Show HN: A Covid-19 testing location site that a group of us are building(findcovidtesting.com)
findcovidtesting.com
Show HN: A Covid-19 testing location site that a group of us are building
https://findcovidtesting.com/
131 comments
Great to see initiatives like this. However, everyone who can should be using a teledoc and getting instructions before visiting a testing site. Otherwise you're putting healthcare providers and patients in danger (a former colleague drove to multiple stations to try to get tested and he interacted with a bunch of HCPs).
Do you mind making it clear in the tool that someone viewing the site should first contact a teledoc?
Do you mind making it clear in the tool that someone viewing the site should first contact a teledoc?
I understand that this is how things are now.
But shouldn't an effort be made to make things easier and safer? Imagine a drive-through location with the web address of an intake app over entrance. You do intake with the app in the parking lot and then get cleared to go through. Everything automate and nearly free of human contact.
But shouldn't an effort be made to make things easier and safer? Imagine a drive-through location with the web address of an intake app over entrance. You do intake with the app in the parking lot and then get cleared to go through. Everything automate and nearly free of human contact.
Apparently not, unfortunately. Each person who gets tested uses up masks, gloves, and other protection equipment that is in short supply. If you think you might have the virus, quarantine yourself or go to a hospital if you need emergency care. Getting tested if you’re healthy won’t change the outcome.
Many jurisdictions (including mine in Calgary) are telling people NOT to visit hospitals. We’re supposed to do the health authority’s online self-assessment and call our local healthcare number to get instructions.
Uh, again,
Sure, we have a shortage. But mask and other equipment production is going to be ramped up shortly. Testing and is going to be the second part of any virus suppression effort.
And yeah, currently, we got nothing. Everyone quarantine, the sick-enough go to the soon-to-be overwhelmed hospitals. But we have to look plausible measures once we have resources, right?
Sure, we have a shortage. But mask and other equipment production is going to be ramped up shortly. Testing and is going to be the second part of any virus suppression effort.
And yeah, currently, we got nothing. Everyone quarantine, the sick-enough go to the soon-to-be overwhelmed hospitals. But we have to look plausible measures once we have resources, right?
You overestimate how tech savvy the common population is and how much hand holding is actually required to achieve this drive through testing efficiency.
People would get in line with their car to ask the attendant questions or for IT app support. There are language, accessibility/disability, cultural, etc. barriers (to name a few).
People would get in line with their car to ask the attendant questions or for IT app support. There are language, accessibility/disability, cultural, etc. barriers (to name a few).
"We saw a need for a site that people could find Covid-19 test locations"
I'm curious what data/feedback you used to conclude this need existed. I haven't seen any news articles that say the bottleneck is knowledge of locations. As many others have pointed out, the issue is with healthcare staff safety, test supplies, etc.
If you end up looking for a pivot, perhaps you could convert this into a map of locations where people could safely donate their excess supplies of masks, etc that they're holding onto unnecessarily. That could contribute to the problem of lack of supplies for healthcare workers.
thanks.
I'm curious what data/feedback you used to conclude this need existed. I haven't seen any news articles that say the bottleneck is knowledge of locations. As many others have pointed out, the issue is with healthcare staff safety, test supplies, etc.
If you end up looking for a pivot, perhaps you could convert this into a map of locations where people could safely donate their excess supplies of masks, etc that they're holding onto unnecessarily. That could contribute to the problem of lack of supplies for healthcare workers.
thanks.
here is a drive happening in Austin, Texas:
https://www.kxan.com/news/coronavirus/masks-gloves-and-therm...
https://www.kxan.com/news/coronavirus/masks-gloves-and-therm...
Nice initiative! Testing seems key to getting control of spread, so anything that can make it easier to get people tested is key. I wonder if there's enough capacity among the testing facilities to signal when they are out of capacity, or severely backlogged on tests, to avoid potentially affected people arriving needlessly?
One technical issue though - I'm seeing a white (blank) page when visiting in Firefox, though it seems to load fine in Chrome.
2 errors in the JS console, in case they help:
TypeError: "navigator.geolocation is undefined" at react-dom.production.min.js:196:194
TypeError: navigator.geolocation is undefined at App.tsx:121:4
One technical issue though - I'm seeing a white (blank) page when visiting in Firefox, though it seems to load fine in Chrome.
2 errors in the JS console, in case they help:
TypeError: "navigator.geolocation is undefined" at react-dom.production.min.js:196:194
TypeError: navigator.geolocation is undefined at App.tsx:121:4
> so anything that can make it easier to get people tested is key
Unfortunately not necessarily. We are past testing in some areas, and people seeking testing is putting strain on overloaded resources.
See for example:
“Not every single person in the U.S. needs to get tested,” said Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases. “When you go in and get tested, you are consuming personal protective equipment, masks and gowns — those are high priority for the health care workers who are taking care of people who have coronavirus disease.”
https://www.washingtonpost.com/health/2020/03/21/coronavirus...
Unfortunately not necessarily. We are past testing in some areas, and people seeking testing is putting strain on overloaded resources.
See for example:
“Not every single person in the U.S. needs to get tested,” said Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases. “When you go in and get tested, you are consuming personal protective equipment, masks and gowns — those are high priority for the health care workers who are taking care of people who have coronavirus disease.”
https://www.washingtonpost.com/health/2020/03/21/coronavirus...
[edit: tldr; There is no such thing as "getting tested". Stop looking for reassurance over a cough and fever; YOU WILL NOT BE TESTED FOR MILD SYMPTOMS; you're wasting very limited and precious healthcare resources which people who are potentially dying from severe symptoms need access to. Just. Stay. Home! /rant]
Woah man, your tone is a bit over the top here. People may not know what's going on.
