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Coronavirus Those who ignore history are doomed to repeat it

#141 User is offline   johnu 

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Posted 2020-March-16, 19:44

View Postsmerriman, on 2020-March-15, 03:55, said:

Google 'why toilet paper' and you'll find many many articles :) There's absolutely no connection whatsoever between toilet paper and the coronavirus, but it seems it's just some weird psychological effect.

View PostFelicityR, on 2020-March-16, 00:05, said:

It is surprising how many in the UK are still in denial about covid-19: panic buy essential goods in the shops, then go to crowded pubs and restaurants on Sunday (yesterday). If this online article in the Daily Mirror about what is happening in Italy doesn't make an impact on the British population, then nothing will. I have to say that I do find many of the British population nowadays, selfish, greedy, hypocritical, and so out-of-touch with what's happening in the rest of the world.

The USA takes a back seat B-) to nobody.

Oregon police want an end to 911 calls for toilet paper

Quote

The Newport Police Department put out a notice on Facebook urging residents to stop making emergency calls due to a toilet paper shortage.

"It's hard to believe that we even have to post this," the police wrote. "Do not call 9-1-1 just because you ran out of toilet paper. You will survive without our assistance."

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#142 User is offline   y66 

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Posted 2020-March-16, 20:08

Trial of Coronavirus Vaccine Made by Moderna Begins in Seattle by Denise Grady at NYT
If you lose all hope, you can always find it again -- Richard Ford in The Sportswriter
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#143 User is offline   FelicityR 

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Posted 2020-March-17, 00:31

View Postshyams, on 2020-March-16, 15:10, said:

https://www.msn.com/...8VnD?li=AAggNb9

I think the Western governments (including the UK Govt.) are guilty of hubris. The level of unpreparedness is shocking.


Hubris might be the right way to describe it, but it's also a case of 'Nimbyism' too. (Not in My Back Yard). All first world countries are just as guilty, Britain, the USA, the countries of the EU, etc. as the recent viral diseases, covid-19, SARS, MERS, Ebola have happened primarily in China and third world countries.

We look from afar thinking it's not going to happen here. As a first world country we should have learnt the lessons of the SARS (another type of coronavirus) outbreak in Canada.

The unpreparedness is shocking, but perhaps more accurately described as 'fatally flawed'. Because nothing of this nature has happened here in the UK, the government has been running around like headless chickens, or ostriches with their heads in the sand, trying to fathom the response.

I'm not blaming the current government, because I don't think Labour or a hung parliament would have dealt with it any better. The problem as you rightly say is this country, and many other western countries, were 'unprepared'.

The seriousness of the covid-19 outbreak is now top of the agenda. And whilst we haven't gone into total lockdown in the UK unlike other countries, that may happen quite soon. It's easy to point the blame with hindsight, but we must also take into consideration that there is probably no easy way to contain both the virus and keep a degree of normality that doesn't impact on a human level.

Shutting the schools will mean parents will have to look after children than go to work.

Asking people to work from home is just a soundbite as many people cannot work from home.

Asking people to stop going to work wholesale will just impact on their financial lives.

Etc. Etc.

There is not an easy solution...

Edit: I was a passenger in a car and we passed a large supermarket this morning 9am (Tesco) and the car park was full of vehicles, and people were leaving with trolleys rammed full of groceries and essentials. Goodness knows what it was actually like in the supermarket. From what I could see, nearly every till was open with lines of shoppers queueing. So much for social distancing...

What people forget is that shop assistants (bar people, waiters and waitresses, too) are probably one of the most lowly-paid workers in this country but they have to carry on serving the general public as if nothing has happened, but they are probably at the greatest risk of contracting the virus, and maybe passing the virus on. And if they don't come into work they probably will lose their jobs.
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#144 User is offline   Trinidad 

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Posted 2020-March-17, 03:51

View PostFelicityR, on 2020-March-17, 00:31, said:

Hubris might be the right way to describe it, but it's also a case of 'Nimbyism' too. (Not in My Back Yard). All first world countries are just as guilty, Britain, the USA, the countries of the EU, etc. as the recent viral diseases, covid-19, SARS, MERS, Ebola have happened primarily in China and third world countries.

