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  #51  
Old 05-12-2020, 04:16 PM
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Originally Posted by Enola Gay View Post
I tested negative and was never so profoundly disappointed to learn that I didn't have a disease. Given that you are on the front line, I suspect you'll have the same reaction.
I, too, was sad to test negative. I got tested by Quest, which claims pretty high sensitivity, so I guess I had some other mystery bug. Oh well, at least I have finally recovered from that bug, whatever it was.
  #52  
Old 05-13-2020, 06:54 PM
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I'm not going to get one yet.

-There are problems with accuracy as noted above
-We don't know the timeline of antibody development (ie you could start showing antibodies but still be shedding virus or even continue to shed virus indefinitely- ex herpes viruses where people who are infected develop antibodies but periodically still shed virus and can infect others)
-We don't know the protective value of antibody development (whether you can be reinfected and/or how long immunity lasts if it is indeed developed)
-I need to be vigilant to protect my patients and I don't want to subconsciously relax my standards if I test positive

I'll wait until the tests are better and more is known.
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  #53  
Old 05-18-2020, 08:18 AM
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I got tested last week (Quest/Abbott test) which I understand has a high false negative rate, but a very low false positive rate. I came back positive - not terribly surprised as I was really sick after international travel to a lrage city (London) back in March, but could not get tested at the time as I did not have all the symptoms that were known to be typical (fever, cough, shortness of breath). I had fever, extreme fatigue, massive headaches, diarrhea and a terrible rash (the latter two, at the time, had not been associated with COVID).

I took the test mainly because I was curious, though in the two days I waited for the results I was hoping it would come back positive. Why? I don't know. Maybe piece of mind, though I know that is a reach to think it won't impact me again because there is no proof (and some counterproof) of long term immunity. I recieved the results early yesterday morning but still wore a mask on my grocery run and plan to, because who knows if I could get reinfected and become a carrier/spreader). Next step is plasma donation if I am eligible - I feel very blessed that it was a "minor" case (though it was as sick as I've been in years) and that my wife and kids never had any symptoms, though my wife is curious now and is getting the test later this week. I self quarantined in a separate room once the fever developed, and only left the room to walk out to the attached patio when I felt well enough and wanted fresh air.
  #54  
Old 05-18-2020, 11:03 PM
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My doc is fairly confident that I did have a brief and mild (or my immune system was really on its game that day and it fiercely defended me) covid-19 infection about a month ago, based on symptoms, but we're not rushing to do an antibody test as most of the tests readily available around here are of dubious quality, and it would be purely out of curiosity to do so, with no good medical reason. If I did have a positive antibody test, about all I'd really be able to do with it is wonder how my partner escaped infection.

There's no evidence that successful recovery from covid-19 will give you immunity, much like there's no immunity from herpes (also a virus, but not a coronavirus).
  #55  
Old 05-19-2020, 02:22 PM
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Originally Posted by psychobunny View Post
I'm not going to get one yet.

1. There are problems with accuracy as noted above
2. We don't know the timeline of antibody development (ie you could start showing antibodies but still be shedding virus or even continue to shed virus indefinitely- ex herpes viruses where people who are infected develop antibodies but periodically still shed virus and can infect others)
3. We don't know the protective value of antibody development (whether you can be reinfected and/or how long immunity lasts if it is indeed developed)
4. I need to be vigilant to protect my patients and I don't want to subconsciously relax my standards if I test positive

I'll wait until the tests are better and more is known.
1. There's a distinct tendency IMO to overstate that for some reason. See the linked article above with claimed results by brand name test. Almost all are usefully high on specificity. Those are not audited numbers but seems to relatively unlikely they are all overstated to come out similar. More straightforward explanation is that most brand name tests are usefully accurate, unlike non brand name ones from China or outright fake ones, and there's basically no medical test that's always right when you also factor in that the people taking the sample or lab can screw up the procedure, accidentally switch names, etc.
https://www.evaluate.com/vantage/art...ecific-problem
2. Could be but I don't see how that logically weighs against getting a test.

3. The consensus AFAIK is that antibodies are much more likely to give some degree of immunity for some period of time than none, or even less likely make it worse the next time for a given person. Though no gtee.

4. No specific comment because my situation is not that. But in general if you are going to factor in non-rational behavioral aspects like that, why not also include the benefit of *some* degree of reassurance against very bad future outcome if you had it and it wasn't terrible.

