Covid-19: Study reveals six clusters of symptoms that could be used as a clinical prediction tool

1. “Flu-like” with no fever—headache, loss of smell, muscle pains, cough, sore throat, chest pain, no fever
2. “Flu-like” with fever—headache, loss of smell, cough, sore throat, hoarseness, fever, loss of appetite
3. Gastrointestinal—headache, loss of smell, loss of appetite, diarrhoea, sore throat, chest pain, no cough
4. Severe level one, fatigue—headache, loss of smell, cough, fever, hoarseness, chest pain, fatigue
5. Severe level two, confusion—headache, loss of smell, loss of appetite, cough, fever, hoarseness, sore throat, chest pain, fatigue, confusion, muscle pain
6. Severe level three, abdominal and respiratory—headache, loss of smell, loss of appetite, cough, fever, hoarseness, sore throat, chest pain, fatigue, confusion, muscle pain, shortness of breath, diarrhoea, abdominal pain.

 Lazy8 wrote:
 
Your ire and most of your argument is aimed at the FDA approval system. I do not necessarily disagree with that concern/argument. I would agree that costs for Covid-19 testing and prescription drugs in general would be lower if there were not requirements for FDA approval. That is a debate about whether FDA approval is beneficial or not, and weighing the benefits, if any, versus the transactional costs. Not sure exactly how that explains shortages for things like cotton swabs , the lack of which currently are hampering testing for Covid-19. 

Your argument also presupposes that we have to accept that testing — and perhaps all medical care  â€” is a zero-sum game. The funny/ironic thing is that the lack of testing for some in the case of this virus is that it will increase the probabilities of more people being infected, including even those with better access. It seems to me that leveling the playing  field as much as possible is a better way to go. My understanding is that test results coming back a week or so later renders contact tracing essentially impossible.   It is testing and contact tracing that will mitigate the spread.  Again, my understanding is that Germany has been successful in doing this countrywide.  The United States has not been successful.   Do you think that is primarily due to our FDA approval requirements?

You are right that I am assuming that the professional sport teams pay to secure expedited testing (it does not matter why they — or anyone else — can cut the line for the purposes of my argument). You argue this provides more $ for the overall system, which I guess you believe will result in expanded testing capacity. Maybe at some point. I believe this expedited testing contributes to pushing back testing for the general populace, at least in the short term. 

I am not sure whether you are implicitly contending that it is better to address a public health emergency without governmental direction. Just step aside and let the private market do its thing. If so, I obviously disagree. 

 Lazy8 wrote:
 
My sister and her husband (NJ) have been tested twice, pretty much at will, for infection, and once each for antibodies.

My nephew was out with buddies and saw some girls who looked a little sick, but they were hot. So he's got it (no symptoms whatsoever) after his THIRD test and second exposure. Brother (extremely high risk) tested multiple times also because his son isn't isolating. The kid has to have two more negative tests before going out and trying to get it again. That's a lot of tests.

Here? Only if I have symptoms. Period. There are no testing sites. The triage nurse at the hospital will decide if I get to drive there and get a swab stuck up my nose.

I don't particularly feel like I need a test, but reading about the daily testing being wasted on our leaders who won't bother to wear masks, the testing for athletes, etc. is jarring.

steeler wrote:

Get out of their way.

I have no idea (and neither do you) how sports teams, say, get priority for testing. If they paid for it why is that worse than getting it due to political pull? At least in that case the people testing acquired more resources in the process, resources they can put to the task at hand. A mandate treats testing like a zero-sum game: sports teams (or the White House staff, or the mayor's kid's nanny) getting tested means someone else goes without.

Testing takes resources—labor, materials, energy, machinery and facilities made scarce by government approval processes. Resources cost money. Need resources in a hurry? Costs more money.

There are currently 185 active Emergency Use Authorizations for COVID-19 tests n place at FDA. As of today I count 72 applications n process. Some of these applications are months old. Government control is not getting testing out to people, government control is an obstacle to people getting tested. Be outraged if you like that some people are getting tested in a hurry, but that outrage would be better directed at those keeping the process slow.

The president described the nation's top infectious diseases expert, Dr. Anthony Fauci, as a “a little bit of an alarmist” about the coronavirus pandemic, and Trump stuck to what he had said back in February — that the virus is “going to disappear.” On Fox, he said, “I'll be right eventually.” The United States tops the global death toll list with over 140,000 and confirmed infections, with 3.7 million.

The common language of deniers...

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 Lazy8 wrote:
 
Perhaps, although I doubt that a public health emergency can best be handled without governmental direction.  Countries such as those in Europe that have taken a national approach seem to be faring better. My understanding is that Germany, for example, has robust testing and contact tracing  that has been instrumental in its success in controlling the spread of the virus.

I understand that technological advances/innovations in testing would help. However, as I pointed out, we have the capacity, albeit limited, that allows for relatively quick testing and expedited results. That kind of testing apparently  is available to those with more resources who essentially can cut the line. That kind of “system” does not make sense to me in terms of public policy in the face of a public health emergency. That is just capitalism doing what capitalism will do. I would not expect — and I do not believe you would — that private labs, for example, would coordinate a unified response throughout the country.  The “hot spots” can and do pop up anywhere and some jurisdictions in which they surface are ill-equipped to handle them. A hodgepodge State-by-state approach, for example, pits states against each other in terms of purchasing power. Then there are the differences in resources among the jurisdictions within the state.  We have shortages in some jurisdictions in cotton swabs and reagents that complicate and slow  testing. The private marketplace has not eliminated  those shortages.