I do not think it is particularly fair to accuse governments to be ill prepared. You summed up reality in your last sentence:

View PostFelicityR, on 2020-March-17, 00:31, said:

There is not an easy solution...

Let's backtrack a little, summarize what has happened so far and how my government reacted.

  • End of 2019, a new virus appears in China. After a while, the WHO comments and states that it hopes that the virus can be contained. The goverment follows what is going on.
  • The virus spreads. It is clear that there is a shortage of ICU facilities at the places where the virus has spread. My government reacted by stating that the question is not whether the virus will hit us, but when it will. They start to expand the amount of ICU facilities, the population is made aware that something big is coming: People will die. Meanwhile: wash your hands, etc...
  • The virus is here and spreads. People are killed. The prime minister is on national TV. He starts by giving his condolences to those who have lost family or a friend. He wishes the best for those who have the disease right now and then he explains clearly what the strategy is: Flatten the curve, control the outbreak, let it run as slowly as possible through the population in a controlled manner. Measures include shutting down bars, restaurants and schools, as well as announcing support for the sectors of the economy that are taking the hit. He also explains why this is the strategy: It is based on facts and science. The scientific community supports this. The only part where there was discussion amongst experts related to the closing of schools. On all other areas, there is vast (unanimous, anyone?) support for the government among the experts.

I am sorry, but given the fact that we have this virus, what should my government have done differently? I think that they are keeping their heads cool, make solid decisions, based on the best evidence available. They seem as well prepared as they can be and they are taking preparations for the future: This includes evaluating more drastic measures for the near future, but also measures about how to continue when the virus has past.

I am sure that in a little while everybody will see what they obviously did wrong. Hindsight will be 20-20, as usual.

But I do not see any signs of my government being ill prepared. On the contrary, I think that they are doing exactly what they should do.

Rik
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#145 User is offline   FelicityR 

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Posted 2020-March-17, 04:12

View PostTrinidad, on 2020-March-17, 03:51, said:

I do not think it is particularly fair to accuse governments to be ill prepared. You summed up reality in your last sentence:
Let's backtrack a little, summarize what has happened so far and how my government reacted.


Yes, maybe the Dutch government was better prepared than the one in the UK. I agree, Rik. But surely all governments should had had some contingency plan in place just in case the virus couldn't be contained. It's as though (especially in this country) there are reacting to each and every event as it happens. A case of locking the stable door after the horse has bolted (gone).
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#146 User is offline   Cyberyeti 

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Posted 2020-March-17, 04:41

I think the truth is that both the government and the scientists were unprepared. Our government seems to be accepting the scientific advice they are being given, and that is changing. In cases like this, you make a model, make predictions, check the validity of your model as time goes on, and if necessary modify some of the assumptions if they're proving inaccurate. With not a huge amount known about the virus, the science has changed over the last few days, and the government's stance has changed with it.

Somebody put this up on FB, and I think it's where we are now:

"To explain Boris’s method for anybody who doesn’t quite get it I’m not saying if I agree with his plan or not but here goes

His plan is to segregate all vulnerable people (older, illand at risk) let’s call this group A

Anyone looking after the older,ill and at risk can be group B

The general population generally healthy can be group C

Group C needs to go about it’s business keeping the country moving kids at school us at work

Group B looks after group A and avoids contact with C

Group C is allowed to contract the virus and because it’s generally healthy it can cope with it better than group A

Group A and B are almost self isolating without the virus to avoid putting strain on the NHS and reducing the risk of getting the virus and then needing the NHS

Group C (the generally healthy) go through the cycle of contracting the virus self isolating and being looked after by healthy family members, friends and the local community
Anyone who has complications gets looked after by the NHS while groups A and B are kept away The NHS are not strained by A and B while its looking after complicated cases in C

As group C comes full circle and recovers it divides in to groups that take group B’s position looking after group A allowing group B to go though the cycle

With B and C though the cycle
A is free to have NHS to itself because B and C are now clear from illness and infection and hopefully have a degree of immunity from getting it again this season.

