Back in the early days of Covid-19 people didn't typically begin displaying symptoms visible without an x-ray until they'd nearly reach their peak viral load. More recently people tend to start displaying symptoms earlier. This is probably due to the adaptive immune system learning about covid through immunization or prior infection, but could also be something related to Omicron variants becoming dominant.

But in any event, it takes a while to get the results back from a test more sensitive than a rapid test. If you take a rapid test and send off a sample for PCR every hour then you'll collect a positive PCR sample long before you collect a positive rapid antigen sample. But you might very well get the results from the rapid test first since viral loads tend to increase rapidly in the early stages and can cross the ~4 orders of magnitude in the time it takes to turn around a PCR test.

EDIT: Actually, I should say and those peak viral loads I quoted are from 2020 when I was paying the most attention to this stuff and have likely changed with mass vaccination/prior infection and Omicron.

A majority, if not all, of the rapid tests I have used explicitly caution against taking one in the absence of symptoms, as it is expected to yield negligible results.

That might explain why governments adopt a blanket rapid test approach irrespective of the potential for false positives (even given the potential, as the article alludes to, for false negatives).

Airline would not do anything at all. Travel agent (website) would only book a new flight, but not refund the old one - they said (probably truthfully) that the airline ties their hands. Travel insurance would only pay out if the trip was _cut short_ because of a COVID diagnosis (how does that even work?), or if they were placed under mandatory quarantine by a government authority.

Seems unethical to me on all fronts but that’s how things are.

I suppose it’s not much different to how people are now, in most countries, just expected to go to work unless they’re heavily symptomatic (and even the “unless they’re heavily symptomatic” seems like lip-service that is not universally observed).

You might feel inconvenienced. Ultimately, you're the beneficiary of this too. Your life is going to be a lot longer, because the people around you are occasionally inconvenienced for your benefit.

If this isn't acceptable to you, I'm sorry about that, that's tough.

That's not the point. You and I both know that not everyone will be upfront about symptoms. The tests are there to attempt to cut down on this.

Every time I think to myself, "this is it, we all got COVID. I can tick off the symptoms."

None of those times were COVID (as confirmed by PCR tests).

More recently I was getting ready to go meet a newborn family member. I felt a little off so I took a Rapid Test. Guess what? I had COVID.

That Rapid Test stopped me from introducing COVID into a household with a newborn baby and parents trying to stay healthy to take care of their newborn baby.

Then how do you explain this:

> However, repeating the test 3 times, 48 hours apart, led to detection of infections in 75% of asymptomatic participants.

Let’s ignore the time aspect, and assume that the test has only a 35% chance of returning positive for an infected but asymptomatic patient.

Repeat that test 3 times, and the chances of at least one returning positive jumps to 73%.

(That’s why there are two tests in most rapid test boxes. You’re supposed to test twice, 24 hours apart, to improve the chances of a positive result if you are indeed infected.)

I wrote about this problem back in 2020 when it started becoming apparent that the public health establishment wasn't attempting to stop or even measure COVID PCR test false positives, because they had simply defined the problem out of existence [1]. Yet dig into the literature a bit and you discover that FPs are a well known problem that have occurred many times before.

There are at least three problems and arguably more:

1. Scope limits. Scientists have an extremely myopic view of what counts as an FP somewhat akin to "that's not a bug it's a feature" in the software world. Sample contaminated somewhere along the line from collection to machine? Maybe even when the sample brushed up against the outside of the machine itself, or the skin of a lab worker? Not a false positive in their view, because the PCR test itself is finding the RNA fragment it's looking for. PCR detects virus your immune system already destroyed? Not a false positive, because the test is actually looking for RNA so begins with a lysis stage that breaks open the viral capsid anyway. Results got mixed up in a shoddy IT system? Not a false positive because the "test" is just the machine they operate, not the whole infrastructure the public interacts with.

2. Over-sensitivity. COVID PCR tests were run at thresholds normally considered way too sensitive for normal usage, which is why they were so frequently triggering for weeks after a patient seemed to have fully recovered. Even with CTs ~25 these tests were pre-2020 run in extremely controlled labs with specialized air handling equipment and the like, to try and avoid FPs, but COVID tests were being routinely run in ad-hoc labs with CTs of over 40 and each additional cycle is twice as sensitive as the last!

3. Circular logic. Normally medicine is careful to keep pathogen and disease separate. It's important because some diseases ("collections of symptoms") can be caused by multiple pathogens, or no pathogen, and many people become infected with a pathogen yet never develop disease. In the very early days of COVID the distinction between disease and causative agent was kept properly separated because diagnosis was done by doctors, but this didn't survive contact with the public health establishment. They wanted a mass-scale system in the incorrect belief that they could slow down spread this way (there's no link in the data between testing levels and outcomes). Once mass PCR testing started the definition of COVID became circular: A positive test means you have COVID, but COVID was defined as having a positive test.

It's obvious what happens if you define COVID this way: the tests can by definition never have false positives. On what basis can you dispute the accuracy of the test if the test and not disease is defined to be ground truth? Using this approach, false positives always become "asymptomatic cases" that inconveniently never become sick and thus are not a case under classical medical reasoning. This is what led to bizarre claims coming from health authorities, like the claim that the tests had FP rates of zero. But it's not reality.

As I document in the essay, we know PCR results have FPs because there have been "pseudo-epidemics" in the past where ordinary coughs and colds were mis-diagnosed as outbreaks of dangerous diseases due to bad PCR results, and because lab challenges have often returned failures i.e. labs were submitted samples known to contain just ordinary rhinovirus or whatever and came back with positive SARS-CoV-2 results. There were also cases where reagent mixups caused false results, or where PCR tests returned results that switched between negative and positive then back to negative from samples taken back to back and so on. None of these were ever really investigated or root caused.

And all that's before you get into the systems that surround the labs. I got a PCR certificate for someone else's name at one point, almost certainly a form autofill mistake (I saw workers wrestling with this problem when they lost my wife's results). When I complained I got a new certificate in under 5 minutes for my own name this time but now the results were signed off by a different doctor i.e. the signatures supposedly demonstrating expert supervision of the test were just being randomly picked by software.

[1] https://blog.plan99.net/pseudo-epidemics-7603b2da839

"[...] finds the largest study to compare home rapid tests with gold-standard PCR tests"

PCR is assumed to be the truth to which rapid tests should aspire.

> False positives with rapid tests are known to be far less prevalent.

That's probably true if you use a normal definition of false positive, but under the intellectual framework public health uses you can't say this because you can't have less prevalent than zero.

Does that not suggest to you that maybe you were wrong? It's not just the decrease in testing, since test positivity has decreased from the peaks even as total test count plummeted.

There is no evidence that PCR tests greatly overcounted SARS-CoV-2 infections:

1/2. The specificity of commonly-used PCR tests for SARS-CoV-2 is clearly very high, >99.9%, since there have been regions (e.g. Australia) where total positivity was <0.1% for months at a time. It's true that other PCR tests (like your whooping cough tests) may have much worse specificity, especially in the early days before primer design was as well-understood; but we know empirically that these ones doesn't.

