There has obviously been a lot of news items about opening up businesses and getting back to “normal”. Let’s be clear about something. We are a LONG way away from the lives we lived before Covid and I think we need to get used to the reality that we will be living in a new “normal”. What that will look like is anyone’s guess, just like the accuracy of testing and the development of a vaccine, which conservative estimates predict is at least a year away.
Why so long to develop a vaccine? The simple answer is that this is a new virus and we don’t clearly understand how it behaves now or how it will behave in the future. It is also complicated to make a SAFE vaccine. There is a reason we don’t just have one immunization for the flu and have to make a new one every year. The virus constantly changes. There is a reason that after 30 years of HIV being around, we still don’t have a vaccine. It’s a complicated virus. There is a reason we don’t have a vaccine against Dengue Fever. The vaccine actually made it more likely to get infected by the culprit virus! There is a reason that the vaccine regimen against Lyme Disease was terminated abruptly. It was rushed to market without proper testing, didn’t work and actually caused illness.
MAKING A VACCINE IS COMPLICATED.
The point of immunization is to trick the body into making an antibody to recognize the microbe you are trying to defend against, without actually infecting the person. However, having antibodies does NOT mean you are immune! It simply means that you have been exposed to the virus and have developed antibodies. It means that the virus was, or still is in your body, and your body responded by identifying it as foreign and created an antibody to it. With something like Lyme Disease, if the microbe is in the body long enough and you form antibodies, the antibodies will be positive forever, even if the bug is eradicated. In the case of HIV and Hepatitis C, the antibodies indicate that the virus is in your body, sitting there maybe doing nothing but more likely, causing damage. There is a lot more to it than that but for now, I’ll end the discussion there.
All that having been said, what’s up with the tests and why is there so much variability in quality, availability and confusion?
First of all, there are 2 kinds of tests.
The first identifies whether you have the active virus in your body, indicating that a) you are infected and b) you can transmit the virus to others. These are tests which look to see if the virus is present in nasal, oral or lung secretions. As mentioned in an earlier post, the lung mucus is the most accurate, followed by the back of the nose, the front of the nose and then the back of the throat.
The second, or the “antibody test”, is a blood or serum test which identifies whether or not you have antibodies to the virus in your body, indicating that you were exposed to the virus at some point in the past or are presently still actively infected, although it can take a few days after active infection for the antibodies to be made and be detectable.
Here are a few points and reminders to keep in mind:
- You can be infectious as early as 2 weeks before symptoms begin. Most people develop symptoms within 3-5 days and in fact, those first few asymptomatic days are when you can be shedding the MOST virus and remember that this virus is 5x more infection than the flu. So without having any symptoms, you may be walking around infecting everyone around you just by breathing and speaking.
- Some of the “swab” tests have been as much as 30% innacurate in the false negative side of things. You may be walking around, told your test was negative, when it was actually positive, again, infecting those around you.
- You can be infectious for up to 2 weeks after your symptoms resolve also.
- Antibodies may not develop for a number of days after you have been infected or even have clear symptoms of the disease.
SO, what all this means is that although tests are important, reliable tests with an understanding of what they mean is more important. A negative swab may not mean you are not infected if you are not yet symptomatic. And also, making sure that the way the swab is done, contributes to accuracy. Having positive antibodies does not mean you are immune and that you can go back to work free and clear. All it means is that you were exposed and have antibodies. Congratulations! You made it through round one. It may not mean that, with the probable resurgence, you may not get sick again or transmit a new exposure to the virus to others.
I say “probable resurgence” because we’ve already seen it happening in the “model” locations like Singapore and Hong Kong where, despite great controls and low numbers of cases seen initially, as soon as restrictions were lifted, in very controlled ways mind you, numbers started to rise again. In Georgia, it seems that they have decided to open things up essential like nothing was going on. Do you REALLY need a tattoo? Can’t you go a little longer without a haircut? Geez. 10-15 days after things open up down there, I would expect another surge.
If any of these yahoos protesting against restriction could spend just 5 minutes in the shoes of an ER nurse or doctor, in the middle of a warzone where many patients are intubated because there are no ICU beds or be the person holding up an Ipad so a dying patient can say goodby to their loved ones who can’t be with them because of isolation, I bet this all would go a lot differently!
There are more questions than answers. I know it’s frustrating. I feel it in many ways.
As the saying goes, the only way around is through. I just hope we learn a few things from this as this will NOT be the only such infectious pandemic we experience. We’ve had them before and have not learned. One could argue, and I would, that we are in the midst of a chronic disease pandemic now. 80% of chronic disease is almost completely lifestyle related. 41% of Americans are obese and another 33% are overwight. That’s ¾ of the country!. 20% of kids are obese. Diabetes and prediabetes rates are over 30%. All of this IS pertinent to Covid since those chronic conditions lead to more severe illness and death.
Stay safe and be well.
AC 😎✌️🌱❤🐖🏃🏻🧘🏻♂️🌎