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The most promising plan I've heard along these lines is detailed in a recent episode of This Week in Virology.[1]

We could have this disease under control by the time school starts by giving everyone (or at least everyone in highly affected areas) tests every day.

This is possible, practical, and affordable.

The technology for fast pregnancy-test style tests for COVID-19 exists right now, and they could cost as little as $1 per test.

The reason these tests aren't being used yet is because of the FDA's misguided requirements for extremely high sensitivity for COVID-19 tests. If these requirements could be relaxed to allow lower-sensitivity tests, then these tests could go out on the market... or, better yet, the government could take over and ensure everyone gets tested with these tests every day for $1 a test.

Even a more limited plan of testing just all schoolkids every day for $1 a test would be way better than what we've got now.

[1] - Starting at about 6'20" in to episode 640: https://www.microbe.tv/twiv/twiv-640/

To put this idea in perspective, there are ~56 million students in the US. To do this daily for an entire school year at $1/test would cost ~1% of the trillion dollars allocated spent in the first relief bill.

Testing and contact tracing is a bargain compared to continuing to pay everyone to stay home. I don't understand why we're not seeing for-real effective contact tracing from our governments yet.

Some of us are seeing effective contact tracing. The most effective step here, I believe, was requiring at-the-door call-backs to verify numbers given by people going clubbing.

(We're currently running 11/million new cases per day @ 3,2% unemployment. At one point our per capita case rate was much worse than that in the States.)

https://www.lemonde.fr/les-decodeurs/article/2020/03/27/coro...

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I would just consider that it's about $30/mo per student. Cheap enough to roll into the tuition costs for most schools I imagine.

Prices would come down fast as this scaled up too

Preventative measures are often orders of magnitude cheaper than whatever it costs to clean up later.
> I don't understand why we're not seeing for-real effective contact tracing from our governments yet.

The trump administration does the worst thing possible in any situation.

> To put this idea in perspective, there are ~56 million students in the US. To do this daily for an entire school year at $1/test would cost ~1% of the trillion dollars allocated spent in the first relief bill.

Which $1 test currently in production would this be? And as a point of context, there’s been nowhere near the ~10B tests (I assume you’re talking about a 180 day school year) you’re proposing administered _worldwide_. Furthermore, what factory produces and ships 56 million of anything on a daily basis? I’ve said this before but I think HN readers suffer from thinking that everything in the world works like AWS in that you can just spin up unlimited “anything” on a moment’s notice.

> Which $1 test currently in production would this be?

It's not about what's "currently in production." It's about what should be a strategic goal to produce the bigger number of tests and use them frequently.

1) The current arguments against the speed tests is that they are not "sensitive" enough. But if one's goal is to do day to day testing and isolating from some environment those that can spread, there's no necessity to detect the RNA leftovers detected by the "sensitive" tests. Rather, the goal is to detect those that are the "powerful spreaders" who in fact have way more instances of virus present in their samples at the moment they are tested. Apparently even the "less sensitive" tests are in fact sensitive enough to catch these who produce a lot of virus. Those who produce a lot of virus have many orders of magnitude more virus RNA present in their samples than those who are in the phase of infection where they aren't so dangerously infective.

Once one accepts that the "ultimate sensitivity" is not necessary, much cheaper tests than those currently used are possible.

2) Even if a single test is still e.g. 20 USD, just stating the goal of having very frequent and regular tests for the sole purpose of protecting a big group of people allows for "pooling" the tests, e.g. testing 20 people together using just one test.

Running the numbers for a university of 1000 people:

1000 / 20 = 50 means only 50 tests per day allow for testing for protection of all 1000 people. Once one batch of 20 is positive, which should not happen every day, additional 20 tests allow for recognizing the one who is the actual carrier. Again, as those that are "dangerous" have many orders of magnitude more virus in the samples, pooling of 20 samples together should be still keep the result detectable enough.

3) Moreover, the test should be less complicated as the one used now: the idea is to test the spit, not to swab the deeps inside of the head.

4) Expensive and slow tests are simply not giving us the possibility to do these "detect early and often" strategies. The really sensitive PCR tests are indeed expensive and aren't as fast as the less expensive can be.

