From early on, we’ve raised concerns about how much protection the much-awaited Covid vaccine would provide, since contracting the other common coronaviruses confers only limited immunity: on the short end, about six months for the common cold and on the long, 34 months for MERS.
A new large-sacle study in the UK confirms these worries. Tests of over 350,000 people determined that the percentage with Covid antibodies has fallen in the last few months, which is alarmingly at odds with the fact that more people cumulatively have contracted the disease over time. The falloff in antibody levels is similar to that of the common cold, meaning consistent with being infected producing only short-term immunity. Needless to say, this result is at odds with the fantasy that merely having enough people get sick would solve the Covid problem eventually.
Moreover, the study data also suggests that those who got asymptomatic cases had their antibody levels fall off faster than those who had more serious cases.
These results are an early warning that antibody-based vaccines will only offer months of protection. Mind you, antibodies aren’t the only defense that the body mounts against Covid. In fact, some scientists were already warning that the focus by most Covid vaccine developers on antibody responses was misguided, and targeting T-cells was a safer bet. For instance, from Berkeley News last month, summarizing a paper in Vaccine:
More than 100 companies have rushed into vaccine development against COVID-19 as the U.S. government pushes for a vaccine rollout at “warp speed” — possibly by the end of the year — but the bar set for an effective, long-lasting vaccine is far too low and may prove dangerous, according to Marc Hellerstein of the University of California, Berkeley.
Most vaccine developers are shooting for a robust antibody response to neutralize the virus and are focusing on a single protein, called the spike protein, as the immunizing antigen. Yet, compelling evidence shows that both of these approaches are problematic, said Hellerstein, a UC Berkeley professor of nutritional sciences and toxicology.
A better strategy is to take a lesson from one of the world’s best vaccines, the 82-year-old yellow fever vaccine, which stimulates a long-lasting, protective T-cell response. T-cells are immune cells that surveil the body continuously for decades, ready to react quickly if the yellow fever virus is detected again.
“We know what really good vaccines look like for viral infections,” Hellerstein said. “While we are doing phase 2 trials, we need to look at the detailed response of T-cells, not just antibodies, and correlate these responses with who does well or not over the next several months. Then, I think, we will have a good sense of the laboratory features of vaccines that work. If we do that, we should be able to pick good ones.”
Using a technique Hellerstein’s laboratory developed and perfected over the past 20 years that assesses the lifespan of T-cells, it is now possible to tell within three or four months whether a specific vaccine will provide long-lasting cells and durable T-cell-mediated protection.
Needless to say, the press reports on the so-called Real-time Assessment of Community Transmission findings from the Imperial College were sober.
Some argued that the survey was less than ideal by not repeatedly testing the same individuals, but the results were so marked over a large population that it seems unlikely that the general conclusion is invalid. The researchers tested groups of 100,000 each round, chosen at random, from 314 “local authorities”. The first test period, from June 20 to July 13, found that 6.6% of the subjects had Covid 19 antibodies. The latest test, from September 15 to September 28, showed the level had dropped to 4.4%.
Imperial College London's Covid-19 prevalence study is relatively bad news:
Antibody response present in 6% of the English adult population from June 20-July 13
Fell to 4.8% by July 31-Aug 13
Fell to 4.4% by Sept 15-28https://t.co/2t9aMfZObU
— Mike Bird (@Birdyword) October 27, 2020
The proportion of people in England with coronavirus antibodies dropped by more than a quarter in the space of three months, researchers have revealed, fuelling concerns over reinfection….
Prof Wendy Barclay, chair of influenza virology at Imperial College London and co-author of the report, said it was not yet known what level of antibody is needed to protect someone from infection or reinfection with Covid-19, but experiments suggested it could be around the same level as the antibody test’s threshold of detection…
Some have raised the possibility that other components of the immune system might continue to offer protection even if antibodies have waned – such as T-cells, which can kill infected cells, or B memory cells, which can rapidly produce new antibodies. However, the team said it is too soon to know if that is the case, or for how long that protection might last, while it is difficult to measure levels of such T-cells.
“The fact that people get reinfected regularly throughout their lives with seasonal coronaviruses [that cause common colds] suggests that the immunity, whether or not it is antibody mediated and/or T-cell mediated, probably isn’t very long-lasting,” said Barclay, who added that the team suspect the body reacts to infection with the new coronavirus in a similar way….
The team said the lack of reinfections could be because it is difficult to confirm such cases – but it may also be that not enough time has passed for antibody levels to have declined to the point where most people are susceptible to reinfection.
Levels of protective antibodies in people wane “quite rapidly” after coronavirus infection, say researchers…
“Immunity is waning quite rapidly, we’re only three months after our first [round of tests] and we’re already showing a 26% decline in antibodies,” said Prof Helen Ward, one of the researchers.
The fall was greater in those over 65, compared with younger age groups, and in those without symptoms compared with those with full-blown Covid-19.
The number of healthcare workers with antibodies remained relatively high, which the researchers suggest may be due to regular exposure to the virus.
The UK’s Health Minister, Lord James Bethell, called the study a “critical piece of research” that could help inform the British government how to take the right action to control the spread of Covid-19.
“It is also important that everyone knows what this means for them — this study will help in our fight against the virus, but testing positive for antibodies does not mean you are immune to Covid-19,” Bethell said in a news release….
Dr. Claudia Hoyen, who specializes in pediatric infectious diseases at University Hospitals of Cleveland, thought the study was interesting and encouraging, since it suggests that at least where antibodies are concerned, this coronavirus acts like other coronaviruses…
“This study is really like the first piece of the puzzle that actually gives us the indication that, yes, these antibodies don’t seem to stick around for everybody,” Hoyen said. “At least in this case, this virus is sort of acting like we can predict, which is a good thing because everything about this virus has been so off the wall.” Hoyen said the study also “cements the fact that we’re going to be in masks for a while.”…
“I think the sooner we resolve ourselves to the fact that this is what we have to do to get through this, we can accept it and move on. This data clearly shows that your antibodies go away. So just because you have had it once, doesn’t make you’ immune and it also means you can be contagious again.”
Needless to say, this doesn’t change my plans. But I wonder what two years of restricted activities (that looks to be a conservative estimate) is going to produce recreational PTSD. Will I ever feel comfortable in an old-normal bar, or restaurant, or conference?
