Fear and Loathing, a Rat Flu Odyssey

[The AD]

Props to bmac for posting that. It's what I keep coming across: the tests are effectively invalid. But people are dying of this thing in significantly large numbers, not to mention the weird side effects and long term damage.

It's interesting. I had to read it twice to agree with the conclusion. I seems so counter-intuitive.

[bennymac]

honestly the whole article is like that - 5 minute read but touches on all aspects of where we are currently at with respect to knowledge of covid - and it also eloquently explains this whole TGR thread and what gets posted here

[LongShortLong]

Props to bmac for posting that. It's what I keep coming across: the tests are effectively invalid. But people are dying of this thing in significantly large numbers, not to mention the weird side effects and long term damage.

They aren't invalid. It just they are difficult to use for some purposes. Antibody tests are great for assessing roughly what portion of the population has fought off an infection. If we find it's only 5% or less, we know the entire population is vulnerable, and covid will spread like Santa Ana driven wildfire (without social distancing). On the other hand, if we find 50% have antibodies, we can consider loosening some on SD, allowing more social interaction while still decreasing spread.

Antibody tests also answer the herd immunity question. While many folks paying close attention have been pretty certain infection rates were very low, and the virus has circulated for only a few months, there was always a small consideration/hope that rates were higher and more of us had immunity. And some folks strongly believed it was widespread in Dec and most are already exposed. Antibody tests confirm there's no herd immunity yet.

Going forward, antibody testing tells us seroprevalence for various regions. While we don't know for sure that antibodies means protection, this is widely expected and will be shown yes/no. We might see that hard hit regions can get by with a little less SD. For example, if 20% are protected in a region, R is reduced somewhat. That means we can do activities that increase R slightly in that region, without exploding cases. In another region, those activities will remain unsafe.

Also, in the short run, antibody tests and dubious research is useful for pushing political agendas. Will be used for other agendas in the future. Covid is bigger than science and medicine. The political and social aspects are also important.

[dunfree]

not really , they are a consequence of the type of actions/policy taken once you have covid

And the potential policys are dependent on the capacity & resources that existed before covid & what you can marshal in response.

Example: If you’ve still got a shortage of masks & gowns you don’t have the resources necessary to carry on in the same manner, even if the beds are empty.

[Buster Highmen]

They aren't invalid..

You're splitting hairs on that one. Go reread the article.
Among 1,000 people, the test would correctly identify antibodies in 47 of the 50 people who had them. But it would also wrongly spot antibodies in 42 of the 950 people without them. The number of true positives and false positives would be almost equal. In this scenario, if you were told you had coronavirus antibodies, your odds of actually having them would be little better than a coin toss."

The distinction between being invalid, poorly defined and wildly abused is m00t.

[Lone Star]

if you were told you had coronavirus antibodies, your odds of actually having them would be little better than a coin toss.

As opposed to doing no test and having someone tell you you have coronavirus antibodies, in which case your odds of actually having them would be little better than getting Heads in five coin tosses in a row.

[getoutside]

real talk

wife started showing symptoms of either 1-allergies 2-covid on tuesday. Wednesday wakes up and cant taste the coffee. Calls our doc who does conference call with covid hotline. Come get tested. She mentions to our doc that I had a headache and sinus issues last week. I have a RP test ran on me every monday at work and haven't popped hot for any of the 27 pathogens (not including covid) and was clean. Yeah lets test him too and team htfb quarenteened until results come back. I got to do the driveup testing at Altaview Hospital. Those nurses are fucking heroes and should be paid 1000 an hour to do those tests. That fucking sinus swab is no goddamned joke and Im coughing and spewing right in their papr'd face and onto their 3 levels of PPE. It was insane.

Nuked the house and cars with a decon protocol that would make CDC proud. Im the only one that leaves the house and travels into hotzones like grocery or bank so I had to be the vector Fuck. Drank too goddamned much last night worried for my kid with asthma my friends who I may not have socially distanced properly from and the potential for my wife to die. I slept downstairs and woke up to the wife sitting in my bed with the laptop on the myhealth wedsite and we are both negative.

Be well my friends

best of luck to you and your family!!

[DougW]

And the potential policys are dependent on the capacity & resources that existed before covid & what you can marshal in response.

