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Old 05-05-2020, 06:46 PM
Dan Turk is offline
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Are you getting antibody tested? Why or why not?


I'm going to the urgent care to get an antibody test tomorrow. Why? It's free and I'm curious. Also, if I have any sort of resistance, I'll sleep so much better.
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Old 05-05-2020, 06:56 PM
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Not.

I believe in getting a test when I will do something different based on the result. This test does not give a result that should change my behavior in any way, but could even in unconscious behavior ways, and may give me a potentially dangerously incorrect belief regarding risks, which can impact higher risk others I come in contact with.

I sleep fine now.
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Old 05-05-2020, 07:00 PM
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I would. I am curious and it will add to the database of knowledge of infections in the area.
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Old 05-05-2020, 07:04 PM
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Your seeking out a test and getting it will not add to the data base. It would be for your curiosity, which is an adequate reason.
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Old 05-05-2020, 07:07 PM
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Your seeking out a test and getting it will not add to the data base. It would be for your curiosity, which is an adequate reason.
I would have thought that this was being tracked. We are seeing data for new infections every day. Is this just for people with symptoms?
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Old 05-05-2020, 07:09 PM
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I am honestly very curious based some suspiciously-timed experiences in early March. However I am not interested in bothering right now because so far it appears the inaccuracy is massive. I just flat-out wouldn't trust any of the tests enough to satisfy my curiosity in the first place.

Last edited by Tamerlane; 05-05-2020 at 07:09 PM.
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Old 05-05-2020, 07:20 PM
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I would have thought that this was being tracked. We are seeing data for new infections every day. Is this just for people with symptoms?
In rank order of value for research/database of knowledge purposes would be:

- a validated research grade test of randomly chosen individuals weighted to represent a region's demographics by age, sex, race, SES, etc. (studies in progress but take time, hugely valuable);

- convenience samples, like at shopping malls (the studies released so far, some selection bias and not as likely representative of the population as a whole)

.
.
.
.
.

- numbers based on those who have sought out a test of unknown validity for some reason (very likely a strong selection bias and pretty worthless in terms of increasing the database of knowledge).



It may also have some value identifying those who are at the least risk of getting new infections of being contagious in the future who then might be the best be in positions taking care of higher risk individuals and in front line high contact positions ... but not as a substitute for the same behaviors and PPE use that antibody negative people use.

Last edited by DSeid; 05-05-2020 at 07:21 PM.
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Old 05-05-2020, 07:37 PM
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I haven't had any symptoms and I'm not that curious. Besides, as far as I know, having antibodies doesn't necessarily mean that I have immunity against further infection. At this point I figure getting tested would only add a point to someone's database and not confer any peace of mind.
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Old 05-05-2020, 07:46 PM
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I would get one if they were widely available or if I was advised I should get one by a medical professional. But for now, I feel other people need the available tests more than I do.
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Old 05-05-2020, 08:02 PM
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No. I do not know anyone that has tested positive. My son does from his job in a hotspot but he has tested negative twice. I have not experienced any symptoms. I feel at this point it would be a wasted test.
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Old 05-05-2020, 08:14 PM
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If the experts in the field conclude that a positive antibody test means immunity to the coronavirus, then sure, I'd get the test. Right now, who the hell knows about that? And there are a number of antibody tests out there, and what I've read is that only a few of them are reasonably accurate, so what would I learn?

Not to mention, we aren't even sure yet that having survived a case of COVID-19 confers immunity, so presence of antibodies means little if anything yet.
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Old 05-05-2020, 08:40 PM
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Anyone seeking to a serology test to check for antibodies for the SARS-CoV-2 virus needs to be aware that currently there are only a handful of tests that have been reviewed by the FDA and none that have been formally approved. The FDA has permitted private companies to sell their own tests provided that they have followed certain guidelines but there is no guarantee of the accuracy of the test. The article mentions one test sold by ToxTest that is ď97.9% accurateĒ, but it is unclear what that means, because tests can have both false negatives (indicating no exposure when you have actually contracted the virus) and false positives (indicating that you have antibodies when you do not). The CDC-developed antigen test (which looked for the viral RNA fragments) had serious problems with false negatives with an estimated 30% error rate, but the problem with antibody tests is the reverse; a Type I (false positive) error may give you confidence that you now have whatever immunity that exposure provides when you actually have none. And even a small error rate can produce a large fraction of incorrect results and detrimental outcomes.

