Why not testing “mild” cases is a mistake

[defthand]

Because early intervention matters.

Covid-19 is not the flu, it is clinically unique. It is typically a very long illness (12-32 days) and symptoms — particularly in the early stages — can be intermittent. Mild cases can abruptly turn severe 7-10 days into the illness.

In Wuhan — where all mild confirmed cases were placed in “mobile temporary hospitals” and all suspected cases and contacts were quarantined in designated hotels — they found early diagnosis and treatment helped to prevent cases progressing to become serious. This is summarised at page 61 of this excellent Harvard study of 25,000 cases in Wuhan:

drive.google.com/file/d/14tGJF9tdv4osPhY1-fswLcSlWZJ9zx45/view

In addition, South Korea has 8162 cases but just a 0.7% case-fatality-rate, something they largely claim comes down to early detection and early clinical intervention:

“Testing is central because it leads to early detection. It minimises further spread and it quickly treats those with the virus and that’s the key behind our very low fatality rate”

• South Korean Foreign Minister,

twitter.com/oxforddiplomat/status/1239147373416394754?s=21 (This tweet was liked by the director-general of the WHO).

Right now in the U.K., by leaving people to isolate until their symptoms become severe, we are surely on track for a similar CFR to Italy.

Nadine Dorries described her test in the ST. She turned up to a car park pace, got swabbed and then someone later phoned her up and told her to stay home. She didn't get extra treatment. That seems the ideal to me. She now knows she had it, knew her mum definitely had it and could inform all her (many) contacts with confidence, rather than vagueness. The WHO is cross with us for not testing, too.

I’ve read the same thing about Chloroquine. The Chinese and South Koreans used it in moderate cases and stopped disease progression. It was crucial that it was taken early.

That drug is a small glimmer of hope. If anything reduces the number of people progressing to life-threatening disease then even if it didn’t work for everyone it could have a large impact overall. Fewer people needing ventilation, fewer deaths, people recovering more quickly so better for the economy.

More reasons to test, test, test:

Through testing and retesting of all 3,300 inhabitants of the town of Vò, near Venice, regardless of whether they were exhibiting symptoms, and rigorous quarantining of their contacts once infection was confirmed, health authorities have been able to completely stop the spread of the illness there.

Andrea Crisanti, an infections expert at Imperial College London who is taking part in the Vò project while on sabbatical at the University of Padua, urged countries that have been limiting virus testing, which includes the UK and US, to learn lessons and ramp up the numbers of people being screened.

“In the UK, there are a whole lot of infections that are completely ignored,” Prof Crisanti said. “We were able to contain the outbreak here because we identified and eliminated the ‘submerged’ infections and isolated them,” he said of the Vò approach. “That is what makes the difference.”

www.irishtimes.com/news/world/aggressive-testing-helps-italian-town-cut-new-coronavirus-cases-to-zero-1.4205354

I am remember thinking a few weeks ago that the infectious disease wards were going to be a scary place to work in the coming months but I now
think it would be preferable to work with known covid positive patients and be able to take precautions that on a general ward were there are potentially asymptomatic shedders and no testing. I think staffing levels in the nhs are going to destroyed in the coming weeks because we haven’t tested enough and exposed frontline staff.

That’s how things got so bad so fast in Italy, wasn’t it? Spread within hospital patients and hospital staff.

The government’s failure to supply tests and adequate PPE to our NHS staff is near-criminal IMO.

I completely agree that testing extensively is the way forward.
Small possibility that DH had CV a few weeks ago. He had all the symptoms, but as he hadn’t travelled abroad, or been near a known contact, it seemed unlikely at the time. Probably it was just flu or another virus, but it would be hugely helpful to know. He works with an emergency service, so knowing that he had immunity would be good. I have a raised risk, so we are isolating as much as possible, and have taken our dc out of school, even though one is doing GCSEs.
Knowing that you have had CV rather than something else, would surely help the impact on the economy. I suppose the glitch in that is that we don’t yet know if it is possible to catch it again, or if we gain immunity.
I can’t think of any disease which doesn’t give immunity though ?

Now that the government have apparently U-turned on "fewer tests needed" after being spanked by the WHO, I expect that the posters who were fervently cheering the reduction in testing will have either melted away quietly, or will have experienced amnesia and now be fervently cheering for an increase in testing.

So this thread is now redundant

Have they?

Testing is pointless, you can be reinfected right after the test and Herd Immunity has only ever been developed through vaccine.

Fancy doing a Herd Immunity experiment with the AIDS virus anyone?

try saying it is pointless to all the NHS workers who have to stay off work, in case they have it, or all the people currently scared of infecting people they live with who have underlying conditions. NHS staff are clamouring for this to be changed.

When Nadine Dorries was infected, she knew both she and her mum were, so could help her mum out. If my DH (heart condition) got ill. I could not go anywhere near him, unless I was definitely ill too.

AIDS is a silly comparison because people know exactly how it is transmitted and, therefore, how to avoid risk. There is no need to build up a herd immunity as the disease is preventable.

@Piggywaspushed and this is a Novel virus that means NEW (virus not seen before) you people are seriously brain dead or believe in the government/media to the point of brainwashed!

Keep drinking the cool AID!

Eh?

FFS. It's Kool-Aid 🙄

@Piggywaspushed so you're up for the AIDS Herd Immunity experiment?

You realise Herd immunity has only been successful though vaccine, so the first few generations will suffer massively, for what is effectively an experiment, self isolate keep social distance!

In case you misunderstood me, I am not buying the her immunity thing either. I just said comparisons to AIDS aren't helpful

Think you need another thread to shout at people. This one seems civil.

Yes, I do. You have misunderstood me. See above.

I am in self isolation. I would simply lie to know if I have it so I can ready myself for the huge consequences if DH gets it.

Piggywaspushed I'm not shouting at you, I'm highlighting your stupidity of your previous comments :)

I agree with you OP. Keeping testing is the key to save lives. I feel not safe to be self- isolate at home if I have a symptom.

Completely agree.
So many will be going about their business in a few weeks thinking they are safe when there is no guarantee people wont be reinfected, and for many that cough would not have been covid19!
There are so many holes in the governments plans it looks like a colander.
People are speaking out, this government needs holding to account.

Can you explain what was stupid. Me telling AIDs was a futile comparison? I didn't say that was because I think they could build up a herd immunity to AIDs be making us all shag everyone and see what happens!

I agree absolutely a vaccine is the way forward and fervently pray those amazing scientists can find one.

On PMQ now Jeremy Corbyn has stated that frontline NHS workers are being told they dont need protective equipment.
This is an absolute shambles.
They had to go back on the ridiculous herd immunity plot so now they are making a show of appearing to do something whilst not doing very much. Soon it will be too late!