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Unpacking the logic behind “slow the testing down, please”

A lot has been made of the President’s claim that we should “slow the testing down,” a claim that he doubled down on in subsequent remarks to reporters. Most commentators state that he’s under the mistaken impression that if we just don’t look at the problem, it’ll go away.

But I follow a bunch of virus skeptics on Twitter and in other venues, and based on what I see from them I think I understand the reasoning behind the president’s remark. The evidence leads experts to believe he’s wrong, but it’s not the logic of a small child who thinks if he doesn’t look at a problem then it stops existing. Rather, there is an actual school of thought behind this, and there are numbers and charts and graphs, and some very smart (but wrong) people are involved in it.

I want to unpack all this not to take a side in or stir some political debate, but because it’s important for everyone who’s monitoring the pandemic and preparing for what’s next to understand that there is an informed and sophisticated community of virus skeptics, that there’s a story they’re telling themselves and anyone who’ll listen, and that this story is driving the US response to the virus at the highest levels.

What the virus skeptics are thinking

The story the virus skeptics are currently telling goes something like this:

  • The outbreak actually peaked in March, and at far higher numbers than we know about. The cases were probably in the millions, and were undercounted by an order of magnitude.
  • We didn’t know about this uncounted mountain of cases because the virus is very mild, probably milder than seasonal flu, and the vast majority have no symptoms. Unless you’re very old or otherwise compromised, in which case it actually is kind of deadly.
  • The number of uncounted cases has been dropping dramatically as the outbreak fizzles, and you can see this in the ongoing drop in deaths. (Nationally, deaths are still dropping despite the upturn in cases.)
  • Therefore, the rise in detected cases is simply because we’re doing a bunch of track-and-trace and testing, which is leading us to uncover all these previously undetected cases that were out there.

So the bottom line of all of the above, is that if we weren’t sending “hotspot hunters” (a real term I’ve come across) to do contact tracing and find all the remaining pockets of infections, we wouldn’t be seeing these alarming rises in case counts. By this logic, this “phantom” rise in apparent cases (remember, really we’re just finding more old cases that are mild) is giving rise to media hysteria and economic devastation.

At this point, goes the reasoning, the economic damage from the “fake” rise in cases is far worse than any damage from the very mild virus, so we need to just quit testing. Or at least slow it down. That way, the perception will begin to match the reality of the fact that the pandemic peaked months ago and is now basically over. We can all get back to work, and things will be normal, again.

The argument: this rise in cases is ‘fake’

Once you understand the above background, the President’s subsequent remarks in an interview begin to make sense as something other than blind head-in-the-sand-ism. From the CNN article linked above:

“No,” he answered, “but I think we put ourselves at a disadvantage, I told my people. I said, ‘We’ve gotten so good at testing … We test much more than any other nation,’ so you hear about all these cases.”

“So, instead of 25 million tests, let’s say we did 10 million tests. We’d look like we were doing much better because we’d have far fewer cases. You understand that,” Trump told CBN. “I wouldn’t do that, but I will say this: We do so much more than other countries it makes us, in a way, look bad but actually we’re doing the right thing.”

Trump also said his comment in Tulsa was “semi-tongue in cheek” and asserted that “when you do more testing you find more cases.”

“We have kids, with sniffles, and all of the sudden we report a case and they’re in no danger whatsoever,” the President added.

To be clear, the above is still head-in-the-sand-ism, but it reflects a sophisticated head-in-the-sand-ism that’s being earnestly promoted by a crowd that includes some prominent medical professionals in the US and abroad. The government of Sweden, for instance, has been operating on a variation of the above story.

If you want a good, brief summary of this virus skeptic case, this Medium post is a great place to start.

I’ve also gone ahead and made my Virus Skeptics list public. So if you really want to go down the rabbit hole, then you can scroll that list and get an eyeful of it.

The website unherd.com features a number of video interviews with the more impressively credentialed virus skeptics, and these often circulate among this crowd. This page especially has a bunch of the popular COVID-19 skeptic videos on it.

I am not planning to engage with any of this in detail, because the only part of it that’s interesting to me is the ongoing decline in fatalities. I think that’s due to a mix of lag (it takes weeks for people to die of COVID-19) and the fact that the new cases skew far younger (younger people are less likely to die.) But I expect that fatality curve will turn back up before July is over — if not nationally then in the hotspots.

What to expect in the next few weeks

My guess: the next three or four weeks (at the most) will put an end to this particular narrative. Once deaths start to rise again, we’ll see this crowd switch to something else. But I’d rather spend time helping people prepare for what’s next than debunk this kind of thing.

