedex test, 3-4 days later they could be a back at work if negative.
Don't forget capital costs. The machines they run the test on aren't cheap and you have to amortize the cost of the machine over the number of tests you can run.
I imagine with breaks, lack of 100% focus and efficiency, and employment benefits it's probably $2-$3 in labor costs per test if you're right on the time required and average salary. So, I think possibly multiples of what you quoted, but still so low that it's not likely to affect the cost much.
Then again, with the people to move the samples around (process and sort mail), clean/sterilize testing materials after testing, and manage the people that perform the tests, and do quality testing, you might see another $1-$2 per test in labor costs. So maybe $5 in labor all said?
My bet is that the most expensive part of the process is the machines to do the tests, which likely cost multiples of a lab tech's salary (but maybe can do multiple tests at once? I dunno).
A sibling comment upthread noted that Maryland got 500k tests for $18 each, which sounds like it's probably close to cost, if it's the same test. That number of tests would be about full time work for 400 lab technicians for 5 days if they averaged just under two minutes a test.
Sure, for a routine clinical lab at your local hospital, but Labcorp is one of the largest ancillary lab networks in the world. I would be surprised if they haven't automated or processed out most of the manual labor for sample to diagnostic test.
For the extra labor I was referring to people actually receiving the mail, opening it and getting the samples into whatever tracking they have. My guess is that there's still real people doing that step, since a machine that can do that reliably and not screw up and/or contaminate systems with the weirdness they get in the mail is probably on the order of a machine that can accurate pick items out of bind in Amazon warehouses (or harder), and Amazon has thrown a lot of money at that just to find it's a lot harder than it seems. Even if it's just people receiving the mail and throwing it into a bin that's delivered to a specific lab tech, that still takes people.
The other labor was really just going by your own numbers.
Beyond that, there's still the layers of management above, that while there are physically less of them likely, their pay scales higher as well.
Genuine question: a lab tech in the US handling contegious virus samples for analysis costs only 30 bucks an hour? whats the salary of such a lab tech?
By the time it gets to the lab tech, it's unlikely that the virus would be as viable as it is when exiting the host. This would be especially true if the swab is put into some sort of preservation liquid (I don't know for this test, but often the nasopharyngeal swabs are put in such a fluid). Remember you don't care about the virus, you only care about its genome.
Even if the virus is viable, it's no longer airborne. You'd have to touch the swab and bring it to your face. Most of these labs handle things like HIV, so lab procedures and training guard against this sort of behavior. I wouldn't be surprised if they worked with shields as well.
In short, maybe they should be paid more, but it's not the danger factor that should govern in this particular case.
Typically lab techs are $25-$30/hr, and I doubt they get hazard pay for covid since they're handling contagious disease cultures on the regular. PPE is normally at a high standard for them.
Note that most of the initial tests required a nasopharyngeal swab which has to go back into your nose several inches. I'm not surprised that the FDA doubts that people would be able to do that reliably on their own given that even trained people seem to get it wrong a lot (1).
The LabCorp test uses a swab that doesn't go anywhere near as deep (2). For a test kit to be widely distributed, you need to have it be drop dead simple to run perfectly.
Given all this, I'm not sure we should jump to corruption as the reason this is the first at-home test.
I spent hours on the phone today with labcorp trying to acquire these for our healthcare center staff. Not a single employee knew how to sell them, or that they were even something labcorp offered.
> Pixel by LabCorp™ is not available in NY, NJ, MD, or RI due to restrictions on how laboratory tests may be ordered. Please talk with your healthcare provider about options for getting tested.
Ah wonderful, so this rules out states accounting for 45% of the confirmed cases.
I remember when they banned 23andme in MD, I researched it and it turns out the health insurance companies successfully lobbied against it with the argument that information asymmetry may lead to loss of profits.
I'm still salty and I think this is part of the same scenario.
Having said that, I think Governor Hogan is one of the best governors out there wrt state level response to Covid. Right up there with Newsom and Cuomo.