Example: If you’ve still got a shortage of masks & gowns you don’t have the resources necessary to carry on in the same manner, even if the beds are empty.

totally agree for covid its the total package of beds, , doctors, nurses, consumables, ventilators.... How can you loosen until you have control so you don't over shot what your capacity is any given time. You can work to increase that capacity but at some point will reach a hard capacity limitation of doctors at the ER level. Sweden seems to think they have not been that close to that limit even with the fumble of communication with their immigrant population causing much higher infection rate in that community.

[bennymac]

You guys should really read the article first - not just what I quoted from it.

The article does not state "antibody tests are useless!" - it also doesn't say "antibody tests are perfect! can't wait to get one!"

It's trying to show that it's not that simple.

The actual quote was "One such test claims to correctly identify people with those antibodies 93.8 percent of the time. "

The author is using the example of one particular/current antibody test to show that it's not as simple as people might think - this reported sensitivity should not be applied to all current or future antibody tests

Yes, antibody tests are going to be useful - especially on a population level like LongShortLong is describing. For an individual person these antibody test results may not be as black and white as we might hope.

[Mofro261]

the tests are effectively invalid. But people are dying of this thing in significantly large numbers, not to mention the weird side effects and long term damage.

The tests are only as accurate as their intended application.

An rtPCR test needs RNA in a sample. If the virus is in the body but not in the sample from the body, or at a concentration below the limit of detection, it will be a false negative. This is likely occurring in 15-30% peoplepresenting with symptoms. The rate of postives among those with symptoms is 20%, which compared to most other nations around 8-10%, means we likely are not testing enough.

An antibody test in people with symptoms can augment molecular assays even in the early course of infection (day<10) to bring the rate closer to 90%. In this case a high sensivity~ >90%, and a specificity of say 95% may work perfectly fine as the number of true positives greatly exceeds the rate of false positives when clinical signs and symptoms are present as the prevelence of potential infection is high.

But using a test as a serosurviellence tool needs to have very high specificity, >99%, esp when the prevalence is low.
This doesn't mean " all tests are invalid"- it means that the intended application of the test had better be well defined before it is used off target. I posted a link to a study out of UCSF pages back comparing 11 Ab tests. Out of the 11, 3-4 had specificities less than 90% and as low as 84%, 3-4 were in the 93-97% range and 2-3 were 99-100% specific in head to head comparisons on well characterized positives and negatives. I think all of the tests were 90% sensitive or above, but only the 2-3 with the highest specificities would be appropriate for serosurveillence when the prevelence in a population is ~5%.

[seano732]

real talk

wife started showing symptoms of either 1-allergies 2-covid on tuesday. Wednesday wakes up and cant taste the coffee. Calls our doc who does conference call with covid hotline. Come get tested. She mentions to our doc that I had a headache and sinus issues last week. I have a RP test ran on me every monday at work and haven't popped hot for any of the 27 pathogens (not including covid) and was clean. Yeah lets test him too and team htfb quarenteened until results come back. I got to do the driveup testing at Altaview Hospital. Those nurses are fucking heroes and should be paid 1000 an hour to do those tests. That fucking sinus swab is no goddamned joke and Im coughing and spewing right in their papr'd face and onto their 3 levels of PPE. It was insane.

Nuked the house and cars with a decon protocol that would make CDC proud. Im the only one that leaves the house and travels into hotzones like grocery or bank so I had to be the vector Fuck. Drank too goddamned much last night worried for my kid with asthma my friends who I may not have socially distanced properly from and the potential for my wife to die. I slept downstairs and woke up to the wife sitting in my bed with the laptop on the myhealth wedsite and we are both negative.

Be well my friends

Good news Happy, stay safe.

[Buster Highmen]

You guys should really read the article first - not just what I quoted from it.

The article does not state "antibody tests are useless!" - it also doesn't say "antibody tests are perfect! can't wait to get one!"

It's trying to show that it's not that simple.

The actual quote was "One such test claims to correctly identify people with those antibodies 93.8 percent of the time. "

The author is using the example of one particular/current antibody test to show that it's not as simple as people might think - this reported sensitivity should not be applied to all current or future antibody tests

Yes, antibody tests are going to be useful - especially on a population level like LongShortLong is describing. For an individual person these antibody test results may not be as black and white as we might hope.

The problem is that the statistics are currently not well defined. I admit I used "tests" inappropriately when I mean the statistics.

I'm not trying to say that antibody tests will never be useful, only that the statistics everyone is quoting now are at the very least suspect, hence invalid.

As far as the poiitical ramifications, bad stats go both ways, which is exactly what we see in the media.

