Common Sense Testing

Seeking Alpha reports:

Results from a study led by UnitedHealth Group Research & Development and OptumCare showed that COVID-19 tests performed on specimens collected by patients themselves, rather than healthcare professionals, are on par with the current approach. Specifically, the sensitivity of self-administered COVID-19 tests was more than 90%, consistent with clinician-administered results. The study,  prepared for publication, included almost 500 patients at OptumCare facilities in Washington state. Widespread adoption of self-sampling would reduce exposure for healthcare workers while improving efficiency.

This makes great sense. It is simply a nasal probe, a Q tip if you will. The problem as is done now is the logistics of setting up a site, operating it, and the gruesome sampling by site staff by jabbing the Q tip up the nose. The cost would drop. It could be set up on line, and all it would require would be a sample tube, Q tip like collector, label numbered and return envelope.  It is akin to Ancestry collections. The logistics would best be done by sending to local labs, with 24 hour delivery 24 hour turn around, secure web site report for HIPPA compliance.

Also one could pick up a "kit" at CVS, bring to patient, patient logs in and enters information and gets number for label on kit. Return kit to CVS and daily pickup. 24 hours end to and is doable. No parking lots, no staff, logistics are easy, HIPPA no problem, data entered into system from the get go.  

 I wonder if Governments even think this way!

New York City Quarantine

A proposed 20 mile New York City Quarantine Zone, QZ. Just a thought. Now watch this one go nuts.

It reminds me of maps from nuclear detonation scenarios of the "kill zones" Not that anyone is any better off outside the zone.

More Data or "Escape from New York"

If we track total infections as a function of Individual Income by County and Air mile distance from Times Square by County we get the following two graphs.

The above is amazing. It shows a clear drop in distance, albeit air miles. The next is income:

This clearly is not as strong as I had suspected.

It will be interesting to see how this changes. So far we have seen no one at any of these presentations presenting data on the epidemiological basis. Someone should remember cholera in London!

Shelter in Place?

The NY Times in its inimitable hubris is now telling us all to hold down. As one starts to look at data, yes unfortunately facts do count, it is part of science and engineering folks, the analysis shows that it is not population density that dominates but income. Thus forcing the poor to stay away from jobs which the will not get any pay from does little other than further drive them into despair. The middle and upper middle class wander about secure in a paycheck, like NY Times reporters one could assume, and interacting with others who have traveled and introducing the virus. The poorest NJ counties have the lowest rate per PoP whereas the most affluent the opposite.

Perhaps data and demographic analyses could become part of the epidemiological analysis. There appears to be some study alleging to improve the results by including putatively the mutation of the virus. It seems to fail to account for demographics. In addition it appears to fails to lack the Gain of Function threats discussed by the NAS five years back. The GOF effect, especially if engineered to be as such, makes for a lethal weaponized viral RNA. How then does one model that!

Overall the issue is one of having data, open data, readily available and usable by as many as possible. The more eyes and brains the better. Yet thus far it seems limited to null.

Thus rather than shouting from Olympus perhaps we should ask why New York has demographic disparity and why DC has such a low incidence? 

Interesting Epidemiological Data

We are tracking the New Jersey epidemiological data by county. The chart below is the incidence of total cases by county versus population density per county.

What is interesting is that income is a greater determinant than density! This seems to hold for New York City area as well. It appears to be travel related. Specifically travel but middle income people.

The New Jersey total per day are:

The above matches my previous analyses fairly well.

Some observations:

1. New contacts via travel are more of a determinant than density

2. The shelter in place paradigm is punitive on the lower income individuals who seem to be at materially lower risk

3. Testing is still critical and NJ has been poor in their implementation, so what else is new.

4. I still see gatherings of multiple middle class teenagers which are living breeding grounds. A parent comes in from travel infected passes it to children and off they go. One could call it reckless.

An Interesting Proposal

Part of damping a pandemic is isolation, namely reducing transferal. The second, and some say a more important one, is determining exposure. Namely the virus has a latent period of say 10 days during which an infected vector, a human, can slough off virions and thus spread the infection.

If we had a way to map out the social contacts of infected people we could then map out the infectivity map. But we do, namely their smart phones record location and thus using everyone's smartphone location we can track the infected persons contacts and then notify them, and then notify who they have interacted with etc.

Now is this difficult? Hardly, Google and Facebook do it every day and the NSA does it as a matter of course. Once we have a confirmed infection we then should map out their contacts and so forth.

But even more so, if we had true wide scale testing, then we could anticipate and head off the hidden exposures. One source of the hidden exposures are younger people who have jobs at restaurants and the like, think they have the "flu" and are spreading this like wild fire.

Data is an essential key to suppressing the continuation. The carriers like Verizon and AT&T hold the key to solving this as are Facebook and Google, combined with competent and real time testing.

Do I think this will happen? Doubtful, after all it requires violation of HIPPA and lawmakers could never seem to get out of their own way.