But still, I wanted to highlight that the president’s remarks actually have their origin in a community of skeptics that has a coherent (but mistaken) view of the state of the pandemic and of what’s at stake in the testing rates. Many of these skeptics no doubt have his ear, and they really, truly do believe that the testing — not the virus, but the testing-driven perception that the pandemic is still A Thing — is the main danger America faces right now. They have sliced and diced the numbers to make this case, and they earnestly believe it’s true.

Unfortunately for all of us, they’re totally wrong, but they’re still calling the shots nationally and in many states. So prepare yourself accordingly.


  • 22 Comments

    • Cia

      I think a large part of the drop in fatalities is because a less virulent strain is achieving predominance, something which usually happens with epidemic viruses. In Italy doctors say that the coronavirus they are seeing now is not at all like what they were seeing even two months ago, being milder and killing few. Doctors in the US have reported the same trend. The original Wuhan virus was strain S, and it is what spread in Southeast Asia and the west coast of the US. The L strain, a mutation, was much more deadly and is what spread to Iran, Italy, the rest of Europe, and New York City. It’s good news that it has mutated again, resulting in a steep decrease in deaths even while total cases are increasing precipitously.

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      • SeaBee Cia

        Citation or link? Sources are super necessary here. This is a lot different than sharing anecdotal preferences for concealed carry or water storage. Hoping that mods will push for support when we are discussing the science side of things.

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      • Cia Cia

        I just found this on some American doctors saying that CV seems to be getting weaker.

        https://www.healthline.com/health-news/is-the-new-coronavirus-getting-weaker-what-to-know

        The doctors in Italy went further, saying it was no longer the same virus that it was two months previously. I think we should remain attentive, but not discount the virus changing in important ways. Charts show that fatalities worldwide peaked in mid-April and have since fallen (although it looked as though they had risen again, possibly temporarily, last week). Case numbers continue to rise. It is too soon to say what this will mean in the big picture. If case numbers go up a lot, as they are, then the number of deaths will go up as well, even though the case fatality rate may go down significantly.

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      • Hardened Cia

        Interesting theory but the source you linked has this to say about it:

        “Health experts say it doesn’t look like the virus has mutated to be weaker. Rather, this observation is likely a result of amplified testing capabilities and increased physical distancing measures.”

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      • Cia Cia

        Doctors in Italy said that in the cases of coronavirus they were seeing at that time, about a month ago, the disease was no longer the same disease it had been two months earlier, but was much milder and much less deadly. Notice the use of the word “likely” which you quote. Everyone has his own theories and is prone to promote them and give less importance to what does not support them. The author does not say it is not true, only that in his opinion it does not seem likely. But with many professionals seeing cases in which the disease is no longer the same, is much less deadly, then it becomes likely that they are telling the truth. Honest professionals are not going to have cases which are only less deadly because they were treated with a certain drug.

         

        if you google S strain and the more virulent L strain, you will see that there were at least two different variants. They were able to pinpoint specific mutations in New York City by minor variations in the amino acid sequences of the genotype, identifying specific cases in NYC as having originated in The Hague. So there are many different subtypes circulating. Bioengineered viruses like this one are well-known to be unstable and to become much reduced in their virulence in a short time.

        We’ll have to wait and see. But extended testing does not result in fewer deaths numerically unless all positives are submitted to mandatory enforced quarantine, something which has not been done here. We do not have any very effective treatment beyond HCQ with zinc in the first week of symptoms. I read yesterday that in my city they have seven patients on ventilators at the hospital now: I thought they had realized that 90% of those put on ventilators die, that this has turned out not to be a classical ARDS disease but one of excessive coagulation, affecting mainly the lungs but also any system, hypercoaguation in the legs often leads to amputation. So Covid is still not being treated appropriately in many instances. These factors could not to causing the great reduction in mortality we are seeing amid an increase in case load.

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      • John RameyStaff Cia

        First, thanks everyone for having a rational discussion about sources etc.

        To jump in on the Italian doctors thing: After that news hook came out, other Italians / the Italian healthcare system walked back the comments. So while it’s an interesting data point, I wouldn’t rely too heavily on it.

