What Are You Thinking About?

[StockEngine]

Yes, but the simple 70 will outlast em... & could even be more valuable in the long haul. Dealership independence is good luxury, too.[emoji4]

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LCP LC2 will do that too..

[travajante]

LCP LC2 will do that too..

No doubt they're reliable & luxurious....but I prefer the simple great cruisers listed below.[emoji4]
The 1 greatest 4x4s of all time

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[misseksaherada]

Sayang ba sa oras kung ilabas din ang statistics ng "severe pneumonia" cases na hindi nag undergo ng COVID test? Mas madali kayang i-test kung merong pneumonia yung tao?
Curious lang din ako.. Baka bukod sa COVID-19 baka need natin bigyang attention ang pneumonia cases.. Baka mamaya masyado tayong focus sa COVID-19.. Tapos mas marami pa pala yung sa pneumonia..

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[uls]

Sayang ba sa oras kung ilabas din ang statistics ng "severe pneumonia" cases na hindi nag undergo ng COVID test? Mas madali kayang i-test kung merong pneumonia yung tao?
Curious lang din ako.. Baka bukod sa COVID-19 baka need natin bigyang attention ang pneumonia cases.. Baka mamaya masyado tayong focus sa COVID-19.. Tapos mas marami pa pala yung sa pneumonia..

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in normal times diba ang diagnosis ng pneumonia chest xray / ct scan

dahil sa corona lahat ng pasyente may pneumonia tinetest for corona19

ung mga namatay bago lumabas ang result di naman yata sinasama sa official count

after lumabas ang result at nag positive doon lang isasama sa official count

--

di lang ung may pneumonia ang affected sa corona-crisis

kung na-heart attack ka or stroke sa panahon na ito ewan ko lang kung ma-aasikaso ka sa ER

[misseksaherada]

in normal times diba ang diagnosis ng pneumonia chest xray / ct scan

dahil sa corona lahat ng pasyente may pneumonia tinetest for corona19

ung mga namatay bago lumabas ang result di naman yata sinasama sa official count

after lumabas ang result at nag positive doon lang isasama sa official count

--

di lang ung may pneumonia ang affected sa corona-crisis

kung na-heart attack ka or stroke sa panahon na ito ewan ko lang kung ma-aasikaso ka sa ER

ang hirap talaga.. kahit ma-diagnose na may pneumonia dahil sa bilis lumala di talaga maagapan.. iniisip ko kasi sana kung paano maagapan.. anyways, i think sa mga PUMs meron naman na din pinapainom na gamot..
tulad nga ng sinabi mo may bottleneck pa sa pagbasa ng test results..
malaman man yung total count ng namatay sa severe pneumonia.. wala din sense..

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[Ry_Tower]

dahil sa corona lahat ng pasyente may pneumonia tinetest for corona19

ung mga namatay bago lumabas ang result di naman yata sinasama sa official count

after lumabas ang result at nag positive doon lang isasama sa official count

Hindi lahat ng may pneumonia eh tinetest for covid19. That is the truth kaya questionable talaga yung accuracy ng data dito sa atin re positive patients.

Just imagine if this was a deadlier virus. Pero sabagay kung ganun eh mandatory na rin testing malamang.

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[uls]

Hindi lahat ng may pneumonia eh tinetest for covid19. That is the truth kaya questionable talaga yung accuracy ng data dito sa atin re positive patients.

Just imagine if this was a deadlier virus. Pero sabagay kung ganun eh mandatory na rin testing malamang.

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sa panahon na ito they should entertain the thought that every patient showing up in the ER with pneumonia is a possible coronavirus case

[uls]

hindi ba criteria for testing ung meron severe symptoms?

isn't pneumonia severe enough?

--

no country's coronavirus data is 100% reliable

there will be always someone out there who died of covid but never got tested

[bloowolf]

Dadaan ka pa rin sa primary care doctor. Depende pa rin sa consulting dr. kung ipapatest for Covid.