I understand you're upset, it's a very upsetting situation. But venting to HN won't really help the things that are upsetting to you.
It's more effective I think to explain the situation clearly and help other on this site understand why mass testing is not a good idea in parts of the US.
EDIT: thanks the edit is much more effective!
I understand you're upset, it's a very upsetting situation. But venting to HN won't really help the things that are upsetting to you.
It's more effective I think to explain the situation clearly and help other on this site understand why mass testing is not a good idea in parts of the US.
EDIT: thanks the edit is much more effective!
I get what you are saying but it is getting really boring explaining basic facts again and again and again. The whole 'my opinion is valuable and the world is a debate' is great in good times. These are bad times and lots of people really do need to stop talking and start listening.
EDIT I hope the downvoters and their families make it through the epidemic alive.
EDIT I hope the downvoters and their families make it through the epidemic alive.
Thanks! Logged
Feedback on the website: it's running quite slow for me on Chromium under Linux, especially if there are a lot of locations (for example, unchecking "exclude public health agencies" makes the site very unresponsive). Also, "exclude local public health agencies" is confusing; I'd expect selecting it to show only those that aren't local public health agencies, but it seems to have the opposite effect. Finally, if I click on one of the locations, what I assume to be X-marks are displayed as just rectangles (I guess a
missing Unicode symbol in the font on my machine).
Thanks again for making this!
Thanks again for making this!
Thanks for the feedback. The map is definitely not optimized right now and it's on the fix list
Pretty neat seeing which states have the most testing locations. I'm pretty sure Houston has a few testing locations, but nothing is showing up on the map for me currently.
Just some feedback, this runs pretty slowly for me on my laptop. Is the full screen map necessary? Might be nice to have a Google Maps feel where it has the list on the side of the locations currently in view
Just some feedback, this runs pretty slowly for me on my laptop. Is the full screen map necessary? Might be nice to have a Google Maps feel where it has the list on the side of the locations currently in view
Echoing what was said about running slowly. On mobile Chrome it is slow but usable. On mobile Firefox it is too slow/janky to use. I appreciate the effort that has gone into this, but I do think it would be good to have an alternative non-map interface without the heavy js. Or figure out how to improve the performance, though that might require swapping out mapbox entirely.
Yes - Houston data will be coming soon. It took extra effort to figure out how testing was being coordinated among the TMC hospitals and their community-based partners. Stay tuned for updates - we are pushing data out regularly from this point forward.
We need better data sources so if you can help us find them send a note about the locations you know about to:
[email protected]
[email protected]
Hi Andrew,
I hope you don't mind, I saw this today and was inspired to build this:
https://tests.covid42.com
I'm planning to extend it with search functionality & an admin interface to help scale the sourcing of new data & validating it at scale.
Would you like to work on this together?
I hope you don't mind, I saw this today and was inspired to build this:
https://tests.covid42.com
I'm planning to extend it with search functionality & an admin interface to help scale the sourcing of new data & validating it at scale.
Would you like to work on this together?
[deleted]
Thanks for doing this. Not all heroes wear capes.
[deleted]
New York City is rationing testing as a measure of lowering healthcare worker exposure and reducing use of limited personal protective equipment supplies.
"If you think you have COVID-19 and your illness is mild, you do not need to see your health care provider and you will not be tested. Getting tested will not change what your provider will tell you to do to get better. They will tell you to stay home so you do not get others sick.
Unless you are hospitalized and a diagnosis will impact your care, you will not be tested. Limiting testing protects health care workers and saves essential medical supplies, such as masks and gloves, that are in short supply."
https://www1.nyc.gov/site/doh/health/health-topics/coronavir...
"If you think you have COVID-19 and your illness is mild, you do not need to see your health care provider and you will not be tested. Getting tested will not change what your provider will tell you to do to get better. They will tell you to stay home so you do not get others sick.
Unless you are hospitalized and a diagnosis will impact your care, you will not be tested. Limiting testing protects health care workers and saves essential medical supplies, such as masks and gloves, that are in short supply."
https://www1.nyc.gov/site/doh/health/health-topics/coronavir...
It is absolutely insane that we are so limited in this capacity, months after we knew we would need it. It is so limited and dire that we are barely able to provide for our own healthcare workers.
I really hope that after this is over, we have the political strength to diagnose the problems and deal with them. However I fear that the current regime will prevent any such correction because of fear that they could blamed, and the extreme dictator-like narcissism that prevents any corrections because it would mean admitting imperfection.
I really hope that after this is over, we have the political strength to diagnose the problems and deal with them. However I fear that the current regime will prevent any such correction because of fear that they could blamed, and the extreme dictator-like narcissism that prevents any corrections because it would mean admitting imperfection.
> as a measure of lowering healthcare worker exposure and reducing use of limited personal protective equipment supplies.
It's not about test availability, but rather exposure of healthcare workers and use of PPE. If you're already in the hospital people will be wearing PPE if they can get it.
Now that NY has gotten to this point PPE seems to be the bottleneck.
It's not about test availability, but rather exposure of healthcare workers and use of PPE. If you're already in the hospital people will be wearing PPE if they can get it.
Now that NY has gotten to this point PPE seems to be the bottleneck.
It is absolutely about test availability.
Nations such as S. Korea are doing considerable and widespread testing and are able to protect their healthcare workers.
And S. Korea is not on lockdown and they have suppressed their outbreak.
Given that we're not going for 'herd immunity' in the short term, the only alternative is widespread testing, forced isolation and excessive testing of those with a recent history of contact of those who turn up positive.
This will take coordination, moreover, it will take fairly comprehensive testing.
I'm not sure if the USA is geared to do this. Maybe a few states, but not the others, which then creates problems.