Cuomo cut Medicaid funding by $6 billion during the pandemic. He dragged his feet on issuing a stay-at-home order for a week after the city government had asked for one (the governor has the sole authority to authorize one in NY). San Francisco beat Cuomo to the punch by nearly a week, even though New York had been hit earlier and harder with COVID-19 cases. Cuomo also fought against closing NYC schools even after the city and teachers were already on board with the idea. As a result of New York's sluggish response, community spread of COVID-19 happened much more rapidly than it did in other urbanized areas of the country (most notably San Francisco), so hospitals were already overloaded even before the stay-at-home order had been issued. On top of that, Cuomo also expanded pretrial detention for nonviolent drug offenders during the pandemic, which puts even more people in unnecessary close contact. https://nymag.com/intelligencer/2020/04/cuomo-has-learned-no...
As of today, 1 in 1000 New Yorkers who were alive a month ago are now dead. Cuomo might not be the only person responsible for the current situation in New York, but it's clear that things would be better in New York had Cuomo taken action instead of fighting public health officials at every turn.
No, they're worried that patients might find out that they have a genetic disposition to disease X, and increase their level of coverage so that when that disease does come along, the insurance company has to shell out for its treatment.
I think there’s another part in that they hope to know more about your health than you do. In fact it seems like the entire private healthcare system is designed to have more information on patients, caregivers, pharmacists and so on than the patients know about themselves. All of this is so they can write policies that make them the most money for the company while shortchanging your health outcomes and your health care providers. Why else would cost of hypothetical future potentially-avoidable preventive care be a worry to a health insurance company? One would think that such predictable expenses are one of the only sure things in the health care system.
They know what most people implicitly know but effectively deny indirectly via ignorant inaction: what you don’t know, can hurt you. The insurance companies also know this.
I think a reasonable calibration would be charity=good, usual behavior=usual, and active malice=bad. Having a return around the cost of capital is usual behavior, so I think complaining about a company profiting off a disaster by selling the product that they usually make is kind of like complaining about a person not giving to a food bank.
Because of the way our system works, you and I will pay that 10% in the form of taxes and insurance premiums. I for one, am glad to reward companies who are contributing to the solution for this crisis. Profit is the reward we give to companies for good behavior, and wouldn't you agree that companies who are making tests are behaving well?
No, I do not agree that profit is the reward for good behavior, nor that companies attempting to profit off making the tests are behaving well. In fact, profit is often the reward for some very, very harmful behavior. I would say it is at least borderline sociopathic to conflate the profit motive with the desire to do good. Your premise is, again, flawed.
I would be glad to pay for the tests through my taxes if it means people can get them now, for free.
The problem isn't the profit, it's the kinds of behaviours to which profit is allocated.
If profit really was a reward for good behaviour, no one would have a problem with it. (Except bad actors.)
In this situation, the goal is to get as many high quality tests out as possible.
If this is truly a reliable and useful test and results are available quickly, then the ideal level of profit is one that maximises that result - i.e. a small profit on each kit to encourage volume sales.
If the tests aren't reliable enough to be clinically useful and they're being sold to the public without a context (i.e. no information about what the result means in terms of changed behaviour or risk) then the kits should be banned for wasting everyone's time and money.
If you want to split hairs, I don’t have a problem with LabCorp profiting per se from the test. I have a problem with the cost being a barrier to people getting it. If the government were to pay them cost + a small profit to offer it free at the point of delivery, I would have no issue.
I have a philosophical problem with profit being the only motivation for producing the test, but that takes a backseat to practicality here.
How do you stay in business long enough to be able to save future lives if you don't any money to do so in the first place.
Should only billionaires and elite have their drugs?
What your proposing isn't actually how the world works. Why don't you go out of your way to go get the same degree as them and make sure you make the bare minimum. Want to spend money on that new machine? Can't, you're only able to charge the cost it took to make the drug, and that new machine wasn't used so it's not in the price...
Profits are about growing and expanding the business, generally a good thing.
You really honestly believe that profits are used by these companies only for innovation, and billions of dollars aren't misappropriated to paying overinflated C-level salaries?
Such a tough conversation. I want to think that these firms should do this research out of the goodness of their hearts, but i know that their employees want to go on vacation and send their kids to college. I believe in the invisible hand, and honestly don’t know the solution to these healthcare problems. Maybe just raising taxes and paying for all research by the government, but then I worry about the inefficiencies therein.
Personally I'd love to see someone explore the idea of incentives that heavily favor benefit corporations and/or employee-owned coops for commercial activity in direct support of human rights (assuming we're approaching the problem from a place where people agree access to healthcare, medicines, etc is a human right).
