I was on vacation this past week, so wasn't active, but generally do a sweep at *least* once a day of all new posts... on busier days, I tend to concentrate on those that look spammy by title, have comments or are downvoted...
If you don't want to downvote a comment is usually the best option for getting attention. While it's not as quick/active as it could be, there are usually not *that* many new posts each day.
And, no, I don't always delete downvoted posts... which is again why even if downvoting, a comment helps understanding why it was downvoted.