First, the best news in my day, was the announcement that the US FDA (Food & Drug Administration) has granted emergency use authorisation for a test that identifies antibodies in blood, to identify whether someone has had COVID-19. The test delivers results on site, within two minutes, from a finger prick. So how good is this test? It has has 94% clinical sensitivity and 96% clinical specificity. What does that mean? It means that:
- 94% sensitivity
- 94 out of 100 people who are tested and told they have had COVID-19 will be correctly identified;
- 6 out of 100 people who are tested and told they have had COVID-19 will be incorrectly identified;
- 96% specificity
- 96 out of 100 people who are tested and told they have not had COVID-19 will be correctly identified;
- 4 out 100 people who are tested and told they have not had COVID-19 will have it or have had it.
How come the test isn’t perfect? That’s easy, no test will be perfect, but this is a good start. It will be checked against PCR testing, as it is only approved as a screening method at this point, to decide whether to use PCR testing as the ‘gold standard’ test. There are a whole lot more rapid tests in the wings, waiting for FDA approval. Some are claiming 100% specificity i.e. everyone identified as not having had COVID-19 is correctly identified. These rapid tests will be an important part of the arsenal against the disease – cheap, easy and rapid tests for screening don’t have to be 100% accurate to be a great improvement on not testing people without symptoms, in order to decide whether to use more accurate tests on them. If you want to know more, there’s a very good paper written for the Office of the Chief Scientist on different tests and their utility.
An interesting addendum to this story is that it was widely announced that a company called ‘Bodysphere’ had FDA approval to provide such a test. Bodysphere had misintepreted a communication from the FDA, and their test remains in the wings waiting for approval, while Cellex is the actual company who has approval. There was a relatively quick retraction of the announcement but this is taking quite a while to filter through the media.
On the Covi-noia front, I have been speculating on potential future scenarios and how one feels at present when sneezing or coughing…imagine being in a queue waiting to get into the supermarket. You are being a good person, standing quietly on your strip of tape, 2m from the people on either side of you. It is a windy morning and the dust from the construction works, that are currently in abeyance, are blowing through the car park. You are wishing that you had brought your sunglasses, because the sun is bright and making you squint. Oh no, you start to feel a sneeze building in your nose. You do everything you can to suppress it. You hold your breath. You shut your eyes (gone are the days of turning to a bright light to get the welcome relief of sneezing). You imagine white elephants, pink elephants, pangolins (one of the potential culprits for transmission of COVID-19 into humans). Nothing works, you are going to sneeze. You curl up into a ball on the ground so that your face is immersed in your clothing (you are already wearing a mask) and let out a huge sneeze, followed by another, and another. Then you look up with dread.
Your nearest queue neighbours are looking pretty angry and people further out in the queue are not looking happy either. Your nearest neighbours are whipping out their extendable poles to measure the distance between you and them, have you infringed the 2m rule in any way? Are they going to start beating you with their poles? You struggle to pull your phone out of your pocket and negotiate to the appropriate screen. “I’m green”, you say, “Look, you can see my COVI-APP flashing green, it’s all OK, just my regular seasonal hayfever, honest.” You think, “Why didn’t I remember to take my Loratabs before coming out this morning? I should have known better!” The faces of the other supermarket queuers subside somewhat, then the glares return and expand, because if you are COVI-green you have to go shopping in the 9-11am slot, not be here in the COVI-orange time zone.
“I know, I know.”, you plead. I should have come earlier, but my 93 year old mother is living with me since I went green, and I am still dead scared of transmitting the virus to her. I am so afraid of shopping with all those other people milling around the supermarket, just in case they have paid for a false COVI-status. This is getting worse by the second, now I am raising the potential in their brains that I might have paid for a false status, as well as admitting that I shouldn’t be here. Is anyone pulling out their phone? Are they reporting me? They might be sending in a report on symptoms to be checked against my daily self-report. Or they may be reporting me for shopping at a COVI-orange time. Any of these reports might result in a status change, and if I go COVI-orange then my job in the medical logistics warehouse will be at stake. I only have a couple of hours a day, but it is a pretty safe environment, not risking Mum, and I have no other way to pay my bills. I abandon all idea of shopping and slink off to my car, praying that no reports are filed, and dreading the status update wait. At midnight I will be able to check, and see whether my life can limp on in this new normal, or whether my status demotion will send my situation into a huge new downward spiral. “Thanks pangolins.”
“You’re welcome.”, the pangolins say. “You have been turning us into musical instruments, pseudo-medicinal products so that your species could continue to reproduce, and eating us. Frankly, we don’t like you very much. So the least we could do was facilitate transmission of a virus to reduce your population, while you were doing your best to reduce ours.”