Wu Flu

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Sangoma
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Re: Wu Flu

Post by Sangoma » Thu Mar 12, 2020 10:00 pm

It's understandable that the technological Western mind believes in testing as the final answer. Unfortunately it is not. Let me explain.

Imagine there is a disease XYZ for which there is a test. This test is reliable, and only 5% of the results are false positive. Say, you send the parent for testing, and the test is positive. The patient is asking: "Doc, so what's the probability that I have the disease?" Think about it before reading the answer in the next post.
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Re: Wu Flu

Post by Sangoma » Thu Mar 12, 2020 10:11 pm

The standard answer among my registrars is almost invariably 95%. Sure, 5% are positive then the rest should be true positives, right?

Wrong. Testing cannot be taken out of context with the incidence of the disease. Bear with me, the next paragraph requires a bit of concentration.

Let's say the incidence of the disease XYZ, for which the patient was tested, is 1:1000. let's say we initiate a screening campaign and test the whole town. How many patients in 1000 tested will come back positive?.... Correct, 50 (% percent false positive). How many will have the disease? One. So the answer to this guy's question - the probability of him having the disease - is 1:50, or 2%.

In the article I posted above over half of positive results are false. Are you going to base your actions on that?

So Trump is - maybe unwittingly - smart guy, and until he develops symptoms testing is useless. And then it's pretty useless as well: the treatment will not be modified by the test results in any way, and testing everyone who has been in contact with him is pointless, as half of them may test false positive. You can as well isolate everyone, but I think we will all agree the result of that will be devastating.

More detailed explanation of pre- and post-test probabilities: https://en.wikipedia.org/wiki/Pre-_and_ ... robability
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Re: Wu Flu

Post by Fat Cat » Thu Mar 12, 2020 10:22 pm

Sangoma wrote:
Thu Mar 12, 2020 10:00 pm
It's understandable that the technological Western mind believes in testing as the final answer. Unfortunately it is not. Let me explain.

Imagine there is a disease XYZ for which there is a test. This test is reliable, and only 5% of the results are false positive. Say, you send the parent for testing, and the test is positive. The patient is asking: "Doc, so what's the probability that I have the disease?" Think about it before reading the answer in the next post.
Its understandable that the fatalistic Slavic mind believes testing is pointless. Unfortunately, it is not. Let me explain...
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Re: Wu Flu

Post by nafod » Thu Mar 12, 2020 11:27 pm

Sangoma wrote:
Thu Mar 12, 2020 9:57 pm
Testing asymptomatic patients is not useful.
We can’t test the symptomatic ones.
Don’t believe everything you think.

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Re: Wu Flu

Post by Sangoma » Fri Mar 13, 2020 12:08 am

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Re: Wu Flu

Post by Fat Cat » Fri Mar 13, 2020 12:38 am

Sangoma wrote:
Fri Mar 13, 2020 12:08 am
"Wash your hands, ye sinners." - James 4:8
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Re: Wu Flu

Post by Sangoma » Fri Mar 13, 2020 2:09 am

Circumcision is the answer
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Re: Wu Flu

Post by newguy » Fri Mar 13, 2020 2:54 am

Sangoma wrote:
Thu Mar 12, 2020 10:11 pm
The standard answer among my registrars is almost invariably 95%. Sure, 5% are positive then the rest should be true positives, right?

Wrong. Testing cannot be taken out of context with the incidence of the disease. Bear with me, the next paragraph requires a bit of concentration.

Let's say the incidence of the disease XYZ, for which the patient was tested, is 1:1000. let's say we initiate a screening campaign and test the whole town. How many patients in 1000 tested will come back positive?.... Correct, 50 (% percent false positive). How many will have the disease? One. So the answer to this guy's question - the probability of him having the disease - is 1:50, or 2%.

In the article I posted above over half of positive results are false. Are you going to base your actions on that?

So Trump is - maybe unwittingly - smart guy, and until he develops symptoms testing is useless. And then it's pretty useless as well: the treatment will not be modified by the test results in any way, and testing everyone who has been in contact with him is pointless, as half of them may test false positive. You can as well isolate everyone, but I think we will all agree the result of that will be devastating.

