WHAT are the two types of COVID-19 tests? WHICH one should I get, and WHEN?
The risk of a second wave in the U.S. is high, since if few dozen infected in Seattle Washington in early March could lead to over 40,000 death in our country in only a few weeks, can you imagine WHAT the 5 million infected silent carriers could do when they come out of their home confinement into the wide-open society in May?_
So the point is: EVERYONE has to know these “7 measures” below, and know them now, in April, and be prepared!
As a nation, we got burned, very bad, in early March, by not being prepared; now, this is a second critical time (when the flood gate is about to be open in May, releasing 5 million infected silent carriers into the society), and we really cannot afford, to get burned again (by not being prepared, again!)
Two DIFFERENT types of COVID-19 tests (that tells DIFFERENT info):
**V**irus diagnostic test: a nasal swab (now a new spit test), testing the presence of virus ("**V**"), using polymerase chain reaction detecting virus RNA.
**A**ntibody test: a drop of blood from finger prick, testing the presence of antibodies (“**A**”).
V+= you have the virus right now.
A+= you have antibody right now.
Antibodies IgM (early antibody)/IgG (late antibody):
First 2 weeks of infection: **A from - to +.** The antibody present is IgM (the “early antibody”), its presence indicates new infection.
Starting 3rd week, until up to 1 year: **A+.** The antibody present is IgG (the “late antibody”), its presence indicates past orchronically persisting infection.
V+/A+: active infection, has the virus, has antibody. If the infection is acute (first 2 weeks), the antibody is IgM. If the infection is chronic (3rd week onwards), the antibody is IgG.
V+/A-: active infection, has the virus, the antibody has not been produced yet (this occurs only in the very beginning of the infection, then quickly IgM (the early antibody) is produced).
V-/A+: no longer has the infection, no virus, but has antibody (the late antibody IgG). This is the*best situation*, infection is gone (no virus now), but still had antibody, so immune to the virus, for a while.
V-/A-: has never had the infection, so one is vulnerable to be infected (by non-silent (V+) or silent carriers (V+)).
The typical course of a COVID-19 infection:
For ALL pts (first 2 weeks):1st week has no symptom (V+(has the virus), A from - to + (IgM)); 2nd week has symptoms (V+(has the virus), A+(IgM)).
Then, at the beginning of the 3rd week (V+(has the virus), A+ (IgG)), patients then diverge into two groups:
SURVIVE (about 99%): the IgG "beats" the virus, yeah! The virus IS STILL released from the patient for up to more 4 weeks! The person is still INFECTIOUS for that additional 4 weeks (see the #3 of my "7 measures" below). So, repeat virus tests V are needed for that additional 4-weeks until the viral count V drops to zero*(V-).*
- The total duration that an infected person is INFECTIOUS to others (V+) is thus about 6 weeks, and notably, 5 of which, i.e., 1st, and 3rd – 6th weeks, he/she is actually a very dangerous*“silent carrier”,* since NO ONE (not even him/herself) knows that he/she actually is infected, has the virus (V+) and is thus infectious to others, gush!
- After about 6 weeks, now with V-now (no virus), but remaining atA+(has antibody IgG), the person is now 99% likely immune to COVID-19, for a while (up to a 1 year).
DEATH (about %): the virus "beats" the IgG, ouch! We get increasingly sicker, viral count continues to rise, hospitalized, on ventilators, and 80% die!
Conclusions on testing, for staff at early-to-open businesses, high-risk facilities, high-risk professionals and for all who want to get tested voluntarily:
Required: **V**irus test, for all of these groups of people (see #2 - #5 of my “**7 measures**” below).
Optional: **A**ntibody IgM/IgG test, to identify the already immune people (see #2 - #5 of my “**7 measures**” below), they can come back to workearlier.
Please note that this is a rapidly evolving field and the above info (percentages and durations etc) are all just estimates, to allow us to have a general frame of mind to at least begin to think about these tests. The information and data are incomplete and are continuously evolving and changing, as we are developing more and more understanding of this new virus.
