We have already generated and put into our scientific manuscript the data that FDA requires for EUA. As a high-complexity CLIA-licensed clinical laboratory, we don't see significant risk in getting the authorization in 2 weeks. However, we need to start working with clinical laboratories across the country today if this is going to scale to hundreds of thousands of tests as soon as we get the EUA. Also, international laboratories don't need EUA and can start using the test immediately. We did not think it would be responsible to hold off on making the technology public when every day is so critical in our response to the current pandemic.

With the details described in the manuscript, the onboarding can be only a few days (or even self-onboarding based on instructions). The only part that is somewhat tricky is the bioinformatics algorithm for positive vs. negative calls, which we can supply.

Pure capitalism has never existed anywhere. So, yeah, agreed. Yet what we have (not just the US but lots of nations around the world) has elevated society to levels not attainable through any other system we know.

> the failure of the airlines to operate responsibly

I don't think this is fair. Nobody could have predicted or prepared for this. Nobody. I mean, how?

I've read people say things like "We could have stockpiled 50,000 ventilators ten years ago". This is, frankly, silly on many fronts.

Technology being what it is, ten year old ventilators would have likely been 5 year old designs at the time of purchase, which would make them around 15 year old designs today.

The first level concern would be if those ventilators would be adequate or acceptable in today's context. I'll assume they could be. That said, professionals are trained to operate and know the equipment they use every day. If a dinosaur shows-up they might not be able to (or want to) use them because of lack of training that could lead to negative outcomes for patients.

People have this idea that a word, like "ventilator" fully defines a product, its usage and the entirety of the dynamics surrounding it. Things are never that simple.

Another point is equipment mortality. Anyone who has dealt with hardware in large quantities and across extended periods of time knows what can happen with 50,000 units of anything manufactured 10 to 15 years ago and in storage for ten years. You can end-up with massive failure and reliability problems. You would have to design and manufacture these devices to failure-tolerant aerospace/military standards to improve outcomes...and even then you have no guarantees.

Things are not as simple as "ventilators", not even close.

> The same thing happened in 2008

No, this is nothing --not even close-- to 2008. I lived through that period. It was an absolute mess precipitated by politicians loosening the rules on lenders and pushing them to let anyone buy homes. Great for votes but horrible for the economy, as history has proven. You had people making minimum wage buying half million dollar homes because the government (both Democrats and Republicans, BTW) removed all sorts of regulatory requirements on making loans. The banks operated under the law. And the consequences of the law ended-up being the opposite of what politicians sold us. Instead of "the American dream of home ownership" the thing turned in to the world nightmare of unintended consequences. Frankly, every single US Senator and Representative who voted for those demented changes should have lost their jobs and maybe even done some jail time. Sadly most of them are still there.

> it's weird to think only governments are running Cobol.

The issue is one anyone who has built non-trivial software for enterprises is familiar with. Once software "works" there's very little appetite to spend more money to continue working on it, much less migrate it to new tool sets, hardware, etc. It's just one of those things that, in the world of politics at least, doesn't earn you votes, so you ignore it until people are screaming for it because the system crashes and they can't get their checks.

Before the massive boost in throughput imposed by this pandemic these payment systems essentially worked as required, issued checks and payments on time, accurately and maybe even efficiently (per government standards). Anyone proposing to re-write the entire system, spend tens of millions of dollars or more in order to migrate to another language and add capacity would likely be laughed at. It is only in hindsight that these kinds of things can be justified.

This also applies to such things as CDC/NIH testing capabilities, manufacturing dependencies and more. Humanity rarely acts proactively. I can't think of a single example of this at scale in the history of humanity. For example, the dams in The Netherlands, brilliant as they are, were the result of a reaction, not proactivity.

Things are never simple. Sadly the media, politicians, popular conversation and social media tend to simplify everything beyond the reasonable and people end-up with distorted models of reality.

Seriously.

Someone has a great idea and is able to attract good people to work with them? Then even though item X is the focus, you see quality in items Y -> Z. It naturally seems to happen.

I'd love to know WHY this is the case.

I think the comment was meant that if you are in the food business, the only option is to deliver ingredients. Some businesses that used to deliver vegetables to restaurants now deliver to houses instead.

But in-person shopping for food is allowed. I don't know what they will do in the medium term, because other services will have to start operating again.

If you include that your goal is to test everyone too, I have no doubt that you can easily reach 96% negative test quite easily.