Hope this helps

Everyone has a job to do for the above to work

Stay safe and keep washing those hands"
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#147 User is online   Winstonm 

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Posted 2020-March-17, 07:52

View PostFelicityR, on 2020-March-17, 04:12, said:

Yes, maybe the Dutch government was better prepared than the one in the UK. I agree, Rik. But surely all governments should had had some contingency plan in place just in case the virus couldn't be contained. It's as though (especially in this country) there are reacting to each and every event as it happens. A case of locking the stable door after the horse has bolted (gone).


A lot of the problem has been created by a type of thinking that can be traced all the way back to economist Milton Freedman. It is this type of market mentality that has led to the ideas of smaller governments with less government intervention and a reliance on "the market" to solve problems. Obviously, there are problems with this approach, and an important one is that preparing for an unlikely event is something governments can do - because they can afford to - and private enterprise won't do, even if they can afford it, because it doesn't generate enough return on investment.

This does not mean I am advocating all socialism, but rather a reasonable approach to solving problems where the best method is used. Let's not be slaves to ideology.
"Injustice anywhere is a threat to justice everywhere." Black Lives Matter.
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#148 User is offline   Trinidad 

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Posted 2020-March-17, 12:48

View PostCyberyeti, on 2020-March-17, 04:41, said:

I think the truth is that both the government and the scientists were unprepared.

I don't agree that the scientists were unprepared. The scientists were prepared to deal with an outbreak of a virus: The knowledge is there to identify the virus, the knowledge is there to track it, the knowledge is there to develop a test, the knowledge is there to study the outbreak and model it. The knowledge is there to find a cure and a vaccine. The scientists were ready. In fact, they were very well prepared.

Of course, the scientists were not prepared for an outbreak of Covid-19. How could they be? Before November 2019 there was no such thing as Covid-19, (hence the "19"). It is hard to study something that doesn't exist.

In this short time that this virus has been going around, and, therefore, has been available to scientists:
  • Scientists have isolated and identified the virus.
  • They have recorded the DNA fingerprint.
  • They are recording the family tree of the virus (No, Mr. Trump, the American outbreak did not come from Europe.)
  • They developed test methods.
  • Data are gathered on the spread of the virus through the population. They are interpreted and modeled, despite the fact that the data is hard to interpret (the infection in South Korea contains a heavy bias, since the infection started around a religious group). Predictions are made based on these models.
  • An antibody has already been identified that is able to block the virus (i.e. not a perspective for a vaccine, but for a cure). Of course, it takes time to develop ways to produce it, formulate a dosage form, and have it properly tested (and it may not get approved).
  • Progress is made on the development of a vaccine.

All this has been done, using methods that were ready to use as soon as the outbreak started. The scientists were prepared.

Keep in mind that only 4(!) months have passed since the first person in Wuhan was infected.

Don't forget that scientist are humans, not wizzards or witches who could stop this by casting a simple spell. Science is hard work. And the scientists have been working hard and continue to do so.

Who, then, was not prepared? The population was not prepared. The population was not prepared to accept the inevitable: Lots of people are going to die, many will live but not recover completely, and even more will have been seriously ill. This potentially includes you or me (for all options mentioned).

Is it bad that the population is not prepared? No, that is good. In fact, it is excellent!! (Just not now.) We are all a lot happier if we do not have to worry each day that a lot of people might die. It would not want to live in a world whose population "is prepared" as soon as someone sneezes in Wuhan.

I understand the frustrations. It is human to look for someone to blame for this mess (and, yes, we are in a mess): The Chinese, the government, the scientists, the weather man (?!?!). But the blame should be put where it belongs: sh-t simply happens. Western society has not had a lot of sh-t in the past years (decades) and, as a result, "we, the people" are ill-prepared. We should be grateful for the great time we have had... and that we will get again once this is over. Meanwhile... keep your properly washed fingers crossed... and let's take care of each other.