How can the cheap test be made? For example, by designing them to be used the same way the diabetics test their blood sugar levels:

https://www.diabetesaustralia.com.au/blood-glucose-monitorin...

Or even the way the pregnancy tests work:

https://www.123rf.com/photo_107386863_positive-pregnancy-tes...

In short, just new test strips.

Moreover, there are already companies that did some development of such kinds of tests.

It could be done, but it depends on the goals being set.

China successfully used pooling to test the population of 11 million:

https://www.bloomberg.com/news/articles/2020-05-29/how-china...

"Which $1 test currently in production would this be?"

The technology to make these tests currently exists, but the companies which own the technology have chosen not to put them in to production because the tests aren't sensitive enough to gain FDA approval under current regulations.

If the regulations were relaxed to allow these less sensitive (but perfectly adequate) tests, then they could be put in to production.

So what's necessary for us to get $1 tests is to convince the FDA that these less sensitive tests are adequate for use, which is what the This Week in Virology podcast and the NYT article linked to earlier argue for.

"Furthermore, what factory produces and ships 56 million of anything on a daily basis?"

From the TWiV podcast[1]:

"Take every manufacturing company that knows how to print paper, adapt their tools to print monoclonal antibodies on to those sheets and just start slicing it up and shipping it out. It's as easy as that, I mean, you know, I'm simplifying it a bit, but..."

[1] - from about 32'30" in to the podcast https://www.microbe.tv/twiv/twiv-640/

>what factory produces and ships 56 million of anything on a daily basis

Maybe more than one factory would be needed.

The idea that 56 million a day of anything is outside the realm of anything but software might be exaggerated. Global production of microcontrollers, for instance, seems to be around 80 million per day.

https://www.grandviewresearch.com/industry-analysis/microcon...

The money is barely going to individuals. $35,000 USD per tax payer (at least) has been pushed through. How much went to individuals? A few thousand for the people that got any money at all. The entire base money supply of the US shot up and the ramifications will be felt for decades. Casinos and steak houses received bail outs, the money was never meant to be used wisely.
Good luck convincing people who refuse to wear a mask to subject themselves to a test every day.
If testing was required to go to work, go to school, enter a restaurant, a bar, or a theater, people would do it.
Wearing a mask is required for many of these activities are people still refuse.
No mask, no service.. surely businesses can refuse service out of safety concerns
Can confirm that every day in Seattle I am seeing customers not wearing masks and businesses serving them without issue even though they are not allowed to.
When you own a business, the customer is always right.
I’ve noticed that opinion always comes from people who don’t deal with customers directly.
I own a business, and while a customer might not be right, I always treat them like they are right. Thus, the saying.

So, you now cannot say "always" in that statement, because I deal with customers daily.

My daughter works a minimum wage job. Her stories about her coworkers are appalling. For instance, a bunch of them went to a crowded rave after work one day and most of them got the virus, but they didn’t say anything and kept showing up for work until one of them became symptomatic and then it came out.

My point is, the minimum wage workers at many of these businesses could not care less whether you are following mask rules or not.

Many minimum-wage workers desperately need that income (maybe not middle-class teens working summer jobs) so it's unsurprising that they'll come to work sick.
There's arguments to be said that this is a violation of ADA and grounds for massive lawsuits.

See: https://www.workplacefairness.org/medical-privacy-workplace#...

Also, just as a personal aside...I will gladly join massive, maskless protests to underscore that I will never accept medical testing as a condition of engaging in society. This is a completely unacceptable violation of civil liberties.

I assume you're referring to "Section 4. Can my employer require me to take medical tests in order to keep my job?"

But that section explicitly states, "... unless they are related to your job and necessary for the conduct of your employer's business.

I think there's a pretty strong case that the health and safety of fellow employees and/or customers during a pandemic qualifies.

Yeah, no. There is no clause in the Constitution that says "except in a pandemic". We've had far worse pandemics than Covid-19, from tuberculosis to smallpox to Spanish flu, and no such provision was ever required. So if you want to get an amendment to the Constitution, start collecting signatures.
I’m sorry, but you’re just not right.