Needless to say, that’s far from the biggest worry. The press reports tonight on protests in many cities in Italy over the latest round of Covid restrictions. When governments act so that meaningful numbers of people lose income and suffer more burdens (like having to care for kids at home when they were formerly at school) without making concerted efforts to ameliorate a lot of the damage, it should come as no surprise that they don’t want to go along. But the West seems incapable of getting out of its neoliberal underwear.
I have a question for Ignacio, or other with the relevant expertise.
To my knowledge, PCR tests are test on presence of a strain of RNA, which is a subset of the total viral RNA. In other words, they can turn positive regardless of whether there is a viable virus or not, as long as the particular bit of RNA is present.
We also know that there are many asymptomatic people, on some counts as many as 80% of PCR-test positive.
I do not know how many of asymptomatic PCR-positive will turn into symptomatic, let’s call those “pre-symptomatic”
Asymptomatic (as opposed to pre-symptomatic) aren’t really ill. Their innate immune system dealt with the virus and whatever PCR is finding is just viral debris. They are not infectious either (anymore, although I’m not sure whether they can or can’t be infectious earlier on), and they will have no to little antibodies (because only innate immune system was triggered), and any antibodies will fall of very quickly.
The test of the hypothesis would be to test (on a sample) for viable virus – or, to test everyone not just for the CV-19 but say for other viruses, where if we find a lot of “positives”, we can likely assume that they are debris from warded-off infections.
Is the hypothesis even feasible though?
There would be relatively little advantage from the hypothesis immediately, as testing for viable virus vs PCR is harder (and more expensive), although if we had the ability to do so, we could presumably have much better testing.
It could have an impact on something like the above though, because if it was true, i.e. most people do not get ill, the fall off in antibodies (and relatively small number of people who exhibit them) is what I’d expect. It would also mean that vaccine can be sucessfull.
I thought the whole problem was that asymptomatic unfortunately doesn’t mean not infectious.
For example, back in March in Tyrol, north Italy, there was a report of about 50 early cases all traced back to a very socially active individual who had remained asymptomatic the entire time.
(Interestingly, I read China no longer includes asymptomatic cases in it’s figures for new infections.)
I know that there are asymptomatic cases that can spread further (I call those “pre-symptomatic”, on the assumption that all that will go and develop symptoms are infectious even when asymptomatic, but we can’t tell beforehand).
My question is, do we have an idea of the proportion of them?
The basis for my hypothesis is that a) PCR test doesn’t tell between a live virus or debris b) we know that we fight of tons if viruses on a daily basis – and to my knowledge, no-one really run a PCR tests on large samples to say “ah, you all have a flu”, the massive testing for CV is the first time we do this, so we might interpreting the results incorrectly.
In the first approximation, it’s better to consider all with positive PCR test infectious, but we’d not stay at the first approximation IMO.
My amateur understanding is this: PCR tests do not only provide a yes/no answer, but also a numerical result based on the number of cycles needed to see an effect. High cycle numbers implies a low amount of rna. They do repeated tests in hospitals, and there they see that people show higher cycle numbers (so low RNA) as the disease progresses. The infection itself is over, the patient is now battling the damage done. People in this late stage do not appear to be (very) infectious anymore.
The same appears to happen (in reverse) on the way up. First high cycle numbers for presymptomaric people, then low cycle numbers on the peak of infectiousness. Data is much more scarce, since the “upswing” is only days and without symptoms, so people don’t get tested much in this stage. The bulk of test results is either low cycles, or high cycles and further along in the disease
There does seem to be consensus that if some has a PCR with low cycle values, then they are (nearly) always infectious. There might be people who never reach that stage at all, but they don’t show up much in the data, cause they don’t get tested.
Yes, but when you see the results, you have no idea what the cycle value is (and while lower cycle value very likely means viable virus, it’s not 100% true, but I have no idea what it would translate to).
Presumably, there’s a cut-off for “PCR positive”, which should translate to some viable virus probability, but I never saw any numbers.
Last week I read an evaluation report that cited three attempts to match viability to RNA load. So, at which load (I think derived from PCR cycle numbers) could they reliably replicate the virus in a lab. The samples came from real life testing, in hospitals or mass tests. The 3 studies gave values (in counts per ml) of 6.7log10, 5.4log10 and 4.5log10.
The majority of test results were between 7 and 9log10 in one of those studies, but might be different in the others.
I think that’s roughly what you are looking for?
I can’t interpret these numbers, but I can note the large spread… Might be different circumstances, or subtle differences in methodology.This looks to me like an open issue, without clear-cut answers yet.
Edit: a further complication seems to be that the translation from PCR cycles to viral load is not straightforward, and different for different labs and machines. That is not big problem if you set the barrier high (because the exact location of the barrier only affects a few percent of postive tests there). But it is super critical if you try to split the main body of positive tests.
The last point is what I’m (not very suscessfully) driving at and trying to figure out.
If you’re infected, asymptomatic or presymptomatic, the virus is replicating inside your cells, and you’re shedding the virus. As far as I remember, a person is most infectious (shedding highest viral load) right before showing symptoms. People who never show symptoms are expected not to be as infectious (and for as long) as people who eventually show symptoms, but they are shedding the virus nonetheless, so they are potentially infectious.
As for the technical questions, PCR (qPCR) is an amplification technique. You take DNA (or RNA) and multiply it many times to make it easier to further process. It’s very effective when you’re working with very small samples. So, PCR-based tests identify DNA (or RNA), wherever that may come from (dead viruses, live viruses, cross contamination…).
There are techniques to detect live viruses, but they’re slow, laborious, and not as “effective”. There are also techniques that detect proteins, but either they aren’t as “effective” as PCR, or they’re extremely slow, and you aren’t detecting viral infectivity anyway. If you want a summary, I found this in a quick search:
I like your hypothesis. If I may speculate further: CV-19 is like a common cold, except that it’s still so uncommon/unfamiliar that it (or immune overreaction to it) can kill you. The key seems to be viral load — lowering it with masks (as Taleb noted as far back as Jan/Feb), washing, zinc++, social distancing and more (the emerging “swiss cheese” model) means that with time we all might get exposed to CV-19 without getting profoundly sickened or killed by it.
This is not “herd immunity” — any more than we have herd immunity to the ‘common’ cold. We all get colds, and the viruses that cause them are ever with us — but our systems are rarely overwhelmed (and we “catch a cold”) and they mostly don’t kill us. Given that “cold” coronaviruses do seem to provide some immunity to CV-19, I’m surprised that no one seems to be suggesting a cowpox-analagous “cold-coronavirus vaccine.”