More detailed explanation of pre- and post-test probabilities: https://en.wikipedia.org/wiki/Pre-_and_ ... robability
Does exposure to people who are definitely sick change that?

So what if instead of testing the whole town, you test the 500 people who were known to be in close contact with 50 who are definitely ill?

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Re: Wu Flu

Post by Turdacious » Fri Mar 13, 2020 3:32 am

Sangoma wrote:
Thu Mar 12, 2020 10:00 pm
It's understandable that the technological Western mind believes in testing as the final answer. Unfortunately it is not. Let me explain.
We don't believe that testing is 'the final answer,' more that it's a useful step in arresting the spread of the disease.

Many tests are very useful-- testing symptomatic individuals lets people who have been in close contact know more about their exposure risk; and filtering tests (like temperature, age, other comorbid factors) let providers know which patients to treat and which to send home.
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Re: Wu Flu

Post by Sangoma » Fri Mar 13, 2020 5:16 am

newguy wrote:
Fri Mar 13, 2020 2:54 am
Does exposure to people who are definitely sick change that?

So what if instead of testing the whole town, you test the 500 people who were known to be in close contact with 50 who are definitely ill?
Maybe. You can argue that if someone who has been in close contact with a sick person can be isolated and this could reduce the spread of the disease. By then though they would have spread it considerably anyway. I suppose post-exposure testing in some groups can be beneficial - someone with the potential to spread it to many people - cashiers, health workers, cooks etc., as they have much higher potential to spread it.

Given the contagiousness of this virus I don't think isolation is going to be very efficient in stopping this epidemic. Personal opinion, and I am not very qualified to talk about it. It's actually possible to model various scenarios in Excel. I'll try play with it.
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Re: Wu Flu

Post by Sangoma » Fri Mar 13, 2020 5:25 am

Turdacious wrote:
Fri Mar 13, 2020 3:32 am
Sangoma wrote:
Thu Mar 12, 2020 10:00 pm
It's understandable that the technological Western mind believes in testing as the final answer. Unfortunately it is not. Let me explain.
We don't believe that testing is 'the final answer,' more that it's a useful step in arresting the spread of the disease.
The belief in tests is the side-effect of highly technological Western medicine and faith in technology in general. It's prevalent not only among patients but among doctors as well. Is it a useful instrument in reducing the spread? As I said above, maybe.
Many tests are very useful-- testing symptomatic individuals lets people who have been in close contact know more about their exposure risk; and filtering tests (like temperature, age, other comorbid factors) let providers know which patients to treat and which to send home.
What you mentioned in the brackets are not tests. Temperature is part of physical examination, and age and comorbidity is part of history taking. There is no specific treatment for COVID, and biochemical diagnosis doesn't change the treatment. Aspirin and Vit C for mild, oxygen and ventilation for severe cases.
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Re: Wu Flu

Post by Grandpa's Spells » Fri Mar 13, 2020 5:29 am

One of the downsides of the Internet is that it allows like-minded people to form communities, and sometimes those communities are stupid.

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Re: Wu Flu

Post by Grandpa's Spells » Fri Mar 13, 2020 2:03 pm

BTW, depending on where you are, you may not be experiencing this, but we went from Wednesday night "Why are these clowns buying so much stuff" to Thursday night "All the dry goods and proteins are gone" from our local supermarket.

If you have the ability I would get to stores before you think you need to, just to avoid the large crowds and daily jumps of infected.
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Re: Wu Flu

Post by motherjuggs&speed » Fri Mar 13, 2020 4:03 pm

I would like to see a panic index map along the lines of the infection map that Johns Hopkins has up and updates every few hours. It can change rapidly though, as mentioned. We haven't had any impact here yet (rural NM), but at Walmart there was no vitamin C or zinc available, although there was still couch syrup and alka selter.