Consider what I believe might be four general factors in a bad outcome
a) age: I know my age obviously, so the test doesn't impact that
b) comorbidity: that's more subjective. If someone had asked me before the test 'do you have a chronic condition which might exacerbate COVID-19?' I wouldn't have been sure exactly how to answer. Few people my age (early 60's) have zero health problems. Now I have a data point, just one, no gtee indicating my mild conditions aren't enough to create a very bad COVID outcome.
c) individual genetics: like b), I now have at least one data point indicating I'm not a genetic poster child for a COVID horror story.
d) viral dose: this is a wildcard which *could* upend my logic in b and c. What if I got such a marginal dose that virtually nobody would get really sick from it? The test result tells me nothing about that. However, I know from my situation I'm not going to have face lots of strangers up close for long periods. Even the situation where I believe I was infected, crowded funeral mass with people milling around greeting and giving condolences no protection measures at all, around end Feb/beginning Mar, is not likely to be repeated by me for a long time. So it seems fairly likely my future exposures to COVID if any will also tend toward low viral load.

The test gave me some useful indication I'm not a COVID disaster waiting to happen, even assuming no antibody protection from reinfection, though no gtee. And some antibody protection is AFAIK also more likely than not, again no gtee.

All in all very much worth zero $ cost and half hour+ time, no actually plausible downside, for me. Glad to have done it. *Not* 'glad to have had it'. I have some residual breathing symptoms two months on, and I'm not happy about that. I hope it completely goes away eventually, though livable as is.

Last edited by Corry El; 05-19-2020 at 02:25 PM.
  #56  
Old 05-20-2020, 12:43 PM
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gtee? Seems funny to cook up one's own personal abbreviation and coerce spellcheck to allow it while spelling out exacerbate, comorbidity, and straightforward.
  #57  
Old 05-21-2020, 02:53 PM
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Originally Posted by gotpasswords View Post
gtee? Seems funny to cook up one's own personal abbreviation and coerce spellcheck to allow it while spelling out exacerbate, comorbidity, and straightforward.
Seems funny to nitpick at bullshit stuff like that.
  #58  
Old 05-21-2020, 05:32 PM
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I am going to ask about it in a month when I have my annual exam.

Why? Because I was #3 in a five person chain but had no or very minor symptoms.

However #1, #4 and #5 tested positive. #1 & #4 became ill, #2 got sick but was not tested and #5 never got sick. Ages were 50, 54, 71, 69 and 93.
  #59  
Old 05-21-2020, 10:15 PM
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I haven't been convinced. If I am doing it for population surveillance then I would certainly participate but it offers nothing in changing my actions. It's sort of like getting an MRI for back pain. Except in the small amount of people who are planning surgery, it has little value. It will probably show arthritis but that doesn't mean the arthritis is causing the pain. Regardless, the treatment is the same and most people get better so it offers nothing to the treatment course except that people can say that they had one and it showed arthritis in their back. (I tell everyone over 50 that they have arthritis in their back). Now it is helpful in those cases where you need surgery and the antibody test can be useful in population studies, and hopefully with the right studies we will have a better appreciation of how the antigen and antibody tests relate and of the predictive value of antibody testing.


Quote:
The test gave me some useful indication I'm not a COVID disaster waiting to happen, even assuming no antibody protection from reinfection
There is no evidence to back up this statement. Maybe you are still infected and will soon develop a raging infection requiring ICU care. Maybe having antibodies means that if you do get reinfected you are more likely to have a cytokine storm. Maybe having a smouldering form of the virus means it is more likely to cause long-term damage to the blood vessels causing blood clots. We just don't know.
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  #60  
Old 05-25-2020, 07:55 PM
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Originally Posted by psychobunny View Post
I haven't been convinced. If I am doing it for population surveillance then I would certainly participate but it offers nothing in changing my actions. It's sort of like getting an MRI for back pain...
Interesting analogy... because I just postponed a shoulder MRI after talking to the doc and my PT person. The MRI would probably show a tiny tear in a tendon or a rotator cuff, in which case I'd probably choose PT and a steroid shot over surgery. So... since that's what I'm doing now, why spend the time/risk of walking into a hospital/money (copay is hundreds of dollars)?

So, IF the test were 99% accurate, IF having antibodies meant 99% chance of immunity, IF it were 99% free, and IF I got a juice box afterwards... then maybe.

But as it wouldn't make any difference in my behavior, I'll skip it.

(And I wonder if not knowing will make me more careful around others... I've been living as if "I might be asymptomatic, and I'll wear a mask/distance myself/stay home so's not to infect anyone else". I'd hate to get cocky and go back to hanging out in bars, and hugging strangers on the street)
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