I would personally wait until a test has been thoroughly vetted and there are additional tests to verify a positive result as a much more likely true positive, otherwise the testing tells you nothing useful and may actually mislead you in your choices and behavior.

For those not put off by a little bit of simple math: Bayesí Theorem Example: Surprising False Positives

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Old 05-05-2020, 08:50 PM
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I would personally wait until a test has been thoroughly vetted and there are additional tests to verify a positive result as a much more likely true positive, otherwise the testing tells you nothing useful and may actually mislead you in your choices and behavior.
I'd be happy to get a test...just as soon as the false positive rate is much lower.
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Old 05-05-2020, 09:10 PM
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The antibody tests are unregulated and incredibly unreliable, you’re better off reading your horoscope.
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Old 05-05-2020, 09:14 PM
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The antibody tests are unregulated and incredibly unreliable, youíre better off reading your horoscope.
Many of them but not all of them. The Roche one is supposed to be excellent.
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Old 05-05-2020, 09:45 PM
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The antibody tests are unregulated and incredibly unreliable, youíre better off reading your horoscope.
What I don't get is that the FDA didn't make companies get any sort of rigorous approval and now seems surprised that only three of the tests that were rushed to market are any good, so now they're on the verge of yanking the ones that are awful. What happened is pretty much what anyone with half a brain predicted would happen.
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Old 05-05-2020, 09:51 PM
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We don't have free widespread antibody testing for the asking here in the Portland area, but you can buy hometesting kits from Quest Diagnostics for about $129.
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Old 05-05-2020, 09:54 PM
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I'm aware of the possibility of an inaccurate result. I'll still get it once it's available. Just curious.
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Old 05-05-2020, 10:03 PM
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We don't have free widespread antibody testing for the asking here in the Portland area, but you can buy hometesting kits from Quest Diagnostics for about $129.
That Quest test is supposed to be crap.
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Old 05-05-2020, 10:07 PM
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I got tested on 23 April 2020 as required by the Education Commission of Beijing. Since nobody has knocked on my door, I'm assuming I'm okay.
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Old 05-05-2020, 10:28 PM
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The Roche one is supposed to be excellent.
Based on what beyond Roche's own self-reported performance testing?

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Originally Posted by Esprise Me View Post
I'm aware of the possibility of an inaccurate result. I'll still get it once it's available. Just curious.
The problem with that is that if it gives you a false positive result and you change behavior accordingly, you may be putting yourself at risk. Of course, if you don't particularly care--and given the number of people I've seen heading to crowded parks and beaches, many don't--then it doesn't really matter either way, but then you can just save your money and consult a Magic-8 ball, which is only only likely just as reliable as many tests but can also be reused.

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Old 05-05-2020, 11:01 PM
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Based on what beyond Roche's own self-reported performance testing?

The problem with that is that if it gives you a false positive result and you change behavior accordingly, you may be putting yourself at risk. ...
Fuck that shit that they are putting themselves at risk. They may feel it is now impossible for them to be an asymptomatic or presymptomatic spreader and put OTHERS, potentially higher risk more vulnerable others at risk.

Belief that one is immune can lead people who should know better to do that.
Quote:
"I have immunity. I've already had the virus, so I can't get it again and I can't give it to anybody," ... "I can't get it again, nor can I transmit. So of all the people you'll meet here, I'm about the only safe person in Washington."
That's a medical doctor speaking.

I don't care if that person gets again and gets sick or not, but if they get an asymptomatic case that they can spread, and spread it to a vulnerable person, well they deserve to have some ribs broken!

