COVID-19 Shutdown Exit Strategy?

[ls99]

I'm confused. Maybe this will help:

Finally a good explanation of baseball.

 

[Leo1277]

Reopenging the Economy and Coronavirus Antibody Tests

There is an interesting article in the NY Times, comparing the accuracy of various antibody tests out there, titled "Coronavirus Antibody Tests: Can You Trust the Results?"

https://www.nytimes.com/2020/04/24/health/coronavirus-antibody-tests.html

Here are a few quotes:

A team of scientists worked around the clock to evaluate 14 antibody tests. A few worked as advertised. Most did not.

These tests are crucial to reopening the economy, but public health experts have raised urgent concerns about their quality. The new research, completed just days ago and posted online Friday, confirmed some of those fears: Of the 14 tests, only three delivered consistently reliable results. Even the best had some flaws.

Surveys of residents in the Bay Area, Los Angeles and New York this week found that substantial percentages tested positive for antibodies to SARS-CoV-2, the official name of the new coronavirus. In New York City, the figure was said to be as high as 21 percent. Elsewhere, it was closer to 3 percent.

The idea that many residents in some parts of the country have already been exposed to the virus has wide implications. At the least, the finding could greatly complicate plans to reopen the economy.

In the new research, researchers found that only one of the tests never delivered a so-called false positive — that is, it never mistakenly signaled antibodies in people who did not have them. Two other tests did not deliver false-positive results 99 percent of the time. Four of the tests produced false-positive rates ranging from 11 percent to 16 percent; many of the rest hovered around 5 percent.

The proportion of people in the United States who have been exposed to the coronavirus is likely to be 5 percent or less, Dr. Hensley said. “If your kit has a 3 percent false-positive, how do you interpret that? It’s basically impossible,” he said. “If your kit has 14 percent false positive, it’s useless.”

 

[Leo1277]

^^^ About possible NYT paywall: This article is part of their free "Coronavirus" coverage, and hence not behind a paywall. But if you have already read some articles with them, you may have have to sign up for a free account (and likely get nagged later to pay for all the other great coverage they will tell you they have).

It has been mentioned recently that one can circumvent this by clearing browser cookies. Another way that often works is to re-open the article in a new private window. However, there is another tool that lets you get beyond most of these nag screens, not only for NYT but most other news sources as well. It's called "Tranquility Reader", and it basically strips out all the non-text parts, including nag screen overlays. I use it on Firefox, but it also exists on Chrome and perhaps other browsers.

 

[Midpack]

There was some promise in the NYT article if you keep reading. We'll get there, but it's going to be two steps forward, one step back and it's going to take longer than any of us want or expect. We're all going to have to be patient and discerning re: sources (considerably more bad info than solid), easier said than done (self included).

The results overall are promising, Dr. Marson added. “There are multiple tests that have specificities greater than 95 percent.”

Rapid antibody tests are generally used to get a simple yes-no result, but the team assigned the positive results — which appear as bands on a test strip — a score from zero to six. They trained readers to interpret those results, and found their decisions often agreed and were supported by the more quantitative Elisa tests.

“If you train the readers well, they can start to be reliable,” Dr. Marson said of rapid tests. “That is critical to understand if these tests could ever be deployed.”

The team at Mass General set a higher bar for specificity; they considered a score of one for the intensity of a band to be a negative result, rather than a score of zero.

Perhaps because they eliminated the fainter bands — the ones most likely to be erroneous — their estimate of specificity for BioMedomics, the one test that was evaluated by both teams, was more than 99 percent, compared with the San Francisco team’s estimate of 87 percent.

 

[Leo1277]

There was some promise in the NYT article if you keep reading. We'll get there, but it's going to be two steps forward, one step back and it's going to take longer than any of us want or expect. We're all going to have to be patient and discerning re: sources (considerably more bad info than solid), easier said than done (self included).

Indeed. Part of the problem is that the numbers of real positives may be rather small, and so false positives have a larger relative effect than in other epidemiological tests.

