Miscellaneous And Off Topic Subjects

[iam416]

Filibuster is a “Jim Crow relic.” Talking points are out there. It’s totally gone by June 2021.

[Dr. Strangelove]

Ironically it's been used far more in the post-Jim Crow world at least in part because they changed the rules so much to make it significantly easier to do a filibuster. You don't actually have to stand there and piss your pants anymore.

[lineygoblue]

It is funny you think Kamala is progressive.

She sure ain't moderate.

My definition of a progressive would be someone that continues to learn and accept new ideas. They're open to new ideas, and they give fair consideration to all POV's. I haven't seen a scintilla of evidence to show that she's any of those things.

Your definition is probably different.

[iam416]

Ironically it's been used far more in the post-Jim Crow world at least in part because they changed the rules so much to make it significantly easier to do a filibuster. You don't actually have to stand there and piss your pants anymore.

I think "Factually" works better than "Ironically".

[AlabamAlum]

I think “STFU” works better than both words.

[Jeff Buchanan]

Last week wrote about "rapid" COVID testing. My point was that "rapid" is an illusory term and at the time I wrote about these tests, getting results in 72h, which the NBA's brand of rapid saliva tests promised along with ease of collection methods, was a marked improvement over the 2w it had been taking to get results and the uncomfortable nasopharyngeal swabs.

There's a lot of misinformation out there about testing - a lot is an understatement. It's a complex subject wrapped up in "if's and and buts" language from the CDC on how to administer, process and report results. The latest news on testing came last week when the FDA approved two manufacturers of rapid antigen tests using a much more comfortable to administer nasal swab to start delivering them to clinicians for immediate use.

Quick review:

• The gold standard test for C-19 is the RT-PCR, molecular test (big ball of cotton up your nose or down your throat). It is a diagnostic test when certainty of results is important. Hundreds of different manufacturers have FDA approval. The CDC, IMO, incorrectly embarked on the US testing strategy using this test. It is a terrible test for screening or surveillance - an important task of public health departments.
• Antibody tests - dozens of them have been approved for use - are serologic tests. They look for C-19 antibodies in your blood. They do one thing - show if you've been exposed to SARS-CoV-2. They are surveillance tests and more applicable to the PH role of identifying the extent of the spread of a virus in a specific community.
• Antigen tests - only two manufacturers have obtained approval out of dozens of them that have requested FDA approval. Testing can be done from nasal swabs or saliva, the later with known accuracy issues and only suitable for use in congregate settings: NBA bubbles, prisons, nursing homes where testing frequency overcomes the accuracy issues.
• Antigen tests use a cassette to place the testing sample collected at a point of care into and results take about 15 minutes. If you or your child have been tested for Flu A/B, that was an antigen test. They provide rapid results with between 84% and 97% accuracy (the FDA approval standard).

Now comes the complicated part. In the US all C-19 testing has to conform to and be conducted in accordance with a laboratory standard developed by CMS (Center for Medicare & Medicaid Services) and defined by CLIA (Clinical Lab Improvements Amendments). There are some good reasons for this but compliance has absolutely been responsible for the long wait times for RT-PCR and Antibody test results rendering those results pretty much useless for screening tests: ID of the infected, isolation and contact tracing.

Here in FL and starting on Friday, you can now get a antigen test processed in a casete at a number of CLIA designated drive up facilities and in clinics that purchase them. You have to make an appointment, have C-19 symptoms or been contacted by PH for risk of exposure. You can also get a test without qualifications if you are between 4 and 17 or over 65. Qualifying is a way to keep supply of tests inline with demand. Officials making the announcement are saying results in 1-2h. That would account for large scale collection and processing the results and then probably notifying you of results by text or phone.

The bottom line is that no matter what you here about getting ahead in the testing game, while the approval of the two manufacturers of the rapid result, cassette type antigen tests, the CDC's strategy that requires all testing to be conducted in a CLIA certified lab still introduces processing and reporting drag.

One can argue both sides of the question - eliminate or don't eliminate the requirement to collect, process and report results in a CLIA lab setting. If you eliminate that requirement, testing for screening purposes could be done on a massive scale and IMO, what is required to return to a semblance of normalcy. OTH, the CDC/FDA argues that eliminating strict collection and processing protocols introduces too much potential for error. I'd argue you reduce error by the scope of testing and the frequency by which it is done. Of course, you have to have the manufacture and distribution infrastructure to do it at scale - we don't have that.

........ and this concludes your instruction of C-19 testing in the US. Have a nice weekend.

[Dr. Strangelove]

When he politicizes the hell out of everything like this he does double harm. He's encouraging people to believe that government agencies run by people he hand-selected are letting people die simply to hurt him politically. And on the flip side, if a vaccine DOES in fact get released before the election, a bunch of people are going to wonder if it is some half-assed snake oil rammed through to keep the President happy.

[THE_WIZARD_]

I think “STFU” works better than both words.

Seconded, thirded, fourthed, fifthed, sixthed, seventhed, eightthed, ninthed and tenthed.

[iam416]

TwoPointFive’d

[Jeff Buchanan]

When he politicizes the hell out of everything like this he does double harm. He's encouraging people to believe that government agencies run by people he hand-selected are letting people die simply to hurt him politically. And on the flip side, if a vaccine DOES in fact get released before the election, a bunch of people are going to wonder if it is some half-assed snake oil rammed through to keep the President happy.

Those tweets will convince his idiot base that the CDC and FDA are the enemy. More sensible folks around here that have paid attention to my posts recognize right away that Trump is an ignoramus when it comes to alot of things but especially SARS-CoV-2 and COVID-19 and has no interest in understanding anything that is beyond 1+1 = 2 with regard to it.

