D&D and the rising pandemic

[Deset Gled]

Unfortunately, a lot of legislation has loopholes made to specifically exclude what happens on Capitol Hill. (Funny how that happens.) Not sure if OSHA regs, etc. are among them, but I wouldn’t be surprised.

That said, it’s possible that a court could find such an exclusionary clause to be unenforceable (on several grounds) and allow a case to proceed.

How much immunity will extend to his extracurricular activities could also be an exciting round of litigation. I haven't been keeping tabs on his exact whereabouts for the past months, but this president is known to spend a lot of time away from the White House (e.g. golfing, resorts, etc). Could someone be sued for reckless endangerment by an unwitting guest or an employee at a country club that he visits on the weekend? Will it make a difference if he owns that club, that he hasn't properly removed himself from running a number of his companies, or if the government has invested in infrastructure there? A lot of these are untested questions, because no president has been allowed to do the things Trump has done.

 

[tomBitonti]

Background: I was reading the CNN Corona virus live stream today (06-Oct-2020), and read the following:

"Coronavirus testing in the US is still lagging, but Fauci says we're better off than we were a few months ago", from CNN’s Health Shelby Lin Erdman

White House blocks FDA on Covid-19 vaccine guidance: New York Times report

The coronavirus pandemic has brought countries to a standstill. In many places, as countries reopen, Covid-19 cases are on the rise. Follow here for the latest.

www.cnn.com

The article continues:

The Abbott test, which received an Emergency Use Authorization from the US Food and Drug Administration in August, returns test results in 15 minutes. The company says the test is 97% accurate in detecting positives and 98.5% accurately identifying people who are not infected. Abbott had trouble with accuracy in one of its previous coronavirus tests.

I was interested in how those accuracy numbers translate into false negative and false positive test results.

First, there is a question of the meaning the "accuracy" percentages. I found this, which indicates that the numbers are likely "positive percentage agreement" (PPA) and "negative percentage agreement" (NPA) values, since the numbers very closely match this published chart of test results:

"Abbott rides to the rescue with $5 Covid-19 test"

Resources

Read Evaluate's latest blogs, reports, webinars and thought leadership for detailed analysis of the state of the biopharma market.

www.evaluate.com

"Abbott reports positive and negative percent agreement"
"Accuracy of FDA-authorised antigen tests"

Date of EUA	Company	Test	PPA	NPA	Size*
Aug 26	Abbott	BinaxNow	97.1%	98.5%	102
Aug 18	LumiraDx	LumiraDx	97.6%	96.6%	257
Jul 2	Beckton Dickenson	BD Veritor	84%	100%	226
May 8	Quidel	Sofia Sars	96.7%	100%	209

* Suspected positive sample size

To understand what "positive percentage agreement" and "negative percentage agreement" mean, I found the following:

"Statistical Guidance on Reporting Results from Studies Evaluating Diagnostic Tests"

https://www.fda.gov/media/71147/download

And the answer is ... complicated. PPA and NPA are measure of how well a test results match a non-standard reference test. Without knowing the accuracy of the reference test, understanding the Abbott test results is difficult. If the reference test was 100% accurate, then the PPA and NPA are percentage measurements of sensitivity and specificity. But, if the reference test is less than 100% accurrate, the PPA and NPA may indicate a lesser or a greater accuracy. For example, the test which is being compared to the reference test might agree with the reference test where the reference test is accurate, and dis-agree where the references test is inaccurate.

The FDA has this to say:

Comparing a new test to a non-reference standard does not yield true performance. If the new test is better than the non-reference standard, the agreement will be poor. Alternatively, the agreement could be poor because the non-reference standard is fairly accurate and the new test is inaccurate. There is no statistical solution to determining which scenario is the true situation.

In any case, labeling PPA and NPA as "accuracy" seems quite incorrect.

