Could an antibody test help us keep society functioning over the next few months?

[andrewducker]

Researchers have developed a test for COVID 19 antibodies. Which means we have a method for telling who has had the virus, and is now immune to it.

Those people are _safe_. They can't catch the disease any more, which means they can't spread it (excepting on their clothes, I assume, which is probably reasonably low-risk).

That means that they're the best people to put on the front line. Get them on the tills at supermarkets, driving the food trucks, and opening the schools up (albeit only for children who have also got the antibodies).

Basically, we can start dividing the world into those who are safe and those who aren't - and the safe people can be a lot of use to those of us who are still waiting to catch it. Particularly the people who are at-risk.

I wonder how fast this could be scaled up.

Note: I am completely sure that this has drawbacks. If nothing else the tests will take ages to make available in volume. And it relies on much much more testing, (although we're going to end up doing a ton of testing for either the infection or the immunity, or both).
And it does rely on the immunity lasting a while. I'm hoping it will mostly last the two years that SARS did. If it lasts only a few months then we're in an awful lot of trouble.

Comments

[dewline]

This is progress. It buys some more time for the vaccination and curative projects to keep moving along if nothing else. Agreed on the "scaling-up" hurdle.

[rhythmaning]

I'm not sure that they are absolutely certain that one is immune if one has had it. There are reports (albeit it limited) of people being reinfected, and I read something today (sorry - I can't find it right now!) that if those infected do develop immunity, it might last less than a year.

However it seems a much better strategy than anything else!

[lyonesse]

these seem likely to be a very small minority, and may represent relapses rather than reinfections. waiting on data.

[armiphlage]

As of two weeks ago there were two strains, which may be an explanation as to why some patients may have come down twice. But as you said, best to wait for data to tell us more.


https://www.newscientist.com/article/2236544-coronavirus-are-there-two-strains-and-is-one-more-deadly/

[andrewducker]

But as that article says "Epidemiologists generally agree that, once a person is infected with the coronavirus, they are unlikely to be infected again "

[jjhunter]

Larry Brilliant has the best take on this I've seen so far: The doctor who helped defeat smallpox explains what’s coming

The world is not going to begin to look normal until three things have happened. One, we figure out whether the distribution of this virus looks like an iceberg, which is one-seventh above the water, or a pyramid, where we see everything. If we're only seeing right now one-seventh of the actual disease because we're not testing enough, and we're just blind to it, then we're in a world of hurt. Two, we have a treatment that works, a vaccine or antiviral. And three, maybe most important, we begin to see large numbers of people—in particular nurses, home health care providers, doctors, policemen, firemen, and teachers who have had the disease—are immune, and we have tested them to know that they are not infectious any longer. And we have a system that identifies them, either a concert wristband or a card with their photograph and some kind of a stamp on it. Then we can be comfortable sending our children back to school, because we know the teacher is not infectious.

And instead of saying "No, you can't visit anybody in nursing home," we have a group of people who are certified that they work with elderly and vulnerable people, and nurses who can go back into the hospitals and dentists who can open your mouth and look in your mouth and not be giving you the virus. When those three things happen, that's when normalcy will return.

[andrewducker]

Thank you that's excellent.

[jjhunter]

My pleasure. I always get excited when I find another scientist who can communicate to laymen well.

[dewline]

Less rare than we fear, less common than we hope, those seem to be.

Hmm

[lsanderson]

I think the dear doctor may be working too hard. I agree with them until they get to point three, and then logic and proportion have fallen sloppy dead. Children, not teachers would be the main disease vector. The whole wristband or card thing seems right out of a concentration camp, and whacked to boot. If recovery conveys immunity, those people would be great back at the hospitals, dentists, and elder care, but I'm uncertain that that's certain yet. Having them as teachers is putting a very small cork into a giant hole.

[wolflady26]

Wait, I still couldn't send my kid back to school. I'm less worried about the one teacher than the 300 other kids with parents who need to get to work and will send them, even if they're only "mildly" sick. Not unless all the other kids had concert wristbands, too. And then I guess it wouldn't matter, because my kid would have had to have had one to get to school to begin with.

[jack]

I think this one of the things we should be thinking of.

My impression of the problem is that even in Wuhan they're only now getting to the point of having many people who've recovered, so the outbreak needs to be really widespread before this helps much.

[andrewducker]

True

[alithea]

We need the staff to administer and analyze the tests though... I don't know what the situation is like up here but in England, they have centralised biomedical scientists to one or two hospitals per health authority (or whatever they are called now) and cut the number of jobs a lot.

[dewline]

That will have to be reversed to some degree, then.

[alithea]

Yes. But that won't be a quick process; like nurses, biomedical scientists need to be registered to practice so anyone who has been out for a year or longer will need some retraining.

[threemeninaboat]

It's a nice idea that, however, >20% of people with COVID have a second or third infection or diagnosis.
You have COVID and strep and (in Golden) Measles. Just an example.

There is maybe, based on past work, but I've seen nothing about it, that When You Get a Flu Shot you are so much less susceptible to many other illnesses. So the flu shot may be doing some to protect people, just my own thought not proven at all.
Just one of the many things we are discussing at midnight and
fuck I am so tired.

[andrewducker]

*hug*

Jane and I both got flu shots in November. I'm really glad of that now.

I hope you get some decent sleep soon!

[lyonesse]

i believe antibody tests are available now in china, but not in the usa, anyway.

[lyonesse]

i could REALLY USE ONE. i was exposed to a sick person (not the tested person but someone who lives with someone who had a positive test), and i was mildly ill on schedule. but only mildly (mind being me i was already on cordyceps and treated the incipient fever with curcumin, so).

i wish :/

[andrewducker]

Yeah. With a 2-year-old she brings home diseases on a weekly basis from nursery (until they shut it last Friday), so we may both have had it in disguise already!

[anna_wing]

Since the UK is essentially in a situation of uncontrolled community transmission, there is also a capacity problem. If it does not have the capacity to test extensively for the virus itself, will it be able to additionally test for antibodies, even if a test becomes locally available? I think it is a good thing to have, but probably at a slightly later stage. Its current utility seems to be for contact tracing, but that may not be relevant to the UK now.

Incidentally, for people wanting more information about the rest of the world, especially outside the EU and the US, both Al Jazeera English and Channel News Asia have decent coverage.

https://www.aljazeera.com/https:/

https://www.channelnewsasia.com/news/international

[reverancepavane]

The big advantage of this is that engineered enzyme should be pretty easy to clone, which reduces the effective cost of the test (in terms of both time and materials) from the current PCR-based genetic assay. Which means that more testing can be done, which studies have shown needs to be done, because where testing has been more comprehensive a lot of carriers are actually unaware they have the virus at all.

[Plus blood tests are a lot easier to perform (especially considering that one of the two sites where samples need to be collected at the moment is where Romans used to tickle themselves with a feather to induce vomiting in large feasts).]

The downside is that you have to have had the virus for at least three days for the test to work. On the other hand, actually not knowing whether they have a simple cold or the coronavirus is seriously worrying people more than it should, so this should hopefully normalise some of the panic.