Two comments: First, it's a good thing we have the FDA to prevent a snake-oil vaccine, dangerous therapeutics and shitty testing kits. They have steadfastly resisted pressure from the WH. Second, the FDA can be a pain in the ass for manufacturers of vaccines, therapeutics and test kits but that is generally a good thing.

There's a lot of grumbling out there about how the CDC should have undertaken a testing strategy that was (a) centralized and (b) used the right testing tools (a combination of RT-PCR for diagnostics and antigen tests for screening). Some say the FDA should have relaxed standards and in some cases they did.

If the US had done a better job with testing in February instead of dicking around with the wrong approach and screwing that up too and if the FDA had been less reluctant to approve POC (cassettes) antigen testing, we may have never gotten to this point. There's no telling if Trump had his hands in any of this. My bet is that he did, owns some of the blame and should be held accountable at the ballot box for it.

But, by-in-large the CDC and FDA have held strong to process - an essential ingredient in bringing sensibility to C-19 infected patient management and safe stuff into the public market place. I've said this before but there were systemic, long standing organizational problems that plagued a robust, PH response to the virus. It's decentralization - more appropriately abandonment of a proper federal role - and the mess it has caused in data collection, processing and reporting is probably all on Trump and Pence. But state's PH capacity was severely limited by under funding and under staffing over the last two decades. Not much could be done to recover quickly from that fuck-up.

[Dr. Strangelove]

This is wild...this afternoon's forecast now believes that two hurricanes could hit virtually the same spot in Louisiana but two days apart

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[Ghengis Jon]

Quick! Someone with a Sharpie change their courses!!

[Jeff Buchanan]

This is wild...this afternoon's forecast now believes that two hurricanes could hit virtually the same spot in Louisiana but two days apart

Because I live in S. FL, I'm tuned into some really good web sites that do a great job explaining the weather phenomena that shape tropical storms. For years, I have believed that politics play a role in what comes out of National Hurricane Center (NHC). For the most part, though, the NHC errs to the worst case scenario and given how stupid people can be in preparing for and facing these storms it's probably a good thing.

There are a myriad of organizations that model weather and they provide track and wind speed data for tropical storms in an amazing array of maps and charts. When you look at all this, you can see why you get this hedging on what a storm will do from local weather girls and guys. It really is hard to predict wind speeds and land fall. There's a web site I frequent that's run by a meteorologist who does a daily evening update and runs videos of the different models and explains in detail the weather features that shape these things. I find it interesting to see how complex forecasting is yet how much forecasters really know about a storm with much more certainty than what comes out of the US's go to source - the NHC.

Anyway, yes, there will be two storms in the Gulf of Mexico at the same time. Both will likely be CAT 1 Hurricanes (winds < 90). It looks like Marco will come ashore just West of NOLA on Monday Afternoon. Laura will come ashore very early Thursday morning SW of Beaumont TX headed towards Houston. Of course, all of this is subject to change but not by much at this point .... we're talking 10s of miles one way or the other. Intensity is another matter as these storms have a mind of their own and can spin up or down unpredictably. I enjoy studying this stuff but hate it for coastal residents that have to go through trees down and power outages - you get over 70 and both of those things are around 90% certain to occur.

That these two storms are not likely to require massive evacuation (there will be regional, coastal order to evac) the COVID mess shouldn't be made much worse than it already is. Fingers crossed on that one. Guard against "dire consequences" shit on the COVID/Storm interplay from the media. Here's a link to a neat, interactive graphic that you can see the storms track and winds (just to 60 by colors but you'll get the idea). Down in the bottom R hand corner you can select the three most common models (GFS, ECMWF, NAM) to see how varied the models are on track and wind-speed. The NHC tends toward the GFS in it's forecasting. Plenty of people think other models are better.

https://www.windy.com/?2020-08-27-06,29.396,-94.170,7

[Jeff Buchanan]

In COVID news the obviously hot topic is school openings. There are a couple of studies floating around out there, hard to find the actual study but results reported within the CDC web site, that it's entirely safe for K-12. The UK and the EU have similar studies with similar outcomes. Importantly, identification of a child having a + C-19 test does not necessitate a shut down. Still, that's what's happening in the US, less so in Europe. Because of the unjustifiable fear factor and pressure from Teacher's unions, plenty of school districts opened with only on-line learning. Broward, in S. FL is one of them. Fortunately, Broward's positive rate hit < 5% on Saturday and if that persists, schools will open for in-person learning.

The general consensus from what I'm reading nationally is that the degree of community spread at a county level, as measured by positivity rate, should dictate the type of school openings. Of course, you have to believe that the data feeding positivity rates is accurate and, IMO, it's not. It has to be contextualized and that's where politics starts to play if officials move forward in opening in-person learning trying to look at all the metrics to assess degree of virus control.

College campuses are another matter. I think officials are correct in fingering off-campus partying as the source of most new infections occurring within the student body. It's how they react to new cases that I have a problem with. I can make a case against shut-downs at ND and UNC and likely every other college that's taken that path as soon as new cases are ID'ed. I think what drives that thinking is an overwhelming fear of being accused of negligence in managing outbreaks no matter how well they do it by the plans they have in place. I commented in another post how good I thought ND's plan was until the abandoned it without much of an explanation. Officials wet their pants.

It does little good to rail about this anymore. It is what it is and we're just too far down the road of fear of the virus to reverse that. There's also an acceptance of the immense social and economic damage already done emerging. Everyone is waiting for a vaccine, better testing, better therapeutics. What if none of that pans out? Well, count me among the pessimists that say, we're properly fucked. Basically years lost in all of our lives.

[Dr. Strangelove]

Supposedly Trump will speak all 4 nights of the convention around 10 pm. Because of course he will