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      • Cia Cia

        I hadn’t seen that the doctors had walked back their comments on Covid becoming milder and looked for more information. I found this at Medium. https://www.google.com/amp/s/elemental.medium.com/amp/p/928f2ad33f89

        The issue has become politicized, in Italy as here. But many think that the doctors’ first reports were correct. It would be different strains competing for predominance, not a sudden change completely from one to another. This article discusses why it is usual for viruses to become less lethal over time. It seems likely that the several coronavirus strains which can cause colds (along with rhinoviruses and adenoviruses) originated in animals and were very virulent when they made the species leap, but became attenuated over time. I think we should remain observant and wait and see. It would be a plausible explanation for the drastic decrease in mortality, even as case incidence soars.

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      • Cia Cia

        If there’s a huge increase in cases, as there has been, there will be a numerical increase in deaths even if the rate is lower. If the death rate was 6% in April and you had a thousand cases, there would have been sixty deaths. If the fatality rate drops to 3%, but cases increase to three thousand cases, there would be ninety deaths, even though mortality had been halved.

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    • hbic

      Curious — how do they square this theory with the increased number of hospitalizations, both ICU and medsurg, that we’re seeing in places like Houston? Is the argument that severe cases are fine as long as the patient doesn’t die immediately?

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      • lemur hbic

        I was going to point out the same thing. If the hospitals are receiving more critical cases, you don’t have to wait until a raise in deaths to declare bunk the notion that the increased number of infection cases is some sort of mirage. (Oh, but just wait for the deniers to declare that the ICU cases are really paid actors.)

        Now for a general comment addressed to nobody in particular: I do wish we’d stop focusing on “COVID-19 deaths” as the one indicator of how much the virus is screwing us. Why? Because, as has been pointed out on this very site:

        1. COVID-19 can leave you with permanent disabilities even if it does not kill you.

        2. The COVID-19 fatalities do not include those fatalities that happen due to other illnesses than COVID-19 but cannot be treated because the hospitals are at capacity. Eg. Bob has a heart attack but because the nearest hospital is full due to COVID-19, his ambulance is redirected to a more distant hospital, and he gets there too late. On any normal day, he would have had an excellent chance to get speedy care needed to survive it.

        3. Even if you 100% recover from a trip to the ICU caused by COVID-19, going through the experience is awful.

        As doctors learn how to deal with COVID-19 cases, they’ll get better at reducing the fatality rate. There are already some treatments known now that they did not know at the beginning of the crisis that help reduce the rate. I suspect they’ll find more as time goes by. It is not clear to me how treatments will help with point 1 and 3 above. In fact, reducing the death rate may increase the rate of people left with disabilities. For treatment to have an impact on point 2, it would have to do more then prevent death but cause people to stay in the hospital for a shorter time, to the point that the ICU is no longer overwhelmed.

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      • Jon StokesStaff hbic

        I thought about covering this in the article, but I didn’t want to bloat it out. The answer on hospitalization increases is straightforward: these folks constantly circulate anecdata to the effect that anyone who walks in the door of the hospital for any reason is tested for COVID, and since a bunch of them have it (asymptomatically, of course), they are then classified as “COVID hospitalizations.

        So if you believe that a very large percentage of the population has totally asymptomatic COVID, then this makes a certain amount of sense. Everyone is infected, and the people who come in get a test and then show up in the hospitalization stats.

        As for what these folks do with the ICU numbers, that is a little more difficult for them to finesse. But what I’m currently seeing is that they deny that there is a surge in ICU load. The claim is that the load is actually pretty normal (even lower than normal!), and there is plenty of ICU capacity, and nothing is amiss.

        The way they get there is by gathering ICU load stats from a wide enough area. COVID produces pretty localized ICU surges, so if Houston is surging then all you do is take your stats from the entire state of TX. And over the entire state of TX, ICU capacity is currently plentiful and there is not a statewide issue.

        Obviously, their ICU strategy has a shelf life. As the aggregate statewide ICU load ramps up, they won’t be able to deny it. But then what I expect they’ll say is, “well, the only reason the statewide stats are up is because of these three areas, but if you look at the rest of the state it’s all normal or down!”

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    • Cia

      Here’s one source: https://www.actionnewsjax.com/news/trending/italian-doctors-say-covid-19-is-losing-potency-who-say-thats-not-likely/R4V5DB6FIBH2HI5KYMC7HKEZPQ/?outputType=amp

      I’m going out. I just found this by googling it, when I come home I’ll use my search engine to find a source for some doctors in the US saying the same thing. The WHO says, without giving any evidence or explanation, that it’s not likely, but the WHO has very little credibility at this point.

      it’s just information and everyone is free to interpret and use it as he likes. It does not mean that Covid is no longer dangerous for anyone, but as we struggle to balance preventing disabling or fatal cases of Covid with salvaging the economy, it would be good to further explore the evidence that it is mutating to become less dangerous.

      i don’t think we should depend on a vaccine saving us. Available evidence has already led many authorities to say that it may not happen. In the US, about 15% have said they (we) would not take it, while over 30% more have said they might very well refuse it. Most realize that it would be years before many severe vaccine reactions fully manifest and play out. Trump has said that he would not support a vaccine mandate.

