"Everyone we found to have Covid-19 had serious symptoms, so we don't want to waste money testing you if you don't!"
I feel this is a trillion dollar mistake, testing more aggressively like South Korea means that you don't have to deploy the army and quarantine people. I had mild symptoms and they refused to test me, what am I to do? Self quarantine without a notice and hence without pay? I could work from home, but most can't so they will just go to work as normal and spread it. And now it is all over the world so only drastic measures will help.
I'm not sure if you're quoting something or paraphrasing a position you disagree with.
If it's a paraphrase, I'm not so sure it's a fair one.
In the United States, for example, we are urging people not to be tested unless they have severe symptoms. The reason for that is not to save money, but it's for a lack of testing capacity. As a policy we would much prefer to be testing even the mild suspected cases. But we don't (currently) have the testing capacity to do so.
So I think the lack of testing of mild cases (at least in the United States, and I suspect in other countries) is more a reflection of our rationing priorities than it is a reflection of our spending priorities.
If the testing capacity becomes unconstrained and we (or other countries) still fail to test mild cases.
I feel compelled to point out that it's purely a lack of _authorized_ testing capacity, although things seem to have improved recently. The test itself is relatively trivial from a scientific perspective.
The fact that our bureaucratic apparatuses were so ill prepared for such an event I find highly concerning.
Yes, absolutely. The lack of testing capacity was a total failure of the government.
After the acute phase of the crisis, we should investigate what happened in great detail.
But the advice about who should get a test is based on the testing capacity we have now. If we hadn't failed at testing capacity, we would be recommending more users get tested.
So, if the critique is: "we failed to produce adequate testing capacity", then I absolutely agree. If the critique is instead: "The recommendation of who gets a test is bad", then I disagree. The recommendation is correct given the test capacity failing.
The solution is not to recommend everyone gets tests, because they can't! Those tests are being rationed. The solution is to rapidly improve out testing capacity.
Yes, we are 3 months late. These wasted last 3 months were critical after the December outbreak in China. I don't think it is the U.S. problem, Europeans didn't move a finger until the beginning of March either. Literally everyone watched China as if they could contain it properly. They didn't even tell people until it was very late.
Testing randomly gets us a better picture of how widespread it is then testing to confirm severe cases. I'd much rather know that X% of the population has it with an error of Y than Z% of severe cases are due to this virus.
Yes from the research/understanding perspective but a lot of the testing is also to provide healthcare to those most in need. You test the most severe to make sure you can treat them effectively.
> Self quarantine without a notice and hence without pay?
If you have symptoms of _any_ illness you should always get a sick leave and stay at home. It does not matter if it's covid, seasonal flu or just a common cold - sick leave and stay at home.
Unfortunately this is not an option for many people. I don't disagree with the sentiment - avoiding the spread of disease is good - but often the reward systems in place don't optimize for the best global outcomes.
Where are you from? Where I live - I think I am even motivated to get sick leave. If I feel ill, I can get sick leave, with no time limits I am aware of [0], and as a reward I will get 80% [1] of my salary back for essentially doing nothing. IMHO it's a win/win. I will get well and be productive as soon as possible [2]. If it's a viral illness - my employer would be happy that I will not make dozens of other people ill.
[0] I have not read the law, but I have never heard of anyone reaching that limit. You can stay ill for months and still be compensated. Of course after some long time, you'll probably be moved from sick leave to some kind of disability program, which sucks, but we are not talking about disabilities.
[1] There's a cap for sick leave compensation, but unless you are earning _a lot_ it should be enough.
[2] Personal anecdata, but personally common cold takes couple of days of rest to go away, if I try to be tough and won't rest - it may take couple of weeks before I feel well again. Better couple of days of 0 productivity, than couple of weeks of work simulation.
Luckily we are born with "judgment" for all these cases were instincts or rewards do not point in the right direction. According to some, that's literally the reason d'etre of consciousness.
I wish it worked better and I were not confined home right now.
Right. But how often does this actually happen in the real world ?
And most importantly, what are we, as a society, ready to bet on the fact that not enough will make the "wrong" judgement ?
They actually cost a lot of money to businesses, but no one cares to track to show the ugly truth. Europe has a lot of data showing that going to work sick ends up costing much more than staying home, thus this is a irresponsible attitude - given you keep getting your pay of course.
I agree with you and practice that. But even in tech where work from home is an option and companies are rich enough to let people stay in bad anyway, in many companies it is treated as heroic to push through. Meaning, staying at home makes you seen as less comited and less passionate. Thus, people avoid it.
If you're working for a company where it's seen as "heroic" or "passionate" to come to work sick, you're in a toxic environment.
I've had a couple co-workers who perhaps see themselves as heroic for coming to work sick, but everyone else resents them and wishes they would just stay home.
> in many companies it is treated as heroic to push through.