People who do the incredibly valuable work of developing drugs shouldn't be forced to live a life of squalor, and can be compensated generously for the value and complexity of their work, but I think most people's objections to pharma companies as they typically exist today are centered around companies reporting substantial profits and conflated ideas about obligations to shareholders.
Its a lot easier to feel good about a company reporting a profit if you're confident the company's governance structure ensures that profit is mostly lockboxed for future R&D instead of a shareholder dividend to people who may not even know their investment is funding medicine.
On the other hand, businesses in other industries that are not so beneficial to society will happily charge gob loads of money for their services. IMO giving these companies some profit is a good thing, so long as the money is made available so that everyone can afford the product, and so long as it doesn't stop or slow it's distribution.
Well that’s just it, isn’t it? We are talking about corporations, not people. A corporation is motivated by profit and is, in some loose sense, a “psychopath.” Sure, corporations are composed of people, but your moral argument is a lot more complicated in relation to an aggregate of people instead of just an individual.
Anyway, more tests are available than would be had LabCorp not existed, so seems like a win-win to me.
Personally, I would do (and have done) certain kinds of work without monetary compensation because I want to see it done, or because I think there's some other upside.
However, I probably wouldn't ask that of LabCorp in this circumstance, because what I want from institutions providing testing is scaling up while providing an effective product/service. Not getting revenue makes that considerably harder.
Public subsidies might make a lot of sense, though, especially to the extent that everyone wins the broader/deeper test coverage is, but not everyone has a disposable $100.
How have you been foregoing profit for your work during this calamitous time? Have you been laid off like many people or are you simply returning the cheques that your employer sends you?
Personally I've been continuing to show up for work despite my employer not having sufficient funds to pay me but I understand that every situation is different.
Profit != wages. A company profiting off a test is not the same as a worker being paid for their labor. Something being made at cost would price in the cost of labor, while profit is in excess of that (and all other expenses).
It won't do much for most people - which is why healthcare workers and first responders are being prioritized.
My wife is a doctor and cared for our county's first COVID-positive patient before he was formally diagnosed (took 11 days to get test results). She was on self-isolation for 3 weeks for late March/early April. Two weeks for the initial exposure, 1 more week because of a low-grade fever. We're still not certain if she had it (I got symptoms about 5 days after she did) because it was extremely difficult to get her tested.
The challenge now is monitoring her with likely exposure when she'll be working in-patient for the month of June. While these tests aren't perfect, they can give us some direction on how we need handle things at home. The price is reasonable enough that we can simply order the test for her directly without having to call 20 different people across 3 different hospital systems to get the sign-off on testing.
A negative doesn't tell us much (as she could still have it), but a positive is a strong indication that she should be avoiding patient interactions and likely self-isolating at home.
> A negative doesn't tell us much (as she could still have it), but a positive is a strong indication that she should be avoiding patient interactions and likely self-isolating at home.
Doesn't it only tell you if you should now be immune once your sickness is over? Otherwise you have to act like you have it if you have the symptoms regardless of the test. Avoiding patient interactions and self isolating should happen regardless, shouldn't it?
In theory, yes. Sensitivity and Specificity should be considered. In practice, there's a lot of BS going on in the healthcare system right now - these tests are often taken at face value.
It's unfortunate, but somewhat understandable given the extreme circumstances of our health care environment. If everyone with mild symptoms (likely not COVID related) had to self-isolate for two weeks, we wouldn't have any healthcare workers left to care for people.
This seems to be a "good enough" approach for most healthcare systems.
All current evidence says infection confers temporary immunity to the vast majority of people infected. It’s not clear how long immunity lasts, but it’s most likely on the order of years. And even if you lose immunity, the reinfection will likely be more mild.
I’d say it’s a relief if you test positive and then 14 days pass and you experience no or mild symptoms. But I know for me, personally, I’d be a nervous wreck during that period waiting for the symptoms to come (but I also have an underlying respiratory condition so that’s a big part of my anxiety).
That’s a fair question. I do think some people may buy and take the test if they’ve been in an area where the potential for exposure is high and they worry they are an asymptomatic or presymptomatic carrier.
This test is mostly useless anyway: you need to administer it at the narrow window when you have covid for it to be effective. This implies that you have to keep it on hand, ie it can be too late to order it when you have symptoms since it can be delivered too late to detect anything. Then you have to wait for results for many days once you send it - so it’s useless for guiding your action during the time you have symptoms.