Sloppy lab work could result in false positives by cross-contamination, but contamination has to come from a true positive sample; so this is a problem only when the true positivity is high. Sloppy clerical work could result in any possible incorrect result, but you've presented no evidence that this is a significant problem in aggregate.

Lots of papers studied the relationship between PCR positivity and culturable virus, for example

https://academic.oup.com/cid/article/72/11/e921/5912603?logi...

It's true that at high Ct, the cultures are often negative; but (a) the relationship between Ct and culturable virus may vary dramatically with small changes in PCR protocol, (b) a patient early in their infection may have high Ct now but lower Ct later, and (c) it's not clear whether all naturally infectious patients would be positive by artificial culture anyways. Based on these factors, most public health authorities chose not to use an artificially lower Ct. So a positive PCR test doesn't necessarily mean that a patient is infectious now, but it does mean that they are or were recently (weeks to months) infected.

For emphasis, it is absolutely expected that some samples will be positive by PCR but negative by cell culture--the PCR is testing for any RNA matching the primers, but the culture is testing for replication-competent whole virus. Presence of the latter implies the former, but the converse isn't true. The public messaging on that wasn't very good, and perhaps they initially misinformed you; but no one with any background in molecular biology was confused here.

3. Your idea that the PCR test is simply assumed to be accurate is completely false. The point of papers like the one I linked above is to compare two test methods, find the places where they disagree, and try to judge--from the experimental results and from our understanding of the biochemistry of the test methods--the reasons for those disagreements. They're not assuming either method to be perfect. Based on many such comparisons--against cell culture, against electron microscopy, against antibody tests, against excess mortality once that got big enough to distinguish statistically (which it mostly wasn't by Jul 2020), etc.--public health authorities judged PCR to be the best available gold standard, and good enough for many statistical purposes.

The public messaging was again pretty bad there, and if you looked only to that then I understand why you'd feel misled. The actual scientific literature is there for anyone who wishes to read it, though.

Where do you see that? Where I live that isn't the case and according to official data the pandemic has never ended:

https://www.covid19.admin.ch/en/epidemiologic/test?epiRelDev...

As recently as April the positivity ratio was as high as it was in December 2020 (~16%). I have no idea who these people are who get tested 10,000 times a week but they do.

Now, I don't think this is just due to false positives. It might be - my point was and still is that we can't ever know due to these logic problems - but it might also be that Omicron mutation rates have just settled down into a background pattern that these tests still pick up or something. With no real definition of what COVID is beyond test results this question is unanswerable.

> contamination has to come from a true positive sample; so this is a problem only when the true positivity is high.

So? FPs are a problem regardless of when they occur or why.

> Sloppy clerical work could result in any possible incorrect result, but you've presented no evidence that this is a significant problem in aggregate.

How could I? Governments were told by scientists that PCR testing has an FP rate of zero, so they just didn't build any processes to recognize the possibility or measure the error rate. I had direct experience of clerical errors twice, and we didn't get tested much. And that's in Switzerland which has a relatively strong culture of quality control and carefulness. During COVID there were many viral social media posts and videos where people did things like submit a swab that had never been used, or that was dipped in a puddle, or where they swabbed their dog, and got a positive result. There were also lab challenge studies which showed some labs failed badly (although others didn't). To me these things are good enough evidence that FPs were a real problem.

> a positive PCR test doesn't necessarily mean that a patient is infectious now, but it does mean that they are or were recently (weeks to months) infected ... perhaps they initially misinformed you; but no one with any background in molecular biology was confused here

You're supporting my points here. Nobody cares about detecting people who were infected months ago. Yet governments reacted to any positive test by assuming they were highly infectious and immediately forcibly quarantining the unlucky person who got it. Even when people said "yeah I had it weeks ago but am fine now", that counted for nothing, because the test was taken to be the gospel truth. Anyone who pointed out that this was nonsense got shouted down as a "denier" (see responses to that blog post, or even my comments here on this thread in 2023!).

> Your idea that the PCR test is simply assumed to be accurate is completely false ... good enough for many statistical purposes

Statistical purposes!? People were locked in hotel rooms for weeks on end on the basis of these tests, they were prevented from taking vacations no refunds allowed, they were fined, they were locked in their homes. The Swiss government had a web page that stated point blank that PCR tests had no false positives at all. If this assumption is completely false, how could someone appeal a false positive, in your jurisdiction? Because I'm sure it was impossible in mine.

> The public messaging was again pretty bad there

The public messaging came directly from scientists. Unless you think politicians had opinions on the accuracy of PCR tests predating the pandemic, of course. I even ended up arguing about this with an immunologist acquaintance who used PCR testing for his job, he was also under the impression that PCR tests couldn't have false positives and anyone who thought they could was the victim of misinformation. When I told him COVID tests used a Ct>40 though, he turned pale, suddenly lost his confidence and said they shouldn't be doing that.

If those data don't show the end of the pandemic, then what would? Your confirmed deaths are around 1/100 of the death peak. Positivity fluctuates much less, in part because there's a feedback loop--authorities will test more if it gets too high (subject to resource availability), and less if it gets too low. It's well below the positivity peaks, though. In any case, if the plummeting death count were due primarily to plummeting testing, then we'd expect the test positivity to increase, and it definitely hasn't done that. I'm in the USA myself, with broadly similar trends.

> Governments were told by scientists that PCR testing has an FP rate of zero, so they just didn't build any processes to recognize the possibility or measure the error rate.

I don't know what the Swiss government did, but globally scientists certainly considered that possibility--for example, that's basically the point of all the papers comparing excess mortality against confirmed deaths. The agreement isn't perfect, but the trend is pretty clearly there.

> So? FPs are a problem regardless of when they occur or why.

Non-contamination false positives show up like an additive offset to the positive count, while contamination false positives show up more like a multiplicative scale. They're both bad, but the latter is usually less bad, since relative error is usually what matters.

> Nobody cares about detecting people who were infected months ago. Yet governments reacted to any positive test by assuming they were highly infectious and immediately forcibly quarantining the unlucky person who got it.

All governments that I dealt with were clearly aware that a positive PCR test didn't mean you were infectious now. For example, travel guidance generally permitted a recent (but not too recent) positive PCR test as an alternative to a very recent negative PCR test, since they knew that recovered patients might test PCR positive for a long time.

For people newly testing positive, governments didn't advise or mandate isolation because they thought the tests perfectly predicted whether a person was infectious now. They did so because those tests were the best tool available, and they judged the harm of missed isolation of infectious people to be greater than the harm of unnecessary isolation of non-infectious people. I agree that in many cases, that was a policy mistake. That problem is with the policy, though--the tests were performing exactly like any competent microbiologist would expect.

I'm not sure why your immunologist turned pale, since Ct cutoff around or slightly above 40 isn't unusual. For example, here's a pre-pandemic test for infectious salmon anemia virus that chose Ct = 42 in certain cases:

https://journals.sagepub.com/doi/10.1177/104063871102300102?...