SPOILER:
Rand Paul
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Old 05-06-2020, 01:00 AM
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Fuck that shit that they are putting themselves at risk. They may feel it is now impossible for them to be an asymptomatic or presymptomatic spreader and put OTHERS, potentially higher risk more vulnerable others at risk.
Absolutely true...and from what I can tell, many people just don't seem to care that even if they are personally willing to accept the risk of infection, they are also increasing the chance of spreading it to others and prolonging the period that society as a whole is going to have to remain locked down. With an effective response once we learned the virus had reached North America, reliable testing with a vigorous track & trace effort, and a willingness by the public to endure a few weeks of lockdown (enabled by a legislature and executive willing to take the measures necessary to ensure that people weren't fearing for their livelihoods and well-being) the United States could have squashed the infection curve like South Korea did. Instead, dawdling, partisan hackery, and an apparently literal belief in miracles means that we are now experiencing per capita deaths that are approaching Italy and Spain at their peaks with no real end in sight now that so many states have decided to "open up for business". Expect new waves of deaths in more rural areas followed by more shutdowns, finger-pointing, and a continued lack of any plan or leadership on the national level and in many states.

Inaccurate antibody testing is nearly worthless at best, and has the potential for great harm at worst; for the FDA to eschew their responsibility to validate those tests before they are released to the public is contemptible. Regardless of what anyone sees on a test, until we have both reliable antibody testing and are confident that the presence of antibodies means that one cannot become reinfected or be an asymptomatic carrier, everyone should continue to behave as if they can contract and spread the SARS-CoV-2 virus.

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Old 05-06-2020, 09:18 AM
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The there is this guy: Washington Post:ĒHe was banned from performing autopsies. Then, he tried selling coronavirus tests to victimsí families.Ē

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Old 05-06-2020, 10:04 AM
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I'm going to the urgent care to get an antibody test tomorrow. Why? It's free and I'm curious. Also, if I have any sort of resistance, I'll sleep so much better.
I have no reason to believe I ever got it, and if I did get it, I was completely asymptomatic and any it doesn't change a thing. Even if I had it nobody's gonna let me go around without a mask and stop social distancing, so my behavior is the same either way. It's also $200 where I live, all the tests I'm aware of have a chance at false results, and I'm not really that curious.
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Old 05-06-2020, 11:34 AM
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Have they even sussed out whether or not you can get re-infected with antibodies?

And have they decided once and for all if plasma with antibodies is helpful/useful?

My brother thinks he had it in February. He wants to get tested just to see, and also to see if his blood would be useful. But he's not trying to pay $200 for any hokum.
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Old 05-06-2020, 01:56 PM
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I wouldn't pay $200 but per the CARES act it's generally free. There are cracks people can fall through I'm sure and get billed, but I confirmed it's free the place we plan to go soon (in NJ). I will try to find the type (ELISA, lateral flow) and brand and check that against manufacturer's finding of sensitivity/specificity as well as monitor future independent findings for that particular test.

The combination of specificity and prevalence of exposure in the population *can* give a high % of false positives, but not necessarily.*

Nor can anyone gtee what antibodies do for you, but 'nothing much' isn't likely AIUI.

I think it's worth knowing at zero marginal cost, and the availability here now is 'sure come on in'.

*assume for argument sake these manufacturer numbers are correct, though aren't audited yet by anyone else. At the lower end of sensitivity/specificity in this table and a 1% true positive rate, false positives would outnumber real ones close to 10:1; toward the upper end of these numbers and 10% real positives, real would outnumber false around 10:1. And the true positive rate around here could be 10%, it was found to be ~20% in a test just across the river in Manhattan, though it goes around in circle somewhat without an absolute gtee on the specificity of the test.
https://www.evaluate.com/vantage/art...ecific-problem
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Old 05-06-2020, 02:18 PM
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We donít know for sure whether antibodies to this will help or not. Some infectious diseases like dengue fever can be worse if you catch them a second time. Plus who knows which of these tests are accurate. Plus you have to go to a medical facility to get them done, thus exposing yourself, probably unnecessarily and for no benefit, to more germs.

I think I probably havenít had it so no point anyway.