Actually one aspect of the article I found quite interesting, and which I hadn't really thought about much before, was that even if a test does have larger than desired false positives, if we know what that number of false positives is precisely enough, we can filter it out of the calculation. That works to a certain extent if you have large enough population size, unless the known false positives in the test are more than a couple times the real positives in the population.

 

[travelover]

I found this depressing. https://www.npr.org/sections/corona...covered-covid-19-patients-are-immune-who-says

The World Health Organization has pushed back against the theory that individuals can only catch the coronavirus once, as well as proposals for reopening society that are based on this supposed immunity.
In a scientific brief dated Friday, the United Nations agency said the idea that one-time infection can lead to immunity remains unproven and is thus unreliable as a foundation for the next phase of the world's response to the pandemic.

 

[Leo1277]

I found this depressing. https://www.npr.org/sections/corona...covered-covid-19-patients-are-immune-who-says

Really, that is discouraging. Also, we are starting to learn more and more about the virus, and study separately the at least three distinct sub-types currently around, where for example the dominating one in NY is apparently different from the one in CA. It's currently not clear that even if one is immune to one of the strains, that that would also confer immunity to the others. The common cold is caused by many different strains of viruses, some of which are also coronaviruses, and far-reaching immunity is not achieved. So let's hope for the best that this virus is not a "super common cold" And, in general let's try to be aware that there is still so much we don't know well enough.

 

[copyright1997reloaded]

There is an interesting article in the NY Times, comparing the accuracy of various antibody tests out there, titled "Coronavirus Antibody Tests: Can You Trust the Results?"

https://www.nytimes.com/2020/04/24/health/coronavirus-antibody-tests.html

Here are a few quotes:

A team of scientists worked around the clock to evaluate 14 antibody tests. A few worked as advertised. Most did not.

Interesting - I looked at the study and don't see where they included Abbott's anti-body test in the results. So I wonder if this was using tests available as of some time (in the past)? I didn't spend a lot of time digging, just asking.

p.s. According to Abbott, their anti-body test has a sensitivity of 100% and a selectivity of 99.5% which is pretty darn spectacular. It was announced April 15, 2020.

 

[Leo1277]

Interesting - I looked at the study and don't see where they included Abbott's anti-body test in the results. So I wonder if this was using tests available as of some time (in the past)? I didn't spend a lot of time digging, just asking.

p.s. According to Abbott, their anti-body test has a sensitivity of 100% and a selectivity of 99.5% which is pretty darn spectacular. It was announced April 15, 2020.

I haven't looked at the details of the study behind the article, but my impression was that this was mostly meant to caution about the "Wild West" type situation where many players are quickly pushing tests out of the door, and we should be cautious about what we really trust. I think this will be even more important once we get home tests selling on eBay.

About the Abbott test, these numbers for sensitivity and specificity indeed look spectacular. And while I don't know much about their work and the track record of their other tests, that these numbers are so good may mean it would be interesting to see external cross comparisons.

 

[Doribe]

GA,SC, FL, TN. All taking steps to open up. NY just opened golf courses and marinas. A little at a time.

IL opened golf courses and marinas and some non-essential business.

We are still in SIP, but we can go out for walks. The county forest preserves are open but the parking lots are closed on weekends to limit crowds. The state parks will open on 5/1, but limited amenities. Starting May 1 we will all have to have face masks on any occasion a person will be closer than 6 feet.

I won't be going to any of the parks, I'll let the apartment dwellers use them and I'll enjoy my yard. I have been either having groceries delivered or using curbside pickup and will continue to be cautious.

 

[Dtail]

I found this depressing. https://www.npr.org/sections/corona...covered-covid-19-patients-are-immune-who-says

Perhaps in the end, we all might get the virus and hope that there could be a process developed which mostly prevents the severity of the disease even if not a vaccine.