Coronavirus crisis reveals our need for common ground | Opinion
The Tennessean article, by Dr. Ming Wang, Harvard & MIT (MD,magna cum laude); Ph.D. (laser physics)
7 effective measures to prevent a second outbreak
Ming Wang, MD, PhD
When the COVID-19 outbreak reached America in early March, we as a nation found that, unfortunately, we were not sufficiently prepared. The lack of availability of test kits resulted in a delay in identifying and treating the earliest groups of patients in the first few crucial weeks of the outbreak. America has now become the most infected nation in the world, with the highest number of deaths.
Now another critical period will soon be upon us. As our nation reopens, we face the potentially serious risk of an even more deadly “second wave!”
50 million people died in the 1918 Spanish flu pandemic which infected one in every three people in the world, and the majority of the deaths actually occurred not in the first wave, but in the _second and third waves_of the deadly outbreak.
Over half a million Americans have now tested positive with COVID-19, but the actual number of those who are infected could be 5 to 10 times higher. In other words, 2.5 to 5 million Americans could now be infected but are silent carriers.
Most of us are staying home right now. However, when we go back to work, the flood gates will open. These silent carriers will come out of their homes, merge into society, and infect potentially tens of millions of people, starting a second wave of the pandemic.
A resurgence is already seen in some parts of Asia, such as Hong Kong and Japan. Since they are 2 months ahead of us, we have a valuable opportunity to learn what is and is not working in the effort to mitigate a second wave of outbreak. I believe that implementing the following 7 key measures will help America avoid a second wave when we reopen our businesses:
The reopening should be gradual and sequential, i.e., beginning with only essential, high-priority, less-crowded businesses. Temperatures should be taken for everyone who enters these facilities.
_“No test, no work!”_ Test all employees in these early-to-open businesses.
Allow those who are immune to COVID-19 to come back to work first, i.e., those who have completely healed from COVID-19 (and have also been shown in the subsequent weeks that they are indeed no longer shedding the virus), and those who are auto-immune to COVID-19 (through antibody tests).
Have _voluntary_ testing (like voting), and whoever _chooses _to get tested has the option to wear a sticker stating “I was tested!”
Require testing in high-risk facilities, i.e., crowded, repeat exposure-prone, and elderly and medical facilities, such as hospitals, clinics, nursing homes, prisons, and in high-risk professionals, such as police, paramedics, supermarket staff and restaurant employees.
Continue social distancing, mask wearing and avoiding crowded activities in enclosed spaces.
Implement cell phone-based contact-tracing technology. It was encouraging that archrivals Google and Apple have been able to find common ground to work together to create this new cell phone technology. However, in a democratic society such as ours, we must also protect the privacy and individual rights of our citizens.
As a nation, we are now at the second critical time in this pandemic, and this time we truly need to be well prepared. We must immediately start the preparation now so we can effectively implement the measures I have outlined above when we reopen our country, so we can prevent a second and potentially more devastating outbreak.
Dr. Ming Wang is a Harvard and MIT graduate (MD,magna cum laude) and one of the few cataract and LASIK eye surgeons in the world today who holds a doctorate degree in laser physics.
Ming grew up during China’s Cultural Revolution – during which millions of innocent youth were deported to remote areas to face a life sentence of poverty and hard labor. Ming had to play the Chinese violin erhu and learned to dance, in order to escape the labor camp. He eventually made his way to America with only $50 and graduated with the highest honor from Harvard Medical School and MIT.
Dr. Wang founded a 501c(3) non-profit organization, the Wang Foundation for Sight Restoration, which to date has helped patients from over 40 states in the U.S. and 55 countries, with all sight restoration surgeries performed free-of-charge. He was named the Kiwanis Nashvillian of the Year for his lifetime dedication to helping blind orphan children from around the world.
Dr. Wang is the co-founder and president of the Tennessee Immigrant and Minority Business Group, and co-founder of the Common Ground Network, a non-profit that focuses on Dr. Wang’s life-long mission to help people find common ground and solutions to our society’s problems.
Dr. Wang’s autobiography “From Darkness to Sight” has inspired the movie “Sight”.