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[bloowolf]

From Dr. Edsel Salvana (Infectious Disease Specialist) regarding testing for COVID:

1. Mass testing is not testing everyone. It is “risk-based” testing. Basically, you test people in increasing circles of risk: test the PUI, then the close contacts, then the community. It is not a shotgun approach because no country can test every single citizen for COVID-19. So we need to figure out our priorities for testing, and WHAT TEST to use. You CAN’T test 100M people, but you can test the MOST AT RISK.

2. Understand the limitations of testing. No TEST is 100% accurate. There are trade-offs. The probability that a test is positive when the disease is REALLY present is called the SENSITIVITY. The probability that a negative test actually means the disease is REALLY NOT there is called the SPECIFICITY.

3. A good sensitivity means that a test is able to detect disease MOST of the time if it is PRESENT in a patient. Having a negative test when the disease is PRESENT is called a FALSE NEGATIVE. In other words, the test failed to detect a sick person.

4. A good specificity means that a test is NEGATIVE MOST of the time if there is NO DISEASE in a patient. Having a positive test when the disease is ABSENT is called a FALSE POSITIVE.

5. FALSE NEGATIVES are harmful because you say that someone is COVID-19-free when he actually has COVID-19 so that patient will be free to spread the disease.

6. FALSE POSITIVES are harmful because you will put a patient WITHOUT COVID-19 in the hospital, possibly with REAL COVID-19 patients such that the patient can get COVID, or be isolated needlessly.

7. So how good are the tests? There are two tests we can use for COVID-19 – RT-PCR and antibody tests.

8. RT-PCR is considered the best test for diagnosing ONGOING COVID-19 infection. PCR itself is very sensitive and specific, >90% for both. HOWEVER, the TYPE of specimen and the stage of disease (how many days with symptoms) can affect how often a test is positive. So for RT-PCR, using a nasopharyngeal swab in a patient WITH disease, the probability of getting a positive test is only 63%. So you will actually MISS 37% of cases. This is why we can do a REPEAT test after 48 hours in a patient who is getting sicker of what looks like COVID, but was NEGATIVE on the first test. The DANGER of RT-PCR is a FALSE NEGATIVE and you can end up clearing someone who actually has COVID-19. This can happen in UP TO 1/3 OF PATIENTS so its not a perfect test.

9. RT-PCR is also a highly technical process that not only involves having the right machine and kits, BUT also the proper SAFETY INFRASTRUCTURE like a BSL2 laboratory. Many labs and hospitals HAVE RT-PCR machines but they do not have the biosafety infrastructure.

10. Antibody tests include PRNT (Plaque reduction neutralization test, the gold standard), ELISA (enzyme linked immunosorbent assay) and lateral flow IgM/IgG. The first two are LABORATORY based assays and the last is a point of care rapid diagnostic test (POC-RDT).

11. As much as we would like to use rapid lateral flow assays (IgM/IgG) because of convenience, NONE of the lateral flow assays have used the industry standard PRNT assay as a gold standard. In other words, we have NO IDEA how good they are despite their claimed sensitivity and specificity. The biggest danger is that because it takes 5 to 10 days to make IgM antibody, the test has a high FALSE NEGATIVE rate in those who just started having symptoms. And so you will get a FALSE SENSE OF SECURITY and end up passing the virus to other people and your family members.

12. The OTHER problem with the lateral flow IgM/IgG is that there are other HUMAN CORONAVIRUSES that cause the common cold, and some antibodies against these viruses may CROSS-REACT with the test, giving you a FALSE POSITIVE, which is bad for the reasons stated.

The BOTTOM LINE is NONE OF THESE TESTS ARE PERFECT. FAR from it. Tests INFORM your response, but they still need to be INTERPRETED in the right context.

To the lay person, they think that a positive is a positive, and a negative is a negative. To us clinicians and scientists, they come with HUGE caveats in management. There are times we WILL NOT believe a test result because it is NOT CONSISTENT with the patient’s clinical picture. If we let ourselves be mislead by a test result without USING OUR BRAIN, people will DIE. And this also holds for doing public health strategies and mass testing.

I do hope this gives the public a glimpse into how complex these decisions are, and that no matter how much the public clamors for something, it isn’t always in their BEST INTEREST to push the issue over what is SCIENTIFICALLY SOUND. Thank you.


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