If you want to follow the science (ie what seems to be known re pCR/infectivity etc) you could go to the musings in the press of Michael MIna who has been trying to get through to the authorities that the PCR is useful as a diagnostic tool but NOT as a screening tool for detecting infectious people in real time in the middle of an epidemic in order to obtain the knowledge necessary to control spread.
This is what I think Vlade is trying to understand. In Mina`s account it emerges that people become infectious roughly 2 days before developing symptoms and on average remain INFECTIOUS for a further 5 days. The PCR as Vlade pointed out, detects RNA and detects it in those 2 prior days then goes on sometimes for weeks picking up fragments and registering positive. Useless therefore for infection control esp if you add in the delay for getting tested and the delay to get results. Totally useless in fact.
Over time they have used the cycle threshold of the PCR and some high security lab work to look for viable virus to deduce the connection between the PCR Ct figure and viral load correlateable with infectivity. Hence his promotion of the earlier much decried antigen test as this is not sensitive enough to detect viral levels below the infectivity threshold. This is in fact its advantage!!!! It turns out to be a nearly perfect test for contagiousness (but not sensitive enough for diagnosis in general in a hospital setting) .
These tests are rapid and really cheap and at last the authorities in Italy, Germany and France (US too we assume)are working on the legal side etc of rolling these out. Testing at the door of schools unis and workplaces is the way to go. Then for the wider popluation just to be able to get on with life etc
Yes, that’s pretty much what I’m getting at, and I’ll look at Milna’s writing, thanks.
The best place to use them would be nursing homes or for care givers for the most vulnerable.
Ok, this is a complex question and in some aspects I have no clear answer. Let’s go first with definitions:
PCRs, indeed amplify separately segments of the genome that may be encapsulated in viral particles and/or in the cellular debris. A positive result does not necessarily indicate viral replication at the time of sampling and SARS CoV 2 genomic RNA has shown to be quite stable associated to the N protein and possibly with membrane structures in the replication complexes. Such stability might explain PCR positives when virus clearance is supposed.
When a person gets infected (virus replicates) that person can be pre-symptomatic for a few days while virus is replicating and possibly shedding virus and, as you say, the way to check this is by infectivity assays in cell cultures that can be done in parallel with diagnostic PCR. Virus shedding testing in all individuals is not feasible but significant samples could be done.
Then, the infection might be effectively stopped by the innate system plus an early adaptive response (with low or no antibody production). Then a mild, very mild to asymptomatic process occurs. As you say a person without symptoms is not ill regardless she has been infected.
An alternative to infectivity assays could be to do PCRs that specifically amplify de RNA complementary to the genomic RNA (negative sense, proof of replication) and or specific subgenomic RNA detection by PCR which is also proof of replication and transcription. This is also tricky because they can also be quite stable and you should define conditions that ensure you detect them only when there is virus replication as a proof of infection, rather than debris detection. This is done in vaccine trials in macaces by challenging when you want to distinguish between the virus input and real replication.
Your last para is IMO quite correct. or at least I agree with what you say. It is well known that antibody titres in blood go from undetected to low in mild cases while some vaccines induce antibody titres which are comparable or even higher to the convalescent sera of not-so-mild and severe Covid cases: the more severe illness, the higher titres. This suggests that the vaccines might provide better protection compared with a mild disease. Vaccines do not meddle with the immune system as SARS CoV 2 does.
Also, the adaptive response occurs in phases, and in the first phase (1 week) the antibodies produced have less affinity and fade quite rapidly, while the second phase (2 weeks) produces high affinity antibodies and is longer lasting. It is possible that very mild and asymptomatic infections do not induce the second phase in many or most cases. This might explain in part the results.
Another problem with the study is that of the sensitivity of the method. You might be protected by antibodies even if the test shows a negative because the method has a threshold of detection. As a matter of fact it is quite usual that antibody titres decline while you are still protected. The unresolved question is for how long does it last. The study suggests that antibody protection might last less in the elder population.
I am sot sure if I messed or solved, hahaha.
I appreciate your well-expressed comments. Thanks for taking the time to do this.
PCR is an amplification technique and not a quantitative or even qualitative test. It can tell you relative viral (presumably) RNA load (based on how many cycles), but not how much or what that means in a clinical setting (eg, are you sick?). It can amplify absurdly minuscule quantities of RNA, the presence of which hardly confirms an infection or disease, and it is not and should never be used as a diagnostic tool. This is evidenced by positive “asymptomatic” people. What does that even mean?
Any test, in an ideal world, is only a part of the diagnosis, but in a country (US) of door docs it is faster and less painless to get diagnosed than it is to go through drive thru fast food. A proper diagnosis requires the presence of specific sequelae and supportive lab results to rule out other possibilities. But, it is critical to remember that some people may have a virus/bacteria and be completely healthy, or they might not, yet they still present with all of the signs and symptoms of a disease. On top of that, any diagnostic test (not PCR) has fallibility, either as false positives or false negatives. Contrary to popular belief, clinical medicine is messy stuff, often relying on hunches and blind guesses where testing falls short (as it invariably does).
SARS-COV-2 is a funny beast. It has no specific sequelae that I know of, (although I think the rare case of losing taste/smell without nasal congestion is novel) and a diagnosis relies only on some arbitrary number of PCR cycles. Absurd, absolutely absurd. And we see the results of that every day. Confusion, chaos, and a lot of bad medicine chasing the ephemeral PCR-test-result tail without a definitive clinical presentation.
But the West seems incapable of getting out of its neoliberal underwear.
Why should it? Bezos, Gates, Buffet, Zuckerberg, and Musk are wealthier and more powerful now than they’ve ever been. Why precisely does anything need to be changed at all?
It’s seriously bad news. The study looks very firm – I wouldn’t say its definitive, but it does seem to rule out the notion that either herd immunity, or some sort of bearable symbiosis is possible. And a vaccine might only get us through a few months (although perhaps the most vulnerable can be given it repeatedly). This clearly points to 2021 being as bad as this year.
Anecdotally, I think people are getting very weary of even thinking about it. We are in the second lockdown in all but name here. It was a holiday weekend, and the parks were packed with people out walking and cycling, but its obviously not as pleasant as it was last April/May/June, when we were at least blessed with great weather. I think lots of small businesses are running out of runway. I ran into a neighbour who is a respected craftswoman and designer, she sells her printed linens all over the world. I asked her how business was and she just shrugged and said that at least she can spend more times with the kids now that her shop is closed. I get the impression her internet orders are way down. My local yoga place is on the verge of shutting as the landlady won’t reduce rent and the guy who runs it is too nice to just refuse to pay and force her to eject him (as most businesses seem to be doing according to another neighbour who works on that side of things in a merchant bank).