As an aside, two other values which are described by the FDA text are "sensitivity" and "specificity":

• Sensitivity refers to how often the test is positive when the condition of interest is present
• Specificity refers to how often the test is negative when the condition of interest is absent

Although of only small value -- given the uncertainty of the meaning of the Abbot PPA and NPA values, I took the values as measuring "accuracy" and determined the proportion of false results for different virus distributions. That is, for populations with 90%, 50%, 10%, 1%, 0.1%, and 0.01% infected individuals:

Populations descriptions:

	Percentage	Proportion	Number of Persons
Uninfected	10%	1/10	100,000
Infected	90%	9/10	900,000
Total	100%	10/10	1,000,000
Uninfected	50%	5/10	500,000
Infected	50%	5/10	500,000
Total	100%	10/10	1,000,000
Uninfected	90%	9/10	900,000
Infected	10%	1/10	100,000
Total	100%	10/10	1,000,000
Uninfected	99%	99/100	990,000
Infected	1%	1/100	10,000
Total	100%	100/100	1,000,000
Uninfected	99.9%	999/1000	999,000
Infected	0.1%	1/1000	1,000
Total	100.0%	1000/1000	1,000,000
Uninfected	99.99%	9999/10000	999,900
Infected	0.01%	1/10000	100
Total	100.00%	10000/10000	1,000,000

Working through the numbers, I obtained the following test accuracy results. Here "accuracy" means "Upon obtaining a test result, what is the chance that that result is correct?"

Unsurprisingly, as the proportion of the population which is infected drops, the number of false positives dominates the "infected" results, leading to increasingly worse accuracy.

Population Percent Infected	Percent True Uninfected Results	Percent True Infected Results
90%	87.8%	99.7%
50%	98.5%	97.0%
10%	99.8%	78.5%
1%	99.98%	24.9%
0.1%	99.998%	3.1%
0.01%	99.9998%	0.327%

Calculations:

Uninfected:     10%       ( 1/10)   100,000  U  97,000 I   3,000
Infected:       90%       ( 9/10)   900,000  U  13,500 I 886,500
Total:         100%       (10/10) 1,000,000  U 110,500 I 889,500 (U 87.8% I 99.7%)

Uninfected:     50%       ( 5/10)   500,000  U 485,000 I  15,000
Infected:       50%       ( 5/10)   500,000  U   7k500 I 492,500
Total:         100%       (10/10) 1,000,000  U 492k500 I 507,500 (U 98.5% I 97.0%)

Uninfected:     90%       ( 9/10)   900,000  U 873,000 I  27,000
Infected:       10%       ( 1/10)   100,000  U   1,500 I  98,500
Total:         100%       (10/10) 1,000,000  U 874,500 I 125,500 (U 99.8% I 78.5%)

Uninfected:     99%     ( 99/100)   990,000  U 960,300 I  29,700
Infected:        1%     (  1/100)    10,000  U     150 I   9,850
Total:         100%     (100/100) 1,000,000  U 960,450 I  39,550 (U 99.98% I 24.9%)

Uninfected:   99.9%   ( 999/1000)   999,000  U 969,030 I  29,970
Infected:      0.1%   (   1/1000)     1,000  U      15 I     985
Total:       100.0%   (1000/1000) 1,000,000  U 969,045 I  30,955 (U 99.998% I 3.1%)

Uninfected:  99.99% ( 9999/10000)   999,900  U 969,903.0 I 29,997.0
Infected:     0.01% (    1/10000)       100  U       1.5 I     98.5
Total:      100.00% (10000/10000) 1,000,000  U 969,904.5 I 30,095.5 (U 99.9998% I 0.327%)

Any errors in the above are my own.

Tom Bitonti

 

[Eltab]

That sounds like a reason to run field tests: pick some rural county with 1-5 patients at one end of the spectrum and some city with a continuing flow of patients at the other. Order say 200,000 tests each ($1M, yes) and set up the needed Excel spreadsheets. Track everybody who took the tests for three weeks. We get a confirmation of their accuracy (or not) vs IRL instead of vs the current standard.