The Supreme Court has repeatedly held that the government has a pretty wide reaching authority when it comes to fighting disease. If the federal government can quarantine entire towns and force vaccines, they can similarly force you to be tested.

No, they haven't. There's no such precedent in U.S. history.

They can't quarantine towns from the federal level. Not in the least. A state might be able to, because the 10th amendment is a thing, but Federal government cannot. And neither state nor federal government can force vaccines because it violates the 4th amendment. You don't get to search my body for diseases and use them to discriminate against me. Sorry. Furthermore, Roe v. Wade was argued on the basis of a right to privacy that's implicit. So no, I'm right on this.

No such precedent? George Washington forced vaccinated his entire army from smallpox. There is precedence from the very start of the country.

I am so embarrassed on your behalf.

Wikipedia says Jenner first demonstrated the smallpox vaccine in 1796. The revolutionary war ended in 1783.
According to a tiny bit of research, it was a crude form of smallpox vaccination, yet still a vaccination.
The constitution doesn't say you have to wear pants either but it's still required. In any case the workplace link you cited is not in the constitution it's the disability law.
Sorry, but you are wrong.

This would no more violate the ADA than random drug testing (legal) or requiring temperature checks, which some employers are already doing to protect against COVID-19.

Also, the ADA is not a constitutional amendment, so even if there is a potential conflict with ADA, Congress could easily address that in a new bill without needing to pass a new constitutional amendment.

From an outside viewpoint, this is an interesting demonstration of a failure mode of the US social and political system.

Of all the hills to die on, "not wearing a safety mask" [0] is one of the more batshit crazy, but in a nation where the people have decided that "schoolchildren being slaughtered in their classrooms" is an acceptable price to pay for free and easy firearms, I guess it's not surprising that "people dying horribly, gasping for breath as their lungs fail" is an acceptable price for not wearing a safety mask.

[0] This poster's particular hill isn't the mask, but it is for some, and if I'm doing "batshit crazy", there it is.

> in a nation where the people have decided that "schoolchildren being slaughtered in their classrooms" is an acceptable price to pay

There hasn't been a single death in California from Coronavirus for any child, period. In the US, there've been about 20 deaths, nationwide, of children from COVID.

Read the whole comment before jumping in. I said the people have decided that schoolchildren being slaughtered in their classrooms is an acceptable price to pay for free and easy firearms.
> "people dying horribly, gasping for breath as their lungs fail" is an acceptable price

Ever heard of big tobacco? I got lots of relatives that died like that after enjoying cigarettes all their life. It is not surprising.

But, when you consider that the second amendment is an inalienable right, one has to wonder how to separate children from their guns.

"Parents, please don't send your child to school with their gun."

It’s peak HN that you’re getting downvoted for explaining your own comment.
Mayhe they didn’t die but this Kawasaki like complication is a thing
They’re making a comparison between our inaction on school shootings to our inaction on COVID. You’ve completely missed their point.
Oh. I get it. They're really shutting schools in the US down because of school shootings. That makes sense.
I genuinely can’t tell if you’re making a bad argument, or if you still don’t get it.
I think you probably agree with the original commenter that school shootings have killed more than the coronavirus (within the age group). They are saying, if people don't really care about the former, it's not surprising they don't care about the latter, which has killed fewer people. Are you really disagreeing with what they said or just the tone?
You know, I actually think you've got a point to make and I can see the shape of it, but you're so inept at expressing yourself that you come across as either completely misunderstanding or just plain wrong. I guess this is still an insulting thing to say, but at least it's not wrapped in snark or passive-aggression.
You are not alone, no matter what the downvotes say.
Here we go. Let's jump from convincing to requiring. This is the difference between freedom and tyranny, and the fact so many Americans are ready to make that jump is outrageous.
Schools already require proof of vaccination and antibody testing. Workplaces already have dress codes. Conflating mandatory testing or mask wearing with tyranny is why we're losing.
Everyone must listen to TWIV. It’s actually the best podcast on any topic, let alone virology.
How would the testing once a day happen? Would people take the tests at home and self report? Would everyone have to go to a central location?
With a “pee on stick” test you’d do it every day before heading out and be trusted to self report of positive (presumably you’d then do a better lab based test which could return within 24 hours to confirm the case)
Are there lab tests that return in 24 hours? Two of my kids recently got lab tested (thankfully both negative) in 2 different states and both took 72 hours to get results back.
Here are some references to quick COVID-19 tests:

"Blood test detects positive COVID-19 result in 20 minutes" - https://medicalxpress.com/news/2020-07-blood-positive-covid-...