If those $20 testing kits are available in volume, enough people will able to 'test themselves' and that will serve as a really good '1st pass filter' for the regular medical testing systems.
Nations such as S. Korea are doing considerable and widespread testing and are able to protect their healthcare workers.
And S. Korea is not on lockdown and they have suppressed their outbreak.
Given that we're not going for 'herd immunity' in the short term, the only alternative is widespread testing, forced isolation and excessive testing of those with a recent history of contact of those who turn up positive.
This will take coordination, moreover, it will take fairly comprehensive testing.
I'm not sure if the USA is geared to do this. Maybe a few states, but not the others, which then creates problems.
If those $20 testing kits are available in volume, enough people will able to 'test themselves' and that will serve as a really good '1st pass filter' for the regular medical testing systems.
It is absolutely insane that we are so limited in this capacity, months after we knew we would need it.
1. According to Gov. Cuomo [0] New York is now testing more per capita than any place else including China or South Korea.
2. This comment [1] illuminates a bit the point about not getting tested by your healthcare provider.
[0] Around 11:30 https://www.ny1.com/nyc/all-boroughs/coronavirus-blog/2020/0...
[1] https://www.reddit.com/r/nyc/comments/fmb6p5/just_had_a_sobe...
2. This comment [1] illuminates a bit the point about not getting tested by your healthcare provider.
[0] Around 11:30 https://www.ny1.com/nyc/all-boroughs/coronavirus-blog/2020/0...
[1] https://www.reddit.com/r/nyc/comments/fmb6p5/just_had_a_sobe...
We are going to need to massively scale up that testing; per capita tests is not a terribly relevant metric. The best measure is: can we test everybody who needs it?
All around the country, many (most?) people with symptoms are being denied any form of testing. We need to go beyond that to massive testing of even asymptomatic people that have come into contact with people who have tested positive.
The healthcare workers are thinking about how to best help the people under their care, with severely limited resources. And for them, testing doesn't matter unless it changes treatment. But there are other reasons to test.
What the rest of our leaders need to be thinning is how to engage a strategy to contain the broader spread and let people return to normal life, safely, as soon as possible.
South Korea has shown us one way, massive testing:
https://twitter.com/trvrb/status/1240444836982878213?s=21
https://www.reuters.com/article/us-health-coronavirus-testin...
The other ways or get there will be some sort of antiviral treatment or vaccine, but those will not be fast.
All around the country, many (most?) people with symptoms are being denied any form of testing. We need to go beyond that to massive testing of even asymptomatic people that have come into contact with people who have tested positive.
The healthcare workers are thinking about how to best help the people under their care, with severely limited resources. And for them, testing doesn't matter unless it changes treatment. But there are other reasons to test.
What the rest of our leaders need to be thinning is how to engage a strategy to contain the broader spread and let people return to normal life, safely, as soon as possible.
South Korea has shown us one way, massive testing:
https://twitter.com/trvrb/status/1240444836982878213?s=21
https://www.reuters.com/article/us-health-coronavirus-testin...
The other ways or get there will be some sort of antiviral treatment or vaccine, but those will not be fast.
I'm not so sure it's a huge issue. Like OP's quote says, testing wont change what you need to do to get better. You will be told to take the same actions regardless of if it's coronavirus, flu, or common cold. Even if we had unlimited tests, I would rather our medical professionals be focused on treating those who need it instead of testing those who only have mild symptoms.
> I'm not so sure it's a huge issue.
Have a read of /r/medicine, it absolutely is.
They're already making (probably split-second) choices between endangering themselves without PPE or leaving patients untreated, in countries that have a long, long road ahead.
PPE seems to be the primary equipment shortage, not ECMO/ventilators, though that's an issue too.
Have a read of /r/medicine, it absolutely is.
They're already making (probably split-second) choices between endangering themselves without PPE or leaving patients untreated, in countries that have a long, long road ahead.
PPE seems to be the primary equipment shortage, not ECMO/ventilators, though that's an issue too.
In NYC, PPE is running low now, ventilators will be all used in 5 days. The PPE crisis is coming first, but not by many days.
Aggressive testing earlier would have allowed people to be taken out of circulation, which would have limited its spread. That horse has left the barn, however.
Maybe. What would we have done, though? Tested everyone, even those without symptoms?
If your symptoms are mild enough to not need hospitalization, your instructions are the same regardless of if it's the coronavirus, flu, or common cold. Now they're just telling the general population to follow those instructions.
What really disappoints me is that people seem to think it's okay to ignore those instructions if it's not the coronavirus. One possible silver lining to this mess is that flu cases will probably be significantly reduced in the short term.
If your symptoms are mild enough to not need hospitalization, your instructions are the same regardless of if it's the coronavirus, flu, or common cold. Now they're just telling the general population to follow those instructions.
What really disappoints me is that people seem to think it's okay to ignore those instructions if it's not the coronavirus. One possible silver lining to this mess is that flu cases will probably be significantly reduced in the short term.
Actively tracing contacts and testing them would be the key thing. When one person is found to be infected, you figure out where they've been and who they've interacted with, so you can test those people. Any of those people test positive? They go into quarantine and you trace their contacts. That's how you slow and eventually break the spread. Note that contacts don't need to be symptomatic to be tested.
Instead we're effectively doing the opposite, which is testing IF AND ONLY IF you BOTH have symptoms AND can prove contact with a confirmed case. Which doesn't do much to stop transmission (it's too late at this point; you've already spread it), and certainly doesn't give an accurate picture of the prevalence or behavior of the disease.
Instead we're effectively doing the opposite, which is testing IF AND ONLY IF you BOTH have symptoms AND can prove contact with a confirmed case. Which doesn't do much to stop transmission (it's too late at this point; you've already spread it), and certainly doesn't give an accurate picture of the prevalence or behavior of the disease.