I remember in Quebec while we were only testing people with symptoms and that had traveled (or have been in contact with someone that has been tested positive), we were still way higher than 90% of negative tests (even right now we are a 90.1%

ETA: never mind, ~dvdt signed off on the change. Appreciate the collaboration!

The Seattle Flu Study wasn't allowed to communicate back to patients but "By Feb. 25, Dr. Chu and her colleagues could not bear to wait any longer. They began performing coronavirus tests, without government approval. What came back confirmed their worst fear. They quickly had a positive test from a local teenager with no recent travel history." https://www.nytimes.com/2020/03/10/us/coronavirus-testing-de...

I'm glad to hear they're allowed to do the SCAN study!

I think rightfully so. I was on a government video conference where a doctor showed the current CDC testing procedure, which involves stick a swab in the nose all the way to the back of the throat. They explained that the further the sample is taken from the lungs the less accurate it is.

The current equipment owners are already the clinical laboratories. It is unused capacity for them. Other owners are sequencing service providers. The full cost of running an end-to-end Sanger reaction as a provided service is $2-$6, so at the $50 reimbursement price, the laboratories will still be incentivized.

https://assets.publishing.service.gov.uk/government/uploads/...

So my calculation shows cov2 is about twice as bad as a strong flu, with no preventative measures. If we hit the 20k or less with preventative measures that the Imperial model predicts, this will be on par with regular flu season.

At any rate, much less than the 200k+ deaths originally predicted by the Imperial model and that pushed the UK to lockdown.

Purely speculative, but I think if swabs remain an issue for too long, alternatives could start coming online, such as even using qtips + saline (no idea if it works, it's just an example). The current swab + Universal / Viral Transport Medium combo is optimized for flexibility; it is designed to work across a very broad range of viruses and bacteria that have different viral loads and shedding characteristics. The current pandemic is pretty much COVID-19 only, so I think it's a priori feasible that a specimen collection procedure can be found that uses common materials. We did try early on to see if saline or other buffers affected the performance of the assay, and it worked fine in those conditions.

We use fairly standard chemicals. I haven't heard from our suppliers about shortages for the chemicals we use. Chemicals and enzymes tend to be relatively fast to scale up for bulk manufacturing.

There's always manufacturing risk that a product will not work as expected. In fact, the first COVID-19 test developed by the CDC did not work as expected, and this delayed testing by several weeks. We de-risk this as much as possible by performing experiments as early as possible, akin to the fail fast mentality of checking for the highest risk failure modes first. Since we don't have a national healthcare system in the US, the manufacturer takes on the vast majority of the risk of a defective product.

> Our initial data show no false-positives and no false-negatives out of all specimens assayed.

Is:

> the false result rate [of the test] is low

While you originally responded to the statement from the OP with:

> [You're saying that] your test is perfect? Color me skeptical.

I wouldn't make a major edit without letting them know. In the present case, I just let the whole community know, because the edit was a substantial one. Had it been a trivial one, I wouldn't have bothered. The priority is interesting discussion, not punctilious bookkeeping, and you can't necessarily have both.

In the flurry of these threads, the founders are focused on responding to substantive questions. That's what they should be doing: satisfying community curiosity in their area of expertise. It's my job, not theirs, to prevent the discussion from getting derailed by things like the unfortuitous use of a buzzword which they have no clue the community has been tired of hearing for years already.

If the users weren't YC founders that we have an explicit coaching relationship with, I'd always consult with them before offering help. That would happen by email. By the way, if anyone wants this sort of coaching, we're happy to help as much as we can via hn@ycombinator.com. I give this sort of advice to startup founders, project creators, and article authors all the time, and everyone is welcome to it. Just don't worry if you don't hear back right away. The inbox has gotten to the point where it piles up regularly.

This is not so. They are valuable right now.

This is only true for the IgG class of antibodies; we typically see the IgM class of antibodies arise within 5-7 days of infection.

You are generally correct, however, in stating that antibody tests have a window in which they cannot detect a new infection.

But I’ll accept that I am mistaken about that.

Even after ~6 half-lives, remaining 1% of viral load is still potentially dangerous, but it's not a good basis for a test if you want it to be sensitive.

¹ Inactive does not mean destroyed. It may be possible or even easier to detect a partially decomposed virus, even with the current tests. Or not.

Even the idea of 41k at this point beggars belief, they are already well over capacity with some mitigation and the bodies are literally piling up.

I find it hard to wrap my head around the logic here.

South Korea has tested a tiny fraction of their total population, because the testing is largely targeted via contact tracing.