I know everyone is tired of hearing about it. I want to offer some advice really quickly. With ANY antigen test please keep in mind a few things. Hopefully none of you or the people you love have to take this test because you are sick. Its a good idea to understand it before you get symptoms and feel rushed, scared or anxious and cant think straight. In simple terms, an Antigen test discovers parts of the viral protein specifically the cool little spikes you see in pictures. It doesnt pick up and amplify RNA like the PCR tests. A PCR test is sort of like a cop asking for your drivers license and using that license to verify who you are. An antigen test is more like a cop seeing you in a black Ford Mustang with a red stripe and using that to identify you....could be someone else in the car but probably not. If you get an antigen test and are symptomatic, you need to get a "reflex test" if the test shows NEGATIVE. Not all doctors and hospitals are following protocol with this. A reflex test is sending you for another test that is more accurate (the PCR test). There will be false negatives with the antigen test and thats expected. If you are symptomatic and test negative with an antigen test, just go get the PCR test. Again, some doctors and clinics (especially ones new to testing...there will be alot of organizations out there picking this test up that are not familiar with point of care testing....they have new CLIAs and will not be good consultants as they have zero experience). An antigen test is a SARS test. Not that anyone will have the first SARS but antigen testing does not distinguish the difference....SARS and SARS COV2 look the same to the test. Other cross reactives and ok....what that means is if you have herpes or Leprosy or some other virus, it will not pick that up as a positive and thats a good thing. Antigen testing works really well and is a key part of diagnosing but not the ONLY part.
I am not tired of hearing about it. I appreciate your level headed insight to this thing. Beats the heck out of the dramatized stuff I hear on TV.
@MatrixMP-9 : Thanks for your post, you explained both the underlying science and the practical implications very well, without any nonsense.
Funny thing is I hear my colleagues sometimes over complicate things or get too technical with their customers. Doctors are human and all have varying levels of talent, knowledge, experience and expertise. Very few are virologists and biologists. They do their best. People expect them to be almost Godlike at times. Some of the best doctors leave a room and use google and webmd to verify their diagnoses. Ive talked to quite a few that still cant wrap their heads around the difference between testing types. I have to slow my cadence waaaay down being sure not to sound condescending and offend them but ensure their brain is digesting what they are hearing. At times over the last week Im more of a bartender and find myself just listening to these men and woman. Some of the doctors are actually scared ....I can hear it. At first, them being scared SCARED me! I find myself trying to find the right time during a consultation to remind them that the vast majority of patients will recover and we are learning tons each day that passes about specific treatment paths that greatly improve outcomes. Medicine has changed alot in 20 years. Believe it or not, "good" doctors really appreciate educated patients that ask good questions. An even a slightly educated patient is usually a more calm one and they honestly appreciate it. Understanding the basics of testing before you get sick (I keep saying this because lord knows once symptoms hit, you tend to freak out and act insane lol ) really will help your practitioner help you. Have sort of a plan and understand what you will want and expect....all with an open mind and lots of humility of course.
@MatrixMP-9, bit of a technical question that's been bugging me... I understand that here you're talking about an antigen test, which looks for the virus itself circulating in the body -- in other words, an active infection. There are also antibody tests, which look for your immune response to the virus; these tell whether you have been infected by the virus. (Once you've been infected, your immune system continues to make these antibodies for years, or maybe even decades, depending on the pathogen.) My question: is there only one possible antibody target on this virus? Everybody's talking about the "spike protein", the little bumps all over the virus that are the actual can-openers for getting into a host cell. That's what the antigen test looks for, and that's what's targeted by the antibodies that the antibody assay looks for. But is it possible that there could be other antibodies, with other targets, that are effective against COVID-19? I'm guessing the answer is "not likely enough to matter". The spike protein is the big deal, and maybe the adaptive immune system never looks any further than that for a target. I also get the impression that small mutations could change that protein enough to evade the antibodies, while still letting it do its job. I see references to an "Achilles' Heel" on the protein, a section that can't change without breaking the machine, and therefore can be a good target for tests and therapies. The adaptive immune system isn't smart enough to zero in on that piece, though. Not sure any of this matters for the tasks at hand -- getting reliable tests manufactured, distributed, administered, and digested -- but I'm also not sure it doesn't matter...?