I disagree, I see myself as weak for staying home an extra day or two, but I don't see others as weak for doing the same.
Today, I think the pressure to push through is mostly self-imposed. That's makes it no less real though.
Personally, I don't like sitting in an office with someone who is coughing. During the current virus out break, I doubt anyone will appreciate you pushing though :)
I mean, sure, if you have sick leave. The above comment is perhaps aspirational, but otherwise it is woefully ignorant of the sad, sad state of US healthcare for most of its residents.
It's a problem everywhere. Sick leave is something you take when you have high fever or need surgery, not when you start coughing. Reasons include: there's only so much sick leave you can take, employers expect sick leave to be extremely rare and will "phase you out" if it isn't, getting a sick leave involves a visit to a doctor - which, like any visit to a healthcare facility processing sick people - comes with a risk of catching something even worse than what you came with.
Every place on the planet needs to rethink how we handle infectious diseases. This requires both a cultural and legal shift, so that one can just not come to work when showing mild symptoms and not face any negative consequences. The market will not make this happen on its own. But this is a golden opportunity for the cultural shift - every society on this planet is going to be deeply scarred by SARS-CoV-2.
> Sick leave is something you take when you have high fever or need surgery
No, you take it when you have a problem big enough that it impacts your ability to work OR when you have a contagious disease.
It's a lose/lose situation for a company if a single person gets half the company sick.
> there's only so much sick leave you can take, employers expect sick leave to be extremely rare and will "phase you out"
In the US sure, in Europe you can't fire someone for health reasons. In France you'll even get 66% of your salary for 3 years if you can't work at all for health related reasons.
> Europe you can't fire someone for health reasons
On some types of contracts. Probably not the most common ones in practice. Also, making the job a living hell for someone, or laying them off the first legal opportunity arises are common practice, and I think everyone outside our industry knows it (in most industries, employers have more power than employees on the job market).
Well yes of course if you're employed with a contract that doesn't represent your working conditions, which is illegal in the first place, you're fucked.
What I meant is that in some countries you can come to work on day x and be asked not to come on day x+1, even with a regular contract, that's going to be very hard to pull in europe, and especially not going to happen if the reason is "took a week of because of the flu".
That's also why there is such a big thing around uber, deliveroo &c. in europe. These types of contracts weren't the norm 20 years ago and are very limiting when shit hits the fan.
In my company we just had the opposite, some dude was very obviously sick, couching for weeks, the CEO couldn't legally force him to take his sick days. So he stayed, and got a few of use sick. So brave and heroic, right ?
> Every place on the planet needs to rethink how we handle infectious diseases. This requires both a cultural and legal shift, so that one can just not come to work when showing mild symptoms and not face any negative consequences
Do I live on another planet? Coming in sick even with mild symptoms is frowned upon at least for a decade where I live. As a tech worker I can easily work remotely, so on mild symptoms I inform my employer that I will work remotely and that's it. If I feel, that I am not capable to work productively - I get a sick leave from my doctor and that's it.
I am of course not from medieval US (though POTUS probably could easily call place where I live a "shithole" country) where sick leave is compensated to 80% of your salary (there's a cap, but it's high enough) and I am not aware of any time limits, if there is - it's a year or more. That's the reason I pay taxes! :)
So no "legal shift" required. There's a "cultural shift" needed for some employers though, where being unwell is a sign of weakness, though legally they cannot do anything to the employee.
All in all, I do not want my restaurant order to be handled by anyone who's is even mildly ill or have a runny nose. Same thing applies to doctors, nurses, grocery store staff, etc. All politicians, employers and people in general who cannot grasp this simple idea - belong to live in the dark middle ages.
As tech workers, we're particularly privileged. Ask your local grocery store clerk, or the person that handles your paperwork in the bank.
I too am from a highly-developed (relative to the US) European country. It's all nice on paper. But in practice, a lot of these legal protections are commonly evaded (and government attempts at fixing it get badmouthed by a population considering itself "not exploited proletariat, but temporarily embarrassed millionaires").
It's still much better than what Americans have, but nowhere near good enough in terms of biosafety.
I agree that everybody who can work remotely is a bit privileged compared to someone who cannot, and in general tech employers are richer and more liberal.
As I said in my reply above, some employers or employees need a cultural shift. Either employers put pressure on employees to not get sick leave (which is illegal and unethical), or as you say some employees think that they are "temporarily embarrassed millionaires" (or just conditioned by decades of peer pressure), but I digress.
My point is that in my whole life I was _never_ rejected a sick leave by a doctor and my doctor definitely does not check if I am grocery store employee or "privileged" tech worker. Also it's not employers business to regulate how often employee can be ill or what "pre-existing conditions" employee has. People are not robots.