Have any nations found success with that strategy? Could it be that we simply couldn't conduct that level of investigation fast enough at scale to be effective? And are the tests accurate enough for that approach to work?
The horse left that barn when we had a couple weeks of unknown spread in Washington state.
Yes, although it is possible to put the horse back in the barn with lockdown measures. And then IFF you have the extensive testing, those measures can be relaxed after a few weeks without cases exploding again.
So how long should it take to be able to create a reliable, sensitive and specific test , and then produce millions of such tests, for a virus which didn't exist in humans until 3-4 months ago?
A week? Two weeks tops? Once we have the viral genome sequence, which we've had for a looooong time, it's really easy to make a test.
Testing a new virus is not the difficulty! We've had all the info we needed for months, and the bottlenecks are not anything specific to SARS-COV-2. IDT, TWIST, and others can produce the specifics for this virus in no time.
What we are seeing is a massive logistical and organizational failure, driven right from the top of all of the organizations.
Testing a new virus is not the difficulty! We've had all the info we needed for months, and the bottlenecks are not anything specific to SARS-COV-2. IDT, TWIST, and others can produce the specifics for this virus in no time.
What we are seeing is a massive logistical and organizational failure, driven right from the top of all of the organizations.
I dunno, how long did it take in South Korea?
South Korea and the US found their first covid positive case on the same day[0]. I can't understand how the richest nation in the world failed this hard at containing and controlling covid.
[0]https://www.reuters.com/article/us-health-coronavirus-testin...
[0]https://www.reuters.com/article/us-health-coronavirus-testin...
If you look at South Korea's population, they have 1/7th the pop of the United States but yet have 1/3rd the number of deaths. They are doing almost twice as bad as the U.S. in terms of deaths per million people.
There are so many ways to slice the raw data, each giving a different sound of how alarming it is. For example, if you look at just Washington state, it has roughly the same number of deaths of South Korea, with one seventh the population.
Exactly. It’s already done. Why there isn’t more or even any public outcry regarding the US/FDA refusing to use their testing kits/system is beyond me.
For those reading who may be reminded of a recent news story - There was never any refusal of purportedly offered test kits. The WHO confirmed that there was never such an offer or even availability and that the rumor was false.
https://www.politifact.com/factchecks/2020/mar/16/joe-biden/...
https://www.politifact.com/factchecks/2020/mar/16/joe-biden/...
I’m not sure when the WHO reported that it did not have kits to offer, though they did state that many countries develop their own kits.
It still makes sense to ask why FDA only allowed CDC to develop a test, vs allowing all extant, validated tests and/or allowing private US tests.
It still makes sense to ask why FDA only allowed CDC to develop a test, vs allowing all extant, validated tests and/or allowing private US tests.
This is not the same story or question. This is a derailing statement and should be removed.
Looks like they were on the ball and started developing their tests way back in January, when the virus's gene was first sequenced. I haven't been able to find a detailed timeline of their test production, though: https://www.aljazeera.com/news/2020/03/south-korea-coronavir...
SK reformed their pandemic response in 2015.
They were ready long before Covid-19 showed up.
https://www.propublica.org/article/how-south-korea-scaled-co...
They were ready long before Covid-19 showed up.
https://www.propublica.org/article/how-south-korea-scaled-co...
How were their false negatives?
(Edit: typo: just noticed I accidentally wrote false positives instead of false negatives.)
(Edit: typo: just noticed I accidentally wrote false positives instead of false negatives.)
Seems not to matter much given that they were able to get their cases under control
How have they established this has been due to testing rather than something else?
Testing and tracing are core parts of both SK's and Singapore's strategies who had cases in their countries and seem to have beaten it. I don't think we'll ever be able to proof with 100% certainty that their strategies worked because and it wasn't good luck or some other unknown factor, however it seems highly likely given the same strategy is working out well on two different places.
South Korean foreign minister believes it's testing that was key: https://www.bbc.com/news/av/world-asia-51897979/coronavirus-...
Singapore was hit hard by SARS. They adjusted their strategy and are successful with COVID-19. paper: https://academic.oup.com/jtm/advance-article/doi/10.1093/jtm...
Maybe they were just lucky, but if it was my decision, I'd put my money on the strategy that worked in those two countries and minimized cost in lives and economic impact.
South Korean foreign minister believes it's testing that was key: https://www.bbc.com/news/av/world-asia-51897979/coronavirus-...
Singapore was hit hard by SARS. They adjusted their strategy and are successful with COVID-19. paper: https://academic.oup.com/jtm/advance-article/doi/10.1093/jtm...
Maybe they were just lucky, but if it was my decision, I'd put my money on the strategy that worked in those two countries and minimized cost in lives and economic impact.
Thanks for the links! To be clear, I'm not suggesting they had good luck or anything like that. I'm not even saying testing would be unhelpful (obviously it'd be helpful at least in some cases). I'm trying to figure out if there's more to the story, and if the effect testing itself is really as big as people imagine. Note that in the video she says testing is important because it minimizes further spread and quickly treats those found with the virus. But, for example, I'm hearing many Americans aren't exactly heeding the shelter-at-home orders. Would testing change that? And is there no other way to already change that without testing? Or for example, I'm hearing the US is running low on masks (not sure about other supplies) which I presume would harm patients' treatment. Would testing change that in any way? And like I mentioned elsewhere, the US can't legally just collect GPS data on everyone, and if we tried to put known cases on a map for everyone to look at, I'm not sure how well it would fly here. So are these going to be bigger obstacles to tracing even if we test people? Is testing really our biggest obstacle here?
I find these “devil’s advocate” perspectives a bit trying at times - yes testing would lead people to stay at home (since we could simply post a cop outside), yes testing would reduce PPE use (we would reduce transmission before a new case ever could walk in the ER door). You don’t need GPS data to do contact tracing.