If you administer the test when you don’t have symptoms it useless as well since most likely you will miss the window.
Not sure why you would take it if asymptomatic (assuming you aren't an essential health worker), unless you were told to either as part of a random sample study, or because a contact tracing effort told you you were at risk.
If you take it while symptomatic, I believe the sensitivity is improved, so if it comes back negative, you can be pretty assured that you just have a regular cold, right?
Given the sensitivity, absolutely nothing. Seriously, a negative only means that the sample swab didn't have COVID on it. This test is not very useful unless you get a positive.
For context, my wife is a physician. Had a patient that turned out to be positive, test negative while in the hospital. A day later, he was intubated. While he was intubated, his original, outpatient, test from 11 days earlier came back positive.
Does "At Home" mean at home, or send the kit from your home to their lab? It looks like I have to ship my DNA to them. That is not "at home".
LabCorp has been hacked enough times for me to stay far away from them. I was also not impressed with their Lab setup. I had to help other customers input their sensitive data into LabCorp's Kiosk systems because their 2 employees were overloaded. I am happy I left before giving them my data.
Yeah, I'm hoping we'll see serology tests soon that truly are 100% "at home", operating through a test strip. They already have had these tests available in China and other countries since February, but since the US is apparently a third world country in 2020 we will be lucky to see these tests before 2021.
Actually those test strips tests are basically useless at the moment because they have way too many false positives. But I think there is some interesting work, so maybe we will see these tests at some point in an accurate form which would be extremely helpful.
You send your DNA to someone every time you post an envelope. LabCorp is the largest provider doing tests, when you are tested at hospital for example, most likely they will send your sample to them, so there is no difference with doing it at home.
Before people get excited that the FDA approved something, how much testing have the FDA done on this product and how many other tests have they declined to authorize?
Right now, FDA approved means about as much as Probably not immediately lethal.
> Negative results do not preclude SARS-CoV-2 infection and should not be used as the sole basis for patient management decisions. Negative results must be combined with clinical observations, patient history, and epidemiological information.
Here's a brief article that explains why observed symptoms are more important than a test:
144 comments
[ 3.4 ms ] story [ 210 ms ] threadhttps://techcrunch.com/2020/03/25/study-behind-updated-fda-g...
https://www.medrxiv.org/content/10.1101/2020.04.01.20050005v...
The FDA doesn't think it is necessary to go that deep.
But, the video from the actual labcorp website someone else posted shows it does not actually have to go very deep.
https://www.pixel.labcorp.com/covid-19-sample-collection
I wouldn't be surprised if a light nasal swab like being discussed here doesn't pick up anything post-symptoms, whereas PCR with the deep nasal swab may still be detectable for a longer time after primary symptoms have faded.
Strep tests are just a pain. Had one or two every year of high school.
P.S. ignore the website, it’s not the product.
We then proceeded to present our solution to the FDA. They were positive so we filed for our pre-EUA and now we are working with an FDA reviewer.
I’m not going to pretend that our solution will end being approved. I have no idea since none of us (the three founders) have medical device experience. Nonetheless, we are willing to take a huge risk in terms of money and time, and at least know at the end that we gave it our best shot.
Quest is now selling a consumer initiated antibody test. It's not at home, of course.
It would go a long way in managing the epidemic while reducing the impact on the economy.
But there needs to be anonymous antibody testing at home like a pregnancy test.
BTW also needs the post office properly funded and saved from bankruptcy. WTF are we bailing out cruise ships and not the post office?
https://www.cologuardtest.com/
The sample is sealed inside a heavy grade plastic container with a screw top lid.
The plastic container is sealed inside a heavy weight zip-lock bag already form fitted to the inside of the shipping box.
The shipping box itself is quite sturdy.
I suspect something similar for this new LabCorp test, just customized for a swab.
Shipping biological hazards is a solved problem.
Also, not yet available to the masses:
> With limited quantities of kits available, Pixel by LabCorp is currently prioritizing healthcare workers and first responders, consistent with guidance from the CDC. We plan to make kits more broadly available soon so please check back.
[0]https://www.pixel.labcorp.com/
Edit: This isn't a total cost analysis, just labor like the person asked.