In general, Ct values aren't comparable between different protocols. Sensitivity and specificity are judged from results on positive and negative controls, not from absolute Ct. There's no single best Ct; it's always a tradeoff between false negatives and false positives, and the weighting of that tradeoff varies with the intended use of the result.

> The Swiss government had a web page that stated point blank that PCR tests had no false positives at all.

That's clearly false. I don't think the American government said that, though they made other false absolute statements (if you get the vaccine then you definitely won't get sick, etc.). The consensus of the scientific literature told a much more cautious story, though.

It seems like your complaints are about the use of the PCR results, not the accuracy. If the PCR test correctly reports the presence of viral RNA, and based on that a patient is forced to isolate based on the x% chance they'd infect someone else, and you believe x is too low to justify that, then that's not a false positive; it's just a policy position that you disagree with.

This thread is sufficient to prove my point - the idea that PCR tests have very low or even zero false positive rates is essentially misinformation spread by scientists who are unwilling to consider anything about how the tests are actually used. Your whole post boils down to, "we only did PCR tests for statistical purposes so FPs didn't matter as long as they didn't affect the trend, if governments used them for other things well that has nothing to do with scientists".

Sorry, but like hundreds of millions of other people I simply don't accept this perspective. We don't think politicians had much agency because they just followed instructions from scientists at every point. Therefore the science community owns the COVID response. They don't get to now dissemble and engage in blame deflection when people point out what a catastrophe it was.

No matter what your desired policy, you could find a scientist to support it--some scientists were advocating for Chinese-style lockdowns, while others were drafting the Great Barrington Declaration. So how do you think the politicians chose which scientist to listen to, or to promote in the mass media? It's not like they took a poll--the vast majority of scientists expressed no policy opinion at all, and simply concentrated on their actual work.

Politicians are the ones with the power to make laws, and direct the police to enforce them, if necessary with physical violence. It's amazing to me that their attempt to cloak their policy decisions in "trust the science" worked so well on you that you've absolved the people with actual power of their actions, instead directing your anger at some abstract "scientists".

Because who cares if you're asymptomatic but your viral load is low and you're unlikely to infect others? If lack of viral load is the reason that the test is a false negative but that's also correlated with low likelihood that you can infect others, then this understanding is not useful. The test still did it's job for what people needed it for.

The full article does not seem to be publicly accessible, so I'm not sure if my comment is already covered.

IIRC ~75% of PCR positive samples couldn't have any virus cultured from them at all. Viral culturing isn't easy, but PCR tests can trigger on destroyed virus, so it's not a surprise that you can't get replicating virus out of many such samples especially at CT>40.

But even if you can grow virus, that doesn't mean someone is infectious. To determine that the ground truth is contact tracing and followup. But this showed that many people who were clearly sick with COVID never infected people they were in close contact with. Even within the home, most cases did not transmit, I think. I got direct experience of this when my wife got COVID and was sick for a couple of weeks, I was then quarantined by the government at home but never got sick. How this could happen was never officially explained.

This reveals one of the core scientific problems with the epidemiological simulations that were driving policy: they assumed infection is a one-way event i.e. 100% pre-existing susceptibility. I infect you, because I'm sick, you never were when we get close together we roll a dice and if it comes up 3-6 then you get infected too. This isn't how it works in reality. People's immune systems differ significantly and some are just stronger than others. To be infected I have to be infected but you have to be susceptible. The COVID models basically ignored this and assumed a homogenous population. When adjusted to reflect a more realistic heterogeneous population herd immunity thresholds went down a lot:

https://www.medrxiv.org/content/10.1101/2020.04.27.20081893v...

This research wasn't merely unnoticed, it was actively suppressed. Journals refused to publish it because, "Given the implications for public health, it is appropriate to hold claims around the herd immunity threshold to a very high evidence bar, as these would be interpreted to justify relaxation of interventions, potentially placing people at risk."

https://twitter.com/mgmgomes1/status/1291162358962937857

When you're in the heart of an epidemic that's going to kill millions, you err on the side of caution. Quarantining you at home, for example, makes sense when you're dealing with a deadly disease and you don't know enough to know you're not contagious.

Again, thanks for the info, but "lessons learned" should generally be left to the people who will have to deal with the next pandemic, especially since (I'm betting) they won't express their lessons learned as confidently as you are.

There is far more to life than the prevention of exactly one very specific respiratory illness. If you leave it to only the “experts” the only lessons you’ll get will be so narrowly focused as to be completely useless.

“Experts” never should have been allowed to directly drive public policy. Public policy is a holistic exercise focusing on the big picture, not just one very tiny myopic thing.

An entire generation of kids will grow up forever scarred thanks to the myopic, hysterical actions of these “experts”.

Putting scare quotes around the word "experts" says more about you than the experts.

These covid "experts" lied, manipulated the narrative, hid data, played politics, ignored data, and coerced media and big tech to play along. They silenced and attempted to discredit any colleague who went against their narrative--no matter how qualified or expert that colleague was.

I trust all kinds of experts from lawyers to water quality folks. Experts are always needed. But once you start lying and bending the truth the way the covid "experts" did... you lose the right to be considered an expert.

Nobody gets to tell me or anybody who gets to be an actual expert. That title is earned, not pushed by some authority figure and a bunch of hysterical people on social media.

I find it depressing how many people still buy into the narrative these "experts" pushed. It has nothing to do with tribalism or politics--these "experts" fucked up big time and caused incalculable damage to society that will haunt us all for decades to come. In short, Covid "experts" can rot in hell. And mark my words, what I just wrote will become the mainstream opinion soon enough.

You and I were told by “experts” that SH had WMD and that the brief war would cost about 400M.

Yes, I hope my scare quotes do, indeed, say something about me.

All the crap these “experts” pushed was the exact opposite of what was in tons of different pandemic plans. It was all unproven and untested. Making us all in unconsenting research subjects.

Intuitively yes, in reality no. It was known by March 2020 that quarantines had no effect because of the outcome of trying it on the Diamond Princess, a sealed environment where quarantine could be perfectly enforced. That didn't stop SARS-CoV-2 spreading between cabins and causing COVID apparently at random, i.e. it'd propagated everywhere but not everyone was susceptible. This knowledge was never incorporated into health policy. The same thing had been found during the SARS-1 outbreak in Hong Kong, where it was able to move between apartment blocks separated by a garden on air currents. The quarantine within the origin apartment block didn't work due to airborne transmission, something the WHO denied was possible.

It was even known before 2020. Public health planning before this time said clearly not to use mass testing and mass quarantines because they don't work. This was torn up once COVID started.

> your tone comes off as "I know better and would have been more sensible if I were in charge."

Frustrated, yes, I know how it sounds.

The COVID response was deeply flawed from the start, and in ways that were obvious even to outsiders. I was writing about the impossible claims being made for PCR tests and the history of failed epidemic models in Spring 2020, but I don't think I'd have done better if I ran the WHO. That's because the incentives and structures such people operate under are terrible, and apparently overwhelmingly strong.

