Status of COVID19 Testing (as of April 2020)

[longebow]

To All:

Here are the comments from our local Infectious Disease specialist regarding my comments below.

Brief explanation of antibodies: Immunoglobulin G (IgG), the most abundant type of antibody, is found in all body fluids and protects against bacterial and viral infections. Immunoglobulin M (IgM), is found mainly in the blood and lymph fluid, is the first antibody to be made by the body to fight a new infection.

I hope that you find this helpful...

longebow

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I agree with what you have written. You have echoed what the infectious disease society of America has released as their official statement this past week in regards to antibody testing. As I see it major pitfalls are the following:

1. Cross-reactivity with other coronavirus species
2. Lack of data on duration of IgM/IgG immunity. Is this more like Measles where once you get it you’re immune for life? Or simply like the other Coronaviruses, where you get a fleeting short term immunity?

For right now we are certainly not recommending serological testing. We are also having numerous requests as well.

As for the vaccine, I would suggest we have no idea whether the vaccine will be effective, when it will be available, will it have many adverse side effects and who will have access to it.

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Status of COVID19/SARS-CoV-2 Testing (as of 26 April 2020):


The two major laboratories in the US are LabCorp or Quest. They both offer the same testing at this time, while they, and other labs are working to produce new, better, more accurate, and cost-effective testing to address the current pandemic.

Background:

COVID 19 is ONE type of the "human corona virus" family. There are seven (7) other human coronaviruses. Four (4) of which are responsible for 10-15% of ALL viral infections in our country: HKU1, NL63, OC43, 229E.

According to the CDC: "People around the world commonly get infected with human coronaviruses 229E, NL63, OC43, and HKU1."

https://www.cdc.gov/coronavirus/types.html

Here is a NIH article discussing the human coronaviruses and a review of virus/host interactions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5456285/

Selected quotes:

Human coronaviruses (HCoVs) represent a major group of coronaviruses (CoVs) associated with multiple respiratory diseases of varying severity, including common cold, pneumonia and bronchiolitis.

Four HCoVs (HCoV-229E, HCoV-NL63, HCoV-OC43 and HCoV-HKU1) are globally circulated in the human population and contribute to approximately one-third of common cold infections in humans [4]. In severe cases, these four HCoVs can cause life-threatening pneumonia and bronchiolitis especially in elderly, children and immunocompromised patients.

Testing in the USA as of 26 April 2020:

Nasopharyngeal swab: used for a patient with an acute illness "Influenza Like Illness" (ILI). It will tell us if a patient has an ACTIVE infection with COVID19 (aka: SARS-CoV-2). Results are given as: Present or Not Present.

Blood Test "Antibody Test:" tests for Immunoglobulin G to the human coronavirus. It is Positive IF a patient had prior exposure (more than 10 days prior to generate these "memory" antibodies). The CURRENT test cannot distinguish between ANY of the human coronaviruses. In other words, IF positive, it only tells us that the patient had prior infection with ANY of the above five (5) human coronaviruses. The CURRENT test cannot tell us if the patient had prior exposure to COVID19 only.


Editorial comments to consider:

Right now, everyone is demanding "testing." As a more informed citizen given my above explanation, you can see that testing, as of now is essentially MEANINGLESS in regards to COVID19.

Recent research in CA and NY indicates that a "large percentage" of the population is "positive." Again, positive for ANY of the five (5) human coronaviruses. Almost useless information, UNLESS someone educates the population as the meaning of these tests, which is that human coronaviruses are common, have been around for decades, and "may" provide immunity to the current pandemic.

There are seven (7) identified Coronaviruses infecting humans. Four, are common, and we have all been exposed at some point in our lives. These previously described coronaviruses account for 10-15% of "viral infections" in the U.S. As a physician, we test/screen for acute, treatable illness (Influenza, Group A Beta-Hemolytic Streptococcus), and as a routine, do NOT screen for the viral subtypes (at the recommendation of our local infectious disease specialist, we just ran a 20-virus PCR panel on a patient, and it was VERY expensive). Due to our frequent exposure to these common coronaviruses, I have to presume that we, as a population, have SOME innate immunity to COVID-19 (I'm a physician, not a virologist). This may explain why the symptoms are so variable in patients seen thus far. As testing becomes more common/available, I expect the number of COVID-19 patients to increase rapidly, increasing the "denominator" and thus reducing the "death rate" from this infection.