 

[MichaelB]

I recently read (or heard) a discussion that highlighted the Abbot test as highly accurate. Can’t rememer where, but it was a repudiable source. I also read an expert / informed opinion that said even a bit less accuracy was acceptable, once enough testing was conducted the trend would be informative.

Here’s an informed discussion on “serosurveys” https://www.statnews.com/2020/04/24...to-be-released-heres-how-to-kick-their-tires/

The conclusion is telling

Still, with all the current problems, two things are clear.

The first: Whether the study was conducted in California or Denmark, in the Netherlands or Germany, most have shown the virus has not yet infected a big portion of the screened population.

“In general I think things have been pretty consistent. It’s only in the really hard-hit places that we’re seeing anything above a single-digit number,” said Dean. “The harder hit places have higher seroprevalence, but even the hard hit places don’t seem to have crazy numbers. Certainly not at the herd immunity level.”

That leads us to the second thing: The world still has no idea how to interpret the import of any of these studies.

 

[Midpack]

I found this depressing. https://www.npr.org/sections/corona...covered-covid-19-patients-are-immune-who-says

All the reports I've seen state the WHO isn't saying antibodies aren't effective, they're saying it hasn't yet been confirmed for Covid-19 yet - IOW we don't know yet.

Admittedly it's just one example, but one case of reinfection, turned out to be the patient had developed antibodies but hadn't yet kicked the virus. It wasn't a reinfection, it was the original infection lingering when symptoms were subsiding. FWIW

 

[Brat]

I wonder if 're-infection' is actually the result of a false positive from an antibody test whose illness flared up.

I listened to Gov. Como this morning, his discussion of an exit strategy makes good sense.

 

[travelover]

All the reports I've seen state the WHO isn't saying antibodies aren't effective, they're saying it hasn't yet been confirmed for Covid-19 yet - IOW we don't know yet.

Admittedly it's just one example, but one case of reinfection, turned out to be the patient had developed antibodies but hadn't yet kicked the virus. It wasn't a reinfection, it was the original infection lingering when symptoms were subsiding. FWIW

Yes, it says it hasn't yet been confirmed, but some governments are moving forward on the premise that it has. For me, that is / was a big hope given no vaccine or treatment at this time.

 

[Chuckanut]

Another look at what WHO really said. It’s not what was reported by many media sites.

https://reason.com/2020/04/26/world-health-organization-tweet-coronavirus-covid-19-antibodies/

Snippet:

“This weekend the World Health Organization (WHO) had to delete a misleading tweet about the coronavirus. Unfortunately, several media outlets had already cited it, spreading unwarranted fear about the likelihood of secondary COVID-19 infections.”

“"When they say 'no evidence' they mean something like 'no definitive proof, yet,'" wrote statistician Nate Silver in response to the WHO tweet. "But the average person is going to read it as 'there's no immunity to coronavirus,' which is likely false and not a good summation of the evidence."”


A later WHO tweet:

“Earlier today we tweeted about a new WHO scientific brief on "immunity passports". The thread caused some concern & we would like to clarify:

We expect that most people who are infected with #COVID19 will develop an antibody response that will provide some level of protection.”

WHO’s Tweet was not specific enough to start with. Alas, others filled it in with an incorrect interpretation

 

[MichaelB]

Another look at what WHO really said. It’s not what was reported by many media sites.

https://reason.com/2020/04/26/world-health-organization-tweet-coronavirus-covid-19-antibodies/

How about a snippet or short summary ..

 

[audreyh1]

Yes, from what I read some experts have said that there will be some level of protection. It might be short but numbers out to 3 years have been thrown around. Also, those who tested negative and then positive again, these folks hadn’t completely thrown off the infection but don’t appear to be contagious - and some even think there were errors in testing finding not viable virus. And apparently some people don’t develop a large number of antibodies.

So I am cautiously optimistic.

 

[fh2000]

At this point, it makes me want to have the mask from the movie, Avatar.

