What's the point in testing?

[Dongdingdong]

Why is everybody placing such an emphasis on the need to test everyone? If you have a fever and a cough then you almost certainly have this virus - in which case you should stay at home and self isolate for 7 or 14 days depending on the circumstances.

Of course, if we were testing everybody then the death rate (number of deaths as a proportion of people who have the virus) would be massively reduced.

However, testing millions of people is surely a huge waste of NHS resources when staff need to focus on those who are actually sick and in need of urgent treatment.

Also, how would it work in practice - would we all have to go to testing points (thereby increasing the risk of infection) or would testing kits be sent to people's homes?

Furthermore, if someone tests negative then they could easily contract the virus a week later and test positive - so how often do you repeat the test?

AIBU?

www.ft.com/content/0dba7ea8-6713-11ea-800d-da70cff6e4d3

1. if you test everyone, regularly, then you can catch those without symptoms and pretty much stop virus completely. It needs to be done very consistently though. Big effort.

1. at very least test health workers, maybe other essential groups - you don't want those people at home unnecessarily, nor do you want them risking infecting vulnerable people in hospitals.

1. I don't think it is that easy to tell. lots of people are self-isolating when they really aren't sure

1. testing has a cost, but surely less costly then either passing the virus on, or staying in when you could be doing something useful.

The WHO seem to think testing is important but it only seems to make sense if they then contact trace and isolate people who have been in contact with a positive tested person.

However now it's reached such a large number and certainly in the coming weeks when it really explodes, that's going to be impossible. We should have been doing it extensively and rigorously from the beginning but we clearly let it slip. it seems impossible and pointless now and there can't be enough staff to keep up with such a thing.

We can tell the number of infected by extrapolating from the number of deaths so there really seems no point now. The cat is well and truly out of the bag.

There are doctors self isolating for 14 days because there partner has a temperautre - which could be anything! There are lots of bugs. At the very least test hospital workers and their families.

How would we ever know we have this virus beat without testing?

Testing, when combined with greater knowledge about immunity/reinfiection could help people limit the impact to their lives and thus to the wider society and economy. Right now you have to self isolate if you develop symptoms. If you do that and recover you will have to isolate again if you develop a temperature again because you cannot be sure which (if any) of the instances was c-19.

If we can get to a point of knowing
a) who has had it
and
b) that a dose renders you immune, at least for a significant while

...then we an start to understand how the hell we are going to get out of the pickle we are in.

Testing patients and staff to protect hospitals from contamination is probably the best use of teresues right now.

More testing would be better - even if all it does is provide further nformation to epidemiologists. Agree we are beyond the point where testing with aim of contact tracing.

What will be a game changer is the development of a new test, which will tell you if you have formed an immune response to it. They say we are close to having one. I really hope that's true

I was reading an article about a heart surgeon who had seen 70 odd patients in the last few days. He was running a temperature and self isolating. All of the people he came into contact with were vulnerable. A patient died of COVID at the hospital and he was sure they picked it up from the wards.

Just to add, he wasn't tested.

If the government is not going to put us in an official lockdown then they need to test.

There are two types of people - one who will take the advice seriously and isolate as instructed for the stated symptoms which could result in a lot of time off work/school due to how common they are with numerous illnesses and the other who thinks it’s all bollocks and will do as they please if they’re not sick enough to be laid up (this is also dependent on employer pressure).

Neither of those are particularly helpful if they want a steady rate of infections so the NHS can deal with them. Testing removes an element of guesswork and people deal much better with facts.

I’m sure there are other good reasons but these are the ones most applicable to me.

Yesterday someone was posting about care home residents who nobody was willing to care for because they had CV symptoms. But it might not be CV! If they could be tested negative the staff could return to work. And if positive they could be isolated or moved to hospital etc.

I'm finding it difficult to believe they will do it. I've had the symptoms for over 3 weeks, and this weekend I was so full of mucus I could barely breathe until I was able to cough or puke it up and they still wouldn't test me. (Previously, they'd refused to test me because I hadn't been abroad or been in direct contact with a confirmed case.)
And there are so many others in that boat.

Are they really going to go round to every person they wouldn't test before?

Our whole household is self isolating because two of us have a cough - no fever. Do we have it? Not a clue. What if we isolate for 14 days, re-emerge then one of us gets another cough? Back into isolation for 14 days for all of us. If we are never tested we have no idea whether we have it mildly or not at all. If we knew we had had it (or not) it would cut down the need for a lot of the isolation that's going to happen. Where I work probably 10% of people are currently isolating with no idea whether they really need to or not.
I agree though that it's probably too late now for this but it should have been done rigorously

Without testing we have to assume that the virus is absolutely everywhere. Testing is key and imo not doing it is the biggest mistake they are making although it isn't actually mistake it's because they don't have capacity so can't do it.

