Sticksboi05

I think the fact that COVID-19 is causing an ongoing global pandemic and national public health emergency. Obviously they aren't literally arguing for zero chance as that's impossible to guarantee, but a simple safety check with the tools available. I don't think that's unreasonable except of course if you're going to implement this, then antigen tests need to be plentiful for it to work.

I'm going to assume if Taiwan's infectious disease organization felt the CDC was incorrect, that some of these cases have indeed been contagious longer than five days after symptoms resolved - or they're going to make the reasonable conclusion that they cannot document even a minute fraction of the hundreds of millions of cases since 2020, but that isn't needed to use the precautionary principle regardless. I'm also going to assume that if Dr. Fauci said the CDC got so much push back from public health experts on their proposed guidance that they are likely to update it, that that says something. I personally don't need them to give me a documented case study, I am going to take the word of the huge number of highly talented immunologists and virologists who said they disagree, plenty of which, has been on Twitter expanding their thoughts. It's one thing if a couple folks here or there were angry with everyone else in lockstep. Again the CDC could have put this to bed by providing all the data they alluded to in their media advisory. I think everyone's in agreement the odds of transmission is drastically lower for the range the CDC is referring to, but not absolute zero, especially not for unvaccinated people.

CDC came to its senses. Not requiring a negative test was unacceptable. Changing the guidance only puts more pressure on the FDA to get more tests on the market (there's 70+ in Germany for instance). But yet again the immediate back and forth here and quick reversal after experts said WTF erodes public trust. Taiwan said they've seen people contagious with Omicron for 12 days after testing positive. I really don't know what is going on at the CDC but it's going to take them a long time to regain public trust post-pandemic.

Dr. Malone is a grifter who is clearly mad he wasn't getting all the attention in 2020 when Moderna and BioNTech announced they were making mRNA vaccines. His claim to fame is a 1989 paper where they moved mRNA by mixing it with fat so he claims he designed the delivery vehicle for mRNA vaccines. Except delivering mRNA via a liposome was already done in 1978, which his paper conveniently ignores. He clearly has an agenda and for him to put "inventor of mRNA vaccines in his Twitter bio for over a year is inaccurate. +++ https://www.nature.com/articles/274923a0

I wouldn't let that experience change your perception - they're supposed to only go positive when there's high viral replication in your nose (or throat if you swab there). This is why public health experts have been calling for a mass amount of rapid tests - they're at their best when people can test over and over again - one day you may be at a minimal viral load and in less than 24 hours you can be highly contagious so it makes sense to be negative one day and positive the next.

Tests from Roche and Siemens among other companies, which we could have had earlier, have finally been authorized as the NIH has stepped in to assist the FDA with rapid test approval. Tens of millions more home tests now available each month. This is great federal collaboration - more more more! Bring us the tests. This is great to see.

I'm agreeing with you! It's the issue of how much faster Omicron replicates in the throat so by the time it does the same in the nose, it leaves a gap where rapid tests could miss contagiousness.

At-home tests from all the major manufacturers can detect Omicron as they detect the N protein rather than the highly mutated spike protein. The issue is Omicron seems to replicate so much more quickly in the throat and thus you are contagious faster than previous variants before nasal replication is high enough for detection. But they will all detect it at some point. Some people are now recommending taking a throat + nasal swab now for at home tests. It's not FDA authorized as it may lead to a little bit more false positives but regardless, better safe than sorry.

I'm sorry you're having to deal with this, and this is exactly why we're behind the virus (to be fair there's many reasons), testing speed and accessibility is not enough to keep up. It's why the 500 million tests could not come sooner - I hope rather than just releasing them the Biden admin does a big press conference walking through how to most effectively use rapid tests so people are taking them just moments before events, and using multiple over days. The symptom onset you mention aligns with the general kinetics of COVID-19, you go from a viral load of 1000 ---> 100 billion in a matter of a day and then after another 1-3 days go right back down. Very fast kinetics.

As I said in the vaccine thread, the CDC is likely going off the fact that most people test positive after they have started their infectious period, which is typically a day or two before symptoms start to about 3-5 days after depending on your immune response (changed a bit by vaccination and Omicron). However, that is not everyone and you will undoubtedly still have people going outside while contagious following this guidance. We also have less data on the infection kinetics of Omicron though I think that will be a bigger issue at the beginning of the infectious period vs. affecting the end. The argument to eliminate the steadfast 10 day rule has been strong for a while, but the CDC should have at the very least said recommend you get a negative rapid test before you re-enter society. It is better to be safe than sorry and it only takes one oops to trigger outbreaks. It would also encourage people to make more use of rapid tests. That paper is from March 2021 - if the CDC is going to gain public trust they should present the recent data they are working with, and then say, here's why the change, not just allude to it.

They said they have data and presented none - not exactly going to build up confidence. The chorus of public health experts saying this change in policy is unsubstantiated speaks for itself.

I know many of us may have friends who look at what the CDC just insanely did with their isolation guidance and put people at risk. If you have friends who say hey I waited five days without symptoms, do NOT go see them unless they test negative on a rapid test. Ideally back to back tests on back to back days but of course tests are in short supply sadly. The idea is probably that many people test positive days after they were infected and thus well into their contagious period already, which is 100% true, but it's an unnecessary risk - most people are contagious 3-5 days give or take, but many are for over a week. Don't risk it with high risk people especially. We should have done what the UK/NBA does - after 5 days, test negative and then return to public.