Consider this article from 2010 [1]. Der Spiegel investigated the Swine Flu "mass hysteria" and stated that the world clearly overreacted. Reporting on the WHO, "At any rate, efforts to downplay the risks were unwelcome, and the WHO made it clear that it preferred to base its decisions on a worst-case scenario. "We wanted to overestimate rather than underestimate the situation," says Fukuda."

Given everything that happened since I'm really convinced that the right way to handle a pandemic is just to let individuals and their doctors get on with it. Academics and NGOs can make recommendations if they want, but giving these people power is a bad idea. Central health planners are incentivized to maximally over-react, every single time. No lessons are ever learned, and why would any be? They have absolute immunity from accountability and consider interventions to be cost free. That is corrupting. What happened with COVID will happen again.

[1] https://www.spiegel.de/international/world/reconstruction-of...

It is an absolute certainty that the response to covid was suboptimal. Apart from how complex the situation and the response was, just given that responses varied widely from region to region guarantees that most were not perfect.

But while it's certainly possible to nitpick some aspect or another of the response, to jump from that to therefore you (or I) know better than the people being paid to do nothing but study the situation and learn from the outcomes, is as conceited as looking at the Challenger explosion and saying, "Clearly there was a problem with the O-rings, therefore I know better how NASA should be run."

I didn't mean to attack you with my comment -- I just wanted to inform you of how your tone seemed in case you were unaware. It seems that you're not only aware, you think your tone is justified. So good for you, enjoy your confidence.

Your examples of experts you trust are all engineers, not public health scientists. Air disasters, power outages and rocket explosions are immediate, visible and concrete failures. You can't consensus your way out of a plane crash. If a plane goes down ordinary people demand serious answers and because plane travel is run by the private sector the operators are all very incentivized to cooperate with a real investigation, in order to reassure the public it won't happen again. The investigations into these failures are very deep, very real, root cause what went wrong and generate concrete changes.

Scientists aren't operating in the same environment. Many people use as a test of scientific competence "do you agree with other scientists" and nothing else, which is circular reasoning. When scientists fail there's a tendency for them to argue that oh well the situation was complex, lots of unknowns, did the best we could, consensus of experts etc. People are trained to never argue with scientists so they can do this.

Engineers don't get the same privilege. Saying "the experts decided it" is worth nothing to governments, the media or the public if your oil drilling ship just sank.

I encourage you to play the other side of this argument for a while. I've been called all kinds of absolutely awful things by people I used to respect. Why? Because I dared to question or examine things myself. I guess I was just expected to shut up and listen to "the experts" even if I found their edicts to be completely useless, unethical, immoral, and not even close to being driven by data. I've been banned, blocked, and called "dangerous" just for linking to public data hosted on a government website.

Somewhere I read "consensus"... well, there was absolutely no consensus. Any critic, no matter how qualified, was immediately discredited by those in power. Covid policy was completely one-sided the entire time.

So, I'm kinda sorry but not really sorry about my tone. Those of us who had to suffer through 3 years of hell thanks to "the experts" intentionally painting us as heartless alt-right grandma killers... well we are kinda pissed. We've all heard every argument you write. We heard it for three years. And we believe it is wrong; ethically, morally, and legally.

And we have a complete right to that opinion. Because public policy is not based on "experts" or "the science" but on opinion and values. And quite frankly, the values that drove the lockdowns and all the other nonsense covid theater are, in my opinion, bad...even evil.

The values that drove lockdowns and such expose some of the absolute worst aspects of humanity--arrogance, hubris, and tribalism. Modern humans think they are way more advanced than people thousands of years ago, but based on our reactions to covid, I'd say we have the same archaic superstitions our ancestors had back when we all lived in caves.

Anyway, I hope this helps you understand where those of us with a difference of opinion come from.

It seems you have been doing in-depth research about Sars-Cov-2/Covid-19, how did you miss the secondary attack rate/household infection rate? It used to be one of the crucial measures of transmission in early 2020, and has been studied for every variant ever since.

What I don't understand is this jump between the complexity of the situation and the simplicity of your conclusions. You go into great length to point out the shortcomings of PCR tests or that 100% susceptibility is an unrealistic modelling assumption, but your interpretations/conclusions are often blanket statements like

> This reveals one of the core scientific problems

> This research wasn't merely unnoticed, it was actively suppressed.

I notice that in your conclusions you tend to lump together very heterogeneous groups, like "scientists", "the media", "government", "the people who run healthcare" - and "they" seem to be responsible for the shortcomings? I find it very puzzling. E.g. scientific consensus is rarely clear-cut, but you will find plenty of papers/opinions arguing for and against something. Same with governments, there are some 200 countries and "they" followed very different policies. Wouldn't it be more convincing to present both evidence for and against a certain hypothesis?

I get what you mean about consensus but scientific consensus is by definition clear cut, it's supposed to mean 100% agreement. Often something is presented as a scientific consensus when it's really not, rather, people who disagree are being ignored or blocked from publishing.

During COVID a lot of things were presented to the public as if it were 100% obvious and agreed with by every specialist, then policy was made on that basis. You couldn't just disagree with government mitigations and ignore them, they were enforced by law and this was justified by the idea that anyone who disagreed with their effectiveness was a misinformation-addled rube who had to be forced for the good of everyone else. People who pointed out data or papers that disagreed with this supposed consensus were fired or banned from social media to try and maintain this illusion of universal agreement.

> there are some 200 countries and "they" followed very different policies

Did they? I'm pretty sure virtually every (rich) country all imposed mass testing, quarantines, mask mandates, lockdowns and mass vaccinations. Other than Sweden famously rejecting lockdowns, which countries didn't do these things? Policy was globally homogenous because the public health community is global and their methods don't really vary. Tegnell was the exception that proved the rule.

> During COVID a lot of things were presented to the public as if it were 100% obvious and agreed with by every specialist

Who is it that presents things to the public? Who are "they"? Who is "the media"? At least in the country I live in different journalists/writers/bloggers had very different opinions and they changed significantly over time. You could even watch the scientific process in real-time: New evidence comes in, people update their beliefs.

> scientific consensus is by definition clear cut

> maintain this illusion of universal agreement.

> Policy was globally homogenous

We can agree or disagree whether there are these groups that all act in unison, what I want to point out is that you need these homogenous groups for your argument to work.

If different countries had come to similar conclusions independently, that would mean the conclusion are likely valid, no? If different journalists/experts/scientist from different countries/cultures/political backgrounds came to similar conclusions independently, that would mean the conclusion is likely valid, no?

I'm making a guess here: I hypothesise that your discontent stems from the fact that you don't want other people to tell you what to do or not to do. In particular you disagree with the concept that society is a mechanism to distribute both wealth but also burden. Does that ring a bell?

We got to watch the scientific process in real time, indeed. It consisted of new evidence coming in and nobody updating their beliefs.

> If different countries had come to similar conclusions independently, that would mean the conclusion are likely valid, no?

No. After all, that cuts both ways. Many hundreds of millions of people around the world who were fully independent of the scientific grant funding structure watched this process and came to very different conclusions. So that must be mean the conclusions are likely invalid, no?