Rik
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#149 User is offline   pescetom 

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Posted 2020-March-17, 15:42

Today's statistics in Italy: positive 26062 (+13%), dead 2503 (+16%), no longer infected 2941 (+7%). Intensive care 2060 (+11%). Fatality rate 8.8%.
So another moderate drop in growth rate, and a slightly larger drop in intensive care despite a slight increase in fatality.

Nobody in Italy is explicitly discussing triage choices yet but this Reuters article raises the issue.
To get an idea of how bad this virus can be despite originally excellent health care, the Province of Bergamo (population 120,000) which in normal times has 3-4 deaths daily, had 350+ deaths in a week, with 51 on March 11 alone. There is a 5 days wait at the crematorium even burning multiple coffins at once.
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#150 User is offline   helene_t 

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Posted 2020-March-17, 15:57

View PostTrinidad, on 2020-March-17, 12:48, said:

  • Scientists have isolated and identified the virus.
  • They have recorded the DNA fingerprint.
  • They are recording the family tree of the virus (No, Mr. Trump, the American outbreak did not come from Europe.)
  • They developed test methods.
  • Data are gathered on the spread of the virus through the population. They are interpreted and modeled, despite the fact that the data is hard to interpret (the infection in South Korea contains a heavy bias, since the infection started around a religious group). Predictions are made based on these models.
  • An antibody has already been identified that is able to block the virus (i.e. not a perspective for a vaccine, but for a cure). Of course, it takes time to develop ways to produce it, formulate a dosage form, and have it properly tested (and it may not get approved).
  • Progress is made on the development of a vaccine.


And then there's UV disinfection robots:
https://www.therobot...fection-robots/
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#151 User is offline   y66 

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Posted 2020-March-17, 18:11

Some governments learned from SARS and MERS. Some didn't.

From Dennis Normile at Science:

Quote

Behind its success so far has been the most expansive and well-organized testing program in the world, combined with extensive efforts to isolate infected people and trace and quarantine their contacts. South Korea has tested more than 270,000 people, which amounts to more than 5200 tests per million inhabitants—more than any other country except tiny Bahrain, according to the Worldometer website. The United States has so far carried out 74 tests per 1 million inhabitants, data from the U.S. Centers for Disease Control and Prevention show.

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#152 User is offline   Cyberyeti 

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Posted 2020-March-17, 18:34

View Posty66, on 2020-March-17, 18:11, said:

Some governments learned from SARS and MERS. Some didn't.

From Dennis Normile at Science:


I've seen a counter argument to that in another article which says that SK is largely an outbreak among nonsmoking young women, whereas Italy it's largely older male smokers, so the Koreans get recovered much faster and are presumably infectious for a shorter time.

The test is also not particularly good, I've heard claims of only 60% accuracy as it works off a throat swab and the virus concentrates in lung tissue.
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#153 User is offline   y66 

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Posted 2020-March-17, 23:31

From Ezra Klein at Vox:

Quote

America does not have enough ICU beds for the coronavirus outbreak
America has about 924,000 hospital beds, about 98,000 of which can be used for people who need intensive care, according to the American Hospital Association. The number of Covid-19 cases that will require ICU care could expand far beyond what the US is currently capable of providing.

The Imperial College London projections are just one set of estimates among many (based largely on modeling for influenza outbreaks instead of the current facts on the ground), but they paint a grim picture. The short version is that even the most aggressive mitigation strategies — general social distancing, quarantines, closing schools — will not be enough to prevent US hospitals from being overwhelmed eventually unless we commit to such drastic measures until a vaccine becomes available.

Posted Image
Source: Imperial College London

For people 60 and older, between 17 percent and 25 percent of cases are expected to require hospitalization; of those, 25 percent or more will require intensive care (as many as 70 percent for patients 80 and older), according to this analysis. The ability of hospitals to provide that care will be imperative if we are to protect those most vulnerable populations.

