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Comment by erentz | Hacker News Reader

One reason people seem to be missing for why antibody tests are very useful is it will allow us to confirm those that are now immune. We can’t get this from the RNA testing because it’s primarily being used on only symptomatic people at the time they have symptoms (and then only if they can get the test which typically means severe symptoms)

But if we start to test widely for antibodies we can start to clear people from this effective quarantine/lock down situation we are going through. Those people can then start to go back to regular life (what’s left of it), moving around as normal, doing work helping others, so on, and that will help all of us (and of course the economy).

I don’t know if this is something that anyone official is talking about yet, but it seems like it should be.

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> I don’t know if this is something that anyone official is talking about yet, but it seems like it should be.

I agree. I think this will greatly help with people's mental state, etc, plus they can help family and friends who are under quarantine. The question of how long immunity lasts, is it effective, etc is still a bit open. Also, how in a Western democracy do we distinguish (from the point of view of law enforcement personnel) between those who are immune and those who are breaking quarantine?

Perhaps requiring people to sew a red-colored letter to their clothing?

>are breaking quarantine

Happened today. Police can stopped outside our building Two policemen came out. One was holding a notepad+pen, and one was holding his cellphone. One was reading phone numbers and keeping notes, the other was dialing numbers, asking people to come out to their balconies so they see they are self-isolated and staying at their homes. Very simple and efficient way to see who stays and who runs.

Having antibody doesn't mean you can't spread the virus. For example, antibody tests are often used to diagnose HIV, but testing positive for HIV antibody (i.e. you are infected) doesn't mean that life will be normal.

That’s true. Though you could still buffer it with a “must be positive for N weeks” rule.

Also, while there would be concern about a positive but still shedding person coming into contact with one who hasn’t contracted it, there’d be no issue with them hanging out/working/etc with others who are positive.

Having antibodies and waiting 14 days to be safe will be good enough to be whitelisted.

Right now the only way to be whitelisted is having had a test done while being ill, but asymptomatic cases are unlikely to ever get tested.

> Those people can then start to go back to regular life (what’s left of it)

You sure that's not hyperbole? If you believe that, you need to turn off the news.

There is evidence that people can become re-infected, so antibodies aren't enough.

There’s not good evidence of that. There have been cases of people testing negative then positive again but that doesn’t mean they had cleared the virus and got reinfected. It more likely means they had a false negative. (E.g. I have a friend in hospital right now with COVID-19 that has had four tests, one positive, two negative, then one positive again, all tests within the space of four days.)

It also can be the case if you are immune compromised that you may clear the virus through good luck, drugs, and your innate immune response. But you never developed a good adaptive immune response and so don’t show a strong antibody response.

Immunity to this virus may not last 10+ years, but it’s seeming unlikely that is lasts less than 6 months.

> It also can be the case if you are immune compromised that you may clear the virus through good luck, drugs, and your innate immune response.

uh, how? Perhaps this is tangential, but it's important that anyone who is immunocompromised takes this seriously. Don't just think you'll be ok with a bit of luck. If you are immunocompromised your immune response is by definition weak and we have no working therapeutics.

Yeah, yeah, I know there are 2 promising ones but its not really clear. The Gilead one is fairly legit, but the protocol used to compare Chloroquine for covid is fucking bullshit. They compared people across hospitals, way too many things different, you can't actually draw any valid scientific conclusion - it's purely anecdotal (as thankfully Fauci made more clear to the public today).

I don’t think you read my comment in the context of what it was replying too. It was a response to someone saying people can get reinfected. The reports of this appears not to the case for the reasons I and others explained (false positives/negatives). I speculate it might possibly happen for real though in the case of immune compromised people who are lucky enough to survive, but due to being immune compromised do not mount a proper adaptive response. Thus develop no antibodies and and thus are able to be reinfected. Obviously that would be rare. (But so are these case reports that are driving these rumors of “reinfection” overall.)

Not really sure how you read that as somehow advocating immune compromised people do not need to take this seriously.

Wouldn't it then make sense to have camps where young, healthy adults can go to get immunity by intentionally getting infected and recover ? Then they can go back to having normal lives. The epidemiology version of a controlled burn.

If someone take the gamble of intentionally getting the virus, his/her life expectancy is reduced by 3 months (a ballpark figure).

If someone stay in isolation until a vaccine arrives, he/she may consider it a greater loss.

I am pretty sure some entertained this idea. The real problem is tail risk is huge. If a youth gets complications or dies from the virus - is the camp organizer responsible?

The problem is that with such a high rate of hospitalization or even death, even for young healthy adults, that’s a risky approach.

It might be necessary at some point, however.

Citation? IIRC all of the examples were either false positive re-tests or atypical patients (i.e. with some immune issue that only supressed the virus when they tested negative)

Citation?

I saw the one story about people "testing positive again" but that seemed to be a testing abnormality, not people getting sick a second time.

https://www.latimes.com/world-nation/story/2020-03-13/china-...

Time will tell, but from that article:

>Scientists in and outside China agree that reinfection is a highly unlikely explanation for the patients who retest positive. They say testing errors are more likely to blame — either false negatives that resulted in patients being discharged too early, or false positives when they retested and were taken back into hospital.

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