I just get a sense of resignation when I talk to people. Everyone over the age of around 40 seems to have accepted that there will be no family gatherings or socialising all winter. People are talking about their ‘covid stones’ (a stone being 14lbs weight, lots of people seem to have put on that much around their waist), although around my area some people are enjoying their newfound fitness from all the walking locally. The government has done relatively well, but I sense resentment at every new announcement, even when people know it makes sense.
What is interesting is that some sectors are bullish – construction is going full ahead and the housing market is surprisingly strong – the Irish economy has done much better than expected, mostly because its dominated by sectors which have not been effected (like pharmaceuticals and IT). But even the good economic news just doesn’t seem to have brightened up the mood, even among those who are doing quite well – and a surprising number of people will freely admit to doing well out of Covid, whether its people in secure jobs enjoying working from home or those in the industries that are thriving. A guy I know with a furniture supply business says he’s never been busier (he is openly ignoring the lockdown).
What will be interesting to see is if the major countries (and the EU) change their strategy in the light of this. I think its widely accepted that the rush to try to save the summer holiday season in Europe was a major mistake. It didn’t help the businesses, and only spread the virus more widely, and may well have led to the current peak. Serious consideration needs to be given to simply abandoning all non-essential travel all over Europe in 2021 and putting in place financial supports for all those regions and businesses. Agreeing this would make the Brexit negotiations look simple.
On this point, one population sector has been largely overlooked – people living abroad, who would normally visit family at least once a year. Several of my Chinese friends moved back to China over the summer as they felt it was safer, but most people in jobs stayed put. Some from Europe are still determined to get home for Christmas, but this isn’t an option for most Asians or South Americans. I suspect some students will simply abandon their studies to go home for good (many can’t afford to stay as there are much fewer casual jobs). I know two Japanese who are negotiating with employers to see if they can work from Japan for a few months, and I’m sure this is widespread. The many Indians and Filipino’s in healthcare don’t have that option, and many have left children in their home countries and may now not see them for a year or more.
I think it may also have political implications. In Ireland we had an election last February – the results were a shock – there was a huge swing away (far bigger than the polls predicted) from establishment parties to the left and Greens (thankfully, we don’t really have a viable far right in Ireland). I think much of this was due to the time of year – people were grumpy after a long dark winter and wanted to take it out on the politicians, even those who had been seen as having done a good job. A Covid winter is likely to leave people far angrier and disgruntled, especially if there is no prospect of a summer respite. I don’t think there is any way of predicting what this will do to the mood in multiple countries. But I suspect its very bad news for politicians in power, even those doing a comparatively good job.
The knives are already out for this demonstration of classic Imperial College “press release science” research.
As even their own report states:
“exactly what the antibody drop means is uncertain…”, “on the balance of the evidence I would say…”. Hmm. James Lind must be turning in his grave at what’s happening to his profession.
Seroprevalence is falling despite much higher numbers of cases https://twitter.com/profkarolsikora/status/1321006611935207424
The fact that Imperial don’t know what’s causing this doesn’t mean the immune system is not responding in some way. Something is clearly at work. Their approach seems to have been, if we don’t know what it is, it doesn’t exist (or even if it does, then we don’t need to dwell on it).
Their patient information sheet is a classic. It’s exactly what I would have written in my previous career if I wanted to very very carefully say “We have absolutely no familyblogging idea WTF is going on here, nor do we know what a positive result actually means……we’re fishing on a grand scale….”
Until I see a full analysis – and I do not for one moment believe they have enough data to do regional analyses properly (which HAD to be the focus before student movement in late September mixed us all up and levelled us all in terms of regional rates) since post-hoc subgroup analyses are a HUGE no-no in biostatistics – then I’m deferring judgment. I still think that on balance their conclusions are correct (from what we know about coronaviruses generally) but their quoted figures don’t (in my opinion) pass the “sniff test” to conclude this…….there could be lots of other explanations. But, just so I don’t seem like a “covid-denier”, I DO still think immunity is not lifelong. TL;DR – Right but for the wrong reasons.
Well that was anticlimactic and annoying. Invalid test result. I know full well how to do these tests but I think the test kit was defective. It looks as if it leaked blood in the wrong way “into the testing window”. The postman forced it through our letterbox, damaging the packaging (which was soaking wet due to the extreme rain anyway).
I’ll submit the pic of the result online to the trial people as requested and I’ll complain to local post office. I think I saw the postman – not the usual one. The usual one always rings the doorbell for unusual packages. Gah!
Everything is scaring everyone. Antibodies are not the only thing keeping people alive and I was glad to read that bit in the study. Do they think the human body that survived this long without medicine is that stupid?
We are descended from the survivors of the great plagues of Europe. And, more recently, the survivors of the 1918 flu pandemic.
Looking thought the ol’ family tree on the paternal side, I seem to have decended from a long line of people who died of now-preventable diseases, childbirth, infections following accidents, accidents, and wars. Live long enough to reproduce and then you can die of anything.
I’m a little confused. Is this the antibody test that was denounced as not very accurate when used in a Stanford study months ago (including by the study authors themselves)? Isn’t the lack of a good antibody test a reason that the infection fatality rate was hard to nail down in the beginning?
IIRC the PCR test (for CURRENT symptoms/infection) was denounced early on. People are impressed by “99% sensitivity and 99% specificity” and suchlike…..but when a condition has a low prevalence those figures are AWFUL. Basically a positive test could mean your chances of ACTUALLY having COVID-19 are 50/50.
I’m less clear on the antibody test, which is what THIS study is looking at – ignacio would be the one to comment. Though I think this finger-prick test (which I just took) is ALSO flawed – IIRC quite a lot of “positives” are, in fact, antibodies against ANOTHER coronavirus (likely one of the four “endemic” ones, one of which was widely suspected to have flared up early this year).
Please use Google. The tests for having had Covid are considered accurate. From Sept 20. And yes, the UK tests used blood samples, some of the press reports discussed “pricks” and not meaning jerks:
Some positive points to consider before we throw in the towel.
1. This study doesn’t provide any new information. We have known for a long time that antibodies only last for a period of time. If our bodies continued to produce antibodies for every virus we are exposed to that would not be good.