If, as they believe, you are immune once you have had it and fully recovered then this data will be key to getting society back to normal sooner. People with immunity will be able to go out and help others and get things moving.

I may be being dim here but surely it would be quick to train people up to take swabs to be tested? I understand the testing must be intensive and highly skilled but taking the swabs must be relatively easy?

I have plenty of tissues with mucus on, so it would be very easy to test me if they really are interested in testing everyone. I would also appreciate knowing, as, if it isn't COVID-19, but bad flu (despite me having had the flu jab), then it would be helpful to know that I'm still at risk of catching it.

They should also test my DD2 (8), who had very worrying symptoms for 3 days 2 weeks ago and had 3 days off school.

It would also mean that our family could end the self-isolation.

New evidence suggests covid is overwhelmingly asymptomatic (ie you have no idea if you’ve had it).

People who have had it once and produced antibodies should in theory now not act as vectors (the basis behind herd immunity)

If we knew who these people were they could return to work, give revenue to pubs/restaurants etc and generally go about their lives as normal. Would have huge benefits for at risk groups who could be needlessly isolating for months.

On Monday in the press conference they said a test to confirm if a person has had Covid 19, is very close. This will be much more useful as the test they have only tells a snapshot ie a test is negative today and positive tomorrow or vice versa.
I think they may be saving resources for that test.

Unfortunately we are way beyond effective testing ie using it as a tool to eradicate the virus. We have entered the next stage which means lockdown and focusing resources on treating those needing hospitalisation.
When the peak infection rate comes down then testing for immunity will give us an idea of how many people have been infected. As well as a vaccine they are developing a test to see if you have immunity. It would be sensible to test health workers first to establish whether we have sufficient work force for the inevitable/possible second wave. It would also reassure them.
Because China is hopefully already on the case I hope they are going to be more transparent with results considering they are at fault.

@willdoitinaminute That would make a lot of sense, I think. I can't really imagine that they'll have the resources to test everyone they didn't test before. We'll have to wait and see what happens.

Mittens it’s sounds like you have a common cold. The cough associated with Corona is a dry cough. Although you may have caught a cold while you have the Corona virus.

No, I had a temperature, then a dry cough for 10 days, before developing mucus that I couldn't find the energy to cough out, until I managed to puke it out. I literally couldn't breathe on Saturday evening and most of Sunday. I don't think it was a cold.

Symptoms do appear to vary quite a lot

My DH called 999 on Sunday, because I was almost losing consciousness as I could only breathe very short breaths. It was only at that point that I eventually found the strength to puke it out. An elderly or immunosuppressant person couldn't have done that.

Currently in 14 days isolation as ds is vomiting, feverish and mild cough. If he could be tested and proven negative I could go back to work as a valuable ICU nurse! I'm pretty sure it's a vomiting bug.

South Korea tested extensively and so could target resources. Hence they have really got on top of the virus quicker than everyone else.

Testing for immunity is most likely to be a blood test so much more labour intensive than swabbing. I would imagine they will sample the population and retest these individuals over a twelve month period to see if immunity is temporary. They will also need to monitor the virus for mutation.
This is where the WHO come into their own and probably the reason for their obsession with testing. Remember they are just as in the dark as our scientists. They have never seen anything on this scale in their lifetimes.

I had fatigue as well, though I do have Chronic Fatigue Syndrome, so that might be playing a part. I had very bad flu last year that turned to pneumonia which is where the CFC started from on top of my PTSD. (As well as a lot of stress connected with being an adoptive mum.)

I've also had a bad headache a lot of the time and my DD2 had a bad headache and a temperature. My DH and DD1 (nearly 11) haven't had any symptoms. (DD1 is sad that she won't get a birthday treat, we'll do our best to give her a very nice day.

@leafyygreens

New evidence suggests covid is overwhelmingly asymptomatic (ie you have no idea if you’ve had it).

What new evidence?

Until you provide a link to a credible source for this new evidence I shall continue to believe Dr Bruce Aylward and the team from the WHO-China joint mission as well as the Chinese scientists who state that the evidence showed only 1% of people where truly asymptotic. At the height of the outbreak in China they were testing over 50,000 people a day and while some people are asymptotic and test positive the majority of them go onto show symptoms.

www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf

This web conference is hosted by CROI. The first presenter is Zunyou Wu the Chief Epidemiologist China CDC. For those without time I have attached a snapshot of the relevant PowerPoint slide.
special.croi.capitalreach.com/