The case for smarter coronavirus testing

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The case for smarter coronavirus testing | via nytimes COVID19

As COVID-19 continues to wreak havoc in communities around the country, many people are seeking tests for evidence either of the virus itself or antibodies to it, an indicator of past infection.

Late in June, there were long lines for testing, noted Dr. Howard Bauchner, editor of JAMA. He said that if people had been well and not knowingly exposed to the virus there was no reason for them to be tested. Overuse of testing clogs up the testing lines, he said, and could make it more difficult for people truly infected to get a test that would help protect others .

A further caveat: The FBI warned last month that scammers were advertising fraudulent antibody tests, and urged those seeking a test to consult the Food and Drug Administration’s website for an approved list of tests and testing companies. The two main types of antibodies relevant to COVID-19 are immunoglobulin M, which the body generates during an active infection but that gradually dissipate, and immunoglobulin G, which are long-term antibodies. But Wilson emphasized, “The mere presence of antibodies does not mean that those antibodies are protective.”

Osterholm, who directs the center, explained that accurate testing requires the use of tests that are least likely to result in either false-negative or false-positive results. He called drive-in tests that many people now seek “terrible,” generating lots of false-negative and false-positive results, in part because of how samples are collected.

You might think any test with 95 percent sensitivity and 95 percent specificity would be highly accurate. But while these would be great grades on an organic chemistry final, the ability of such a test to render a reliable result is extremely poor: 50 percent of the positive results would not be true positives, Osterholm said.


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