Is there some way to get a test done without going to a medical office? Iím avoiding that as much as I can unless I develop severe symptoms of COVID or of a heart attack or something.
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Old 05-06-2020, 02:27 PM
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Have they even sussed out whether or not you can get re-infected with antibodies?
If you are expressing antibodies specific to SARS-CoV-2, you will have resistant to reinfection; that is, your immune system is already producing or at least capable of producing immunoglobulins capable of binding to antigens (infectious microorganisms). How effective this is, and how long immunological memory will last, although absent of rapid antigenic drift of the virus it is likely to last months and more likely years. However, it is possible that this virus can remain latent tissues and then be reexpressed and shed later. This is unlikely for a 'respiratory pathogen', but it is clear that this virus affects more than just the squamous epithelium of the lungs and respiratory tract tissues, so we can't really assume anything until the pathogenesis of the virus is better characterized.

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And have they decided once and for all if plasma with antibodies is helpful/useful?
The use of convalescent plasma is undergoing trials in various countries and there have been a few tentative indications of efficacy, but no controlled trials with verifiable success as of yet. Even if that does work as a theraputic intervention, it will not provide lasting immunity unless the patient immune system kicks in and doesn't cause uncontrolled cytokine release.

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Old 05-06-2020, 02:52 PM
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I haven't had a symptom, don't even know anyone who had a symptom. Just finished my second gloved, masked, shielded shopping trip since the beginning of March. Total positive cases in my county 0.1 percent of the population. I didn't even see a thousand people today, much less come within 6 feet of them. Probably haven't seen 1000 people since 2018.
So, no, I am not getting an antibody test.
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Old 05-08-2020, 08:34 PM
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I got tested this morning. Ugh, that was horrible. I knew they'd stick the swab up my nose but I was not aware that the nurse would have to twist it around back there for ten full seconds.

Anyway, I'm having a minor procedure done on Monday and the hospital is requiring all patients to be tested so it was off to the drive-thru test center - in a parking lot at a mall - I went.

Now, I wait. I suppose I'll find out it's bad news if I get a call from them cancelling the procedure.
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Old 05-08-2020, 08:47 PM
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I got tested this morning. Ugh, that was horrible. I knew they'd stick the swab up my nose but I was not aware that the nurse would have to twist it around back there for ten full seconds.

Anyway, I'm having a minor procedure done on Monday and the hospital is requiring all patients to be tested so it was off to the drive-thru test center - in a parking lot at a mall - I went.

Now, I wait. I suppose I'll find out it's bad news if I get a call from them cancelling the procedure.
That was not an antibody test. That nasal swab looks to see if you are currently infected despite your lack of symptoms.
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Old 05-08-2020, 09:38 PM
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Got tested yesterday at the insistence of my doctor.
Just got back the result: negative.
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Old 05-08-2020, 10:00 PM
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That was not an antibody test. That nasal swab looks to see if you are currently infected despite your lack of symptoms.
The antibody test will necessarily be a serology (blood) test because it is looking for immunoglobulin proteins in your blood. The nasal swab testing seems to have a large number of false negatives (originally the CDC test was suspect but from what I've seen many other nasal swabs seem to be fairly inconsistent as well, so it is possible that the virus just doesn't host that effectively in the tissues of the nasal cavities) so I wouldn't rely on antigen nasal testing to give you a high confidence result.

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Old 05-09-2020, 08:56 AM
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I had posted some early data that it was 30% false negative but apparently (assume ideal technique) many are not so bad. Abbott’s seems to do the worst. https://www.google.com/amp/s/www.the...tudy-67451/amp
Quote:
In Procop’s analysis, Abbott’s test had a false-negative rate of 14.8 percent.

“So that means if you had 100 patients that were positive, 15 percent of those patients would be falsely called negative. They’d be told that they’re negative for COVID when they’re really positive. That’s not too good,” Procop tells NPR, adding that, ideally, test reliability should be above 95 percent.

The DiaSorin Simplexa test had a false-negative rate of around 11 percent. Tests developed by the US Centers for Disease Control and Prevention, Cepheid, and Roche had false-negative rates of 0, 1.8, and 3.5 percent, respectively.
In this preprocedure screen context you are right that low false negative rate is most important. OTOH true positives should low. 100% confidence is not possible though. Just lowered risk.
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Old 05-09-2020, 09:03 AM
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I'd get one.
Back in mid march, right around the time the quarantine kicked off, I came down with something. Awful sore throat, cough, sore (but probably just from coughing). I checked my temp regularly for a few days and it never spiked. It was most likely just a cold, but keep wondering if that was it. I know some cases are pretty mild.
Even knowing that the tests aren't 100% accurate and even knowing that we don't know how likely you are to get it a second time if you have the antibodies, I'd still like to know.
I've seen tests that you can get for $200ish dollars, but I'm not going to pay that for some curiosity. I signed up for an NIH sponsored at home test. We'll see how that pans out.