Its a good question Jeff. I dont know the answer to it. If you want my opinion, I'd say yes its possible. It would probably be a good thing too if it were stumbled upon. You bring up something interesting though and that is antibodies. I am by no means an expert in treatments outside of treating symptoms with FDA approved drugs and methods BUT a few of the companies in the race for a "cure" are developing some super interesting vaccines. I mention it because it isnt a vaccine in the traditional sense that triggers an immune response but rather an injection of antibodies. The antibodies are being created in a lab in volume for inoculation. I dont know enough about to speak to it intelligently but it seems like science fiction. Creating an antigen to kick in the immune system that creates the antibody itself is amazing to me but now we are skipping right to the antibody....thats nuts! It brings up a whole entire bunch of questions for me. Its conflicting in my pea brain because on one hand I would want something like this out TODAY to start saving lives ....but the logical half (well, not half more like 1/20 lol) tells me whoa, whoa, whooooooaaaaa Tex, slow down and lets walk this one through FDA trials like big boys. Can you imagine injecting someone with an antibody and getting a trojan horse effect? Suddenly, out of nowhere, the body decides its not welcome and its an invader. Everything goes ape shit and your liver shuts down and your brain turns all prion swiss cheese? Ohhhh man!!! You seen anything about this???
(1) (1 resp)For the antibodies to be generated, the antigen ( virus markers ) have to use human cells ( or human cell cultures) without much rejection to make it respond and be active for humans. Rhesus monkeys might work due to similarities, but not enough around to make large amounts, and it would be brave people to test it. This mean that using convalescent serum from recovered humans, and that should only be done under life and death situations as a treatment and not a vaccine as other molecular difference exist.. (2 resp) The big assumption is that the majority of the humans being vaccinated can actually produce the antibodies that inactivate the virus . Several viruses can cause production of detectable antibodies, but they do not destroy the virus and only lifelong drugs are needed. Genetic immunity is not the same for every family tree, Some are lucky and some are not.Genetics have made quantum steps in visualizing and duplicating the process. IMO, Jim
Re: the use of antibodies vs. vaccines for SARS-CoV-2, there's a useful (and not over-technical) discussion on Derek Lowe's "In the Pipeline" blog for today: https://blogs.sciencemag.org/pipeline/archives/2020/05/14/monoclonal-antibodies-and-vaccines-a-qa Fun fact (that I didn't know until reading the blog): 11 of the top 25-selling drugs last year were monoclonal antibodies. Those top sellers were not against viral diseases, but antibodies are already proving useful against various other conditions (notably cancer). It seems to me that the most likely use of a monoclonal antibody to SARS-CoV-2 would be in acute treatment of infected patients, to quickly get in antibody against the virus as the patient's own immune system takes a while to start producing appropriate antibodies. This could be a valuable treatment, but would not be useful in preventing new patients from catching the virus.
You might find the historical timeline interesting https://www.genscript.com/history-antibodies.html The development of high speed computer controlled sequencing machines was the main key for the rapid evolution of monoclonal antibodies. Most of the normal world heard about PCR first in 1995 in the OJ Simpson trial and now a company can have many multiple machines working all the time to produce a product.They have resurrected a vaccine prototype ( Thank heaven for freezers) that may be modifiable. https://www.usatoday.com/story/news...e-houston-baylor-college-medicine/5183082002/ Jim
Well thank God Im on the testing side of all this! Doctors naturally ask me for consultation on how to proceed or "what are other doctors doing" with a positive confirmation. Generally, its an easy question because law dictates that we have to follow approved FDA treatment plans. I can simply proclaim "Im not a doctor buuuuttt". Its ok and accepted. Doctors need others to "learn" just like everyone else. Where do they learn? Other doctors, manufacturers etc. Its easy with disease thats been around for decades with numerous approved treatments and lots of great studies and stuff but this Sars Cov2 is so different. Theres been alot of rushing to findings and alot of panic and "hope"....and "hope" isnt good in medicine. Fun fact- This sars antigen test has been requested more by practitioners than any other test in history and has done that in 6 days.
