You can pick an actual infectious disease specialist to say whatever you want, but looking at that article, it doesn't make a whole lot of sense.

The TLDR is something like:

- If you have cold symptoms it's probably covid
- You need to isolate if you have cold symptoms whether you tested or not
- The test makes no difference to your isolation protocol and a negative test won't end your isolation early in most cases (except for healthcare workers who can maybe go back early?). If you get a negative antigen test you should go get a PCR test.
- "You can continue to test positive for COVID-19 on a PCR test for months, even though you’re no longer sick or infectious"

If the test makes practically no difference to the outcome, what is the point of it? And why would we recommend everybody try to test when they're isolating anyway and test capacity is strained in most places? I guess it's possible Chicago has tons of capacity so the advice makes sense there but not here where people were lining up for 4 hours in some cases and in some cases taking public transit to get to the test site.

As the CDC is loosening the recommended isolation protocols, my guess is many places will back off on testing (and contact tracing) and we will gradually move back to previous norms we followed for endemic illnesses that aren't all that threatening to most people. The test/trace/isolate strategy is for relatively high severity contagions with relatively low prevalence, the opposite of omicron.

:yes:

Exactly, that's silly. The naivety of people to think that there aren't differing opinions from medical professionals (yes, that also includes ID specialists) as to how to deal with this mess.

This clusterfuck was created by the CDC, and they are only making this worse for everybody. Throw these idiots out.....

Well no, you don't need to isolate if you have cold symptoms but tested negative, that's the whole point of getting tested if you have symptoms. But yes, if you prefer to just isolate and not bother getting a test at all that's also reasonable...

Read the section entitled "How can a PCR test be negative when an antigen test, which is less sensitive to the virus, comes out positive?", and contrast with "But with demand for testing on the rise at pharmacies and clinics, you may be in for a wait."

These are so many caveats and problems that this approach does not seem viable at a population level. And a lot of places unsurprisingly are running out of test capacity right now.

"Just isolate" if you have symptoms is the recommended normal way to handle being sick prior to 2020. Does it really make sense to go to work when you're sick just because you think it's not covid, thereby potentially triggering many other covid-like colds that will spawn more tests if people follow this advice? The only debate I guess is how long to remain isolated after your symptoms go away. The CDC now says you don't need to wait very long apparently.

Well the cold isn't nearly as contagious as COVID-19, so you would presumably respond differently, like going in the next day if you're no longer feeling symptoms. But yes, it's easy enough to get a test (plenty of walk-in places), but the response times vary a lot depending on where you get them. Some places are pretty good at giving you a response within 12 hours, though typically require appointments you may not be able to get until the next day, while other fly-by-night walk-in clinics will give you a test immediately but may take 2-3 days to get a result. I get tested at UChicago and have always gotten a result within 24 hours, though this is not available to the general public (and also unavailable if you're symptomatic... it's specifically for surveillance testing or travel).

What is "the cold" and how do we know this? I don't think there has been SARS-CoV-2 style testing for any other virus.

We know this because there were virtually zero colds last winter but a ton of COVID-19 cases. Evidently, common cold has an R0 of 2-3, while Delta has an R0 of ~7 and Omicron ~10.

It keeps getting worse. And we're not even at New Years yet.

If there wasn't decent quality prevalence estimation done for SARS-CoV-2 and other potentially-cold-causing viruses, nobody really knows.

The people saying omicron has an R0 of 10 did a terrible job of predicting the course of infections in South Africa. They're already trending down and peak positivity was only moderately higher than in their pre-delta wave. R0 seems pretty useless as a real-world concept for understanding what will happen.

So much of this stuff is a house of cards and some major fields of experts don't do a good job of predicting anything or preventing bad outcomes. They invent post hoc reasons for why following their advice didn't prevent problems, e.g. deplorables or omicron. It reminds me a lot of "crazy uncle" investment tips that would have worked out well if only some unforeseeable freak event had not occurred. I don't blame people for not being able to make these predictions because they are hard, but I think more people should be epistemically humble about covid, experts included. And in such situations the default is to behave approximately as we did before 2020, or at least not add tons of disruptions. The default should not be "omg, somebody made a model that will be bad if true, we must disrupt society until we can rule it out".

^ Not only that, but there is also evidence that infection from some respiratory viruses tends to prevent infections from others. That is partly why Covid largely eliminated Influenza for the 20-21 season

The argument that “Covid spreads faster than the Cold” cannot be determined by such simple measures

Depends on how you define “worse”

I think that the rapid spread of Omicron is actually a good thing. Lots of immunity being generated in our population, and among the vaccinated relatively rare serious infection.

Best way to get our population immune is through a highly infectious virus

:tup:

That's what I was saying at work earlier. Today alone, 5 more people getting tested. If this keeps up, out of a building with 400 folks, were looking at a 20 percent positivity rate in the last three to four weeks.

I guess we will find out in a week or so the effect from Christmas.

And that's the thing that Omicron potentially offers... more antibodies. Its like a viral booster on top of a booster.

Stop testing if the workers that have no symptoms.

It makes no sense 2 years into this.

^^^

I can tell you this surge is way worse than December 2020. Much worse. Just the pure amount of folks testing positive.

For a lot of folks, its very mild. Probably Omnicron. But we also have a lot of tards that don't have the vaccine, because well... its the inner city culture. That might be causing a lot of this.

Usually what we hear, its sniffles, some coughing and fever. But goes away. No one has died.

The spread is much, much worse. Which is ironic because no one was vaccinated in December 2020.

Every case that I personally know of has been "mild", but mostly everyone I know who tested positive became symptomatic. I think the people testing positive without symptoms are the minority of cases, tbh. A lot of symptomatic people are saying that they didn't test positive immediately on the rapid tests, but got positive results from the PCR test.

Given the extremely high vax rates among at-risk older cohorts, the number of people testing positive is largely irrelevant, especially given that this strain isn't particularly lethal.

It's like there's no middle ground between the hysterics and the anti-science nuts. Mask, distance, vax and test, sure. Nothing else needs to be done.

The latest official guidance around here is not to test if: "You are fully vaccinated (two doses), experiencing mild symptoms and can manage your illness at home. Self-isolate for seven days and notify your close contacts so they can self-monitor for symptoms."

Of course, this isn't a question purely about "the science", it's that there's so much spread and so little consequence from testing mildly ill vaccinated people that it's better for those people not to go to the test sites and to use the capacity for something else.

Next door to us, Alberta has apparently said they will drop the isolation requirements for healthcare workers mildly ill with covid. So many people are getting omicron that they don't have the capacity for these workers to isolate for 10-14 days.

One factor that has changed, at least around here, is that people took the lockdown of December 2020 quite seriously (we locked down from around March-May 2020 and then again around November into 2021). But lots of people are having gatherings this year.

Around here we never really saw how fast the original version of SARS-CoV-2 spread around in the population given normal behaviour. Maybe some places like NYC or Wuhan got closer to that. We're still not at 2019 levels of interaction. And testing capacity has grown over time.