I have a feeling once 'wide spread testing and contact tracing' gets going, if it's shown that presence of antibodies gives you some level of (even temporary) immunity, wide spread antibody testing will be done as well.
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Old 05-09-2020, 10:59 AM
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Had to go for blood work at my doctors yesterday for my upcoming MRI (and for my six month visit). They asked if I wanted an antibody text and I said, "sure, why not"?
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Old 05-09-2020, 12:13 PM
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I’ll get one eventually. Basically out of curiosity. I spent a week with my parents just before they both got sick with confirmed Coronavirus. Based on the level of exposure to them and the fact that we went to all the same places I should have gotten sick as well. So I’m curious if I had an symptomatic or minimally symptomatic infection. I’m going to wait until they sort out which of the various antibody tests are most reliable though.
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Old 05-09-2020, 01:45 PM
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Yes. Basically, because I'm curious if this bug I FINALLY recovered from was covid or not. I might also be slightly less panicked about our necessary grocery shopping if I have some evidence I've already survived it, although I'm aware that having antibodies doesn't mean you are immune, and can possibly make reinfection worse in (cf dengue).

I got sick with symptoms that are broadly consistent with covid 5 days after a middle-schooler with "some bug" from a town with known cases coughed on me. Of course, pretty much every virus produces symptoms broadly consistent with covid. Still, I want more clarity.

Quote:
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That Quest test is supposed to be crap.
https://www.massdevice.com/quest-dia...antibody-test/

Quote:
The company is using tests developed for high-throughput environments, starting with one launched yesterday by Abbott and another by Euroimmun/PerkinElmer (NYSE:PKI). The Abbott received an Emergency Use Authorization from the FDA and the Euroimmun test has been released for use under an emergency FDA guidance updated March 16, 2020 but has and has not been reviewed by the FDA.
https://www.fda.gov/medical-devices/...st-performance

The Abbott one is supposed to be pretty good, with 100% sensitivity (95% confidence intervale 95.8-100) and 99.6% specificity (99%-99.9%)

The Euroimmun one isn't as good, but isn't terrible, with 90% sensitivity (74.4%-96.5%) and 100% specificity (95.4%-100%), based on a fairly small sample tested.

They don't tell you which they used.

The biggest change it would make if I tested positive is that my husband would get tested, and if HE tests positive, he'd try to arrange to donate plasma. He's currently a regular platelet donor.
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Old 05-09-2020, 03:02 PM
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When my (small rural) county medical officer says reliable tests are available, MrsRico and I will dash right over.
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Old 05-09-2020, 04:52 PM
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I got one and it was negative. I was disappointed and now am wondering if it was even accurate.
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Old 05-09-2020, 04:54 PM
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As a person who believes I probably had it several months before it was identified and the news got out in the U.S., my answer is yes, for research purposes if nothing else.
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Old 05-09-2020, 07:07 PM
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I am pretty sure I had it in early February, and would like to take an antibody test so I could feel comfortable visiting my at-risk mother.
But none appear accurate enough.
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Old 05-11-2020, 04:16 PM
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I wouldn't pay $200 but per the CARES act it's generally free.
I think it's worth knowing at zero marginal cost, and the availability here now is 'sure come on in'.
So I got the test and it came back positive. It was the 'VITROS Immunodiagnostic Products Anti-SARSCoV-2 IgG Reagent Pack'. Per linked article, the manufacturer's claim is 100% specificity.

