Lots of foolish opinions out there...
You know what they say: science doesn't care what you believe.
Here is something that many independent tests/approaches show, unequivocally, regardless of your personal and political views:
"Even if you don't reduce total cases, slowing down the rate an epidemic can be critical".
(re: COVID-19 in the context of the workings of a health care system)
I will refrain from sharing my own opinions on how the top figures of our government approach this crisis (would break too many forum rules, lol).
However, let me point out some of the things missing from the discussion here so far:
- The lag in testing can, at least in part, be blamed on the Zika virus epidemic and response to it. LDTs (lab developed tests) quickly put in place there were a mishmash of good, not so good, and terrible, resulting in the US FDA clamping down on the entire LDT viral infections testing process in order to standardize testing an bring the QC process up to par.
- The above resulted in the "Emergency Use Authorization" requirement that makes labs (like the one I help run) submit for approval before anything can be done in house... Which is good and bad depending on how much attention (and money) a gov efforts into staying in front of things. (full stop on my comments here... lol)
- The current CDC approved test is pretty bad (seriously, I'm speaking as an expert). It is an RNA virus so the testing is on viral RNA that needs to be extracted (isolated), reverse transcribed to cDNA and then tested by quantitative (TaqMan) RT-PCR. The problem is:
- the current test uses 4 different sets of primers (2 that are narrowly specific for the N region of the COVID19 virus, 1 for the conserved SARS and Corona gene, and 1 for "loading" - total human RNA - to ascertain loading and reactions running to completion)
- those 4 reactions are run separately because they are labeled with the same fluorochrome (??? why) and... still lack internal controls (!!!!!) so the assay is not ratio-metric (lol)
- currently conclusive results of all 4 sets of primers are necessary to reach a report-able result, which often can not be achieved due to a variety of reasons (too much to explain here)
- if the N1 or N2 regions of the virus mutate (and mind you - this is an RNA virus, it mutates a lot, just like the flu virus) - the test will stop working (and yes, it will potentially generate a lot of false negatives...)
- there are no clear guidelines as to "intake considerations"; think of this as what you put into a collection tube/container/swab - to extract the viral RNA from... snot, NP/OP swabs, sputum, what not - if this is not standardized (and it is currently not) there is no way of telling if the same individual would test positive/negative in separate tests (on separate samples) - this is one o the key, critical, essential points of any test validation - AKA "sample requirements". Missing here. Lol.
- Add to this the critical shortage of "positive controls" - there is no way most all diagnostic labs can handle the live virus; attenuated virus is not available at this time; the RNA positive control samples are in critically short supply, and even the largest reference labs are only allowed two aliquots a year... (not ideal, to say the least). The actual testing involves handling of samples containing the whole viral particles, not isolated RNA, so those CDC approved isolated RNA positive controls are just not adequate for a robust validation...
Anyhow. I'm sure I can go on for another few minutes listing more issues...
Just my 0.02 as the OP asked for opinions.
The OP has been a source of invaluable information here on various topics, most notably for me on the subject of skiing the Wolf Creek!
So, I felt obligated to respond (as I felt I may know something for a change, lol).
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