I'm not talking about getting a sick note rejected. I'm asking, would you realistically go and get a sick note for a runny noise and feeling generally unwell? Would you feel secure at your job if you did that 20 times a year?
I do not see what the problem is. People with small children get sick leaves many times per year, because children get ill in kindergarten very often. I know women who will get 5-10 one to two day sick leaves per year due to menstruation cramps.
People are not robots, people get ill. I have very good employer which would never question employees job security due to illness. If you do not - search for a better one, join a union and/or inform your colleagues that their rights are protected by law.
The horror stories I hear about evil employers - usually the employers themselves would be the first to take sick leaves or have luxury long lasting holidays that the employees cannot enjoy. Such employees are conditioned to slave away and forget that their rights are protected by law.
It's a huge opportunity and I hope it'll become popular everywhere.
Like e.g. someone in my family has been noticing a rash on their hands recently and was getting worried. There's no way in hell I'll let them go visit a doctor now, and this kind of consultation is something perfectly suited for doing it over the Internet.
> It's a problem everywhere. Sick leave is something you take when you have high fever or need surgery, not when you start coughing
Do you be any experience outside the USA? Your description doesn't fit my experience in the UK and Denmark, or my general understanding of the rest of Europe.
Europe will need to consider smaller changes — there are more gig economy workers than ever before, different countries have taken different approaches to closing schools etc — but I think the fundamentals are OK.
I'm in Poland. We have free public healthcare and all the other nice employee privileges Europe boasts about. On paper.
In practice, most of those are guaranteed when your contract is the regular full-time one. Which is minority of jobs in Poland. To avoid paying taxes, most employers strive to employ their workers via contracts meant for part-time or gig work, or through B2B (thus we have lots of sole proprietorships "entrepreneurs" in the country). Most protections don't kick in there.
On top of that, getting a doctor's note for a runny nose is too much of a hassle, and nobody realistically does that.
Thirdly, regardless of how much worker protection your country has, day to day nobody wants to be seen as the panicky outlier at work. That's a self-limiting move, both career-wise and socially. This normalizes coming to work with potentially infectious diseases.
> To avoid paying taxes, most employers strive to employ their workers via contracts meant for part-time or gig work, or through B2B (thus we have lots of sole proprietorships "entrepreneurs" in the country). Most protections don't kick in there.
I know that this "loop hole" exists where I live too, but AFAIK it's either used by very small companies, which can fly "under the radar" or it's not done at all, because inspecting agencies will quickly stop this.
Where I live if you work for employer like a full-time long-term employee - you are full-time long-term employee, and cannot work as a "freelancer"/sole proprietor-contractor (I do not know exact terms in English, but I think we'll understand each other). Work inspection will check this employer rather soon. Usually, because competitor or some employee will make an anonymous report.
If you agree to work on this loop hole - then it's your problem - work as a full time employee, or charge enough to compensate yourself for possible downtime during illness.
Big enterprises definitely do not use this kind of loop hole.
The employer wants a doctor's note, for you to get a paid sick day? They explicitly do not trust your self-assessment?
I think this is a cultural defect. Evidence? We keep getting most everything wrong and paying more per capital to do it. The free market failures. The government failures. Their various incentives are widely considered flawed or perverse. We even fail to have effective conversations, almost immediately they get rail roaded, and we allow them to be rail roaded. The language strikes me as a lot of attachment/adoration for ideological things like "the free market" and "proper regulation" and being unable to get past our emotional attachments to these things.
Literally the entire rest of the industrialized world does this better and cheaper per capita, and somehow Americans keep defending the system using various slogans and name calling.
I think it's bad culture, like a national mental health disorder, resulting from long term cognitive dissonance. The longer it continues, it's like a perpetually recurring psychological trauma, at a national level.
System is overwhelmed, can't really blame anyone since maintaining such, ready to spring, system would cost a lot of money. In an ideal world a drone would come and take your temp and then drop food supplies etc etc.
But I'm wondering...if we all are going to get infected (40-80%) wouldn't it better to choose the time? Early on you get all the benefits, 3 weeks later you are lucky to have someone measure your temp. Of course you might escape it entirely or new knowledge might be gained in weeks ahead, but the downside is terrible https://news.sky.com/story/coronavirus-italian-doctor-says-f...
Three weeks later you will most likely still be in ICU if you have a severe case. It is better to catch it six or twelve months later when the first peak is over and treatment options may be better.
How have South Korea's numbers meshed with this study? They've been testing very aggressively, surely if there was a huge asymptomatic population it would show up in their testing as well as Italy's?
I feel this is a trillion dollar mistake, testing more aggressively like South Korea means that you don't have to deploy the army and quarantine people. I had mild symptoms and they refused to test me, what am I to do? Self quarantine without a notice and hence without pay? I could work from home, but most can't so they will just go to work as normal and spread it. And now it is all over the world so only drastic measures will help.