This price includes Fedex shipping both ways, mail handling and controls (which are CRITICAL for this type of testing), R&D, validation, hoopjumping for the FDA and much more (buildings, accounting, payroll, HR, PR, attrys).
This is a very low price. Plenty of business would be $150/test TODAY to test huge numbers of employees, and $250/test TODAY to test employees they were worried might be sick. Someone comes in with a fever, have them do this fedex test, 3-4 days later they could be a back at work if negative.
https://news.ycombinator.com/newsguidelines.html
Then again, with the people to move the samples around (process and sort mail), clean/sterilize testing materials after testing, and manage the people that perform the tests, and do quality testing, you might see another $1-$2 per test in labor costs. So maybe $5 in labor all said?
My bet is that the most expensive part of the process is the machines to do the tests, which likely cost multiples of a lab tech's salary (but maybe can do multiple tests at once? I dunno).
A sibling comment upthread noted that Maryland got 500k tests for $18 each, which sounds like it's probably close to cost, if it's the same test. That number of tests would be about full time work for 400 lab technicians for 5 days if they averaged just under two minutes a test.
The other labor was really just going by your own numbers.
Beyond that, there's still the layers of management above, that while there are physically less of them likely, their pay scales higher as well.
Even if the virus is viable, it's no longer airborne. You'd have to touch the swab and bring it to your face. Most of these labs handle things like HIV, so lab procedures and training guard against this sort of behavior. I wouldn't be surprised if they worked with shields as well.
In short, maybe they should be paid more, but it's not the danger factor that should govern in this particular case.
In case people forgot the first step of the FDA was to shut down at home testing. Then they fast tracked Roche and Thermo Fischer.
Now a month later they approve an expensive at home testing kit. You take your own conclusions of this behaviour.
https://techcrunch.com/2020/03/23/updated-fda-covid-19-testi...
The LabCorp test uses a swab that doesn't go anywhere near as deep (2). For a test kit to be widely distributed, you need to have it be drop dead simple to run perfectly.
Given all this, I'm not sure we should jump to corruption as the reason this is the first at-home test.
1.) https://slate.com/technology/2020/04/coronavirus-testing-fal...
2.) https://www.fiercebiotech.com/medtech/labcorp-s-at-home-coro...
https://www.admin.ch/gov/de/start/dokumentation/medienmittei...
Ah wonderful, so this rules out states accounting for 45% of the confirmed cases.
I'm still salty and I think this is part of the same scenario.
Having said that, I think Governor Hogan is one of the best governors out there wrt state level response to Covid. Right up there with Newsom and Cuomo.
Cuomo cut Medicaid funding by $6 billion during the pandemic. He dragged his feet on issuing a stay-at-home order for a week after the city government had asked for one (the governor has the sole authority to authorize one in NY). San Francisco beat Cuomo to the punch by nearly a week, even though New York had been hit earlier and harder with COVID-19 cases. Cuomo also fought against closing NYC schools even after the city and teachers were already on board with the idea. As a result of New York's sluggish response, community spread of COVID-19 happened much more rapidly than it did in other urbanized areas of the country (most notably San Francisco), so hospitals were already overloaded even before the stay-at-home order had been issued. On top of that, Cuomo also expanded pretrial detention for nonviolent drug offenders during the pandemic, which puts even more people in unnecessary close contact. https://nymag.com/intelligencer/2020/04/cuomo-has-learned-no...
As of today, 1 in 1000 New Yorkers who were alive a month ago are now dead. Cuomo might not be the only person responsible for the current situation in New York, but it's clear that things would be better in New York had Cuomo taken action instead of fighting public health officials at every turn.
How would this work? You learn of some (useful?) information about your genetics and eat better? And that affects insurance how?
They know what most people implicitly know but effectively deny indirectly via ignorant inaction: what you don’t know, can hurt you. The insurance companies also know this.
https://www.technologyreview.com/2017/09/28/148899/as-consum...
I would be glad to pay for the tests through my taxes if it means people can get them now, for free.
If profit really was a reward for good behaviour, no one would have a problem with it. (Except bad actors.)
In this situation, the goal is to get as many high quality tests out as possible.
If this is truly a reliable and useful test and results are available quickly, then the ideal level of profit is one that maximises that result - i.e. a small profit on each kit to encourage volume sales.
If the tests aren't reliable enough to be clinically useful and they're being sold to the public without a context (i.e. no information about what the result means in terms of changed behaviour or risk) then the kits should be banned for wasting everyone's time and money.
