Why are we prioritizing testing the sickest people? AFAIK diagnosis doesn’t change what care is given, so it’s irrelevant to them. Testing people who might be sick and take high impact action based on the results (e.g. medic deciding whether to go to work) seems higher impact.
Possible explanations: sickest people get the most positives and that’s important for contact tracing, I am wrong about how it affects care (in particular it might affect if you get an isolation room or no)
My assumption has been that the primary purpose of testing is for contact tracing. I would suspect that probably don’t have enough tests at this point to usefully test everybody who is ill and yet still planning to go to work, even just people with healthcare jobs—I’m assuming that someone who is ill, but still thinking about going to work at their healthcare job, is probably not very sick, in which case most of those tests would end up negatives, on people who just have colds/flu.
Most tests you carry out on anyone else will be negative, so even if you think there’s an 80-90% chance the patient is COVID-19 positive, you still get more information from running those tests than the lower symptomatic people.
Also, it does change all sorts of decisions. It probably changes what precautions the healthcare workers need to take, and it lets you tell the person’s family to self-isolate. Otherwise the husband is in critical condition, and the wife might be a week behind, so she’s in the waiting room making everyone sick.
Hm, can you say more about information? I believe you should get the most direct information (in the information-theoretic sense) out of running tests where the outcome is most in doubt (i.e. where your prior is approximately 50%, although I think this might budge a bit depending on the FP/FN rates of the test if they are different.) You also get information about their contacts—if their contacts have a lower-than-50% base rate of exposure, then it seems like you get more of that “secondary information” from a positive than from a negative. (I’m not too confident about that, but certainly at worst it’s equal, right?)
An accurate count of how many people are infected may be a highest priority. Since the virus has exponential growth, the difference between a known count of 10 infected vs 100 infected is massive in terms of policy decisions. Undercounting is extremely dangerous to the entire population.
This could change once the number of infected patients gets very high, but we may not have seen numbers high enough to justify that anywhere outside of China yet.
Why are we prioritizing testing the sickest people? AFAIK diagnosis doesn’t change what care is given, so it’s irrelevant to them. Testing people who might be sick and take high impact action based on the results (e.g. medic deciding whether to go to work) seems higher impact.
Possible explanations: sickest people get the most positives and that’s important for contact tracing, I am wrong about how it affects care (in particular it might affect if you get an isolation room or no)
My assumption has been that the primary purpose of testing is for contact tracing. I would suspect that probably don’t have enough tests at this point to usefully test everybody who is ill and yet still planning to go to work, even just people with healthcare jobs—I’m assuming that someone who is ill, but still thinking about going to work at their healthcare job, is probably not very sick, in which case most of those tests would end up negatives, on people who just have colds/flu.
Most tests you carry out on anyone else will be negative, so even if you think there’s an 80-90% chance the patient is COVID-19 positive, you still get more information from running those tests than the lower symptomatic people.
Also, it does change all sorts of decisions. It probably changes what precautions the healthcare workers need to take, and it lets you tell the person’s family to self-isolate. Otherwise the husband is in critical condition, and the wife might be a week behind, so she’s in the waiting room making everyone sick.
Hm, can you say more about information? I believe you should get the most direct information (in the information-theoretic sense) out of running tests where the outcome is most in doubt (i.e. where your prior is approximately 50%, although I think this might budge a bit depending on the FP/FN rates of the test if they are different.) You also get information about their contacts—if their contacts have a lower-than-50% base rate of exposure, then it seems like you get more of that “secondary information” from a positive than from a negative. (I’m not too confident about that, but certainly at worst it’s equal, right?)
An accurate count of how many people are infected may be a highest priority. Since the virus has exponential growth, the difference between a known count of 10 infected vs 100 infected is massive in terms of policy decisions. Undercounting is extremely dangerous to the entire population.
This could change once the number of infected patients gets very high, but we may not have seen numbers high enough to justify that anywhere outside of China yet.