It is small enough. It has a perfect fit to anyone's face and covers eyes, nose, mouth. It automatically converts the oxygen level for Earthlings.

If I have one of those, I can go anywhere I want. I can fly. I can go to the beach or hike. I don't have to wear it but as soon as I am getting 6 feet of another person, I will put it on right away. Wouldn't that be nice.

 

[martyp]

Scientists can extrapolate from what they know about previous similar infectious virus strains. As we have learned, this virus has it's own characteristics. In the end no one knows for sure. The existing test can be useful to researchers trying to calibrate their infection models. They don't generally recommend them for use in making return to work decisions. All the equivocation about the anti-body test does highlight a growing realization that there is no solution to this virus in the 6-18 month time horizon. You have to decide to lockdown, open up or do something in-between.

 

[Leo1277]

Virally Distant, Physically Close

At this point, it makes me want to have the mask from the movie, Avatar. If I have one of those, I can go anywhere I want.

How about one of these bubbles? You can maintain perfect viral distancing, yet can be socially close to others. And as the ultimate symbol of love in the time of coronavirus, you can invite your significant other inside your own bubble!

 

[Sunset]

One thing I do not see mentioned in US, that China is doing, which is using big disinfecting machines. In many large gathering such as entrance of factories, workers have to go thru a tunnel kind of disinfecting streams coming in all directions to each person. Some schools and large malls also have these:

At first I thought they had developed a StarGate, and were abandoning the plague planet

My serious thought is, this does little, as the virus is inside a person and is exhaled.

 

[gwraigty]

Here is the Ohio plan for reopening some parts of the economy:

May 1st - Health procedures that don't require an overnight hospital stay, all dental and veterinary procedures

May 4th - Manufacturing, construction, distribution, general offices

May 12th - Consumer, retail, and services

New protocols are detailed at the link:

Reopening Ohio: Gov. DeWine gives dates, protocols for reopening businesses beginning May 1

Businesses that will remain closed include restaurant dining rooms, salons, gyms, entertainment venues, and others that are detailed at the following link:

Continued Business Closures

Reopening more businesses will depend on how it goes with all of the above being open after a few weeks. The press conference is still going on. We're still going to be under a stay-at-home order, although we'll soon have more places to go.

 

[Independent]

Interesting - I looked at the study and don't see where they included Abbott's anti-body test in the results. So I wonder if this was using tests available as of some time (in the past)? I didn't spend a lot of time digging, just asking.

p.s. According to Abbott, their anti-body test has a sensitivity of 100% and a selectivity of 99.5% which is pretty darn spectacular. It was announced April 15, 2020.

I see that I posted in the wrong thread...

The Abbott antibody test is a blood-draw-from-arm, mail to lab test.

I think the San Francisco researchers were looking at finger-prick, rapid readout tests.

https://www.healthlabs.com/covid-19-antibody-test

If I thought I'd had it, but wanted to be sure, I'd be willing to go to a lab, get the blood draw, pay my $169, and wait 24 hours for a result. It would be worth that to me to know for sure.

I think the massive, test millions of people, vision is hoping for simpler processes.

 

[Midpack]

Here is the Ohio plan for reopening some parts of the economy:

May 1st - Health procedures that don't require an overnight hospital stay, all dental and veterinary procedures

May 4th - Manufacturing, construction, distribution, general offices

May 12th - Consumer, retail, and services

New protocols are detailed at the link:

Reopening Ohio: Gov. DeWine gives dates, protocols for reopening businesses beginning May 1

Businesses that will remain closed include restaurant dining rooms, salons, gyms, entertainment venues, and others that are detailed at the following link:

Continued Business Closures

Reopening more businesses will depend on how it goes with all of the above being open after a few weeks. The press conference is still going on. We're still going to be under a stay-at-home order, although we'll soon have more places to go.

I haven’t followed Ohio, but I’ve heard DeWine has gotten good marks on handling the virus response. The steps above make sense on the face of it, way more than GA.