Just a nit but stronger is a weird term to describe any functioning immune system. Some genetic trade-off that makes one immune system better suited to blocking COVID infection might make it worse at something else.

> To be infected I have to be infected but you have to be susceptible. The COVID models basically ignored this and assumed a homogenous population.

And the data used to drive those models is going to be a result of a real world average across the population, so that is fine for nation level decision making.

Let’s say you’re using data from two traced cases, a case with high susceptibility (HS) family members and one with low susceptibility (LS) family members.

The HS case was in contact with 4 family members, 3 of which became infected. The LS case was in contact with 4 family members and 1 became infected.

Two infections, 50% transmission rate. That is fine for modeling and policy, unless we have some sort of a test to determine if you are HS/LS which could be used to make more granular policies.

All of this is moot considering the the different variants we never reached some magical “herd immunity” anyways.

When more data did become available the models were often never updated. I reviewed the code of several models during the pandemic. Beyond having severe bugs, they also frequently used values from January in December or even well into 2021! As more data came in it became clear that the original assumptions were far too pessimistic, but epidemiology doesn't distinguish clearly between assumptions, simulation results and observational data. So they just kept using the old numbers. It got their results in the news and peer reviewers didn't care.

> All of this is moot considering the the different variants we never reached some magical “herd immunity” anyways.

Well, we don't really know why variants suddenly displaced each other so fast and so completely. It would appear that there's some kind of viral interference, in which you can't be infected with multiple respiratory viruses at once. That doesn't fit with any classical form of germ theory, but the COVID response was based on the assumption of high-school level germ theory being complete, even when collected sample data showed that couldn't be true.

The parameter’s my region’s epidemiologists were using for their models was certainly being updated as new data became available. I even had a conversation with one of them on Reddit about it.

> Well, we don't really know why variants suddenly displaced each other so fast and so completely. It would appear that there's some kind of viral interference, in which you can't be infected with multiple respiratory viruses at once.

Eh? It is the same natural selection, competitive process at large scale and in the body.

You can be infected with multiple variants.

Maybe you caught Covid but went asymptomatic because your immune system is just better at handling it? (and PCR tests won't detect it because, as this story says, they miss 90% of asymptomatic cases)

This is hardly unheard of, unexpected or unexplained.

Right? Is that not how it went?

It was unexpected. The models deployed to justify lockdown assumed 100% susceptibility to COVID-the-disease on the grounds that the virus was "novel". Although they had some crude notion of chance involved in transmission, they didn't have any notion that you could be heavily and repeatedly exposed to the virus and just never catch it at all. When did governments admit that this expectation had been violated, that must be a lot of pre-existing immunity? IIRC, they never did.

And what's the official explanation for how that happened? AFAIK there isn't one? There were some attempts at the edges to claim that all these people must have had symptoms, just so mild they didn't notice. But if neither you nor anyone else ever notice you got sick, then you didn't get sick using any conventional definition of sickness because disease is defined as a collection of symptoms.

So was Typhoid Mary sick? Is an asymptomatic patient with a positive HIV test? Kary Mullis--the inventor of PCR!--says no:

> A man with gray hair and a goatee raises his hand. He says he's been HIV-positive since 1984, that he took the anti-AIDS drug AZT for a couple years but stopped. Now, he says, his T-cell count -- the number of a kind of white blood cell that is killed by HIV -- has gone way down.

> Mullis interrupts him: "Change doctors!"

> The man continues. His T-cell count is down to 150, which is usually thought of as dangerously low. He asks Mullis for advice.

> "I would say there is no evidence that I can find in the scientific literature that you should worry about HIV or your T-cell count," Mullis tells him. "If you'd stop worrying, maybe you'll be all right. You look pretty healthy to me."

https://www.washingtonpost.com/archive/lifestyle/1998/11/03/...

Do you think he gave that patient good advice?

The point is that even if you feel good now, a positive HIV test means that without treatment, you'll almost certainly die within the next 10-20 years. You can also infect others, and they'll die too. (As to the 14 years, the patient Mullis talked to was presumably some combination of lucky and/or benefiting from the AZT he'd taken previously.)

Likewise, a positive SARS-CoV-2 test meant that you'll die with p ~ 1%[1] within the next couple months. That's much less bad than HIV, and the relative benefits of treatment are much smaller; but that's spectacularly higher than baseline mortality, so the test is clearly predictive.

The concept of asymptomatic disease is well-recognized in medicine; just google the phrase. I'm not sure how Kary Mullis managed to convince so many people to reject it.

1. That's a CFR over all ages, confirmed deaths divided by confirmed positives. The IFR is of course lower, but the statement is conditioned on a positive test.

https://www.cdc.gov/cmv/congenital-infection.html

Your claims are inconsistent with at least a century of boring, uncontroversial medicine. I don't know whether you're doing it knowingly, but you're closely repeating the arguments of Kary Mullis, who was clearly smart (he invented PCR!) but not exactly reliable (he denied that HIV causes AIDS! he saw a talking, fluorescent raccoon!).

https://abcnews.go.com/Health/covid-outbreak-belgian-researc...

Of course, certain news outlets like for instance the BBC have failed to disclose these additional details.

Back then epidemiology was a more curious field so this was investigated in some depth. Nobody had opened any new crates or done anything else that could expose fomites. There had obviously been no contact with anyone else. No source for the infection could be identified.

In the wake of this there were a couple of hypotheses which have since been forgotten:

1. Transmission from the atmosphere. There's some other work that explored the idea that influenza could travel long distances in the upper atmosphere whilst remaining viable.

It's known that SARS-like viruses can float through the air because this is how it spread between apartment blocks in a SARS-1 outbreak in Hong Kong. It's also hard to see how it could have spread on the Diamond Princess except via air ducts. Despite being called SARS-2 though, the possibility of airborne transmission was strongly denied at every point by the WHO and other health agencies, presumably because it would have invalidated the rationale for lockdown.

2. Constant low level infection that our immune systems normally keep suppressed. Then you have a bad day, don't sleep well or something else knocks you off balance and this is enough for the infection to start replicating out of control until the big guns are fired up.

>WHAT ABOUT SARS-COV-2? CAN IT UNDERGO VIRUS REACTIVATION? >Research on SARS-CoV-2, the virus that causes the COVID-19 disease, is still ongoing. Infectious Disease specialists are studying its behavior to figure out if this virus can remain latent in the human body. Early research suggests that the virus may cause a latent viral infection, i.e., people who are believed to be cured of COVID-19 may test positive again due to reactivated virus rather than a re-infection. A person with a reactivated infection can potentially cause virus spread.

>COVID “long haulers,” especially previously healthy people who are experiencing long-term symptoms after COVID, are of special interest to scientists. Researchers are trying to figure out whether the continuing symptoms are because their bodies are unable to put the virus into a dormant state. Only time will tell if SARS-CoV-2 is truly a virus that can undergo latent viral reactivation.

