Dear virologists, epidemiologists and others, please be practical

When you say that the COVID-19 incubation period is long and that antibody tests are not accurate enough, you are right.

But if you consider for example that the UK government wants to quarantine everyone who travels into the country with the exception of people arriving from France and Ireland and/or  French and Irish nationals, you see that the point of accuracy in controlling the virus has already gone out of the window.

Is it possible to find a combination of antibody test (or any other test that give results within a short time frame) taken before and after an international flight that might for example be able to distinguish passengers who definitely must be quarantined or who may not have to be quarantined?

With so many governments failing to lead now, the solutions have to come from others.

It may no longer be enough to do what you’ve always done in the past. (In fact, this equals responding the way Boris Johnson and Donald Trump reacted to the pandemic.)

Could you please run a bunch of antibody tests and combinations of tests and see how they measure up against a PCR test and come up with a good enough combination of antibody tests and a related number for (quantification of) the risk that a passenger presents, perhaps in combination with the purpose of the passenger’s visit?

If you need a calibration point or baseline, use the risk that the average Irish or French national would represent as he or she will not be quarantined upon arrival in the UK. Relative to that, using antibody tests might actually be an improvement. Can’t you see that?

Please, someone has to get out of that ivory tower and start being a little more practical.

Although I understand perfectly well where the virologists and epidemiologists are coming from, many of you seem to have lost sight of the reality of the present crisis. Your work’s context has changed considerably.

Your salaries and your projects are continuing, but the salaries and jobs of many others are on hold. And most of those people cannot afford to wait until science has come up with perfect solutions.

(This includes that distancing on planes is not taking place at all in practice, because apparently it is simply not doable, not before boarding either. Because public air travel was never designed for that.)

You know damn well that governments and companies are not going to adopt everything that you want. So at least some of you have to start working with what is happening in reality instead of what you would like to see happen.

It is no longer good enough to say that 90% or 86% accuracy is not good enough and leave it at that. You would certainly mention, say, an R2 as high as 86 or 90% in your papers, wouldn’t you? You wouldn’t call that “negligible” or leave it out.

There is no dream ticket. (For the record “antigen” more or less stands for virus. An antigen test checks for the presence of active virus.)

Along a similarly practical line of thought, if volunteers can test people in the UK, then why can’t research veterinarians and techs working at universities in the US (apparently, i.e. as far as I know), even though they work with pathogens all the time?

 

 

2 thoughts on “Dear virologists, epidemiologists and others, please be practical

  1. The UK just approved the Roche antibody test. Already had approval from medical regulators in the EU and the United States.

    “The British government said it was talking with Roche on rolling out its test after a Public Health England laboratory at Porton Down, in Wiltshire, concluded it had 100% specificity. That means it can detect antibodies to the exact disease rather than similar ones.”

    Downside is that it does require a health professional to take a blood sample and it needs to be processed at a lab. So how can we get this translated into something portable that can be done on-site?

    Anything that looks hard can usually be done if enough effort goes into it. (I mean, hell, people, we already went to the moon so many decades ago. The idea to go to the moon must have seemed sheer lunacy too – until it happened anyway.)

    https://www.bbc.co.uk/news/health-52656808

    Abbott’s test had also already been approved but was less specific, off the top of my head. I was not aware of the Italian test yet.

    https://www.reuters.com/article/us-health-coronavirus-britain-roche-hldg-idUSKBN22P362

    https://www.medrxiv.org/content/10.1101/2020.04.27.20082362v1

    Okay, so these are both PCR-based tests?

    Nope, I am not into the tests themselves, the science behind it etc. I am into finding solutions that work in society. Some of the science takes a long time to work out and in the meantime, society has to keep ticking. The argument “it’s not 100%” against using something does not hold much water if the alternative is 0%. We may have no choice but to work with compromises in the interim. This is what so many scholars in their fancy home offices don’t seem to get. A large chunk of the population is still out and about delivering essential services, for example.

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  2. It may even be worse. It’s quite possible that this loudly announced two-week quarantine for most people arriving in Britain may never take place in practice. Yep, that’s how the UK often works, in practice. Wouldn’t it be better then, to still have people tested quickly, even thought it would be at a lower accuracy? Ideally, it probably shouldn’t be an antibody test, though, but an antigen test.

    Failing that, an antibody test is still better than no test and no quarantine. You could then ID people who most likely have had the infection and are no longer infectious and tell those who test negative for antibodies to be extra careful and perhaps refer them for an antigen test.

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