Problem is, if you're using PCR tests which are given more often to symptomatic people, you'll potentially miss asymptomatic infections. This is not a problem for severe disease, but is definitely a rationale for vaccination
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Replying to @GidMK
So what would you add to better detect asymptomatic cases? Also they make a similar statement in the discussion.
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Replying to @MoNscience @GidMK
Also their analysis included people with low symptomatologypic.twitter.com/f2aTy5F8E8
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Replying to @MoNscience
Yes I'm not saying this is the fault of the researchers, nor that they're wrong per se, but the inherent issue is that using retrospective analyses of routinely collected data you're always at risk of selection bias
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Replying to @GidMK @MoNscience
What we really need is a longitudinal cohort of the same individuals that has been followed over time, with a non-probabilistic sampling method to minimize selection bias, and who are tested (say) twice a month regardless of symptoms. But that is a really hard ask
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Replying to @GidMK @MoNscience
So I'm not saying the researchers could've done a better study using the data at hand, because I love this piece of research, but that to really answer the question we kind of need a different study design altogether
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Replying to @GidMK
I’m not seeing the selection bias in free-for-all testing but agree on looking longitudinal. But “they need more longitudinal data” can apply to most studies.
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Replying to @MoNscience
Because people choose themselves whether to get tested. While there may not have been a direct monetary cost, testing is certainly not without secondary costs including time, effort, discomfort, etc...
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Replying to @GidMK
But if the barriers to access testing are extremely low, people will seek tests after close calls/suspected exposures even without symptoms?
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Replying to @MoNscience
They will be more likely to seek testing than if there's a monetary cost, but the potential for bias is certainly there. Even in vast studies that offer free tests (i.e. ENE-COVID) AND follow people up with multiple phone calls 20-30% of people don't do it
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Also worth considering that for those who work in casual jobs there may be a very direct and large monetary cost to getting a COVID-19 test if they are forced to isolate afterwards. Lots of reasons that people may not be willing to go and get tested especially if they feel fine
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