"Fresno health clinic offering rapid COVID-19 tests that give results in minutes" - https://abc30.com/fresno-county-coronavirus-covid-19-everyda...

"15-minute COVID-19 test proves accurate at confirming infection" - https://www.upi.com/Health_News/2020/05/08/15-minute-COVID-1...

"New rapid COVID-19 test approved by FDA, results in as little as 15 minutes" - https://www.msn.com/en-us/health/video/new-rapid-covid-19-te...

"A new COVID-19 test can return results in 5 minutes" - https://www.theverge.com/2020/3/28/21197944/coronavirus-test...

So, it is possible, but maybe not practical since at least 2 states are not doing quick tests yet?
That requires an actual functional government.

This is never happening with Trump.

"because" is a stretch and it might be a $1 in variable cost but it's trillions in fixed costs. The FDA is correct to be cautious
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Tests aren’t going to stop the virus.

Self-isolation, social distancing, proper hygiene are going to slow the virus down. To implement those properly requires paying low-income workers to stay home.

A vaccine will stop the virus, but we don’t have one yet. It looks like it will be a year or more for a vaccine to be available.

I would say, testing being the solution is one thing that wasn't pushed in January or even pre C19 that I saw.

It wasn't mentioned in "Contagion" for instance.

A vaccination or cure was always known as not possible but the media pushed these false hopes.

In part I suspect this is the usual medial malpractice of doctors keeping their profession wealthy and keeping everything they can tied up and regulated.

I'd be interested to look at HIV and testing in the 80/90s to see whether at home tests were stopped by doctors or technology.

In "Contagion" almost everyone who got it showed symptoms immediately and died within a few days, so testing wasn't really a solution.
It's a tiny bit of my point.

That's not true generally.

Perhaps because of this misconception we are missing out on a paradigm shift, testing technology needs more money but first get comfortable with anyone using the test and making mistakes, which includes the real poor, including illiterate people.

Because medical has been locked up for so long, researchers and governments aren't looking at people looking after themselves.

No, a vaccination was not always known as not possible. It still isn't, in fact. And amazing amounts of effort are being spent to make the administration of tests easier. The first tests required trained research technicians. Today tests are still not widespread because they require specialized machinery or other materials. If it were possible to pee on a stick as a self test, everyone would be ecstatic - but it's not, so far.

The pandemic planning stuff I've read from before this year seems to suffer from a number of assumptions that were violated by covid, from asymptomatic transmission to the long lead time. E.g in MERS or Ebola or even flu, the infectious but asymptomatic period is more like Contagion. You don't have to worry about infected people wandering around town for a week or two.

Most planning mentions the need for having tests, and quickly gathering materials etc, and then moves on to tactics for containment and vaccine development. Where testing is focused on, it's as a way to differentiate between people who have symptoms but are actually infected with a non-panfemic disease, so that resources aren't wasted quarantining them. I haven't yet found a scenario studied with a long lead time and possible low level or asymptomatic presentation as standard.

"If it were possible to pee on a stick as a self test, everyone would be ecstatic - but it's not, so far."

It is possible.

Listen to episode 640 of This Week in Virology[1] for details.

[1] - Starting at about 6'20" - https://www.microbe.tv/twiv/twiv-640/

Audio doesn't work for me, but if you have a written source I would be curious to see it.
From the article:

Bloomberg: You seem optimistic researchers will succeed in coming up with vaccines. How do you assess the prospects and potential risks?

Stohr: The coronavirus is not a particularly difficult virus to handle. Even the conventional vaccines could make a difference, and we have different approaches, vector vaccines, mRNA. That is very promising.

https://www.bloomberg.com/news/articles/2020-07-18/covid-mos...

