re: Coronavirus Disease 2019 (COVID-19) ***W.H.O. DECLARES A GLOBAL PANDEMIC***

Does India not do testing?

They've only reported 5 cases.

A billion people. Shares a border with China.

I mean, we provide services. We are already incredibly understaffed. We already have rigid attendance rules. If we ha e 3-4 people out, we are fricked. So the business unit senior leadership thought this was simpler.

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What are the methods of test and are there any stipulations around them?

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rt-PCR, Probably of a real time variant. They are definitely trying to limit usage of the test right now however, which is why the case count is so low. As I understand it, they are using imaging of the lungs to determine it on the clinical side (apparently this viral pneumonia looks distinctive on the film, but I'll let the ER docs comment on that).

The burden on the hospital isn't to administer tests as much as it is to get someone on the phone to justify each and every case of it. Thats both a limitation on the clinician on site with other patients to treat, and the person on the other side of the phone dealing with calls from all over.

Without getting to far into the technical weeds on the PCR front and be aware this is complete guess work on my part, the problem has to be with target sequence design. PCR is very very powerful, but it can be a bit of a temperamental bitch. When I loaded aliquots of it, I would hold my breath lest the air movement might move a speck of dust into the vessel.

You have to make sure that whatever you use to mark the boundaries of the target is both highly specific amongst both the viral RNA and whatever human mRNA that is present, but still relatively short to allow it to align with the genetic material in the sample, and containing a certain percentage of certain types of bases.

But not too short lest a mutation make it no longer complimentary to the sample strand.

Oh and BTW, it also needs to be distinct from already present coronaviruses.

All in all, a pretty damned narrow target to hit.

In the absence of well designed sets of primers might lead to false negative results....which sounds like that is happening here. (As well with the independently designed tests from elsewhere which had similar stumbles)

It can be a complicated process with a lot of factors to consider, but not one that shouldn't have been resolvable by now by simple trial and error.

So I think its a political problem rather than a technical one.

Volvagia answered that question better than I could.

On the imaging side, CT scan can show “ground glass opacities”. There are other diagnoses that can give that same appearance but combined with the clinical history of a fever and dry cough it would be a decent screening tool to at least triage patients. If you get a few false positives so be it, anything is better than false negatives in a situation like this.

My problem with the testing issues is that the WHO had working tests. I can understand if the CDC wanted a more specific test but why not use the tests everyone else is using while you develop your alternative test. Nothing should have delayed the testing.

I have a feeling we are about to uncover a hotspot somewhere and people are going to freak out. It would have been better to slowly diagnose cases and show people everything is under control.

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Work from home is always “work” from home.

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True. I can't take a break to rub one out in the office.

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legally too drunk to drive at the moment

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That makes two of us

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Dominate308

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Not his fault that you are a little slow

To work at home....

I said the average poster. I had to consider that some people on here are Idiot Savants and others are normal Dudes.