I tend to agree, and have always made a point of telling founders that their startup will most likely fail, because that's what startups do. Here's a good thread: https://twitter.com/immad/status/1335669459705458688
Yeah, it's so easy to convince yourself that you knew all along that a company would succeed, which is one reason why it's helpful to keep actual notes.
It's also a great example of a company that was not popular on Demo Day. This kind of success is so hard to predict.
This comment really comes across as out of touch... The company just went public and based on their S-1 has been massively growing even pre-pandemic! (both huge measures of success)
It's not out of touch to question metrics when it appears a company was dumped on public investors with no profitability in sight. Growth is not success; profit is, growth is simply the mechanism by which you're supposed to reach profitability.
If we define success as cashing out, sure, success. It feels like the delta in journey between building a sustainable, profitable business that handsomely rewards you at your exit and "congrats on your lottery ticket" is growing by the day. Let's not kid ourselves, investor dollars chasing after your equity when you go public and with no evidence profitability is possible is a rare lottery ticket that has paid out (or maybe not so rare! See: Adam Neumann/WeWork).
EDIT: I want to really stress that this isn't "sour grapes" but more echo chamber fatigue. If you are founders at a startup, who grow it into a unicorn, are delivering value, your employees and customers are happy and delighted, and you're profitable, those are the folks who deserve to be congratulated when they IPO and become billionaires and are who you can learn the most from on your own startup journey.
> If we define success as cashing out, sure, success.
That's the only definition of success that matters to VCs.
Even if the company is not around in a year, if they were able to dump their stock to investors^Wspeculators^Wsuckers before the meltdown then it's bagged as a win.
F-4 they are clearly on a path to profitability...
It seems silly to even focus on profitability at IPO when credit is so cheap. Growth trajectory is rewarded and based on the S-1 they are growing in a healthy enough fashion. This is VERY different than WeWork which had massive amounts of debt on their books and didn't have a plan out.
Again, if you keep getting hung up on profitability you aren't really realizing what stage Doordash is at or the maturity level by which companies are expected to be profitable
If you look at their S-1 there isn't a chance of this looking like what happened in year 2000. Way too much capital, way too low interest rates, and a real path to profitability
The best known treatment at the time the infection is detected. That can be as basic as rest and hydration, but hopefully we'll have something better down the line.
Again, I suggest you look at the data instead of responding emotionally. We need to allow the data to guide us.
I'm skeptical of the Medscape list, since it appears to be the product of a Google form. I'm not saying it's wrong, but I chose not to use it as my primary source because unlike the government data I provided, it's unclear how or if it's being verified.
If I had to put myself in their shoes I would react out of panic too, if all of a sudden my day to day was flooded by cases of this new respiratory disease. Doctors and nurses suffer the same sort of adverse selection bias as CFR data: you're not counting the healthy. The doctors are only ever exposed to the sick, day in and day out, not to the healthy who don't walk through their doors. They're experiencing a concentration of the negative effects, orders of magnitude worse than what's happening outside the hospital.
Thermometers are better than nothing, but unlikely to stop the spread because of asymptomatic transmission (easy to catch the virus from someone who doesn't have a fever). This is why I think directly detecting the virus is essential.
In a best-case scenario, what is the timeline for testing, widescale manufacture, and rollout including “last mile” education to end users for the saliva tests? Is it achievable within a quarter? 2020? Beyond?
What’s the costs/benefits versus the temperature gun method already being used in Asia?
I fear that “perfect” or “near-perfect” solutions such as daily saliva testing would be potentially unrealistic for widespread rollout in an effective amount of time. Could we perhaps consider prioritize the superior daily testing solutions for high-priority environments like first responders and hospitals and nurses while reserving the “less-than-perfect” solutions such as what’s being done in Asia for environments with other essential workers, at least until scale-up hurdles can be surmounted?
The saliva stays inside the tube for that very reason. The test specifically identifies the virus, not the antibodies, again for the reason you identify.
Currently most public buildings are closed, so adding ten minutes is a big improvement relative to that. Also, it probably took them more than ten minutes to drive to work, so I don't think it's completely implausible.
I'd love to hear more! Part of the reason I put this out is to encourage other people with technology for fast, easy, cheap testing come forward.
Is your protein test able to detect as soon as people become contagious? That's where a lot of ideas fail, but I think getting R0 < 1 likely requires it.
Exactly. More testing is good, but actually stopping pandemic will require orders of magnitude more testing, which in turn requires a different approach to testing because the current way we do testing can't scale.
I have not found any mainstream sources that advocate screening everyone every day (which is very different from simply doing "more testing"). Would love some pointers if I'm wrong.
Paul Romer, an economist at NYU, has been advocating for testing millions of people a day for a few weeks. He is co-author of a piece in The Atlantic, "Without More Tests, America Can’t Reopen", https://www.theatlantic.com/ideas/archive/2020/04/were-testi...