Really, there’s no excuse for the abysmal US testing regime. We’re beyond a point where contact tracing is feasible, but there is no reason we had to get to this point.
Really, there’s no excuse for the abysmal US testing regime. We’re beyond a point where contact tracing is feasible, but there is no reason we had to get to this point.
Maybe instead of looking for excuses we should look at what they have done that can be applied to the US and Europe.
That's literally what I'm asking. What else did they do besides testing? My understanding is they've been aggressively quarantining people and tracing their contacts via phone GPS tracking, credit card data, and video surveillance [1], which is what really matters. Whereas in the US, they're telling people that testing them wouldn't change the health provider's response, which would be that the patient should self-quarantine if able. Now I don't like this fact, but I don't see why they would be lying about it. And if we assume they're not lying, then testing really would seem pointless. The problem here (as far as I can tell) seems to not be the presence or lack of testing, but the inability and/or unwillingness to provide the same kind of response in the US as in South Korea.
[1] https://www.businessinsider.com/coronavirus-south-korea-spre...
[1] https://www.businessinsider.com/coronavirus-south-korea-spre...
I think the problem is bigger. We can't do now what SK is doing. They are tracing cases and aggressively quarantining everyone who tests positive. Obviously you cannot do that if you cannot test enough people to get a complete enough picture of the invected population. We also probably now have too many infected to make that strategy workable at this point, even if we had the tests, tracing probably would be the new bottleneck.
This great write-up suggests to shut everything down to get cases back to a manageable level and then move to the SK and Singaporean model: https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-th...
Strongly recommend the read.
This great write-up suggests to shut everything down to get cases back to a manageable level and then move to the SK and Singaporean model: https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-th...
Strongly recommend the read.
I don't really think we disagree on the overall picture to be honest. I realize they're probably doing something (or I should say multiple things) right, and I realize the US has had organizational failures and such. I'm just not clear on what exactly having testing capability would let the US do that it otherwise cannot do right now, and I've yet to see a direct answer to this. If healthcare providers are saying that they'd just tell anyone who might have the disease stay home, then how does testing change the picture? Can't they do it already? Or is the idea that people would only obey this if they actually tested positive? And for tracing, can the US even use GPS etc. data the way South Korea can to trace their contacts, and invade people's privacy just like that? Would testing make that noticeably easier, compared to (I don't know, just thinking aloud) making medical providers report those that call about an illness so their contacts can be traced? etc.
I'm not so sure the tests are really the issue here. Were talking about breathing equipment for sick folks (anesthesiologists have proposed repurposing some of the equipment to aid in the shortage). We're talking about personal protective equipment, and the time/energy of the healthcare providers. At least in the case of simply having enough general use equipment for a pandemic, it's something that can be prepared for well in advance.
One Germany company managed in January https://www.bloomberg.com/news/articles/2020-03-12/a-berlin-...
It's about PPE. The time for testing was February. That ship has sailed. The disruptions to supply from Asia combined with the massive increase in demand in the US have resulted in widespread shortages of essential equipment.
If you're not sick enough to need hospitalization then don't go force somebody to waste PPE to tell you to go home and stay hydrated.
If you're not sick enough to need hospitalization then don't go force somebody to waste PPE to tell you to go home and stay hydrated.
Honestly, it's amazing that we can do so much about a virus that didn't even exist 5 months ago. The tech angle of the history feels like an Start Trek episode.
I think the strategy has shifted in terms of just trying to get people tested. It's a pandemic. Now, we're just trying to figure out how make sure the health system can serve those who really need it.
https://www.latimes.com/california/story/2020-03-20/coronavi...
https://www.latimes.com/california/story/2020-03-20/coronavi...
Are these official state tests or does that include commercial tests?
I believe the New York City Department of Health and Mental Hygiene has regulatory authority over healthcare providers within the City of New York.
Their 2020 Advisory #8 COVID-19 Update for New York City [1] directed towards healthcare providers states in the summary that "Outpatient testing must not be encouraged, promoted or advertised."
Additionally, "To preserve PPE for HCW providing medically necessary care for hospitalized patients, the NYC Health Department is directing healthcare facilities to IMMEDIATELY STOP TESTING NON-HOSPITALIZED PATIENTS FOR COVID-19 unless test results will impact the clinical management of the patient. In addition, do not test asymptomatic people, including HCWs or first responders. COVID-19 testing is only indicated for HOSPITALIZED PATIENTS."
[1] https://www1.nyc.gov/assets/doh/downloads/pdf/han/advisory/2...
Their 2020 Advisory #8 COVID-19 Update for New York City [1] directed towards healthcare providers states in the summary that "Outpatient testing must not be encouraged, promoted or advertised."
Additionally, "To preserve PPE for HCW providing medically necessary care for hospitalized patients, the NYC Health Department is directing healthcare facilities to IMMEDIATELY STOP TESTING NON-HOSPITALIZED PATIENTS FOR COVID-19 unless test results will impact the clinical management of the patient. In addition, do not test asymptomatic people, including HCWs or first responders. COVID-19 testing is only indicated for HOSPITALIZED PATIENTS."
[1] https://www1.nyc.gov/assets/doh/downloads/pdf/han/advisory/2...
Ok so that tells you how f* we are.
On the contrary, that tells us the NYC public health regulator is making logical choices in the face of systemic limitations.
F'd meaning they tested 10k people. The full impact hasn't peaked.
Thanks souterrain for the info.
On a side note, out of curiosity, would you happen to know how much the test costs in US?
On a side note, out of curiosity, would you happen to know how much the test costs in US?