Quote

States are starting to take drastic steps to try to increase the number of hospital beds available, but there are limits on what they can do. New York Gov. Andrew Cuomo said Monday he would order the National Guard and building developers to convert existing facilities — dormitories and former nursing homes, for example — into makeshift hospitals. That order is expected to add 9,000 new beds to the 53,000 already available in the state. Maryland Gov. Larry Hogan issued a similar order the same day, adding 6,000 beds to the 9,000 existing beds in his state. Governors are urging the Trump administration to get the Army Corps of Engineers and the US military involved to set up temporary hospitals.

Complicating matters further is a shortage of basic medical supplies — masks, gloves, gowns, etc. — that hospital staff need to care for patients and protect themselves. The strain on health care workers will only get worse if nurses and doctors get sick because they lacked protective gear and then are unable to work.

I’ve spoken with nurses at major US hospitals who are certain they have already been exposed to the coronavirus because of these shortages and some lax protocols in the early coronavirus panic.

“We just need supplies,” Melissa Tizon, a spokesperson for the Providence St. Joseph hospital system, which has facilities in Seattle, the worst-hit US city so far, told me. “That’s the main thing we need to care for our patients.”

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#154 User is offline   FelicityR 

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Posted 2020-March-18, 01:33

Oh dear! What I don't particularly like is Boris Johnson's slide into Winston Churchill (his hero) mode that has happened in the last few days.

"We will act like [the] wartime Government and beat this enemy."

Whilst other commentators on this forum have detailed at length - thank you - how the scientific community were up-to-speed on strategy on tackling this virus, the government should have brought in more draconian measures earlier.

I feel the panic buying in the shops has been caused due to the ill-thought out statement that a household will have to isolate for 14 days. Whilst the time period is correct to make sure that no-one spreads the virus into the wider community, he never explained how everyone was going to get basic provisions whilst under this 'viral house arrest'.

No statement that the army or social services were going to be involved, etc. And it says a lot for the Sikh community in this country that there are prepared to deliver groceries to families and individuals who are under this self-isolation.

How has this government handled the crisis so far? My opinion: badly. Containing this virus and keeping the vast majority of people safe is a logistical nightmare, I admit Jobs, schools, children, working parents, the ill and the elderly all have to be all accounted for. But Winston Churchill and the wartime cabinet wouldn't have been so casual and indecisive as this government have been.

What was needed was decisiveness from the beginning, real strategies that inspired confidence and set out what was going to happen, instead of trying to 'wing' their way through this crisis.

Winston Churchill made his mistakes during WWII, but the British public generally had confidence as him as a leader.

Boris Johnston as Winston Churchill (the second)? Delusions of self-grandeur.
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#155 User is offline   Cyberyeti 

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Posted 2020-March-18, 04:07

Felicity - a point that many professionals have made is that self isolation in itself is bad for mental health, hence you don't want to do it before it's absolutely necessary or for longer than you have to.

I feel that unlike in the US, the government is going with what the scientists tell them,and that's all we can reasonably ask them to do.
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#156 User is online   Winstonm 

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Posted 2020-March-18, 07:49

View PostCyberyeti, on 2020-March-17, 18:34, said:

I've seen a counter argument to that in another article which says that SK is largely an outbreak among nonsmoking young women, whereas Italy it's largely older male smokers, so the Koreans get recovered much faster and are presumably infectious for a shorter time.

The test is also not particularly good, I've heard claims of only 60% accuracy as it works off a throat swab and the virus concentrates in lung tissue.


This seems to sum up nicely the difficulties we all have with information: one person posts an link to an article from Science magazine - an article with quotes from people we can track down and verify if we so wish - and the other responds about "something I saw" and "something I heard."

These two sources cannot be treated as equivalent. Agreed?
"Injustice anywhere is a threat to justice everywhere." Black Lives Matter.
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#157 User is offline   Cyberyeti 

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Posted 2020-March-18, 08:51

View PostWinstonm, on 2020-March-18, 07:49, said:

This seems to sum up nicely the difficulties we all have with information: one person posts an link to an article from Science magazine - an article with quotes from people we can track down and verify if we so wish - and the other responds about "something I saw" and "something I heard."

These two sources cannot be treated as equivalent. Agreed?


I get most of my news over the radio, so attributable sources are difficult, but when 30 or 40 different scientists say this like it's uncontroversial, I tend to believe it.