Googling for "romer covid 19" should turn up a lot of news sources covering the notion of testing millions of people a day.
Yes, he is the best I've found. This proposal is still at least an order of magnitude more testing though :) (on the order of 100 million tests/day, not 1 million tests/day)
Romer has called for as much as 30 million tests a day, which I think was based on some simplistic modeling. I think he was targeting everyone in the US being tested every two weeks. I think the two approaches are similar: let's test lots of people all the time, however many X million tests a day that is, so that we can quickly isolate and treat them. People are spreading it before they know they have it, so let's just test everyone all the time and not wait until they have symptoms.
> I have not found any mainstream sources that advocate screening everyone every day
That's because we currently aren't capable of testing everyone who is obviously sick just once. If we got there, we wouldn't even be close to being capable of testing key personnel (like health care workers). If we got there we wouldn't even be close to being able to test everyone once. If we got there we wouldn't even be close to being able to test everyone every day.
You haven't heard any advocating for OR against it because it is so far from achievable that it isn't worth considering.
If this concept would work in principle, covid could be reduced to scaling testing capacity. My impression is that estimates about achievable testing capacity don't assume a most-important-short-term-problem-of-mankind priority and resource allocation.
The linked article suggests a novel and much cheaper test, which would be great. But even if that didn't work out, what scale could possibly be feasible with existing tests? Pre-shortage, an RT-PCR seemed to be much cheaper than a missed day of work.
The concept for restarting the German football league involves daily testing of all players. So the idea is indeed widespread, but often enough just impractical for the numbers of tests required.
Testing a few hundred people daily would be doable, as Germany has relatively good testing capacity - probably one main reason for the overall better handling of the pandemic so far. But the concept still gets critisized, as this would mean a fast track to testing for the players while parts of the population don't have equal access to testing.
For the whole population, it would be a good first step to be test really everyone who has any assumptions of symptoms and some time later, everyone in contact. And perhaps a biweekly test for the general population.
I would expect where there's a large enough economic incentive, and wealthy-enough private group (say, the NFL, MLB, etc) who wouldn't need to wait for government policy or supply, we will see daily testing of their 'employees' so that they can get back to operating. May not be any fans in a live setting, but better than nothing.
I think governor Cuomo was saying he'd love to test every day if he could, but just doesn't have the capacity. Edit: as a side note he put out a call for companies that can help with testing saying that NY state might be willing to invest to bring things to scale. I believe he already wanted FDA approved tests but there's an opportunity there to work directly with a government to implement this sort of thing.
IIRC, mainstream objections tend to come from concerns of false positives, since that becomes a bigger problem with this frequent level of testing and could prove a huge disruption if you end up with too many quarantine still, or so many that testing positive becomes essentially meaningless in terms of telling you whether you have the disease or not if you test positive.
Gov Cuomo should call up Gov Pritzger. Illinois recognized the challenge of testing supplies and asked the state universities to solve the problem. They have. Illinois is reporting a lot more positive cases in the past week because they keep increasing the number of daily tests. I believe that today was well over 12000 tests in Illinois. Anyone who feels like getting tested is now allowed to get a test.
New York has done more tests and more tests per capita than any other state per latest numbers - the reason for more tests isn't just to test people who want it, it's to run large random tests, require tests before visiting nursing homes, get an accurate picture of the infection rate, etc. We're testing more per capita than most countries in the world and it's still not enough. We've tested approximately 4 times as many people with only about a 50% higher population than Illinois and it's still not enough.
Sorry, I wasn't clear. Illinois has built out their own manufacturing supply chain and testing facilities. They are self-sufficient. If New York wants to scale up testing and has money to invest in doing so, they should look at how Illinois managed to make that happen.
This is maddening reading this thread. What is the reason for a federal gov't but to coordinate such cooperation? It goes back to creation of the "United States"! (this is hypothetical question, not one i expect you to answer)
Honestly, at this point I wouldn't be surprised if New York has tested more people per capita than all the comparably-sized countries in the world. There's a few countries which have beaten them, but it's generally small ones like Iceland.
Christian Drosten (German virologist, one of the most prominent experts here) has been advocating daily testing of medical workers.
This is a slightly easier situation, since you can trust them to swab themselves, and the logistics for collecting samples is already in place.
Being off work for such should not result in severe reduction in income unless your income was already high; at least that is the case here in Norway where laid off personnel get 80% of their normal salary up to a limit that is above average salary.
Every single country that has had any success containing the virus, including the origin country of China, has had rigorous continuous testing to contain the spread. It's hard to find a country with success containing the outbreak that doesn't do constant ubiquitous testing.
> Every single country that has had any success containing the virus ... has had rigorous continuous testing to contain the spread
That's demonstrably false. There are numerous prominent examples in fact.
Taiwan is not doing a high rate of testing at all, they're most certainly not doing constant ubiquitous testing. Their per capita test rate is 1/7 that of the US.
