Mechanisms of immunity / current test (transcription) / tests coming online soon (antibody) / new research about reinfection.
The problem with this discussion about testing is that it assumes that the current RNA test for Covid-19 has a high sensitivity and specificity rate. In actual fact we do not know the sensitivity/specificity of the test because we donāt know the denominator, ie we donāt know how many cases there are in total in the population because asymptomatic cases are not counted. We know that in vitro testing of the RNA assay is good, but there is data to suggest that in real life application the false negative rate (a person with the disease testing negative) is quite high. Below is a link to a talk given by a physician and personal eye witness to the experience in Wuhan. At 7:11 he shows a slide of the data of testing of people who almost certainly had the disease yet tested negative. As an additional kick in the pants, there is a critical shortage of the special nasopharyngeal swabs necessary for the RNA test as the main supplier is located in northern Italy.
What will be a significant step forward is the upcoming deployment of a serology (antibody) test. This is a simple blood test. Such a test will tells us who and how many have had the infection and identify those asymptomatic cases.
https://players.brightcove.net/719220616001/default_default/index.html?videoId=6142578981001
Itās critical not to forget that the tension between devoting resources to testing, or to care, is an artifact of the U.S. governmentās failed response. The Trump administration chose positively, for misconceived political reasons, to sit on its hands when it was still possible to roll out an effective test/notify contacts/isolate program. Trump still refuses to mobilize the government effectively to increase either testing resources, or care resources.
I recognize that in our given context this is an important debate. But letās not forget that the context for our context, so to speak, is a failure of epic proportions on the part of the Trump administration, and a failure that is ongoing as you read this.
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I would really be interested in antibody testing because I suspect I might have gotten the coronavirus and recovered - but how would I know without testing? It would be nice to know if I had acquired immunity - and if Iād put anyone at risk.
At the end of January I flew to Florida for a wedding. One leg of the trip had me sitting in the back of the airplane - across the aisle from a Delta pilot on his way home after flying back from China. Less than 6 feet, obviously. He wasnāt showing any signs of illness, but he did say heād spent about several days wearing face masks while in China.
Several days later after returning home I became ill with symptoms that might have been coronavirus - or the flu. I eventually recovered after a few days at home. This was weeks before there was any great concern in the U.S. - self-isolation was not the critical matter it has become now. While I largely stayed at home (Iām retired), I did have several contacts during that period.
I would like to have antibody testing to find out one way or another. It sounds like itās going to be months before anything like that is available. So, I will have to take precautions like everyone else until then.
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Yep. Happened to me. I have had trouble breathing for a week. I have seasonal allergies but have never experienced this before. I was dealing with it. Then I was relaxing, playing a game of online chess, and suddenly I couldnāt breathe. Boom. It lasted a few seconds. I stood up and tried moving my body around, it happened again and I got very dizzy and nearly lost consciousness. I hated to do it, but I was gasping for breath, I called 911.
They arrived and said, well, you are obviously having great difficulty breathing, but you donāt have the "other 2 " symptoms. No test, no ER. Stay at home and if your lips turn blue and you have a fever, call us back. The ER is closed to all but life threatening emergencies, with the correct symptoms.
I got the message, die at home, we canāt help you right now.
April will be a killing ground like no other seen.
The response has been hindered by an inability to confirm disease with diagnostic testing!