2. The COVID-19 vaccines in phase 3 all produce antibodies at a much higher rate than when exposed to COVID-19 naturally. In the case of the Pfizer vaccine even after 4 months the antibodies were up to 3x more prevalent than natural infection. Even as the antibody levels drop a person will still have more protection through vaccination without the risk of lung scarring, heart damage or nerve/brain damage.
3. As noted in the study t-cells play a role in the immune response. Luckily the current phase 3 vaccines have shown a t-cell response as well as antibody response. What level of a t-cell response that is needed is yet to be determined but in other illnesses the t-cells can last for years.
As for what the first vaccines will achieve we do need to lower our expectations. These vaccines should protect the lungs from serious infection but they will not protect the upper respiratory tract. Therefore one can still be infected and transmit the illness.
The University of Alabama at Birmingham is developing a vaccine that is delivered nasally which hopefully will provide protection for the upper respiratory tract but it won’t be available until late next year.
Links, please. I see nothing consistent with your claims re Pfizer, which has published results on Phase1/II trials for 45 (!!!) people. No one has determined efficacy, which comes in the Phase III and none of those have been concluded.
This is Making Shit Up, big time. You are rapidly accumulating troll points.
Interesting that Troy didn’t respond. I was wanting to see those links from before their big announcement.
Across the pond here in America, firms are still acting as if everyone will be back in the office by the end of the year. It’s bizarre to watch them try to make this happen.
I just got my test kit in the post. I will do it later when I am more hydrated – I always have issues with finger prick tests getting enough blood if I am not well hydrated! The test has three outcomes: negative, IgG positive, IgM positive. IgM don’t stay in body long, IgG are longer lasting.
As I mentioned previously, whilst I think the “weird” illness I had in late Feb was *a* coronavirus, I don’t honestly think it was covid-19. The gossipy medical docs I know all remarked there was a funny virus going around and several of them were tested for covid (negative) after getting it themselves. Will report back.
More re Covid result. The online survey (where I uploaded photo of my inconclusive test) VERY specifically concentrated on symptoms between 1st Jan and 31st March when I answered that I’d had a suspicious illness earlier this year. Given that the earliest confirmed case in the UK is now known to be at my local hospital and to have contracted it most probably in early/mid February this is very telling.
I complained to the Post Office – my kit could easily have been tampered with and, even if not, was not sealed correctly anymore etc. I’m hoping I get a new kit to retake the test. I said in my answers that I know how to take these tests and documented the Post Office incompetence (which I’ve also escalated at the PO itself).
Just more reason to focus on therapeutics.
Seems to me that good therapeutics combined with fast and easy testing would go a long way toward getting us back to something like normal.
The fact is that people are fast reaching the end of their tolerance for shutdowns. It wont be long before the REAL and permanent economic damage from this is realized. That is just now really starting to be seen.
When you look at the mortality rates this thing starts to look a lot less scary. People are NOT going to go along with multi year school closures, not being able to have family gatherings, and all the rest. Just not.
We are fast approaching a point where the majority are going to insist on reopening and they will do so in full knowledge that high risk individuals will die and that they themselves may get sick.
I’ve suspected from the start of this that at some point the majority of people would look at the costs of the shutdowns, economic, social, cultural, etc and determine that those costs exceed the cost in lost lives. We are just about there.
Or we in the US can do a proper 1-2 month shut-down, with legislated full recompense, and eliminate the virus here.
If you look at the mortality rates and factor in re-infections, long COVID, excess mortality, and a high rate of major organ damage, it’s utterly terrifying.
When you factor in mis-information, it’s not surprising that an average citizen has little patience for quarantine, until they or loved ones are personally affected. Those purposefully spreading COVID misinformation for the purpose of mitigating economic effects, are in my mind, guilty of mass murder. Some legislators and elected officials are completely, and imho, criminally derelict in their duties.
As I mentioned to someone today, the virus is not the problem, human behavior is the problem.
The time when the public would accept a “proper” shutdown has passed. The government had one chance to do this right and not screw it up and they failed in March/April.
So the government can go ahead and try to enforce a shutdown without the consent of people, but I doubt that will go well.
> legislated full recompense
That would give the proles ideas. Can’t have that. The Democrats don’t want to disturb ”the sanctity of the wage relation” any more than Republicans do.
Broad economic damage didn’t come from stay at home orders or bar closures but from people changing their behavior due to fear. I don’t think “majority” against sensible policies really marks an important threshold to reach. Enough people are going to continue to do that so that economic damage will compound until there is a vaccine.
I’ve also started seeing people on social media swear off the restaurants and establishments that violate government orders or even fail to enforce masking well. Possibly we’ll see some bifurcation of customer bases: the qanon and the blueanon… but either way this can be a downward pressure on revenue for businesses that have been struggling.
This is such a wonderful virus. Sorry, but it is. It’s giving us everything we need right now and exposing everything for what it is and everyone for who they are. It’s tragic that so many had to die before we woke up but the same process happened during the holocaust.
Most of all it is showing the complete stupidity and failure of western medicine.
It is not hard to be symptom free after becoming infected, and very few have to die. All the machinery is in you already, you just have to give it the energy it needs. If this were not true we would not see such variability of outcomes.
Don’t shoot me for this comment, I am just a messenger.
Can we not explain the disparity of outcomes by the fact that some countries have actually… controlled the virus and prevented it from spreading to millions? (a la Vietnam)
Not on an individual level.
Ugh. “Most of all it is showing the complete stupidity and failure of western medicine.”
Compared to what? A prescription for grounded unicorn horn, mixed with tiger’s testicles?
I suspect you’re confusing the medicine as a science (as much as it can be, which is actually a reasonble amount) and the society’s approach and application to medicine, often spurred on by profit-seeking as opposed application of what is known to work or not.
But blaming only the science while ignoring the societal role (which includes perverting the science, as I’d agree that a lot of what is shown as science is anything but) is looking at symptoms, not causes.
Compared to what they make it out to be and compared to what we pay for it.
Science and medicine is a product of human thought. It does not exist somewhere “out there”. All any of this “science” is doing now is trying to control itself.
The fact that they think this virus is holistically “bad” is where the complete failure lies in western medicine.
I think I know what you’re getting at but vlade is making the point more succinctly and less prone to being misinterpreted by using inflammatory phrasing.