Not sure, but Medicare (the U.S. federal public healthcare system which covers older patients and some others) will reimburse approximately $35 - $50 per test.
https://www.cms.gov/files/document/mac-covid-19-test-pricing...
https://www.cms.gov/files/document/mac-covid-19-test-pricing...
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Slow clap ...
This is amazing. Thank guys so much for building something like this. Rapidly building up access to, and information on testing sites is one of the most important things we can do right now.
Our leadership (in the USA) certainly isn’t doing it. I feel like anytime I say we should follow the example of countries who focused on testing, I’m immediately rebuffed with talking points, excuses why it won’t work, or why we should just hide in our house for an undetermined amount of time.
This is one of the best Covid-19 related projects I’ve seen come across the front page. You guys identified one of the most pressing problems, and figured out how to get it done.
Thank you so much!
This is amazing. Thank guys so much for building something like this. Rapidly building up access to, and information on testing sites is one of the most important things we can do right now.
Our leadership (in the USA) certainly isn’t doing it. I feel like anytime I say we should follow the example of countries who focused on testing, I’m immediately rebuffed with talking points, excuses why it won’t work, or why we should just hide in our house for an undetermined amount of time.
This is one of the best Covid-19 related projects I’ve seen come across the front page. You guys identified one of the most pressing problems, and figured out how to get it done.
Thank you so much!
SK reformed their entire pandemic response in 2015. They were better prepared for Covid-19 because they were better prepared.
https://www.propublica.org/article/how-south-korea-scaled-co...
https://www.propublica.org/article/how-south-korea-scaled-co...
But that's the point. Why wasn't the US prepared?
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Appreciate the slow clap - would love your help. See Andrew's note to learn about ways to help.
Nice!
I was pleasantly surprised that there is a testing centre 3 blocks from my apartment (i don't know where else I could have found this information).
I also really like this "Unless you are explicitly told otherwise, you MUST complete your self-isolation period - even if your test result is negative for COVID-19." I'm quite concerned by hypochondriac's and general attention seekers spamming the test system, being forced to self-isolate regardless is a perfect deterrent.
I was pleasantly surprised that there is a testing centre 3 blocks from my apartment (i don't know where else I could have found this information).
I also really like this "Unless you are explicitly told otherwise, you MUST complete your self-isolation period - even if your test result is negative for COVID-19." I'm quite concerned by hypochondriac's and general attention seekers spamming the test system, being forced to self-isolate regardless is a perfect deterrent.
Thank you for the work on this.
I have a tangentially related question, hoping that someone knowledgeable can answer. What are the main bottlenecks to scaling testing, in particular in the following stages:
- the supply of virus-specific reagents (primers, perhaps virus-specific reporting probes - are these necessary, or can just generic reporters be used?)
- the supply of other reagents (in case of PCR, polymerase, nucleotide material, buffer)
- the supply of disposable testing equipment. I know that swabs are in short supply for some reason, anything else?
- safety in handling both the samples and the amplified product (can you basically flush the processed sample down the toilet, or do you need to handle it with extreme precautions)
I have a tangentially related question, hoping that someone knowledgeable can answer. What are the main bottlenecks to scaling testing, in particular in the following stages:
- the supply of virus-specific reagents (primers, perhaps virus-specific reporting probes - are these necessary, or can just generic reporters be used?)
- the supply of other reagents (in case of PCR, polymerase, nucleotide material, buffer)
- the supply of disposable testing equipment. I know that swabs are in short supply for some reason, anything else?
- safety in handling both the samples and the amplified product (can you basically flush the processed sample down the toilet, or do you need to handle it with extreme precautions)
Short answer: they have all been bottlenecks thus far. In fact, that's a big reason why testing hasn't improved as rapidly as everyone hoped it would. The biggest bottleneck now is dwindling supplies of personal protective equipment (PPE) for those involved in obtaining and handling the test specimens.
Some places they are not revealing the location of the testing as they are getting overwhelmed.
I this this may be doing more harm than good. The test centers are a stretched resource at the moment.
People need to call their local non-emergency line for instructions if they have symptoms.
This map is incomplete by your own admission, which makes it practically misinformation.
We don't need guerrilla tactics in this war.
People need to call their local non-emergency line for instructions if they have symptoms.
This map is incomplete by your own admission, which makes it practically misinformation.
We don't need guerrilla tactics in this war.
Please make sure to publicize and somehow show evidence that you're NOT that other site: Oscar Health's "free covid19 risk assessment" & testing locator.
Oscar was started by Jared K, (tRUMP's S-I-L). Visitors of their site (at hioscar-dot-com-slash-covid19) are given a "free" assessment and referral to a testing center. So far so good, right?
In the back end, a "service fee" is charged to the Fed Govt for each person that uses the system. Being that Jared's in the family, there's no doubt that Oscar will get paid everything it asks for.
Oscar was started by Jared K, (tRUMP's S-I-L). Visitors of their site (at hioscar-dot-com-slash-covid19) are given a "free" assessment and referral to a testing center. So far so good, right?
In the back end, a "service fee" is charged to the Fed Govt for each person that uses the system. Being that Jared's in the family, there's no doubt that Oscar will get paid everything it asks for.
Out of interest
In the US, how much help is testing now other than to sample the population to get an idea of the spread?
Would it not be more interesting to know how well people are self isolating? Finding out where the message isn't getting through?
In the US, how much help is testing now other than to sample the population to get an idea of the spread?
Would it not be more interesting to know how well people are self isolating? Finding out where the message isn't getting through?
This is amazing work.
But please don't just go there to check if you have corona unless you have some of the symptoms. Otherwise you are going to flood the already strained system.
But please don't just go there to check if you have corona unless you have some of the symptoms. Otherwise you are going to flood the already strained system.