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Re: Wu Flu

Post by Grandpa's Spells » Fri Mar 13, 2020 4:35 pm

Trump was handsy with the Brazilian president this past weekend, who has now tested positive for COVID-19. He is over 70 and has heart disease. He is refusing testing and is continuing to meet with Sr GOP people that are over 60-70.

There are definitely your overreactors, who are out buying water (WTF), but there seem to be a fairly vast number of people who are way underreacting. My mother in law is over 60, undergoing radiation and chemotherapy, and isn't taking any additional steps to protect herself despite being high risk. It's very frustrating.
One of the downsides of the Internet is that it allows like-minded people to form communities, and sometimes those communities are stupid.

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Re: Wu Flu

Post by Sangoma » Fri Mar 13, 2020 8:47 pm

Grandpa's Spells wrote:
Fri Mar 13, 2020 2:03 pm
BTW, depending on where you are, you may not be experiencing this, but we went from Wednesday night "Why are these clowns buying so much stuff" to Thursday night "All the dry goods and proteins are gone" from our local supermarket.

If you have the ability I would get to stores before you think you need to, just to avoid the large crowds and daily jumps of infected.
In Australia it started last week. There is a very large Chinese population in Sydney, and I suspect they are leading the buying spree. Rice and pasta have disappeared from shelves. On the crazy side - toilet paper is in great demand. Of all things!
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Re: Wu Flu

Post by Sangoma » Fri Mar 13, 2020 9:20 pm

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Re: Wu Flu

Post by Sangoma » Fri Mar 13, 2020 9:50 pm

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Re: Wu Flu

Post by nafod » Fri Mar 13, 2020 11:27 pm

Just drove back from the beach and spring break. 10 hours for my son and I, (as opposed to 10 seconds for Fats) Went to a restaurant for chow, it was way slow, and all the workers had on gloves.

Some old lady was coughing in the corner. Then she came up and asked my son how old he was. I almost shanked her with my spork right there. WTF, Typhoid Mary?

Stopped at a Walmart to get some stuff, then kept driving. It was *slammed* and people pouring out with bags of stuff.

We’ve gone full telecommute at work. I should have stayed at the beach.
Don’t believe everything you think.

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Re: Wu Flu

Post by Alfred_E._Neuman » Fri Mar 13, 2020 11:41 pm

Sangoma wrote:
Fri Mar 13, 2020 9:50 pm
Fruits and vegetables have absolutely nothing to fear.
I don't have a lot of experience with vampires, but I have hunted werewolves. I shot one once, but by the time I got to it, it had turned back into my neighbor's dog.

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Re: Wu Flu

Post by newguy » Sat Mar 14, 2020 12:52 am

In southern Cali this past weekend it was a toilet paper and water run on costco. Finding any toilet paper in a store now is like winning the lottery.

Then it all went to hell yesterday and today. Yesterday a handful of schools closed. Today all of them did.

This morning it was 45 to an hour minute lines at markets.

And now all meat and frozen veggies are just gone.

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Re: Wu Flu

Post by newguy » Sat Mar 14, 2020 12:53 am

Yeah - if the panic hasn't hit your area, you might want to grab toilet paper, hand sanitizer, lysol wipes, etc. now.
If anything just sell that shit at a 50 percent markup when you get the chance.

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Re: Wu Flu

Post by Fat Cat » Sat Mar 14, 2020 1:09 am

They're not going to shut off the goddamn water. Jesus Christ.
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Re: Wu Flu

Post by nafod » Sat Mar 14, 2020 1:41 am

My son got his verbal offer for a new cool job last week. This week they announced a hiring freeze. Who knows when it will be unfrozen.
Don’t believe everything you think.

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Re: Wu Flu

Post by motherjuggs&speed » Sat Mar 14, 2020 2:57 am

newguy wrote:
Sat Mar 14, 2020 12:53 am
Yeah - if the panic hasn't hit your area, you might want to grab toilet paper, hand sanitizer, lysol wipes, etc. now.
If anything just sell that shit at a 500 percent markup when you get the chance.
Fixed that for you.

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