Innovations may be forthcoming, but what is to be done in the interim? 

steeler wrote:

Because the federal government has shown itself to be so competent and efficient at this.

More centralization, more top-down control is the opposite of what we need. We need as many labs as possible working on the problem, as many tests in as many hands as possible. Innovation (and the incentives that drive it) are stifled by the order you want.

 steeler wrote: 
Yes and all kinds of hoops to jump through due to existing contracts with labs and hospitals and clinics and throw in the insurance carriers.

IIRC, the kits are usually bought directly from the lab that will read the test.  Switching tests would also mean switching labs.  Some like the Cleveland Clinic does in house at all different turnaround times.  If you present yourself to the ER or ED with the appropriate symptoms or in just for general pulmonary problems or look like you will likely be admitted, you get the quick one.  Otherwise you make an appointment, wait 24 to 48 hours to take the test and another 5 to 10 days for the results.

So MLB has no doubt contracted with a lab to supply what they need.  They are probably paying a bundle for it, too.

What we need is a home antibody test kit.

 Steely_D wrote:
 
Interesting.

Here is what I am wondering about testing: I am reading that with demands for testing growing exponentially in some states that test results are taking 5-7 days or more. I also read that professional sports teams can have players tested every other day with test results being returned 24-48 hours later.

Is this just a matter of paying for quicker return times? 

Why is the Defense Production Act not being employed to require all labs to contract only with the federal government and eliminate these private contracts? 

I was medical director for a few months at a relatively small, growing, medical company. As I watch them flail now (not because I’m gone, but I’d like to think so) I’m so glad I’m not in charge. The pandemic hit months after I was gone.

They started by offering free COVID tests to everyone. Period. No copay. If they could recoup some money from the patients’ insurance then they would but nothing out of pocket for the visit. That was losing them a minimum of $10K/week in unclaimed visit costs - while they were still paying me full salary. After me telling them repeatedly they needed to charge, they finally did.

The clinics got some of the early rapid testing kits - then had to give them back after they were un-approved. So all the press they’d done to say how they had them drove people to drop in - and be told no.

Then they got the routine testing straightened out, after jumping from one lab to another, and kept a few of the newly approved rapid tests in clinic for people needing urgent surgery, etc. But people kept showing up saying “I know you have rapid tests here.” And using up the very limited (maybe 3-4 swabs a day?) supply.

In the meantime, since there were the protests, and the people partying for the holiday, and people traveling to see relatives (Father’s Day), and people seeing the new reports...demand for even routine testing skyrocketed. When I spoke to people by Zoom, I’d warn them that the turnaround time for tests is now 1-2 weeks.

“Oh, then I need the rapid test because I can’t return to work/fly home/take care of my mom until I get a result.” So do we rapid test those folks? Even the ones who come in saying “The state I’m flying to needs a negative result within 72 hours of the flight, but turnaround time is a week, so the only choice I have is rapid testing.”

And, if it takes a few days to a week to get an appointment in clinic, and then the testing takes a week to get an answer, the person who’s thinking they’re ill won’t get a definitive answer for two weeks. By then, they’re likely OK.

So my replacement medical director has to answer to all those situations, telling the staff what they should do. Better him than me...

On Wednesday, Woolery abruptly deactivated his Twitter account.

 Red_Dragon wrote:
 
"First we were encouraging Granny to take her chances. Now, we'd like your kids to be canaries in a coal mine.  We're pro-life, but hee-ey, if ya gonna CO$T money, well, y'know, 'we all die someday.' 
But we'd appreciate it if you or a family member pays that $650,000.00 hospital bill before ya go . . .  "

Military medics deploy in California, Texas as virus surges

White House document shows 18 states in coronavirus “red zone”
Unpublicized recommendations say states should return to stringent control measures

A document prepared for the White House Coronavirus Task Force but not publicized suggests more than a dozen states should revert to more stringent protective measures, limiting social gatherings to 10 people or fewer, closing bars and gyms and asking residents to wear masks at all times.

The document, dated July 14 and obtained by the Center for Public Integrity, says 18 states are in the “red zone” for COVID-19 cases, meaning they had more than 100 new cases per 100,000 population last week. Eleven states are in the “red zone” for test positivity, meaning more than 10 percent of diagnostic test results came back positive.

It includes county-level data and reflects the insistence of the Trump administration that states and counties should take the lead in responding to the coronavirus. The document has been shared within the federal government but does not appear to be posted publicly.

Dr. Ashish Jha, director of the Harvard Global Health Institute, said he thought the information and recommendations were mostly good.

“The fact that it’s not public makes no sense to me,” Jha said Thursday. “Why are we hiding this information from the American people? This should be published and updated every day.” (...)

 buddy wrote:
 
To be fair to her, I read that her full quote said listen to the science - she just lied and said the science supported opening the schools. Better?

'I think you can trust me': Fauci stands firm as Trump works to undermine him

 Proclivities wrote:
 
I guess Cruz and Conway TA for them...
c.