There are some who are pushing for making a "vaccine" the precondition for "opening" up the country again. This is very problematic, as after DECADES of research, we still do not have a vaccine for HIV. This should give any thoughtful person pause about this "goal post."

IF I were the President's medical advisor, as a lowly family physician who has a good 360 of situational awareness, I would encourage him to follow his current plan. I support the "phases" of opening up the country, in 2-3 week increments (the incubation period of COVID19), and as REAL data accumulates, adjust accordingly.

We cannot keep America shuttered any longer (except for the "hot spots" of NY and NJ), and must open up by region and state, and observe carefully while science and industry develop tools to specially address COVID19 (tests, treatments, vaccines, etc).

Lastly, we need to consider the possibility that there may more than one type of COVID-19: "mild" and "lethal." Most folks recover, those with "pre-existing conditions" are the most susceptible, but SOME young and previously healthy people are dying from this. It will take time to clarify this theory, as well as clarify what factors result in fatalities.

 

[PinesAndProjectiles]

"There are some who are pushing for making a "vaccine" the precondition for "opening" up the country again. This is very problematic, as after DECADES of research, we still do not have a vaccine for HIV. This should give any thoughtful person pause about this "goal post.""

This. A vaccine isn't going to happen any time soon.

 

[supercorndogs]

It would seem these tests aren't even finding as many people who have had the cold as they should.

 

[Doc68]

Just think, we have a flu vaccination, but still on average 40-60k people die each year from the flu.

Come on. This is all a farce at this point.

 

[supercorndogs]

Just think, with no vaccinations, and no heard immunity, 500k-750k Americans died of the Flu from 1918-1920.

 

[Doc68]

Just think, with no vaccinations, and no heard immunity, 500k-750k Americans died of the Flu from 1918-1920.

Yup. People die in life. Just yesterday 1800 people died from heart disease. About 1600 died from cancer and 685 died from medical malpractice.

People die. We can't save everyone.

 

[DarnYankeeUSMC]

Yup. People die in life. Just yesterday 1800 people died from heart disease. About 1600 died from cancer and 685 died from medical malpractice.

People die. We can't save everyone.

But they weren't put into frenzy panic mode by the propaganda.

 

[HeavyAssault]

Since UV light seems to help "kill" the virus, I wonder when all the tanning salons will get the GOV UV treatment program funding to help stop the spread of COVIN-19??

Maybe in 20 years the lawsuits for contracting skin cancer under the GOV UV treatment program will out weight the lives saved??

Asking for a friend.......

 

[Doc68]

But they weren't put into frenzy panic mode by the propaganda.
View attachment 7309866

That's very true. So I guess their deaths dont count and no one cares. If the media tells you to be upset and scared then it's ok. Wtf is wrong with this country... no one has any thought for themselves anymore.

 

[hlee]

I’m drinking hand sanitizer. Well, the active ingredient. So far so good...

 

[10ring'r]

Just think, we have a flu vaccination, but still on average 40-60k people die each year from the flu.

Come on. This is all a farce at this point.

AND....To add, when you get the flu vac., it's only good for the last strain, not the current one. Just say'n. Mac

 

[DarnYankeeUSMC]

Human nature? That's the only explanation I can come up with.
Looking through out history up to the current time the numbers of people that prefer to be sheep is astonishing.
Amazingly that even the sheepdog is owned by the rancher. He may well gaurd the herd from other predators but the rancher is free to do his will. So far the rancher here has been kinda good. But it's turning into something as bad as a predator. It doesn't seem that it will be long before the sheepdog may mistake the rancher and bite him.

That's very true. So I guess their deaths dont count and no one cares. If the media tells you to be upset and scared then it's ok. Wtf is wrong with this country... no one has any thought for themselves anymore.

 

[hlee]

AND....To add, when you get the flu vac., it's only good for the last strain, not the current one. Just say'n. Mac

Not quite true. The CDC does a survey of the prevalent strains, makes a guess about what will become predominant, then the vaccine manufacturers make a vaccine that contains "some" of those strains. I've read that they are right 20-30% of the time...

 

[supercorndogs]

Yup. People die in life. Just yesterday 1800 people died from heart disease. About 1600 died from cancer and 685 died from medical malpractice.

People die. We can't save everyone.

More shit that is irrelevant to the situation. Do you guys read anything that isn't an opinion piece? You ignore history, ignore everything you don't like, thats called ignorance, not bravery, or patriotism.

The amount of people who think they aren't sheep because they choose to be in the other flock is utterly astonishing.