There’s nothing intrinsically bad about science or medicine — be it western or anywhere else’s. What’s destructive is the politicisation of these things (and if science or medicine are politicised, then they’re no longer worthy of the name). You are absolutely right with your emphasises that it is the physiological response to an illness, like COVID-19, which should be the focus of science and medicine. I’d go so far as to say that the only legitimate concern of medical science is the human body’s response to the virus, how best to understand it, how best to treat is and how best to prevent it. Everything else is simply counter-productive.
I’ve been harsh (above) on the quality of the Imperial report. But really, it’s not Imperial’s team of scientists and clinicians fault per se. Imperial themselves covered the subject of waning antibody responses in another paper of a couple of months ago https://www.imperial.ac.uk/news/201833/cell-immunity-what-does-help-protect/ and how T-cells are an important, if poorly understood, component of immune response. We can’t then, particularly blame Imperial for that paper not getting media coverage at the time, but the current one being seized, gleefully, by the usual media suspects who are bigging up the current paper instead.
However, Imperial themselves are not entirely off the hook of responsibility. They did nothing to damp down some of the worst inaccurate reporting. And the author is Justine Alford, listed as being a “communications manager“. Her PhD is in life sciences not medicine and her career has been in communications not as any kind of clinical viral or immunity practice or research involvement. So it looks as if this whole story was trotted out to bolster Imperial’s priors (Imperial bet its house on “red” and given the high stakes it will be a catastrophic blow for it if it turns out Sweden was right) and amplify its “vaccine as the big fix” narrative (albeit softening the way that you may well need multiple shots if any vaccine only produces antibody responses).
So it all leaves you wondering at how we’ve ended up in this sorry state of affairs.
But that doesn’t mean we should throw the medical science baby out with the science-as-PR bath water.
I speak only in a language I know how to speak. But thanks for interpreting it to other for me.
IMO, science was a failure the moment it was invented and it should not be idolized. As I said before, all it does now is try to fix the problems it has created in the past. Science has at it’s core the mythical belief that it can control the world for a positive outcome.
As was expressed in the movie “War Games”; the only way to win is to not play.
P.S. I just saw a doctor pull into a Starbucks in the most excellent Mercedes and he was still in his blue smock.
I think your take here is a lot more reasonable than that of your interloctuor, who apparently thinks the flaws in science are so vast that we should simply return to the old ways of superstition and premature death.
Here is the problem on full display. This is the typical Trump and/or neoliberal response. A superficial view of life that thrives on complications and needless suffering.
How do you know if a death is premature? Was my father supposed to live to 72 or 71? Did he die a year too early? Was my nephew supposed to die at 14 or 45?
To be superstitious means you need to fear the unknown. Look at all the fear from this virus! Look at all the fear of death!
Is it superstitious to think that science has enabled over population which led to this virus?
When I speak of the “old ways of superstition and premature death”, I refer to the Middle Ages, when the average life expectancy was in the 30s or 40s, and your father and your nephew would both be vastly more likely to die in their 20s than their 70s. That’s what a wholesale rejection of science would lead you to. Maybe you wouldn’t regard those deaths as “premature”. Maybe you’re just a lot more pro people dying of infectious diseases than I am. I am unsure how this distinction between us makes me “Trump and/or neoliberal” though.
You can’t say “science was a failure the moment it was invented and should not be idolized” and not expect people to point out that the science you regard as a failure is the reason you have not died of cholera, TB, smallpox, or any one of the far deadlier plagues which used to spell the end for most humans.
As for your point on overpopulation, I refer you to the point about those previous plagues.
Cholera, TB, and smallpox…all diseases that were brought upon us by our unbridled enthusiasm for science.
Go ahead, look it up. Go back before the Middle Ages. Nothing. Hunter gatherers lived long healthy lives with a lot of leisure.
Science only cures the problems it creates.
You know, there’s so much wrong here I’m tempted just to leave it to the reader to decide who’s talking sense.
I did think of citing, you know… the Antonine plagues or Justinian plagues etc. but I will give you a pass since you seem to assume urbanisation only occurred during the Middle Ages for some reason.
What I will say is that, when I was born, I had a condition that used to kill everyone who got it; 1 in 1,000 babies pretty routinely present with this condition, which my twin brother also had. This problem often occurs in premature babies, such as ourselves.
The first surgical procedure to cure pyloric stenosis took place in 1912. Now, the operation is routine, and those babies almost universally live long and healthy lives.
For this reason, I suppose I am unable to make an unbiased pronouncement on whether modern medicine and the advances enabled by all of science, which you so casually dismiss, has been a “good” or “bad” thing, because I’d be dead without it. However, I would wager, so would you, and this conversation would be triply impossible.
Go back before the dawn of agriculture. Plagues exist in areas of concentrated humanity that are only available with our over application of science and knowledge.
we never learned from the first plauges:
and “Many of the major human infectious diseases, including some now confined to humans and absent from animals, are ‘new’ ones that arose only after the origins of agriculture. ”
Continuing, If you were never born there would be no reason to cure you. There is a depth in that statement that you are missing. Again, the thing that gave your very birth is the same thing you became dependent upon to cure you. I am saying you are arrogant for thinking it matters if you were born or if you survived past infancy.
It is an arrogant assumption that extending every human lifespan is a good thing. Singularly, none of our lives matter to the survival of the species.
It is the glory of God to conceal a matter, but the glory of kings is to search out a matter. Proverbs 25:2
This is an “I wouldn’t start from here” argument.
Yes, it’s entirely possible and even likely that if we had remained hunter-gatherers and not developed agriculture, urbanized etc. we wouldn’t have these problems. So what? We can’t go back, not without discarding centuries of scientific and technological progress and eliminating almost all of the world’s population. Is that what you’re advocating? If not, then it’s just a thought experiment of no practical value in our current situation.
I happen to agree that the problem of limits to growth is an issue, perhaps the defining one of our time. But saying “well, it would be nice if it hadn’t happened” is not a solution.
I agree, I would not start from there. So if it is a place we would not start from, why do we continue with it?
Knowing where it went wrong is a way to find a solution.
No, there is no easy way out and there will be pain and suffering. we can control the pain, but that is about it. More science is not the answer.
Maybe just say I am helping humanity begin to cope with the amount of suffering that will happen by bringing it into our consciousness.
We can’t go back, anyway. Physical impossibility. We can, however, stop LARPing this progress meme, which is really a consequence of financialization and debt-based society, and start consciously picking and choosing what we incorporate into our collective lives without putting a rabbit or a coin box on it.
