COVID-19: If universal testing isn’t the answer, then what is?

This week, we discussed the benefits, pitfalls, and limitations of our current crop of COVID-19 tests. So today, let’s wrap it all up…

We’ve only tested a small percent of Americans so far. So you really shouldn’t be shocked as you watch positive numbers rise every day. But the question is, what do those numbers mean? And can they even be trusted?

Well, just like everything else with this pandemic… it’s complicated.

The FDA didn’t do us any favors

 Even if we could count on the results of antibody testing, we still don’t know whether this knowledge is even useful. Because when it comes to viruses, immunity can go a number of ways.

In the case of measles, for example, infections are “one and done.” Once you’ve had it, you can’t catch it again. But other illnesses, like dengue fever, are a different story—you can catch dengue a second time, and often, that infection will be worse than the first.

We know that people who have recovered from COVID-19 have gone on to test positive again. (Though for now, it appears this is due to residual RNA from the virus—not an active infection.)

Still, we’re not absolutely certain that those patients aren’t contagious. We just think that they probably aren’t.

But that’s not the only unknown. Especially since most of us have already been infected with a coronavirus, in the form of a common cold, at one point or another.

And without proper validation for cross-reactivity, there’s no way to say for certain whether a patient who tests positive to an antibody test has immunity to SARS-CoV-2 or some other coronavirus.

But we do know that the sense of security that a false positive test might provide could prove deadly.

Our best hope for recovery

This is the real problem with the Food and Drug Administration’s (FDA) emergency use clearance I mentioned earlier in the week: We’re relying on a bunch of tests that simply don’t work as well as they should. In fact, their false negative rates appear to hover in the range of 30 percent.

Under any other circumstances, a test with accuracy this poor would be dismissed as a complete joke. Just imagine if the test you used to diagnose any other disease was wrong one-third of the time. How does that make any sense at all?

We’re clearly in the midst of a health crisis here. But if you ask me, dumping all of our eggs into a broken basket by pushing for universal testing that isn’t even reliable in the first place is a total waste of taxpayer dollars that might be better spent elsewhere.

Not to mention the sensitivity of contact tracing. COVID-19 doesn’t require the kind of intimate contact that sexually-transmitted infections like HIV do in order to spread from person to person. Which means that contact tracing isn’t going to be as simple as asking a patient for a list of sexual partners—or even a list of co-workers and family members.

So how effective are conventional contact tracing tactics likely to be? Bottom line, there’s a whole lot we simply just don’t know yet.

Should you get tested? What role do antibodies play? What treatments actually work? When will a vaccine be available? How long do we need to stay home? I don’t have the answers to any of these questions. Because we’re still trying to figure all of it out.

But despite all of this uncertainty, there are some things that we do know. So it’s time to drum up some common sense and work with what we’ve got.

We know that this virus will likely be around for a long time. And we also know that a vaccine is still far away—assuming we ever find one. (After all, let’s not forget that there’s still no vaccine for HIV.)

But we have found drugs that can very effectively manage that virus now. And my bet is that will be our way out of this mess—not through testing or contact tracing. But in the meantime, there are numerous ways to boost your immune system, without drugs, all year-round. To learn more, check out my Complete Guide to Year-Round Immunity.

Source:

“Hold on Antibody Testing: ‘The FDA Has Done Us a Disservice.’” Medscape Medical News, 05/06/2020. (medscape.com/viewarticle/930052)