I have a philosophical problem with profit being the only motivation for producing the test, but that takes a backseat to practicality here.
Should only billionaires and elite have their drugs?
What your proposing isn't actually how the world works. Why don't you go out of your way to go get the same degree as them and make sure you make the bare minimum. Want to spend money on that new machine? Can't, you're only able to charge the cost it took to make the drug, and that new machine wasn't used so it's not in the price...
Profits are about growing and expanding the business, generally a good thing.
Good one.
People who do the incredibly valuable work of developing drugs shouldn't be forced to live a life of squalor, and can be compensated generously for the value and complexity of their work, but I think most people's objections to pharma companies as they typically exist today are centered around companies reporting substantial profits and conflated ideas about obligations to shareholders.
Its a lot easier to feel good about a company reporting a profit if you're confident the company's governance structure ensures that profit is mostly lockboxed for future R&D instead of a shareholder dividend to people who may not even know their investment is funding medicine.
Anyway, more tests are available than would be had LabCorp not existed, so seems like a win-win to me.
I'm guessing there would be zero takers.
However, I probably wouldn't ask that of LabCorp in this circumstance, because what I want from institutions providing testing is scaling up while providing an effective product/service. Not getting revenue makes that considerably harder.
Public subsidies might make a lot of sense, though, especially to the extent that everyone wins the broader/deeper test coverage is, but not everyone has a disposable $100.
Personally I've been continuing to show up for work despite my employer not having sufficient funds to pay me but I understand that every situation is different.
We detached this subthread from https://news.ycombinator.com/item?id=22936488.
My wife is a doctor and cared for our county's first COVID-positive patient before he was formally diagnosed (took 11 days to get test results). She was on self-isolation for 3 weeks for late March/early April. Two weeks for the initial exposure, 1 more week because of a low-grade fever. We're still not certain if she had it (I got symptoms about 5 days after she did) because it was extremely difficult to get her tested.
The challenge now is monitoring her with likely exposure when she'll be working in-patient for the month of June. While these tests aren't perfect, they can give us some direction on how we need handle things at home. The price is reasonable enough that we can simply order the test for her directly without having to call 20 different people across 3 different hospital systems to get the sign-off on testing.
A negative doesn't tell us much (as she could still have it), but a positive is a strong indication that she should be avoiding patient interactions and likely self-isolating at home.
Doesn't it only tell you if you should now be immune once your sickness is over? Otherwise you have to act like you have it if you have the symptoms regardless of the test. Avoiding patient interactions and self isolating should happen regardless, shouldn't it?
It's unfortunate, but somewhat understandable given the extreme circumstances of our health care environment. If everyone with mild symptoms (likely not COVID related) had to self-isolate for two weeks, we wouldn't have any healthcare workers left to care for people.
This seems to be a "good enough" approach for most healthcare systems.
I'm not sure how that works in the states.
Why wouldn't it be tracked?
For those of us who aren't showing symptoms and aren't at high risk for exposure, there's no point in testing us unless the test becomes super cheap.
I think the jury's still out on the odds of achieving even temporary immunity after having caught it.
https://www.wsj.com/articles/does-covid-19-infection-equal-i...
If you administer the test when you don’t have symptoms it useless as well since most likely you will miss the window.
If you take it while symptomatic, I believe the sensitivity is improved, so if it comes back negative, you can be pretty assured that you just have a regular cold, right?
For context, my wife is a physician. Had a patient that turned out to be positive, test negative while in the hospital. A day later, he was intubated. While he was intubated, his original, outpatient, test from 11 days earlier came back positive.
LabCorp has been hacked enough times for me to stay far away from them. I was also not impressed with their Lab setup. I had to help other customers input their sensitive data into LabCorp's Kiosk systems because their 2 employees were overloaded. I am happy I left before giving them my data.
No thanks.
Right now, FDA approved means about as much as Probably not immediately lethal.
https://www.fda.gov/media/136151/download
> Negative results do not preclude SARS-CoV-2 infection and should not be used as the sole basis for patient management decisions. Negative results must be combined with clinical observations, patient history, and epidemiological information.
Here's a brief article that explains why observed symptoms are more important than a test:
https://asiatimes.com/2020/04/how-accurate-are-coronavirus-t...