Science is also F = ma
Let me know when all the speed limits are reduced to 30 mph, no driving on wet pavement (coefficients of friction) and no night driving (optics).
If one life may be saved, then it’s worth it.
I’m not making any cost-benefit analysis about restrictions w respect to COVID-19 at this point; merely standing up for the idea that maybe using scientific evidence to make decisions is not a totally lost cause, albeit other factors clearly need to be taken into account.
My own personal perspective is that in general, Western governments acted far too late to have any good options in combatting this crisis. Look to Vietnam, where early, very strict interventions allowed those same interventions to be in place for a short amount of time, minimising both deaths and direct economic damage. Having allowed COVID to get such a massive foothold in my country (the UK) it is a much more difficult decision on whether the “costs” or “benefits” of restrictions outweigh each other.
This against an interlocutor who suggests that all of science is a mistake, and that I am “arrogant” for being rather glad that science allowed me to live past infancy.
Absolutely, and thank you for elaborating the point.
I guess that would explain why unicorns are mostly extinct and why those who poach tiger testicles are an endangered species.
“I’m just a messenger.”
If you wrote the message, and the message is an opinion, you’re literally not just the messenger, you’re the one who wrote the message. That saying is not meant to deflect criticisms of your own opinions, just when you relay *someone else’s* opinions or state an obvious fact rather than offer analysis or opinion (which is what you’re doing).
The rest of your logic holds up equally well.
It is not an opinion, it is a law of nature. I do not make up laws of nature, they just exist. The Dao gave birth to one, one gave birth to two, and two gave birth to the 10,000 things.
The purest science in no science. And the purest logic is illogical.
Don’t expect to find what you want from me.
Law of nature? Which one, pray?
I see the discussion is meaninless here, as it usually is when someone resorts to pseudo metaphysical drivel, instead of actual arguments.
“Law of nature? Which one, pray?”
How about gravity? How about evolution? How about biological diversity? And how about all the ones that are yet discovered that can only be spoken of with metaphysical “drivel”?
“Metaphysics is the branch of philosophy that examines the fundamental nature of reality, including the relationship between mind and matter, between substance and attribute, and between potentiality and actuality.”
I am a scientist. Hard core. I still am. But there is art as well and we knew art a long time before we knew science. That art of science is metaphysics. I have a different language than other scientists, but it was a language that people like David Bohm understood.
Metaphysics is where science advances.
I know you are frustrated, but I do not think any conversation is meaningless.
If the researchers tested groups of 100,000 each round, it would have been good if they could have noted which of them were “long-haulers”. They might have then been able to correlate this sub-group with those that had antibodies still present in their blood. Further, they might have been able to correlate these people that had asymptomatic cases of this virus and those that had a more serious fight with it.
Isn’t Imperial College itself somewhat controversial or at least Neil Ferguson?
The rap sheet on Imperial is as long as your arm.
There’s the Gates’ foundation near $80M funding https://www.gatesfoundation.org/How-We-Work/Quick-Links/Grants-Database/Grants/2020/03/OPP1210755
There’s an outrageous conflict of interest having a big private practice arm which competes with the NHS services https://imperialprivatehealthcare.co.uk/about/
There’s its hand-in-glove Big Pharma cosying up:
https://www.imperial.ac.uk/medicine/partnership/corporate-partnerships/gsk-case-study/ (big bucks being ponied up for medical devices that can be patented, with a revenue sharing deal)
and https://www.novartis.co.uk/news/media-releases/novartis-move-uk-headquarters-london-bold-move-join-emerging-life-sciences (that last is a peach: “At Imperial, we firmly believe that the co-location of academic research and businesses is central to driving innovation and economic growth…” moi: ha ha ha ha ha).
Yes, and the bonktastic Ferguson who didn’t let potentially dicing with death from the deadly virus deter him from lockdown-breaking hookups with a mistress.
Their reputation is, how shall I put it, not exactly whiter-than-white.
I have to say that after 20+ years working in the field, the fact their study surveys are done through IPSOS Mori rang so many alarm bells I have pretty much decided they aren’t a serious institution anymore. Of course I want a free test so I’m co-operating……but working through IPSOS? Sheesh. There was a time we all programmed our surveys in house and hosted them either on our own servers or via one that wasn’t also in any way connected with commercial activity…..
That is ad hom and has nothing to do with this particular study. You need to address the test and its methods. You might as well claim the Imperial College/Oxford study on vaccine delivery is rubbish because Ferguson? Come on. That’s your argument. A blanket dismissal.
I did try to cover the issues with the study previously in earlier comments.
This particular thread was more about Imperial’s conduct. Overarching the merits of their study, if any, was the manner in which it was disseminated. For one thing, this study is pre-publication (which of course means Imperial have yet to find anyone who will agree to publish it) and pre peer-review (which means it is at the level of unchallenged assertion, not evidence). For Imperial to promote this study, in this current state, in a press release is as a minimum indicative that Imperial are more interested in marketing than science. They knew, or should have known, the press wouldn’t call out with the prominence it needed or care about the pre publication / pre peer-review status in their coverage. They also wouldn’t field anyone on the media willing to support their press release yesterday (all the news outlets here dropped the story by the evening news, certainly if it was featured, it wasn’t in the headlines, I watched about 2/3rd the way through) once the flaws through omission became apparent.
Pending publication and peer review, there’s not a great deal the layman can do to pick holes in the lower level medical science. This is why publication and peer review is so important. But as previously highlighted, it’s been well known and widely accepted that the presence of antibodies will wane after initial exposure and antibodies alone are a poor proxy (and may well be meaningless) in terms of long-term protection.
For example https://www.webmd.com/lung/news/20201023/searching-for-clues-to-covid-immunity.
I’m really not sure what stunts like Imperial’s yesterday hope to achieve. It’s inevitable that, for speculative material like the study, it will be challenged through the normal scientific review process. At which point, the public will merely see a divergence of scientific opinion. And from that they’ll — completely wrongly, but perhaps understandably — conclude that, with all the ambiguity, they (the public) know just as much as anyone what’s fact and what’s fiction. When science speaks with one voice, with an irrefutable evidential underpinning, it can help a great deal in cementing public acceptance of public health policy. Conversely, individual institutions using science to feed a media machine (which will chew them up and spit them out when they’ve outlived their usefulness) as a brand-building exercise detracts from all scientific endeavour. It is a form of despoiling the commons.