And I had something in March, in a relative COVID hotspot (NJ <1 mile from Manhattan). In fact my breathing is not quite 100% back to normal now (my hiatal hernia sometimes affect breathing but this seems a bit different) though still maybe slowly improving. 63 yrs old, reasonable health otherwise and good shape (I feel a bit of breathing issues on steep hills during ~8 mile brisk walks). Odd aspect though is that my wife tested negative. She had milder and briefer symptoms around the same time, but some. OTOH the manufacturer claims 83.3 sensitivity (resistance to false negatives) which is lower than several of the others in the table in the article.

I think this is useful enough info to justify ~35 minutes registering, waiting and getting the test at a place within walking distance on the way to lunch, no charge.

https://www.evaluate.com/vantage/art...ecific-problem
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Old 05-11-2020, 04:34 PM
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I wouldn't pay $200 but per the CARES act it's generally free.
I think it's worth knowing at zero marginal cost, and the availability here now is 'sure come on in'.
So I got the test and it came back positive. It was the 'VITROS Immunodiagnostic Products Anti-SARSCoV-2 IgG Reagent Pack'. Per linked article, the manufacturer's claim is 100% specificity.

And I had something in March, in a relative COVID hotspot (NJ <1 mile from Manhattan). In fact my breathing is not quite 100% back to normal now (my hiatal hernia sometimes affect breathing but this seems a bit different) though still maybe slowly improving. 63 yrs old, reasonable health otherwise and good shape (I feel a bit of breathing issues on steep hills during ~8 mile brisk walks). Odd aspect though is that my wife tested negative. She had milder and briefer symptoms around the same time, but some. OTOH the manufacturer claims 83.3 sensitivity (resistance to false negatives) which is lower than several of the others in the table in the article.

I think this is useful enough info to justify ~35 minutes registering, waiting and getting the test at a place within walking distance on the way to lunch, no charge.

https://www.evaluate.com/vantage/art...ecific-problem
  #46  
Old 05-11-2020, 05:02 PM
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Originally Posted by Stranger On A Train View Post
Based on what beyond Roche's own self-reported performance testing?

The problem with that is that if it gives you a false positive result and you change behavior accordingly, you may be putting yourself at risk. Of course, if you don't particularly care--and given the number of people I've seen heading to crowded parks and beaches, many don't--then it doesn't really matter either way, but then you can just save your money and consult a Magic-8 ball, which is only only likely just as reliable as many tests but can also be reused.

Stranger
I have to put myself at risk. Itís my job. The town I work in that you probably have never heard of has more confirmed cases than several states. We were just doing CPR on a positive case that didnít make it last night. My behavior will not change because it canít. I am curious about the antibody test. I may look into it on my days off. Arrangements have been made through our union to be able to get it. I would like to know if thereís at least a possibility I have some internal protection.
  #47  
Old 05-12-2020, 10:20 AM
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Originally Posted by Loach View Post
I have to put myself at risk. Itís my job. The town I work in that you probably have never heard of has more confirmed cases than several states. We were just doing CPR on a positive case that didnít make it last night. My behavior will not change because it canít. I am curious about the antibody test. I may look into it on my days off. Arrangements have been made through our union to be able to get it. I would like to know if thereís at least a possibility I have some internal protection.
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.
  #48  
Old 05-12-2020, 11:28 AM
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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.
Maybe I have had it. I felt crappy for a few days when this started ramping up. It might have been my mind playing tricks on me. Also since I started working midnights in January I kind of feel crappy most days.
  #49  
Old 05-12-2020, 11:31 AM
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I can’t find anywhere here in the Pittsburgh area where I can get the test, especially since I don’t currently have a pcp who could write me a scrip for one. MedExpress doesn’t offer it. I had symptoms 3d/4th week of March after NYC visit.
As soon as it is available to me, I will take one.
  #50  
Old 05-12-2020, 11:34 AM
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What I don't get is that the FDA didn't make companies get any sort of rigorous approval and now seems surprised that only three of the tests that were rushed to market are any good, so now they're on the verge of yanking the ones that are awful. What happened is pretty much what anyone with half a brain predicted would happen.
A significant amount of the reason we were so slow to get active infection testing going is that the FDA was too stringent with regulations. Obviously, there are pros and cons on both sides, but the overall story of the US's response to COVID has been that delays and missteps caused by overly strict and inflexible regulations has caused a lot of harm.
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