 

[tomBitonti]

That sounds like a reason to run field tests: pick some rural county with 1-5 patients at one end of the spectrum and some city with a continuing flow of patients at the other. Order say 200,000 tests each ($1M, yes) and set up the needed Excel spreadsheets. Track everybody who took the tests for three weeks. We get a confirmation of their accuracy (or not) vs IRL instead of vs the current standard.

Haha, that's peanuts. I'm expecting test budgets to run into the 10's of billions. Figure: For USA alone, 330 million people times $10 to $100 cost to test each person one or more times (on average) gives $3.3 to $33 billion in testing costs. (Billion in the US sense: 10 to the 9'th).

Tom Bitonti

 

[Dannyalcatraz]

How much immunity will extend to his extracurricular activities could also be an exciting round of litigation. I haven't been keeping tabs on his exact whereabouts for the past months, but this president is known to spend a lot of time away from the White House (e.g. golfing, resorts, etc). Could someone be sued for reckless endangerment by an unwitting guest or an employee at a country club that he visits on the weekend? Will it make a difference if he owns that club, that he hasn't properly removed himself from running a number of his companies, or if the government has invested in infrastructure there? A lot of these are untested questions, because no president has been allowed to do the things Trump has done.

It’s a question I can’t give a good answer to.

Reason: most of the stuff you’re asking about isn’t covered by federal law, but state law. Nearly anywhere else in the country, state prosecutors & civil attorneys could be on him like white on rice (eventually) for that stuff. But DC is it’s own little pocket, and ya legal system is an odd checkerboard.

 

[Dannyalcatraz]

Just saw this, and had a knowing, rueful chuckle.

 

[ccs]

Ah, 2020 keeps on giving:
A global pandemic,
wrecked/disrupted economies
Australia & California/the western USA on fire,
Murder Hornets,
protests & riots,
&^ stupid people furthering the pandemic,
Politicians,
potential meteor strike
more politicians,

And now the whales are attacking us! Not that we don't deserve it, but still.... really?

A pod of 'crazy' killer whales is launching coordinated attacks on boats, terrifying the sailors and baffling scientists

Orcas are ramming sailboats along the Spanish and Portuguese coasts in an unprecedented display of aggressive behavior.

news.yahoo.com

 

[Levistus's_Leviathan]

Ah, 2020 keeps on giving:
A global pandemic,
wrecked/disrupted economies
Australia & California/the western USA on fire,
Murder Hornets,
protests & riots,
&^ stupid people furthering the pandemic,
Politicians,
potential meteor strike
more politicians,

And now the whales are attacking us! Not that we don't deserve it, but still.... really?

A pod of 'crazy' killer whales is launching coordinated attacks on boats, terrifying the sailors and baffling scientists

Orcas are ramming sailboats along the Spanish and Portuguese coasts in an unprecedented display of aggressive behavior.

news.yahoo.com

Who ever wrote this season of Earth was throwing in all the clichés. Of course just a month before the election the POTUS catches a super contagious, very dangerous disease. And of course he's dumb enough to pretend like it's nothing. And of course within a day of Election Day an asteroid will be passing by.

There is so much going wrong that makes this feel like I'm living in a crappy TV show that can't think of anything original, so they just pile up every possible calamity into just the span of one year. Thanks 2020.

 

[MoonSong]

Ah, 2020 keeps on giving:
A global pandemic,
wrecked/disrupted economies
Australia & California/the western USA on fire,
Murder Hornets,
protests & riots,
&^ stupid people furthering the pandemic,
Politicians,
potential meteor strike
more politicians,

And now the whales are attacking us! Not that we don't deserve it, but still.... really?

A pod of 'crazy' killer whales is launching coordinated attacks on boats, terrifying the sailors and baffling scientists

Orcas are ramming sailboats along the Spanish and Portuguese coasts in an unprecedented display of aggressive behavior.

news.yahoo.com

You forgot more hurricanes than we had names for.

 

[ccs]

You forgot more hurricanes than we had names for.

Considering all the languages & words in the world, we really didn't run out of names for them.