Really appreciate this guys!
cmiiw, by default the website shows locations which are not public health agencies and "checks patients for symptoms" and if we want to see all locations which provide COVID-19 testing we need to enable (toggle) radio button "Offers COVID-19 testing" in filter which is present in flyout at top left corner. Correct?
cmiiw, by default the website shows locations which are not public health agencies and "checks patients for symptoms" and if we want to see all locations which provide COVID-19 testing we need to enable (toggle) radio button "Offers COVID-19 testing" in filter which is present in flyout at top left corner. Correct?
We were careful not to assume that all public health departments would engage in testing. We manually verified the information, and for those public health agencies that explicitly indicated on their websites or through direct channels that they offered testing we marked them as "offers COVID-19 testing".
That being said, there are many areas of the country where the local, county, and state health departments effectively function as gatekeepers. In those communities, people have no choice but to call their health department and hope for the best. If they meet testing criteria, then they are referred to a testing location or fast-tracked through an existing healthcare provider’s queue.
If nothing else, this site crystallizes the fuzzy image that we all had in mind with respect to testing capacity. The situation is changing all the time, and we expect things to get better. You can help by raising awareness, and asking people you know in the Midwest and Southern states to visit our site and share their on-the-ground knowledge of the situation.
That being said, there are many areas of the country where the local, county, and state health departments effectively function as gatekeepers. In those communities, people have no choice but to call their health department and hope for the best. If they meet testing criteria, then they are referred to a testing location or fast-tracked through an existing healthcare provider’s queue.
If nothing else, this site crystallizes the fuzzy image that we all had in mind with respect to testing capacity. The situation is changing all the time, and we expect things to get better. You can help by raising awareness, and asking people you know in the Midwest and Southern states to visit our site and share their on-the-ground knowledge of the situation.
Nice! He're in Poland government _forbids_ taking virus tests. Private companies have plenty of them, but are unable to even give them to hospitals. Ministry of Health forbids hospitals from taking more than X tests per day, so even if somebody has symptoms they need to wait till morning among other patients.
Why not just make a google map with pins?
How about collecting the price of the test, the expected waiting time and the type of the test?
When I need to be tested, I don't want to phone several providers but I want to find the closest free slot for a test that suits my needs. E.g. if I don't have symptoms, I cannot use an antibody test.
When I need to be tested, I don't want to phone several providers but I want to find the closest free slot for a test that suits my needs. E.g. if I don't have symptoms, I cannot use an antibody test.
Try to get the attention of these guys: https://www.mercatus.org/features/mercatus-launches-prize-fu...
Thanks so much for putting this together!
It is insane that this is not being done by the government, and that it's left to random coders to throw this together in their free time.
It is insane that this is not being done by the government, and that it's left to random coders to throw this together in their free time.
Clicking to zoom is giving me a React-style white screen of death and the error "bearing is required for transition". FF/Chrome latest, macOS 10.14.6
People should be following the instructions of the health authority in their area instead of blindly going to a testing location they see on this website.
Wasn't Verily supposed to do this, or are they moving too slowly?
Edit: This item's page doesn't work on iPad. After three seconds, the page freezes.
Edit: This item's page doesn't work on iPad. After three seconds, the page freezes.
Hey, this is awesome! Just a heads up that Greenwich, CT is labeled as Los Angeles on the map, not sure if other cities are mislabeled too.
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We need updates on Georgia's (USA) sites bad.
Thank you for doing all this.
Also want to share that you're not imagining things: best we can tell, those living in Georgia have very few options beyond their health department. Even Emory is limited in its capacity - last I heard they were hoping to be able to get to 400 tests/day by this weekend. We'll add Emory to the site soon. Even so, I encourage those who live in Georgia to share their insight with us by adding testing locations so that we can help others in their community.
We will also continue to research and update the site as new options become available - including home-based testing. We've already heard from a couple of companies in this space, but we're waiting for them to provide us with proof that their test is FDA validated and approved. Once they do that, we'll add their information to the site as well.
We will also continue to research and update the site as new options become available - including home-based testing. We've already heard from a couple of companies in this space, but we're waiting for them to provide us with proof that their test is FDA validated and approved. Once they do that, we'll add their information to the site as well.
We need people sourcing data, so if you can help we'll take it. [email protected]
Or you can add a site here that we will validate:
https://docs.google.com/forms/d/e/1FAIpQLSe2sCuCrQwEHwi3FLiy...
Or you can add a site here that we will validate:
https://docs.google.com/forms/d/e/1FAIpQLSe2sCuCrQwEHwi3FLiy...
Emory is on our short list for data entry! We are hoping to get that data shortly. And thanks! :)
Surprised Alaska has so many! Is there a reason there's so many there?
Please check what your local medical advice is on whether you should be getting tested; very few places have surplus testing capacity for the "worried well", so you may be taking it from somewhere it's needed.
Most places won't run a test for people that don't meet the criteria.
Which I hope the makers here are thinking about how people will behave. I would be tempted to only show places that were basically testing anyone on a map and then provide per state/jurisdiction information about figuring out whether it's worth going somewhere otherwise.
Figuring out where to go to provide a sample is the easy part.
Which I hope the makers here are thinking about how people will behave. I would be tempted to only show places that were basically testing anyone on a map and then provide per state/jurisdiction information about figuring out whether it's worth going somewhere otherwise.
Figuring out where to go to provide a sample is the easy part.
The road to hell is paved with good intentions.
This idea seems like it would only be useful when coupled w a screening app that asks questions, give your temp and O2 oximeter reading, then provide locations, but even then, each county of each state has a completely different protocol for scheduling.
This idea seems like it would only be useful when coupled w a screening app that asks questions, give your temp and O2 oximeter reading, then provide locations, but even then, each county of each state has a completely different protocol for scheduling.