Singapore and South Korea are not doing constant ubiquitous testing. The US has already tested at a higher rate than South Korea and will pass Singapore shortly given the continued ramp in US testing. Both are held up as marvels of virus containment.
Japan has barely done any testing. They're seeing a small spike in cases now, however they were not earlier (this is four plus months after the outbreak began and Japan is next to China). Their deaths from Covid are commonly 1/50 to 1/150 the per capita rate of the US and other higher outbreak nations, while doing 1/10 to 1/15 the testing. The only explanation is either that they're covering up ten thousand deaths, or the other non-testing approaches they've utilized work well. Compare Japan to Germany on Covid deaths - again, despite Japan being next to China - and then look at the testing rates. Now explain that.
Finland is testing below the US rate and has contained the outbreak to a stellar degree. That's because Helsinki is colder than Stockholm and Copenhagen. The same reason Moscow didn't get slammed until more recently as the weather began to warm up. There are other factors that impact the spread of the virus, including the rate of social activity and high temperatures (over ~60F / ~15.5C). We know this from several studies that have proven the role of temperature in the spread of SARS and SARS-CoV-2; as well as understanding how the spread benefits from greater social activity (which doesn't occur at the same rate in super cold climates).
Greece has a very low number of Covid deaths and no evidence of serious outbreak this entire time. Their testing rate is 1/3 that of the US. And they're wedged between Turkey and Italy. Much like southern Italy, they've been heavily shielded by their climate. Nobody wants to talk about this of course, it's the Mexico / Texas / San Diego / Baghdad / Lagos effect in action.
Iraq isn't seeing any consequential outbreak, thanks to its climate. Whereas Iran right next door got smashed, because Tehran has an entirely different climate from Baghdad.
Thailand and Vietnam are both testing at a very low rate, and there has been zero evidence of serious outbreaks in either country, despite the proximity to China. That's thanks to their hotter climates.
Nigeria is barely testing at all, with zero evidence of a consequential outbreak there. No crushing of their healthcare system with cases or deaths; no huge spike in deaths, hospitalizations or ICU cases. There are numerous countries across Africa seeing similar low outbreak results, with very little testing.
Colombia isn't seeing a consequential outbreak, their testing rate is super low. They're not seeing a healthcare crush either. They've contained it so far without a high rate of testing.
India and Pakistan were supposed to get buried by SARS-CoV-2 cases. It hasn't happened, week after week goes by and the predictions continue to fail to come true. They're barely doing any testing at all. There's zero evidence in either country of a massive outbreak or crushing number of ICU cases swamping their healthcare systems. It's because of how hot their cities are. I've yet to see a single other good explanation for why India isn't buried in Covid deaths by now. India isn't seeing the virus hit for the same reason Africa hasn't.
Egypt is barely doing any testing. Cairo should have millions of cases of the virus and a huge number of deaths by now. They should have 20,000 dead people from Covid at this point just in Cairo. Where is it? The Cairo metro has 20 million people. It's not far from Italy, Turkey, or Iran. Guess what? It's very hot in Cairo.
And if you want to see a belligerent demonstration of the climate impact in action: tell me that Florida has been dramatically more responsible in their behavior than Belgium has (or France, or Italy, or Spain, or the UK, or the Netherlands, or Switzerland), to warrant having a per capita Covid mortality rate 1/12th that of Belgium. If Florida had New York's climate, Florida would have 20k Covid deaths by now. Instead they have a mere 1,066 (and Florida has a lot of old people) despite doing almost everything wrong.
I suggested testing everyone every month about a month ago. This is a conservative testing frequency that would almost certainly put r0 under 1. Everyone every day is an overkill - why not everyone 4 times a day? What's the rationale for it other than it sounds good?
Isn't this a minor upgrade on what the authorities did in Wuhan? They squashed the disease at the epicenter, faster than the tail-off in Italy, and a lot of it was massive screening and isolation of anyone showing symptoms, or with a high temperature (1), or testing positive, or anyone in contact with those.
If "it happened and it worked" isn't "mainstream" then I don't know what is.
You won’t be able to scale your solution before a vaccine is out, rendering your entire solution useless unfortunately.
Johnson and Johnson have already started scaling their vaccine and plan to have 1 billion doses available by January 2021. If their vaccine is approved, it will be an instant solution and better than testing everyone every day.
Moderna has also started the process of scaling their solution as well but J&J have a head start and a known platform.
> You won’t be able to scale your solution before a vaccine is out
Why not? Scaling a test is a completely separate exercise to scaling a vaccine, and it has the advantage that multiple proven working tests exit now, they just need to be scaled. Both can be done, by different people.
You might also find that having a vaccine and a test is better than having just a vaccine.
> If their vaccine is approved
Multiple vaccines are in development. This is not a situation where we should stop doing X now because Y _might_ happen in 8 months or more time. None of the vaccines are guaranteed to be ready and working and scaled at any given date. None of them.
