Testing is art as well as science
The COVID-19 epidemic has highlighted medical diagnostic tests. As a physician, I treat the results of lab tests like I treat movie recommendations from a friend — I am always skeptical. For the movies, I need to consider my friend’s suggestion in the context of their mood, tastes, current life crises and track record. A context also needs to be created for ordering and interpreting test results, including the patient’s current complaints and symptoms, recent activities and medical history, combined with findings from an exam, my personal experience, the expertise of my colleagues and information from published medical studies. My friend’s movie judgments are occasionally biased and off-kilter. In the same way, medical diagnostic test results are not perfect.
Medical professionals, policy-makers and members of the general public may overestimate the accuracy of diagnostic tests. Unfortunately, test results will be negative for some people who actually have the disease, and some people without the disease will have positive tests. The accuracy of the current COVID-19 tests are not precisely known. Reasonable estimates, based on test performance in China and the performance of the influenza tests, are that the tests will correctly identify around 60 percent of the patients with the disease and correctly identify 90 percent of the patients who are disease-free.
Just as people should not demand a prescription for a medication based on TV ads, they should not seek unnecessary medical tests. Physicians and patients need to discuss whether any test, including the COVID-19 test, needs to be ordered and the ramifications of the results. Policy-makers need to define the importance of testing in their plans.
Test kits for COVID-19 will be an important tool for the containment and elimination of the virus, but their use needs to be incorporated into the overall strategy for combating the disease. A comprehensive approach, including the judicious use of testing, will be essential.
Richard Hutchison, Bradenton
Good hygiene at the polls
With the advent of the coronavirus and, especially, its effect on the elderly, what precautions will the supervisor of elections offices be taking during the upcoming elections to ensure the safety of the voters? Will poll workers be wearing the proper gloves? Will hand sanitation stations be available? Will poll workers be using sanitation wipes to cleanse the voting booths? I very much hope the health of the public will be part of the election process.
Gary West, St. Petersburg
Fireworks aren’t fun for all
Time to celebrate with fireworks? | March 10
I am well aware that the new legislation allowing fireworks on New Year’s Day, New Year’s Eve and July 4th is a foregone conclusion. I just can’t believe lawmakers would legalize something that can cause so much mayhem. I get it — loud noises and bright lights are fun to many people.
But I’ve known children traumatized by wayward fireworks. I know PTSD sufferers are brought back to years-gone-by traumas. I volunteered at an animal shelter where intake always increased after an evening of celebration with fireworks. Injuries from fireworks are well-documented. I wish folks who love fireworks could witness a dog trembling for hours after an assault to their much more sensitive hearing.
Kudos to the town of Collecchio in Italy, passing a law in 2015 that all fireworks displays must be quiet. Human beings are great at finding alternatives to bad ideas. Let’s work on that, okay?
Sharon Scheiblein, Hudson