The fine folks at the FDA (and to be clear the FDA has a lot of great minds working there, and the advisory committees are top notch) continue to assess rapid tests for medical diagnosis vs. for public health. There are companies that can make millions of tests a day that cannot deliver to the U.S. because the FDA has set up an approval where these test makers have to skew results to look like PCR - it's not intended to be like PCR. For public health, speed, testing regimen and accessibility are more important than extra accuracy. If we could get PCR results back in hours by the millions, it'd be a moot point, but we can't - especially in big waves. Taking an 80-85% accurate test over and over will catch more contagious people than random PCRs every once in a while coming back in 48 hours+. I think you bring up a great point about the UK - it's not just about making tests available but educating people on how they are used most effectively. For example, many people use rapid tests the day before an event - they should be used literally right before you go to someone's house. They should not be used to say "well I have symptoms but I'm negative so I'm fine", which clowns are doing. Omicron has made it harder to detect early contagiousness so many experts now suggest swabbing throat and nose even if it isn't FDA authorized. The benefit does rely on humans actually using them properly and experts explaining how indeed - and in the absence of that, you won't see much of a difference. But that should be the issue we are dealing with, not the fact that there aren't enough tests.

At this point if people are working without masks, it's borrowed time until an outbreak. And state leaders need to make it clear, cloth mask and mediocre paper surgical masks that you get at CVS are not enough anymore. It's gotta be KN95, N95, KF94 are the equivalent. At the VERY least a medical-grade surgical mask ATSM 3.

+1 I'd rather meet safely on March 7th than unsafely today 10x out of 10.

Beautifully stated!

More proof of how out of touch the Biden administration is with the pandemic and public health ...

THANK YOU for sharing this. This is exactly what I was referring to in earlier posts when I said the testing situation in the U.S. is a disaster. With a virus as contagious as Omicron, having to wait an extra day to test means you will always be behind its spread. Making people stand outside in the cold for hours is also inexcusable. At this stage, if you have symptoms and the rapid test comes back positive, it's a positive and you should begin isolation. Don't wait for PCR to confirm, false positives are much rarer than false negatives on rapid tests. This is why we need an abundance of at-home tests, so people can test over and over again regularly. They may not catch someone on Day 1 of their contagious phase but if they catch them on Day 2,3, 4 etc. that still prevents spread. For public health, speed and frequency trumps accuracy to cut transmission. It sucks people are now having to change holiday plans. Sorry you had to.

Regeneron and Eli Lilly are indeed useless against Omicron. We are lucky GSK/Vir's is still effective and it looks like AstraZeneca's also retains neutralizing activity. But they are still not as good as full vaccination.

If it was anthrax they wouldn't be here to tell us of this conspiracy.

This is great to hear but it has unfortunately not been that way in huge parts of the country - it is very common to get 48 hour+ results, primarily when we enter huge waves and demand spikes - when tests results are needed the most in a fast manner. The vaccines are great but as the WHO has said repeatedly they will not end the pandemic by themselves. They are great for stopping severe disease, decent at best stopping transmission and that becomes even harder with Omicron - this is not a knock on them, you can only do so much with a respiratory virus in terms of transmission. Obviously we are in agreement the Trump response was terrible. Whether I say smidge or "mildly" better, my point is I was expecting us to not still be a step behind at every turn. Biden did improve the vaccine rollout but we need more tests to cut off transmission chains, we need to seriously increase production of GSK/Vir's antibody drug as it's the only one that works against Omicron, and we need to ramp up production of Pfizer's antiviral - as of now the supply of both is minimal. Maybe more will come out on plans for that this week but if not, again, let's be ahead of the virus. 24 hours doesn't seem that long but this virus, and especially in the age of Omicron, is really hard to keep up with waiting that long. You can go from little virus in your body to superspreader levels in less than a day, which is why events with a "negative test within 1-2 days" is not going to do enough to prevent outbreaks. Ideally you'd have to test literally right before entering an event.

Easy access to at-home testing absolutely would make a difference. Meet people where they are - getting tests occasionally at pharmacies that give you results in 48-72 hours will never put any dent in transmission. Being able to test several times a week whenever you feel, is much more effective. The UK, India, Germany etc. all provide free or $1 rapid tests whenever you want and we are still expecting people to stand in line for hours and wait for useless results in days whenever there's a big wave. It's actually sad. We should have prioritized access to testing as soon as Biden took office. At the very least Delta should have been the wave that made us like you know what, we don't have enough testing. Nope, had to wait for an even more contagious variant.

The existing rapid tests from major manufacturers work for Omicron - there are two mutations in the N protein that won't impact detection thankfully. In the past week, Kamala Harris told a podcast we didn't see Delta and Omicron coming, and Joe Biden scoffed at a reporter for just now getting rapid tests to Americans free saying we didn't know Omicron would spread this fast. This administration has been fully incompetent in response, maybe just a smidge better than Trump if we're being honest. Those quotes are embarrassing - we were warned of variants in early 2020, and scientists sounded off on the incredible contagiousness of Delta and Omicron weeks before they became dominant in America - yet nothing was done. We're always a step behind when we don't need to be.

There are billions of rapid tests already in existence, we just don't have access to them, because of decisions by the FDA to incorrectly assess them for authorization. And we would have time to scale this up if we hadn't waited until Omicron was 73% of cases in America and rising.

Biden FINALLY getting the message - U.S. to distribute 500 million rapid tests starting in January. Unfortunately as usual this is after Omicron is already wreaking havoc - we can never get ahead of this virus, it's always wait for cases to skyrocket then react. Two years in, it's unacceptable. But nevertheless rapid tests are coming, and that is GREAT. PCR tests that comes back in 48 hours are essentially useless for a virus this contagious, and with these type of viral kinetics.