Also the bit about the effect on mental health was said by both Boris and his chief scientific adviser in one of their daily press conferences.

There are plenty of articles like https://www.medicine...ticlekey=228250 on the accuracy of the tests, yes this is not a peer reviewed paper, but some facts like:

"Reports suggest some people test negative up to six times even though they are infected with the virus, according to the BBC and Chinese media. Such was the case with Dr. Li Wenliang, the ophthalmologist who first identified the outbreak and was reprimanded by Chinese authorities when he tried to warn others.

Dr. Wenliang developed a cough and fever after unknowingly treating an infected patient. He was hospitalized, testing negative for coronavirus several times before eventually receiving a positive result. On Jan. 30 the doctor posted: "Today nucleic acid testing came back with a positive result, the dust has settled, finally diagnosed," according to the BBC. Dr. Wenliang passed away on February 7 in Wuhan, the epicenter of the outbreak."

are well known
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#158 User is offline   hrothgar 

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Posted 2020-March-18, 08:59

View PostFelicityR, on 2020-March-18, 01:33, said:

Winston Churchill made his mistakes during WWII, but the British public generally had confidence as him as a leader.


Perhaps that's because most of his victims were Indians, Africans, and Australians....
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#159 User is online   Winstonm 

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Posted 2020-March-18, 12:04

View PostCyberyeti, on 2020-March-18, 08:51, said:

I get most of my news over the radio, so attributable sources are difficult, but when 30 or 40 different scientists say this like it's uncontroversial, I tend to believe it.

Also the bit about the effect on mental health was said by both Boris and his chief scientific adviser in one of their daily press conferences.

There are plenty of articles like https://www.medicine...ticlekey=228250 on the accuracy of the tests, yes this is not a peer reviewed paper, but some facts like:

"Reports suggest some people test negative up to six times even though they are infected with the virus, according to the BBC and Chinese media. Such was the case with Dr. Li Wenliang, the ophthalmologist who first identified the outbreak and was reprimanded by Chinese authorities when he tried to warn others.

Dr. Wenliang developed a cough and fever after unknowingly treating an infected patient. He was hospitalized, testing negative for coronavirus several times before eventually receiving a positive result. On Jan. 30 the doctor posted: "Today nucleic acid testing came back with a positive result, the dust has settled, finally diagnosed," according to the BBC. Dr. Wenliang passed away on February 7 in Wuhan, the epicenter of the outbreak."

are well known


I think you missed the most important part of the article - why are some tests incorrect. From your linked article:

Quote

The study authors note that RT-PCR tests may produce false negatives due to: 1) laboratory error or insufficient amount of viral material collected from the patient. 2) Samples that are stored or handled improperly also result in false negatives.

Tests may result in false negatives 3) if the patient is tested too early in the course of infection and there is 4) insufficient amount of virus to be detected. Improper sampling may result in a false negative.

Another potential problem with test kits: 5) Faulty reagents. The CDC recently admitted test kits they distributed resulted in inconsistent results due to a problematic reagent required for the test. They are now manufacturing the reagents using stricter quality control measures.
my numbering and emphasis

If you will note, none of the reasons is the test itself. Provided the above errors do not occur, the tests are accurate. That is not to say the testing process is perfect - it is not. But that the test is not sensitive enough to detect virus in the very early stages is not the same as saying it is inaccurate.

Word choices matter.
"Injustice anywhere is a threat to justice everywhere." Black Lives Matter.
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Posted 2020-March-18, 12:41

View PostWinstonm, on 2020-March-18, 12:04, said:


If you will note, none of the reasons is the test itself. Provided the above errors do not occur, the tests are accurate. That is not to say the testing process is perfect - it is not. But that the test is not sensitive enough to detect virus in the very early stages is not the same as saying it is inaccurate.

Word choices matter.


But that means it's not that useful as the very early stages are when you need to pick this up to avoid the spread. Hopefully the antibody test for people who've had the virus will come onstream soon for both measurement and control purposes.

https://edition.cnn....witz/index.html was the SK/Italy one.
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