* Routsias JG , Mavrouli M , Tsoplou P , Dioikitopoulou K , Tsakris A . Diagnostic performance of rapid antigen tests (RATs) for SARS-CoV-2 and their efficacy in monitoring the infectiousness of COVID-19 patients. Sci Rep. 2021;11(1):22863. doi:10.1038/s41598-021-02197-z

* Currie DW , Shah MM , Salvatore PP , et al; CDC COVID-19 Response Epidemiology Field Studies Team. Relationship of SARS-CoV-2 antigen and reverse transcription PCR positivity for viral cultures. Emerg Infect Dis. 2022;28(3):717-720. doi:10.3201/eid2803.211747

* Korenkov M , Poopalasingam N , Madler M , et al. Evaluation of a rapid antigen test to detect SARS-CoV-2 infection and identify potentially infectious individuals. J Clin Microbiol. 2021;59(9):e0089621. doi:10.1128/JCM.00896-21

* Killingley B , Mann A , Kalinova M , et al. Safety, tolerability and viral kinetics during SARS-CoV-2 human challenge in young adults. Nat Med. 2022;28:1031-1041. doi:10.1038/s41591-022-01780-9

[1] COVID-19 Symptoms and Duration of Rapid Antigen Test Positivity at a Community Testing and Surveillance Site During Pre-Delta, Delta, and Omicron BA.1 Periods. https://jamanetwork.com/journals/jamanetworkopen/fullarticle...

We don't have a labor and cost effective test for this, and we require the test to be done in a BSL-3 facility.

So what remains is that we need to solve public health problems with tests that produce only correlates of infectiousness. Those correlates will be necessarily imperfect, but they're all that we have to craft policy around.

The perfect home test which only detects infectious virus doesn't exist.

And I'd just like to see more published studies which actually cultured virus rather than using PCR as a proxy for infectious virus, but even that is hard to get. So many lazy scientific studies out there conflating PCR positive with virus, but there's a lot more researchers who can do PCR than researchers than have access+funding to a BSL-3 lab.

If you take a test right before you arrive, and you stay for a couple of days, if you just caught covid the day you arrived, you'd like to know that. That's where a more sensitive test is really useful.

This is a particular problem with newer variants of covid because they multiply much faster. A very low viral load in the nose when the test is taken can turn into a lot in a matter of hours.

Anyhow all of this is fairly academic at this point because no one is taking any tests and everyone is doing big events with lots of people.

While some folks are certainly still worried about spreading the virus, for most folks it's always been about whether a positive test requires them to restrict their movement or activities (e.g. whether or not one could fly on a plane in 2020-2022).

Public service request: There are millions of Americans with compromised immune systems who are finding the current environment treacherous since most people have completely moved on. If we have an interaction with someone who is masked, it would be great if we could just mask up at least during that interaction as a courtesy. That person could be at significant risk and it does no harm to us to mask up for a few minutes to help reduce their risk even if we aren't concerned for ourselves.

Additionally, you made a huge leap in assumptions about me that simply aren't true when you assumed what my opinion is/was and how that would project. Let's keep it away from getting personal like that?

Sure but that problem is once removed from the real problem. The underlying reason for restrictions is infectiousness. If tests measured infectiousness accurately, rules on restrictions would follow and use those tests instead.

You lost me at this bit. Use Fiji to run the gel analysis or is this via ImageJ or something else?

(This is a question, not a statement)

It depends on the purpose of the test.

For example, a trillion dollar question is still long covid. Very significant numbers of people are on disability right now. About 10% of Americans have some form of long covid, and >1% are unable to work due to long covid (or >2% of the workforce). Long covid comes up even with mild and asymptomatic cases, and seems to have a strong autoimmune component. If you're trying to understand where those sorts of symptoms came from, it's good to know whether or not you had covid before they started.

Given that we don't understand what's going on here medically at all, it's not immediately useful, but it may be useful to know as treatments come up. A big part of the reason why I test is simply to know.

There are many other potential purposes one might have for testing too. For example, studies might want to track prevalence of covid in populations. It's good to know, methodologically, what they're tracking.

Like, if I had to bet money on it, I'd wager that "long flu" and even "long cold" are real things that happen at least sometimes, but just haven't gotten much attention (and, to be fair, they might also be less common, or less-commonly-as-severe, if they are real).

Also, n=1, but I had a bout of bacterial laryngitis a few weeks ago (was briefly intubated for elective surgery—apparently this is a common side effect) and I'm still feeling a little breathless/cough-y despite having hacked up every last bit of phlegm and finished a full course of antibiotics. Doesn't seem shocking that my lungs would take a bit to recover, even if the bacteria in question have already cleared out.

Anecdotally, for people I know, it would take six weeks to half a year to resolve.

My own speculation is that it's autoimmune, simple due to having it seen resolved when people were vaccinated. However, "anecdote" is not the plural of "data," and it just as well be unrelated.

There are wonky changes to organs during covid, which many doctors speculate are the root cause.

In either case, I'm unaware of any mainstream theories where paxlovid would be likely to help.

Footnote: That's a 180 turn-around from state-of-the-art science a year or so ago. At the time, we thought there were individuals where it persisted (evidence in immunocompromised), but nothing like this.

https://www.acpjournals.org/doi/10.7326/M21-4905

https://astralcodexten.substack.com/p/replication-attempt-bi...

https://www.piratewires.com/p/bisexuals-long-covid

- Had severe memory problems for a few months following covid

- Had severe balance problems for a few months following covid (to the point of falling when walking around the house)

- Basically couldn't talk for a month after a mild covid infection, due to coughing fits (despite having mild/no respiratory symptoms during a very mild covid).

... and so on. These are not psychosomatic symptoms. You can't make up a hoarse voice with an extreme cough.

You can talk to doctors too. This stuff is pretty severe. If your argument was that, rather than 4 million people out on long covid disability, it was, say, 2 million, I'd listen. However, your argument is like someone near the equator arguing snow doesn't exist.

Under/over/misdiagnosis is a thing for a lot of conditions, but that doesn't mean those conditions don't exist.

You'd also be better off citing medical journals than conspiracy web pages with web surveys and sample biases.

“According to large population-based surveys, up to 33.7% of the population are affected by an anxiety disorder during their lifetime.”

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4610617/

published prior to covid

That’s bizarre. I’m not sure what would cause those numbers regardless of whether long covid is real.

https://www.cdc.gov/nchs/covid19/pulse/long-covid.htm

Why?

It's not to begin treatment. So it is a pretty big problem!

Why, if asymptomatic cases are unlikely to infect others, is a false negative for asymptomatic cases a problem? Doesn't this all boil down to "if you feel sick, stay home, if you don't, don't worry about it?"

Defense-in-depth gives a broad range of tactics, and the goal is to combine enough of them to limit risks.

If you think one risk profile is reasonable, and you're interacting with someone who has a much more conservative profile and putting them at risks they consider unreasonable, you're probably being a dick (and vice-versa). That's not just diseases -- it's everything from gun safety to outdoors safety to sparring.

If you've been exposed to covid, and are asymptomatic, you should take reasonable precautions. For introverts, that might be staying at home. For others, it might be testing. For others, it might be using a high-filtration mask. It sort of depends on your preferences. Asymptomatic spread is pretty common, and it's not unreasonable to try to prevent it.