And initial peer responses within the limitations of a non-published paper:
… which, at the risk of oversimplification, restate the current “fresh water / salt water” dichotomy that seems to characterise medical opinion — some clinicians and researchers are of the view that it’s just down to antibodies, no antibodies, no immunity; others state that there’s a lot more to it than that.
All agree more research is needed and understanding is incomplete. No way did this justify the breathless “big blow” headlining the study got in the media. Or explain what Imperial hope to gain by trying to short circuit the customary publish / review disciplines.
“The number of healthcare workers with antibodies remained relatively high, which the researchers suggest may be due to regular exposure to the virus.”
Not saying to run out and act based on this, but doesn’t this raise the possibility that maintaining antibody levels actually requires some degree of ongoing exposure for those who have already defeated the virus?
More broadly, the claim has been made that wearing masks in all social settings weakens the immune system. Has this claim been addressed or disproven?
Interesting. I mean it could be possible that constant low exposure levels might protect against a single large exposure.
It is nonsense that wearing a mask “weakens the immune system”, but it could lower our immunity to the virus. You could compare this to the Native Americans, essentially isolating from smallpox. when the Europeans came in with kit they were decimated.
The other interpretation is that wearing a mask reduces the typical exposure to sub-clinical disease-causing levels and helps to build immunity without causing disease.
It seems reasonable to me that if the body had already fought off COVID and was in the immune period, constant or periodic exposure might keep the immune system primed to fight it off, kind of like booster vaccines. God only knows what constant COVID exposure does to you, so I wouldn’t recommend it at all, and you could easily become an asymptomatic speader, so that would be bad too, but it might keep antibodies around for longer, I’d buy that.
I was thinking today that this is a timely wake-up call for all of us. We have become comfortable thinking that infectious diseases are not much of a threat, compared to the old days which some of us can still remember. But we face declining efficacy in antibiotics through overuse (hospitals become hotbeds of infectious agents), and we never have had a good toolkit for viruses and a variety of other exotic agents. With all the investigation of out of the way places now prevalent, and modern travel levels pre-COVID19, it’s no surprise new diseases keep appearing. The next one could be much worse. We are going to have to re-think the way we live in the light of epidemiology, the old methods of surveillance and quarantine still work, COVID19 would seem to have alerted us to that at (perhaps) a modest price. We must prepare better.
I was thinking today that this is a timely wake-up call for all of us.
Call it self-interest, but support for M4All isn’t just a bleeding heart routine but blatant self interest, regardless of insurance states. Getting everyone as healthy as possible is huge issue, but its not fair to call it a wake up call for everyone.
If I need to the ER and everyone is there because they weren’t getting good preventative care, I’m in trouble.
I wish it were a wake up call for our betters/s. In some ways the best thing that could have happened would have been if more than a few of our Congressional leaders got a bad and lingering bout of the virus and at least one of the younger healthier ones ones died. That they faced an overburdened system and their lives were on the line.
Unfortunately the bubble largely held. They can continue to kid themselves that America has the best system in the world and they have “access” to it. Without the threat being very real or the possibility of tar and feathering becoming likely, they will do the bidding of the profiteers. Science and logic be damned.
In my jurisdiction, the Head Medical Honcho has been saying all along “until there is a vaccine”, all the eggs in one dubious basket. I think few here are aware of an article such as this. The experts here are beyond dumb: negligent, ignorant or coopted. Too many cups of Kovid Koolaid. Just astounding!
Numerous epidemiologists have been trotted out in the media always singing the WHO, CDC, BigPharma song. Vaccine will save the day!
I remember the relief that the Salk Polio vaccine brought to families. The USA once had a Public Health System with a Surgeon General and a Commissioned Officer Corps. The left-overs remain but are ineffective and sidelined.
America was monetarized by the oligarchy. Profit is good. Taxes on the rich bad. Anything the government did that could make a profit, like charter schools, was privatized. Fees for Service. Anything done in the public good was dumped. The plutocrat’s prime directive is to transfer ever more money to themselves.
The only source of profit in the COVID-19 pandemic for the connected is a vaccine or anti-viral treatment. Test kit makers are mostly outsiders. But the basic reason universal testing is ignored is that a public health system is needed to track test results; find, isolate and treat the infected; and manage school and essential worker bubbles for the two months that it would take to eradicate the virus. Taxing would be needed to pay for it. Nevertheless, the costs of winning the war against the virus would be much less than the pandemic depression continuing through 2021.
Sweden’s daily death rate has been single digits for over 3 months now – schools open, no mask mandates. no lockdowns and based on videos from Stockholm, no social distancing.
Is this not direct evidence that the ‘herd immunity thesis’ is no longer a thesis?
Are you suggesting that infection rates have slowed here in Sweden because so many people have been infected? The numbers from recent weeks don’t seem to support that hypothesis. Admissions to intensive care are a lagging indicator and those are up since infection rates have ballooned this fall despite demographics of the infected skewing much younger. “No social distancing” isn’t an accurate description of the reality on the ground, but it’s true that a lot of people don’t make any effort.
There are a lot of valuable lessons to learn from the contrast between Sweden, Denmark, and Norway/Finland, but teasing all those out in a rigorous way is above my pay grade. At the very least, I suspect that countries like Norway show that mask use in public is probably overvalued relative to the public health benefit and I suspect Sweden is showing that a whole lot of people would have to die before there’s much quantifiable reduction in spread.
This is a good thread on the PCR tests and how they are driving a ‘casedemic”
“Sweden is showing that a whole lot of people would have to die before there’s much quantifiable reduction in spread.”
This is a ridiculous statement. Total Sweden deaths are on track to be low 90ks for 2020 which is ON PAR with the last 10 years. This is what you would expect from a cold virus that kills elderly people with one foot in the grave already.
The problem with looking at ‘infection rates’ or ‘cases’ is that the PCR tests are all kinds of jacked up. Do you even know the Ct of the PCRs that are being run there?
Even the NY Times ran an article on this.
In Belgium over the summer, HALF of the ‘cases’ were former positives or simply artifacts of infections that were as much as 3 months old. These aren’t new cases – they are old cases that we are discovering now due to testing with super sensitive tests.
There is also the issue of false positives which are estimated anywhere from 1-4%. If you test 10k people and get 1,000 cases as many as 400 ‘cases’ could be false positives (testing errors) and if Belgium is indication as many as 500 could be ‘former’ positives.
Consider that these “:cases” have been rising in many places but the deaths do not follow.
In order to really understand ‘case’ trendlines, you need to normalize for increased testing and the false and former positives. Nobody is doing that.