We know, we know. Don’t ask what we’re gonna do about it.
The vast majority of even those Houston-area residents experiencing symptoms consistent with COVID-19 are not getting tested, according to initial results of a Rice University survey, the latest evidence of the lack of screening for the deadly pandemic.
The survey, taken at Rice’s new COVID-19 registry, found that testing has been conducted in just 10 percent of respondents with a fever, 11 percent of those with a cough and 13 percent of those with shortness of breath — the foremost symptoms associated with the illness caused by the new coronavirus.
“This continues to make the case that health departments have been making about the need for greater testing resources and capacity,” said Marie Lynn Miranda, a Rice professor of statistics and the director of the COVID-19 registry. “Given that we know many asymptomatic people are spreading the disease, that so many people with symptoms are not getting tested is a concern.”
The survey also found that four of 10 households have lost income as a result of the crisis and that it is causing moderate to severe anxiety in one of four people.
The Rice COVID-19 Registry is modeled on its Texas Flood Registry, established in 2018 to measure the long-term health and housing impacts of Hurricane Harvey. Some 20,000 people have provided information to that registry, which was expanded to include the impact of a May 2019 storm that battered the region and Tropical Storm Imelda in September of the same year.
Some 4,300 Houston-area residents thus far have taken the COVID-19 survey, which Miranda calls an attempt to better understand how the COVID-19 pandemic and social distancing policies are impacting people’s lives, livelihoods and mental well-being.
The registry is here, the initial findings are here, and you can take the survey by clicking here. This is not a representative sample, since people are choosing to participate, but it’s interesting anyway. Anything that calls attention to the need to do more testing is worthwhile.
In a different world, we would have a scenario where every person in an area would take the covid test on the same day, getting results shortly afterwards. Then we could fix it quickly. Also, according to an article in Nature Medicine, symptoms most predictive of COVID-19 are: loss of taste/smell, severe or persistent cough, fatigue, and skipped meals. https://www.nature.com/articles/s41591-020-0916-2
Jen,
Is the “it” you are speaking of 1) the virus spread or 2) the complete treatment of the virus in any confirmed case?
How could “it” be fixed quickly?
That was a little vague. I meant the pandemic could be stemmed, if of course the people in the tested area stayed there until they got the results and those who tested positive isolated themselves. The area might be re-tested in a week or so. The point being, testing people only certain people, spread out over time, is never going to be very effective since many carriers don’t show symptoms.
Jen is right, and she inadvertently points out the problem with testing.
I could get tested today, and then get infected tomorrow, or Saturday. Even if we all got tested on the same day, I could get tested, be negative, and then catch it from someone at the testing center on the way home.
I fondly remember the good ol’ days, when our goal was flattening the curve so we don’t overwhelm our medical system. Seems like not only did we accomplish that, we put millions of health care workers out of a job! Yay, team!
Let people get on with their lives. The virus will continue to wash through, probably less now that it’s 90+ degrees in Houston, and people who catch it who get sick enough won’t have any problems getting treatment.
Either way, the issue goes away in November, when it won’t matter because there will be no election to try and influence. After the election, no one will care about the virus, and there will be no reason to keep whatever business hasn’t been bankrupted shut down.
Oh boy. I know this will probably all fall on deaf ears, but I’ve gotten just so frustrated of all the misinformation surrounding testing that I need to talk about it somewhere. A lot of the blame for that misinformation falls on the media (of all stripes), as there is certainly a hefty dose of fearmongering coupled with the standard inability to understand complex scientific / medical topics (always take media reporting of scientific topics with a HEFTY grain of salt).
First of all, Jen is correct in that in an ideal world we are able to quarantine everyone in the world separately for two weeks, test them all, and then maintain isolation on those that are positive without ever infecting anyone else. Pandemic eliminated, world saved! Obviously, as already pointed out, this is not possible. There are not enough tests in the world to do so, and people will get exposed after that anyway. That doesn’t mean testing is ineffective though!
The goal has never been to “flatten the curve”. The goal has been to reduce overall mortality, and flattening the curve is one mechanism by which to do so. It certainly should have been reported on differently for a few reasons:
1) Social isolation (resulting in flattening the curve) is a stalling tactic, meant to give time to develop treatments, testing potential, and understanding of what we’re dealing with without overwhelming the medical system, which has disastrous consequences not just for covid patients, but of all conditions (people stop being able to be treated for anything else).
2) Flattening the curve is not a one time thing. The moment you stop the measures that resulted in a flattened curve, exponential growth resumes and the medical system is again at risk of being overwhelmed.
3) Flattening the curve is just one part of a multi-step process. On its own, it does not decrease overall case counts, and has a marginal impact on overall mortality unless the program is extended until the disease has been cured (not going to happen). Reporting that the goal is to flatten the curve gave people the false impression that it was all that needed to be done, and now they’re confused and upset that their IKEA furniture suddenly has a step 2-10.
This brings us to testing. Unlike in 1918, we have a robust modern medical system, and the ability to perform true testing and contact tracing (setting aside issues with access for this discussion, that’s another problem). Contrary to popular belief, an infected person is not contagious from the moment they get the disease – it takes a few days (shed viral loads are typically at contagious levels 1-2 days before people develop symptoms, or median 3-4 days after infection).
This means that if we have enough daily testing capacity to test every symptomatic person, as well as those they have come into contact with during daily life, then we can prevent exponential growth from resuming even without extensive social isolation. This is what the testing goals are based on – the expectation is that cases can be held to linear increase rather than exponential, making regular life much more safe to resume.
As a final point, covid is not like the flu. Everyone thinks of the respiratory symptoms and sees how that’s similar to the flu, but n-SARS-COV-2 can attack nearly any system due to the prevalence of the ACES-2 receptor. As a result, aside from the mortality rate 10-20x higher than the flu, it also results in a very high rate of debilitating outcomes, ranging from blood clotting syndromes, to lung dysfunction, to neurological defects. Studies have suggested that as many as 1/3 of surviving symptomatic patients have potentially permanent severe decrease in lung capacity. Taking a blase approach to this disease and assuming that it will just run its course will result in a lot more than an enormous number of corpses – it will also result in an entire generation of people dependent on permanent medical care for chronic conditions, itself a massive strain on our economic prospects. Never mind the extreme cost of that many dead.
Seriously, don’t underestimate the impact that letting this disease “run its course” will have.
Good job Jason