[KQ]

honestly the whole article is like that - 5 minute read but touches on all aspects of where we are currently at with respect to knowledge of covid - and it also eloquently explains this whole TGR thread and what gets posted here

went down several rabbit holes (articles linked within the main article) when reading it. It was like an Easter egg hunt. Lots of good links there.

I found these linked articles insightful:

A New Statistic Reveals Why America’s COVID-19 Numbers Are Flat

There’s Really Only One Way to Reopen the Economy

[The AD]

"False positives are a problem, too. Many companies and countries have pinned their hopes on antibody tests, which purportedly show whether someone has been infected by the coronavirus. One such test claims to correctly identify people with those antibodies 93.8 percent of the time. By contrast, it identifies phantom antibodies in 4.4 percent of people who don’t have them.

Out of curiosity, how do they know this? I guess my question is "how do you test a test?"

[Meathelmet]

It was miserable. What the fuck? Are you French. A gorgeous Spring weekend after skiing up at Le Arcs and stuff, almost 70 degrees, all these outdoor cafes on the river, and everybody is fucking smoking, with a breeze. You may think it's cool, but I don't, and I smoked. Fuck that shit. It's rude and disgusting. May I fart in your face, frenchperson?

No problem for me as I have no peers.

PPS, QOTD, ETC, will steal your line someday.

Edit: Bennys inane post from the past suddenly got quoted as well?
But, alas, let it serve us well in the future: It is not about the amount of words, it's about the context and the eloquence.

[Mofro261]

Out of curiosity, how do they know this? I guess my question is "how do you test a test?"

On well defined confirmed positive and well defined known negative samples, and known "other diseases with symptoms similar to" samples.

[Benny Profane]

true if the health care facilities do become overwhelmed but also the other side of lockdown is that lots of others conditions are not being treated, cancer not caught etc. In my town there have been no cases requiring hospitalizations so whole medical system is working at 1/2 or less real productivity. That will eventually be reflected in health numbers though right now its reflected in doctors bank accounts. Not a criticism of lockdown or SD or anything else , just an observation.

Maybe an exposure of the American health system's treatment for profit machine. Oh, your leg hurts? Not feeling energetic? Let's do some tests....

[mcski]

Can someone with skilz please photoshop a gimp mask onto Pence visiting GM in this picture? It would make my day.

[The AD]

went down several rabbit holes (articles linked within the main article) when reading it. It was like an Easter egg hunt. Lots of good links there.

I found these linked articles insightful:

A New Statistic Reveals Why America’s COVID-19 Numbers Are Flat

I've been following the positivity rates somewhat and they're interesting. I always thought it was curious how few positive results there have been here in Washington compared to the national average. Overall it's been about 7.5% and now seems to be under 5%. Seems to suggest that the state has done a good job responding. Click on the "testing" tab on the graph here: https://www.doh.wa.gov/Emergencies/Coronavirus

[old goat]

Simple question:

Can you say that immunity gained from a vaccine will be equal to or at most slightly less than the immunity gained from having the actual infection?

So if the immunity gained from infection is on the lower end time wise , lets say like the corona viruses that cause the common cold ~12 months , then the vaccine will be about the same. But the advantage of the vaccine would be no mortality chance.

simple answer: no.
longer answer: there is no vaccine. If there is a vaccine the antibody levels may be equal to, more than, or less than post infection antibodies and those antibodies may or may not be protective. But if the vaccine produces protective antibodies than it would be much better to get the vaccine than to get the infection, for all the reasons people listed.

[bodywhomper]

Can we trying referencing golden showers into our conversations more? That was starting to get fun.

[mcski]

Can we trying referencing golden showers into our conversations more? That was starting to get fun.

Can you get sick drinkin piss?

[DougW]

simple answer: no.

so.... vaccine will be better? worse ? maybe better /worse/ equal

[LongShortLong]

The problem is that the statistics are currently not well defined. I admit I used "tests" inappropriately when I mean the statistics.

I'm not trying to say that antibody tests will never be useful, only that the statistics everyone is quoting now are at the very least suspect, hence invalid.

As far as the poiitical ramifications, bad stats go both ways, which is exactly what we see in the media.

Definitely a lot of BS, click bait, misuse, misunderstanding, agendas, and conspiracies (I like pointing out that HK eliminated 'rona shortly after going live with 5G). My agenda includes acquiring tomato plants and a hike, and feeling smart (smug?) enough to post here.

[Mofro261]

so.... vaccine will be better? worse ? maybe better /worse/ equal

which vaccine?