If you've been exposed to covid and are symptomatic, you should take stronger precautions.

This isn't saying everyone needs to be testing at all times and tests should be 100% effective - some situation require testing, and it'd be nice if it caught asymptomatic covid as well.

It's just funny that you have to mention this is a question even if a question mark exists. It shows how much toxic people got instead of understanding others.

Excessively-defensive Internet writing style. You have to make everything clear in three different ways and over-explain everything so that careless, poor, or hostile readers won't/can't flame you or derail the conversation over something that isn't even actually true about your post.

See also: disclaiming "in my opinion", sometimes more than once, for things that are obviously opinions, just to keep idiots from going "LOL that's just your opinion but you're stating it as fact" in all your responses. Once you notice this style, it's a can't-unsee kind of thing. Makes reading Web forums frustrating.

This kind of distracting, mealy-mouthed crap is absent from any decent, say, traditional-publishing book or article, but is standard online.

It's worse on HN (which, you'd think the whole "read generously" guidance would counter it pretty well—but no) than most places, but it's common all over. It's a bad way to write, generally, but there's a reason people do it in these kinds of contexts—one reliably draws lots more stupid or angry-for-dumb-reasons responses, when one does not so-write.

- It's [X]

- Have you considered it might be [X]?

- Is it possible it might be [X]?

- ...

The goal is to not appear overly assertive / confident / arrogant. Once that happens, people start to read subtexts into questions, and all of a sudden, you need disclaimers.

I like direct communications, so I find this obnoxious, but I don't think it's ill-willed or toxic.

You don't have to mention anything and be afraid of what people might say because you don't want toxic behavior towards you.

People need to stop. Read, understand, conclude and write. This is basic communication.

1) In a multicultural setting, words written and words read may carry different meaning. Words carry subtly different meanings, and tones and subtexts need to be translated.

2) Unless one takes 2 hours to draft each email, people will misspeak.

Miscommunications are part of life. Any process needs to account for that.

After a year of negative results, the home test worked when we finally did catch the virus. I had been skeptical, but it turned out all of the negatives (and positives) were correct.

Is my coffee bad or has the editor slipped? Probably and extra “if” after the “But”?

“But if the tests work much better when taken three times over the course of several days.”

It only makes little sense if you don't really care about others. You can infect others with covid 48 hours before you have symptoms. If you know you've been exposed, why wouldn't you check? Plus, you can have symptoms without being infectious.

Similar things with other viruses, too.

Just think about it, and you'll figure out why.

You need lots of cell death and viral replication to cough up enough virions to be a danger.

But sometimes folks tell you they caught it - folks in the office, friends, family - hence, the "Know you've been exposed" criteria. Then it is prudent to test. These are the only times that I've personally tested throughout the pandemic - but I'm in Norway, so I have probably encountered different sorts of restrictions than a lot of other readers.

And honestly: The real reason it isn't as prudent is because the virus isn't the beast it once was. Yes, it can still make you really sick, but it is much rarer than it once was.

I've never "had covid". But I've probably had some amount of covid in my system. I'm sure there are some tests that may have said I have had covid. Is there a degree of infection that confers a specialized immune response? A level of viral load that can exist passively from presence in the environment but suppressed to low level by your immune system?

Not much behind the paywall of the article OP linked:

“Rapid antigen tests are much more reliable at detecting COVID-19 in people with symptoms than in those without, finds the largest study to compare home rapid tests with gold-standard PCR tests1.

Apurv Soni at the UMass Chan Medical School in Worcester, Massachusetts, and his colleagues, followed 5,353 initially uninfected people between October 2021 and January 2022, when the Delta and Omicron variants of SARS-CoV-2 were circulating. For 15 days, the participants regularly took rapid tests at home and sent samples to a laboratory for PCR testing.

More than 150 participants tested positive for SARS-CoV-2 on PCR tests. On the day of infection onset, rapid tests detected almost 60% of infected participants who had COVID-19 symptoms, but only 10% of those who didn’t. However, repeating the test 3 times, 48 hours apart, led to detection of infections in 75% of asymptomatic participants. Two tests conducted 48-hours apart identified 92% of symptomatic participants.

The authors say that an informational campaign about the proper way to take rapid tests might help to preserve public confidence in the tests’ utility.”

Why do we have to spend tax payer money for a campaign to try and force people to care about the utility of a product that can't accurately detect a symptomless virus.

Honestly starting to forget it was ever even a thing.

Let a particularly fun strain catch you like it did to me. Then you can't smell anything, everything tastes off, and you fall asleep in the middle of the day for no reason.

It's been a great two years!

I've known people who tested the day after and considered themselves 'in the clear', and even my day 3 + day 4 strategy is based upon averages I had to pull from papers on disparate or ambiguous variants.

IMO this kind of heuristic should be printed on the packaging.

If wild animals are regularly spreading Covid to humans, this plus asymptomatic cases means zero Covid strategies never had a chance of working indefinitely.

No, it doesn't mean that. An easy reason is that most western governments used PCRs for case confirmations. Another easy reason is that "90% miss on asymptomatic cases" does not mean "90% of all cases are asymptomatic", in fact, quite a lot of "asymptomatic cases" evolve later to "symptomatic cases".

> pandemic probably never really was a problem either to begin with

I already said this in another comment, but it was a huge problem, and a lot of us lived through it and it was scary. You might not have seen it thanks precisely to those precautions you now criticize, but a lot of cities had a very significant collapse of the healthcare system and a massive amount of deaths. Ignoring this reality is incredibly damaging and I don't understand why so many people like you are so cavalier about this.

Part of it could be that they take exception to being called selfish. I take exception to being called a dupe to authority. It all makes us defensive and irrational.

I guess you missed the part with overwhelmed hospitals and mass burials.

My wife has suddenly just now become ill with something fever/fluish and it's testing negative, but I really have to wonder.

Impossible to get a PCR test here in Ontario for over two years now though.

Well, if anything your experience seems to confirm how these rapid tests work. At least my perception has always been that these were advertised to check not whether you had COVID or not (PCR is the gold standard) but whether you can infect others or not. Your daughter barely testing positive on one out of many tests and the rest of the family not getting the disease are coherent in that sense, as your daughter didn't seem to be specially infectious.

The issue with COVID all along vs other respiratory viruses is that it had the potential to transmit before symptoms appear. Which made things like temperature checks, etc fairly useless at preventing its spread. So actually it was important to know in advance if you had it, at least before mass vaccination and omicron changed the profile of the way it spread it seems.

Schizophrenic public policy.

Also by last spring the only way to know what was happening with the virus' spread was to look at wastewater detection numbers.

I hate the overloaded word “grift” but that is all these things are. Just a way to funnel insurance and government money into the pockets of giant pharmaceutical companies.

It was about looking like you were doing something while just getting back to work.

We had twice a week testing for over 18 months for work and it was obvious they were naff.

For each positive result there were 2-3 who seemed to miraculously be ill but negative around the same time.

People would be negative at breakfast and positive by dinner. Tomorrow? Negative again.