 

[10ring'r]

Not quite true. The CDC does a survey of the prevalent strains, makes a guess about what will become predominant, then the vaccine manufacturers make a vaccine that contains "some" of those strains. I've read that they are right 20-30% of the time...

That sounds like the same reasoning I got from my G.P. of 25 years, she's my "mistress" (according to my wife). I haven't had a flu shot in 22 years (last one I got, was from the .Mil), reason being, that's what I was told by her (as you mentioned), so, I said "why" then? I'm still too F'n old school and don't freak-out about too much anymore. Just me, I guess. Mac

 

[Doc68]

More shit that is irrelevant to the situation. Do you guys read anything that isn't an opinion piece? You ignore history, ignore everything you don't like, thats called ignorance, not bravery, or patriotism.

The amount of people who think they aren't sheep because they choose to be in the other flock is utterly astonishing.

How am I ignoring anything. I dont believe in this BS, because it's exactly this BS. If you look at the true statistics for covid, it's no worse than the normal flu. That's a fact. What does your Spanish flu have anything to do with covid, that's right nothing.

By me posting numbers of people dying from different diseases and preventable medical errors is that you dont hear one word about them dying, why you ask, because people fucking die in life.

Covid has turned into a political/economic weapon from about March this year.

There's a video of two doctors who own/run a few urgent care clinics in California. Watch it, it's very interesting.

 

[supercorndogs]

Oh the true statistics, I forgot about them. Could you point me to them? The testing you are banking on to drop the death rate, is flawed because people who test positive for antibodies, could have had any of the other corona viruses. So, once again we really don't know, a month in with a very low percentage of the population infected, what will happen yet.

The spanidh flu has everything to do with the COVID response. The data gained from the 1918 lockdowns has been used to help model responses. Your comparison of flu to COVID deaths, at this point is still also completely irrelevant.

You can post anything you want, it doesn't make it relevant.

I watched it yesterday. They have an opinion, just because its the same as yours doesn't make it right.

 

[Doc68]

Oh the true statistics, I forgot about them. Could you point me to them? The testing you are banking on to drop the death rate, is flawed because people who test positive for antibodies, could have had any of the other corona viruses. So, once again we really don't know, a month in with a very low percentage of the population infected, what will happen yet.

The spanidh flu has everything to do with the COVID response. The data gained from the 1918 lockdowns has been used to help model responses. Your comparison of flu to COVID deaths, at this point is still also completely irrelevant.

You can post anything you want, it doesn't make it relevant.

I watched it yesterday. They have an opinion, just because its the same as yours doesn't make it right.

So my facts would be irrelevant because they have only tested a small segment of the population so far? That makes zero sense.

Now what doesn't make sense to me is why are all these doctors being pressured to classify cases as covid when they aren't. We are the only country making it a covid death when its underlying conditions which in fact are killing the people, whether it be a compromised immune system, COPD, just being old. So those numbers should come out also then. Then we can see a true number.......

And yes if you add more people to the numbers who actually had covid the actual death rate will fall. Thing is we dont know how many have truly been infected and since that's the case and they want to only use a small pool of people to pull from then yes, the death rate will be higher. Now if we had testing from the beginning and everyone who presented symptoms was tested, we would have a true death rate. Which in fact would be lower. So you only want to see your side and that's fine, however dont just say my opinion and facts arent true because you dont want to believe them. Kinda sounds like the left's reasoning. Only use facts when they support your side of an argument.

 

[wade2big]

More shit that is irrelevant to the situation. Do you guys read anything that isn't an opinion piece? You ignore history, ignore everything you don't like, thats called ignorance, not bravery, or patriotism.

The amount of people who think they aren't sheep because they choose to be in the other flock is utterly astonishing.

You ignore what is actually happening right now. Data is in. At least some of it. You have made your mind up 6 weeks ago using fear as your basis. Any rational man could tell the experts were making shit up and lying. You have been wrong on this one. Accept it. Admit it. Move on.

 

[kthomas]

Not quite true. The CDC does a survey of the prevalent strains, makes a guess about what will become predominant, then the vaccine manufacturers make a vaccine that contains "some" of those strains. I've read that they are right 20-30% of the time...

But even if they don't get it right, the immunity you develop from the flu shot will help you combat other strains of flu.

I'm not saying this as a fanboi of the flu shot. I got one this year as I had to for immigration purposes, but otherwise I never get it. But apparently it does help, even if they get it "wrong".