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      • Cia Cia

        Here’s a source for what I said about half of Americans planning to either definitely or possibly refuse the potential Covid vaccine.

        https://www.google.com/amp/s/amp.theguardian.com/world/2020/may/27/americans-covid-19-vaccine-poll

        Should I also look for links to articles saying that the problems with developing a vaccine are so many and so serious that they may not be successful? Starting with antibody-dependent enhancement, but not ending there? I also would rather not bloat this out. The information is essential to know, but easy to google.

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      • Cia Cia

        Here’s a source for what I said about half of Americans planning to either definitely or possibly refuse the potential Covid vaccine.

        https://www.google.com/amp/s/amp.theguardian.com/world/2020/may/27/americans-covid-19-vaccine-poll

        Should I also look for links to articles saying that the problems with developing a vaccine are so many and so serious that they may not be successful? Starting with antibody-dependent enhancement, but not ending there? I also would rather not bloat this out. The information is essential to know, but easy to google.

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    • Cia

      Here’s one source: https://www.actionnewsjax.com/news/trending/italian-doctors-say-covid-19-is-losing-potency-who-say-thats-not-likely/R4V5DB6FIBH2HI5KYMC7HKEZPQ/?outputType=amp

      I’m going out. I just found this by googling it, when I come home I’ll use my search engine to find a source for some doctors in the US saying the same thing. The WHO says, without giving any evidence or explanation, that it’s not likely, but the WHO has very little credibility at this point.

      it’s just information and everyone is free to interpret and use it as he likes. It does not mean that Covid is no longer dangerous for anyone, but as we struggle to balance preventing disabling or fatal cases of Covid with salvaging the economy, it would be good to further explore the evidence that it is mutating to become less dangerous.

      i don’t think we should depend on a vaccine saving us. Available evidence has already led many authorities to say that it may not happen. In the US, about 15% have said they (we) would not take it, while over 30% more have said they might very well refuse it. Most realize that it would be years before many severe vaccine reactions fully manifest and play out. Trump has said that he would not support a vaccine mandate.

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    • Girard Bent

      Put me down as a skeptic of the weakening of COVID-19.virus. The way it has worked in the past is that a scary virus is out there that just poleaxes people.  Then a mutated version shows up that leaves them walking around for a while. That strain is a much more effective spreader and crowds out the original.

      Problem is, COVID-19 is already an extremely effective spreader. A less lethal strain isn’t going to have much of an evolutionary advantage.

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      • Cia Girard Bent

        For many viruses attenuation gives a survival advantage. If the virus does not cause serious illness, the patient remains ambulant and continues infecting others with it. Causing them to stay in bed or killing them prevents as many people from being infected.

        After two years, the Spanish flu, after killing millions, mutated to become much milder and it disappeared as a disease entity, although it later manifested as different flus in later generations.

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      • Cia Girard Bent

        For many viruses attenuation gives a survival advantage. If the virus does not cause serious illness, the patient remains ambulant and continues infecting others with it. Causing them to stay in bed or killing them prevents as many people from being infected.

        After two years, the Spanish flu, after killing millions, mutated to become much milder and it disappeared as a disease entity, although it later manifested as different flus in later generations.

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    • Cia

      This is a very interesting article. I’ve read it several times. I was surprised when many people at a website where I’ve spent a lot of time seemed to have taken leave of their senses, reviling masks as fas-ist mind control, social distancing and lockdowns as antithetical to what it means to be an American, protective measures taken at schools as deliberate destruction of the innocence of childhood. An uncritical enthusiastic acceptance of everything Del Bigtree, for example, says. Willingness to write off and sacrifice older people and those with health problems. This is very dark. But until yesterday, when I read this article, I hadn’t realized the method in the madness. Thank you.

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    • Hardened

      Thank you for the article; I really like to understand the mindset of people with different opinions and don’t always have time to research it myself.

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    • Wanda Y Alberto

      very real and the truth its that we have to prep, for the consecuences of that sandhole head denial reactions.

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