How could that ever stop a particularly contagious virus?

So if you tested positive you knew to take steps to limit exposure to others. Not perfect but not worthless.

Coupled with the fact most took precautions so we had mild cold and flu seasons.

If you had a cough, fever, headache, loss of sense taste/smell take precautions. Don't come into the office.

Guess what, that's precisely the people the test detected except it was delayed!

Asymptomatic? Don't bother testing it probably just gives a false sense of security...

What was useful was testing to end precautions but again..that was very late by the time it was introduced testing had stopped.

Even the kids knew that around here.

Basically the argument is: "if the test misses it, then in most situations the viral load is low enough to have a limited risk for other people"

The only gotcha people tend to forget: The viral load can change over time, which means they are only useful for a few hours not a full day.

I am not surprised by this finding. I would also think the opposite(symptomatic) has a significant figure too. Sadly I can’t find an archive of the entire article to read more.

S to monitor my vaccination status (surprise surprise you may not need to be revaxed constantly, but too many people dont botehr checking their antibodies)

N to check if I ever had it (signs point to now, and I'd be surprised if I did since I wear elastomerics and PAPRs)

https://www.cdc.gov/coronavirus/2019-ncov/testing/self-testi...

So many people were heavily pressured to work while sick if they couldn't prove it was covid, and even then there wasn't anything protecting you from being fired if you got covid at a bad time.

Remember that the "essential workers" make $35k a year.

Horrifying.

But almost everyone has stopped wearing masks, so for those people, testing is pointless anyway. It would be like putting a lock on your own firearm, and then wandering naked across a firing range.

So I'm supposed to spend $20 to find out I'm asymptomatic or not even infected so I can isolate myself?

People get sick. People die. It's not fair, but it also is fair because we all die. Death is actually the only fair thing there is.

Various winter viruses kill on the same order of magnitude, and they kill the same old, obese, sick population.

I'm a bit worried we will have something awful, killing healthy people or large swaths 5-20% of the population, and we will be too desensitized to care.

It def seems like it was a political tool, more than a threat.

I'm sorry, but what the hell are you talking about? In my city there were so many dead people they had to transform a skating rink into a morgue. ER rooms were completely overcrowded, COVID took so much effort to fight in hospitals that other diseases got later diagnoses and treatments, which resulted in even more dead people. Lots of elder people died in care homes because there wasn't any help available for them. There were no ambulances available at all. My mother had to go the hospital due to her infection worsening and she had to stay in the hospital gymnasium in couches, because there weren't enough beds nor space for them. They had to make an improvised hospital in a conference center to hold all the hospitalized people, thousands of them. We had a complete lockdown and it still took several weeks for cases to start decreasing.

We panicked so hard because it was fucking scary. Maybe the reason it wasn't for you is that you lived in a place where the government took precautions before it got too big, but I don't think it's ok to be so cavalier about it when so many people had such a hard time.

I think you missed the part where I said "Maybe the reason it wasn't for you is that you lived in a place where the government took precautions before it got too big".

> COVID standard of care w.r.t. intubation was uniquely terrible.

That's what happens when you're dealing with a disease that's literally three months old and that's saturating the entire health system. We also gave hydroxycloroquine, which was proven later to be useless. We literally knew almost nothing about the disease, what did you expect? Excellent standards of care from the start?

> Disrupting the daily routines of elders in nursing homes is well-known to drive mortality.

I think that an infectious respiratory disease and the lack of medical care are far more significant drivers of mortality.

Seriously, what is your point here?

Anybody who was paying attention saw the crisis in the healthcare system, and its fall-out. But there's a strong ideological bias among many now to look back in the rear view mirror and pretend nothing was there.

But in a way it's not surprising as concern for the vulnerable is clearly not a widely accepted cultural value in many of our societies.

They have to do this because their ideology is that everything about covid was wrong, the vaccine didn't work, it's all the democrats fault and they invented the problem, so any acknowledgement that it actually killed at least a million americans must be avoided, otherwise they have to admit to themselves that not only are they wrong and the people they listen to lied to them, but they were selfish assholes about it.

It really sucks. We could have had a great unifying cause to rally against. We could have genuinely improved health outcomes in the US. Fuck, even Donald Trump himself eventually realized this was a bad thing and helped get the vaccine going. But half of the republican platform right now is covid denial. They have to invent a magic reality where their ignorance doesn't kill people, and people who have studied stuff for decades don't know anything.

Did government mismanage COVID? Yep. Did they do in an unjust way? Yep. You know what's worse? Savagely letting the vulnerable die, and the rather .. deplorable ... people who built a whole ideological edifice out of complaining about social duties during the pandemic and pretending it was all fake.

It's not like it wasn't possible to be critical of gov't approaches and also pitch in to help out.

Lots of suspect motivations and people.

What has a comparable death rate that nearly the entire population has been exposed to?

> Various winter viruses kill on the same order of magnitude, and they kill the same old, obese, sick population.

Name this virus please. If you're thinking the flu, it's estimated that each year worldwide about a billion people are infected and there are ~450,000 deaths[1]. That's a 0.045% death rates, and that's one of our winter biggest killers.

To bring it to America, the CDC has death rates at ~0.1-0.2% [2]

[1] https://ipac-canada.org/influenza-resources [2] https://www.cdc.gov/flu/about/burden/index.html

Regardless, that's moved the discussion a bit, but it's myopic to look at just death rates. What about the rate of hospitalization? ICU use? Death is just one facet of care, and it's assuming a medical system that could absorb the excess load across all areas. If it couldn't that would have lead to markedly increased death rates as those who required more mild care found themselves without that required assistance.

The best way to compute IFR is via serosurveys because those can pick up people who were infected but didn't get sick because their immune system fought it off without symptoms even developing.

Here's a serosurvey meta-study from 2022. It's more recent than when I last looked at this and computes an even lower value.

https://www.medrxiv.org/content/10.1101/2022.10.11.22280963v...

"The median IFR was 0.0003% at 0-19 years, 0.003% at 20-29 years, 0.011% at 30-39 years, 0.035% at 40-49 years, 0.129% at 50-59 years, and 0.501% at 60-69 years."

It does vary heavily by country and age so it's not a very meaningful value, in some ways. It tells you more about the general state of health and healthcare in a place than the virus itself.

It's hard to compare this to the IFR of flu because flu has never had this scale of surveillance applied.

The COVID death rate and what it compares to is a very different and tricky topic. It's probably not worth getting into here. The thread is about COVID testing.

For example, even as early as June of 2020, the public health authority in Canada's most-populous city (with the fourth highest population in North America) revealed that the counting of deaths was being done using a methodology that sounds quite dubious:

"Individuals who have died with COVID-19, but not as a result of COVID-19 are included in the case counts for COVID-19 deaths in Toronto."

https://twitter.com/TOPublicHealth/status/127588839006028596...

- https://www.goodreads.com/quotes/70193-over-85-of-all-statis... - https://www.businessinsider.com/736-of-all-statistics-are-ma... - https://www.quora.com/Someone-once-said-that-98-of-all-stati...