Looking forward to a smooth antibody testing rollout? You shouldn’t.
The antibody testing measures being touted by leaders who realize that the stimulus has failed are a desperate Hail Mary designed to get people working again. Should people go back to work? That’s a tough question: transmission of the SARS-CoV-2 virus will increase if they do. Yet perhaps the desolate economy represents a greater threat to the livelihood of Americans. I want to be clear on this: the federal government could have prevented this issue last month when the stimulus bill was passed. They chose not to.
Now SBA funding has vanished rapidly and the pressure is on governors to help their citizens figure out how to navigate this crisis with as little damage as possible as new evidence emerges that the Trump administration knew about the virus last November and somehow still has not managed to take any sort of reasonable or decisive action.
Antibody Testing: What You Need To Know
There is an extremely dangerous undercurrent in the current discussion about what to do regarding COVID-19. This undercurrent is related to the economy, and the pressure that economic matters are putting on leaders to get people back to work. Antibody testing is something we know next to nothing about — and yet it is being touted as the instant magic ready to save our economy and put people back to work.
As the narrative ramps up, it has already become clear that Republicans are willing to risk a much higher death toll to keep Americans working. Protests in Ohio and Michigan recently made headlines as frustrated and misinformed Fox News viewers appeared in public to demonstrate against containment measures. Unfortunately, we still do not know how to contain this disease without dramatic social distancing measures.
The main issue here is that officials are attempting to put the cart before the horse. Reinfection (as discussed in an earlier article I wrote) remains a concern. The biggest question here concerns immunity conferred by antibodies — it appears that, in some patients, the innate immune system may be the driving force behind remission of the disease. In these patients, a very low level of antibody is detected, and so we need to keep in mind that we don’t actually know how the body fights the disease off. As political pressure to do something, anything, to get people back to work mounts, we will likely see many ineffective remedies and consolations offered.
It is imperative that we step up as citizens during this crisis and make the intelligent decisions we need to make if we wish to salvage something of the world we used to know.
A Crash Course In Serological Antibody Testing
Serological antibody testing is a procedure in which the patient’s blood is spun down and put into contact with a reagent that has been specifically calibrated to react to the presence of particular antibodies. The way this works involves a lot of physics, but the gist is that each antibody has a fairly unique electrostatic profile and the test involves a reagent which will react to the specific protein it’s looking for, but not to other things.
Unfortunately, we really don’t know anything about the disease. We don’t know about transmissibility after infection, we don’t know about immunity to future infections, and we don’t know why some people generate large antibody responses and others don’t. The basic rules of the game with most coronaviruses don’t seem to exactly apply to this one, and the stakes are very high because it is such a deadly variant of that theme.
The serological tests available now include over 90 different versions, but despite the quick ramp-up, none of these have yet been validated in randomized controlled trials. Some of them have been shown to give false positives when exposed to other coronavirus antibodies. The reason why? FDA has become desperate, and is opening the floodgates to essentially test new tests on the market. From the FDA website:
Negative results do not rule out SARS-CoV-2 infection, particularly in those who have been in contact with the virus. Follow-up testing with a molecular diagnostic should be considered to rule out infection in these individuals.
In a nutshell: these tests are a crap shoot and could detect false positives from lingering antibodies directed at other coronavirus infections or completely miss antibodies which are present.
Unfortunately, the most talked-about fad in the coronavirus pandemic right now seems to be essentially wishful thinking. Just as the media has seized upon testing numbers to attempt to infer something about the rate of transmission, they’ve now seized upon serological testing as a way to get people back to work. Neither test is as effective as they make them both out to be, and less is going to get done in the future about the disease than they’re representing. Social unrest, at this point, seems just around the corner as Americans struggle to accept the new reality we’ve all been forced into.
Adding It All Up
As the disease begins to encroach into rural America, which produces and distributes the nation’s food, governors still refuse to lock things down. This is problematic for many reasons, the most significant of which is that exposure to the virus could result in something like a recurring chronic condition — even if it doesn’t immediately cause severe damage to the heart and lungs — or worse, exposure may not confer immunity or protection against further exposures.
This moral dilemma continues to unfold, as Republicans everywhere do their level best to pretend nothing is going on. After cutting US funding to the World Health Organization during what could easily become known as the most devastating pandemic in recent history, President Trump has moved on to threatening to adjourn the US Congress, a move which is controversial to say the least.
As the situation continues to deteriorate, food banks across the United States are experiencing lines miles long. Crime rates are bound to begin to escalate. And of course, the Trump administration has been involved in questionable deals — this time for N95 masks, and a bankrupt company with zero employees. And nothing seems to be getting better at all, yet everyone seems to assume it best to allow Trump to retain office until November despite having sandbagged and misplayed the situation and been utterly amoral in his handling of every one of the important issues here.
As more conservatives reveal themselves to be lunatics who don’t understand the situational calculus here (read: we all stay home awhile, the virus goes away, we get our lives back OR we all keep working and tons of us die and we have no idea whether the rest will get their old lives back or not) including Dr. Oz who later walked his statement back, it is becoming clear that the political pressure these fools are instigating is not going to go away. And thus, far from a unified or efficient struggle against the disease, the United States of America continues to be broken, defeated, and routed by a microscopic enemy because its people cannot manage to unify in opposition of it.