> I'd be interested to look at HIV and testing in the 80/90s

The thing I just can't understand is why they didn't require everyone back then to wear condoms all the time, regardless of whether they were HIV-positive. Those people were so callous in their regard for human safety!

The same political division occurred back then. The right fights for abstainance-only sex ed; the left fights for harm-reduction such as prophylactics and teaching to the science.

But to address the absolutism in your question. If everybody in possession of a penis wore a condom at all times (a) they'd get nasty and possibly gangrenous, [so i'll assume you mean "when the penis is deployed in/on/around a second party"] and (b) it would reduce the birth rate by about 90%.

> If everybody in possession of a penis wore a condom at all times

That would be about as likely as everyone wearing a mask at all times.

This is a thing you wrote. I agree, very unlikely

> The thing I just can't understand is why they didn't require everyone back then to wear condoms all the time

The distinction is consent. You would need to get meaningful consent from everyone present when you walked into a store without a mask.

EDIT: Actually not quite. To elaborate a little further - it has become understood that it is just and reasonable for the state to have jurisdiction over interpersonal interactions that involve money (though the converse is not necessarily implied) - this is 'the market'. Thus going to the store operates under a different regime than going to a friend's birthday party in their own home. Your example would equate to the state mandating condom usage with prostitution, assuming that was legal in the first place.

What you get up to at the store can be regulated by the state - what you get up to in the bedroom (without financial exchange) should not - assuming meaningful consent

The pooled sample testing method looks tractable.
Yes, but it’s only more efficient than testing everybody if you are unlikely to get a positive result. So, in places where covid is not widely spreading.
The method described in the article isn't a traditional pooled test. Each sample is marked, and it tests and reports on all samples at once.
The article says new tests, is that a test for a new person. Or simply a test in a certain time frame

I assume it is the latter, which means the stats can be skwed somewhat. I can't say what degree it would be but I've had 8 tests. Which means I show up in the testing stats 8 times. My situation is somewhat unique, but I'm not alone. Hence the distinction I am curious about.

Testing is great but you can do all the testing in the world, if the population is not compliant and superspreaders in particular simply ignore all health guidelines and don't even show up for tests you've gained nothing.

The pandemic already is under control in most places and I'm not sure testing had all that much to do with it. The successful strategy seems to be pretty straight forward. Initial lockdowns if the country is hit badly to curb the disease, then strong compliance with basic health guidelines and regional lockdowns if necessary.

Japan has performed about 800k tests in total on a population of ~120 million, which is lower than most other countries by a magnitude and about 50 times less than the US, but has had very few excess deaths.

At the end of the day the virus cares about behaviour, not testing.

>The pandemic already is under control in most places

This is an interesting claim. I think it's potentially misleading, and possibly motivated by a need to portray places where it isn't under control as isolated.

I suppose it might be technically correct if you count a list of "places" and divide the number where it is growing rapidly by the number where it isn't. However, the results you get are very dependent on how you define a "place".

If you divide the world into Europe, North America, Asia, South America, Africa, and Oceania, the only one that definitely seems to be under control right now is Oceania. Africa and Europe are growing much slower than the others, but not obviously "under control", and Asia notably is seeing over 60,000 new cases per day even though it previously seemed to be under control until India started reporting large increases.

If you count countries, you could claim that about 3/4 of them have it under control, but that might not be permanent. Considering Brazil (which I think people would generally consider to have a serious problem right now) and everywhere the epidemic is growing faster, it is a minority of countries, but very near half of the world population.

Source (as usual) is https://www.worldometers.info/coronavirus/

Some AI researchers[0] claim to be able to detect the virus by the sound of your voice via speech signals. They took samples of youtube celebrities who were recording videos at a time they were infected, but just before their diagnosis, as part of their positive-case labeled data.

Maybe soon we'll have dogs that can smell Coronavirus too[1]!

[0] http://news.mit.edu/2020/signs-covid-19-may-be-hidden-speech...

[1] https://www.ecowatch.com/dogs-smell-covid-19-2646105814.html