Seems we do have a screening app online https://www.screencovid.org/.
https://news.ycombinator.com/item?id=22649822
https://news.ycombinator.com/item?id=22649822
Now, couple that with this, and get a bunch of volunteers to work the phones and keep it updated by county, and then it is useful.
We just started working with Todd. Thanks!
The challenge to building a screening app is that there is no universal screening criteria (more on this in a bit). Moreover, the criteria has been changing by the day. For this MVP, we decided to stop chasing a moving target. We did the next best thing: link to the testing criteria that a location is using (to the extent that the information is publicly available).
Early in the process of sourcing data for this project, we realized that the CDC guidelines are used as a starting point, and that other factors come into play that are less transparent to the public. For example, there are still many states with extremely limited capacity. In those areas, public health departments have been forced to create lists of patients that would be tested immediately if it were possible. Lacking sufficient testing capacity, they prioritize the list of persons under investigation (PUI) using criteria that they develop internally through a collaborative effort with key stakeholders.
On our site, you will note that there are pockets of the country with lots of testing options. But that doesn't mean that testing is easy to come by. We learned that those areas are enriched for academic medical centers and large hospital systems that have been granted FDA approval for their own (custom) version of the COVID-19 test. Through strategic partnerships with community-based medical groups that predate the pandemic, patients in the broader community benefit from direct access to testing services. But the the problem has resurfaced: the demand for testing is already exceeding supply, and we witnessed the turnaround time for test results grow from 4 hours -> 12 hours -> 24 hours -> 4-5 days since we began this project exactly 7 days ago.
Make no mistake about it: the testing problem is far from resolved. Screening tools are a stopgap designed to lessen the mental anguish experienced by those who are tasked with rationing a (literally) vital resource. We will continue to explore ways to incorporate them into our project, but will approach the decision mindful of our commitment to empower everyone with the information they need to flatten the curve. To the extent that screening tools have thus far played a role in obfuscating where we are on the curve, you can rest assured that, if a screening tool finds its way onto our site, it will serve a greater purpose for a greater number of people.
Early in the process of sourcing data for this project, we realized that the CDC guidelines are used as a starting point, and that other factors come into play that are less transparent to the public. For example, there are still many states with extremely limited capacity. In those areas, public health departments have been forced to create lists of patients that would be tested immediately if it were possible. Lacking sufficient testing capacity, they prioritize the list of persons under investigation (PUI) using criteria that they develop internally through a collaborative effort with key stakeholders.
On our site, you will note that there are pockets of the country with lots of testing options. But that doesn't mean that testing is easy to come by. We learned that those areas are enriched for academic medical centers and large hospital systems that have been granted FDA approval for their own (custom) version of the COVID-19 test. Through strategic partnerships with community-based medical groups that predate the pandemic, patients in the broader community benefit from direct access to testing services. But the the problem has resurfaced: the demand for testing is already exceeding supply, and we witnessed the turnaround time for test results grow from 4 hours -> 12 hours -> 24 hours -> 4-5 days since we began this project exactly 7 days ago.
Make no mistake about it: the testing problem is far from resolved. Screening tools are a stopgap designed to lessen the mental anguish experienced by those who are tasked with rationing a (literally) vital resource. We will continue to explore ways to incorporate them into our project, but will approach the decision mindful of our commitment to empower everyone with the information they need to flatten the curve. To the extent that screening tools have thus far played a role in obfuscating where we are on the curve, you can rest assured that, if a screening tool finds its way onto our site, it will serve a greater purpose for a greater number of people.
Yes, we do.
Most of the locations are by appointment - even that is still hard to get. We need to make that clearer up front so thanks for the feedback both of you.
Most of the locations are by appointment - even that is still hard to get. We need to make that clearer up front so thanks for the feedback both of you.
Agreed. Please get screened first. In Virginia, there are hotlines that you can call first and I'm assuming it is the same in every other state.
Is there raw data available somewhere?
Yes - all over the place. That was the biggest challenge: sourcing and validating the data. It's also why this is and will continue to be a work in progress: the situation on the ground is dynamic. We need help sourcing and validating data. If you're willing to volunteer, send a note to [email protected]
Sweet Google map.
ct520(1)
Over the last week DataDrivenMD and I were able to pull together 15 developers to get this out. The speed that we were able to cobble together a team that can work smoothly, 100% remotely from all different organizations has been amazing. The crisis action team for the state of CA has reached out to see if they can collaborate with us, and we’re doing our best to understand how to work with state and local governments going forward.
Thanks to the fantastic volunteers, we have we were able to refactor early, away from the junk front end I built, to something that we can actually scale on the front and back end. We’re currently struggling with how to scale our collection and updating of test locations as they spring up, and we hope to build an application to allow providers to submit their locations on their own. Right now that whole process is manual, based on manually scraping/validating locations that are publicly stating they are doing testing. If infrastructure existed to identify places that are testing, we would be using it, but it doesn’t as far as we know, so we’re building the communication infrastructure for these test sites as it starts forming.
We’re US only right now but if we can get to a scalable way to collect test location data we can be worldwide.
This is a 100% volunteer effort explicitly for public good. We will not monetize the site, sell access to any resources we have, or in any way monetarily or personally benefit from this project, we have no plans to continue as a group any longer than we need to. No single organization is sponsoring this, and we have credits from GCP and AWS to run our infrastructure so Jorge and I don't go broke!
Please help us: Post in this thread any feedback, suggestions for scaling how we source and verify testing location data (manual currently), or anything you think useful! We’ll be monitoring the thread.
Our code is 100% FOSS: https://github.com/codersagainstcovidorg/covid19testing-map. We're available at @findcovidtest on twitter and [email protected]. Thanks!