May 2 2020
Dr. Why: Hi, your antibodies to SARS-CoV-2 are negative - not detected! I also got negative, and so is everyone else I tested this week. I will send specimen to a different lab and let you know, if I get different results;
Patient: None of the people I was with got sick, so it’s not unexpected. But I was hoping...
Dr. Why: Yes, it does not matter anyway;
Patient: Why?
Dr. Why: See my blogs To Test Or Not To Be and Immunity Or Passports;
Patient: I disagree with your assessment. For each individual knowing that their body can fight the virus without generating an autoimmune storm is a big deal. If I had antibodies, I would have known that I only have to worry about viral load and not my immune system response. That will free me from the lockdown;
Dr. Why: NOOOO! The test is not accurate enough! That is the problem! Read my blogs please.
Patient: I undertand. But the in accuracy is no more than 10%?
Dr. Why: The presence of antibodies DOES NOT mean immunity. We also do not know how long they last, even if developed.
Patient: So, I am negative +/- 10%?
Dr. Why: What do you mean? The false negatives are around 30%.
Patient: It does not mean 100% immunity. But it means that low viral load will not cause a disease.
Dr. Why: We are not checking viral load by this test.
Patient: I understand. All I am saying is presence of antibodies means you had an exposure and did not get sick. This means to me that additional exposures will not get you sick unless you are exposed to large viral load that overwhelm your immune response. No antibodies means that you don’t know how your immune system will respond and that you might get really sick from even small viral load. So no antibodies to me means I keep in quarantine.
Dr. Why: It does not tell if you got sick on not. It only indicates exposure NOTHING ELSE.
Patient: 2% death rate is too high of a risk. But I know that I did not get sick. I have friends who got sick and it’s terrible. Even the ones that got it easy were terribly sick.
Dr. Why: NO antibodies indicates NOTHING because
You might not been exposed, or
Your immune system did not react, or
Your innate immure system fought it off not letting virus in, or
Yes ou did develop antibodies but they are gone undetectable by the time we test.
The mortality is at most 0.1%, in many countries less. I had at least one patient with severe viral pneumonia every year for the last 10 years, some needed intubation. I know that viral pneumonia is a bad disease. Everyone made it although. The longest was on ventilator 2 months…
Patient: None of my friends were on ventilators. But they were just very sick. Most were very sick for two weeks. A couple for 6 weeks. They were all at home. Only two actually tested. Both got positive.
Dr. Why: YESSSS! Here you go! What was the cause in others?
Patient: They did not get tested because they did not want to burden the system. Some of them are now looking to get antibodies test. One already did and came up positive.
Dr. Why: It will be interesting to see. I thought you would be positive for sure, but I was wrong?
Patient: High fever. Loss of taste. Extremely weak. That was common to most. Some had diaria. Some had sever cough. Some had mild fever. Strange taste and or smell was very common. Yes. It will be interesting…
Dr. Why: I have at least a dozen people who reported the same but all were tested negative so far. Plus two whom I sent to the Hospital were found too have a virus Both made it!
Patient: Anyway, I still believe they need to open the economy so people can make a choice. To work or not. But for me. There is no upside in exposure.
Dr. Why: Absolutely. Need to open. Exposure builds immunity.
Patient: If I had antibodies I would have been less militant about it. People now know the risk. And most people know someone who was sick. So they can make their own choice. That is the American way. I made my choice. I will protect myself and my family even if it means not leaving my home for 3-4 more months until immunity in the population builds up.
Dr. Why: I disagree. We drive, we fly, we swim, etc. all involves the risk. Including crossing the street. How about non-cooked food (sushi, etc)?
Patient: BTW, I asked my friends if they are seeing the virus becoming weaker. They said no. We see the people becoming weaker. My doctor friends. This is now becoming a disease of the lower socioeconomic class…
Dr. Why: Well, I have no comments. Viruses always weaken unless they are spreading among weak population.
Patient: Mostly Latino in OC;
Dr. Why: 80% in NYC are Latinos and African-Americans.
Patient: It started as Asian disease here. Then whites from newport and irvine got it. But now it’s predominantly Santa Ana and Anaheim. So the virus is not getting weaker. It’s now attacking weaker people more. These are the people that have to go out to work. The cleaning ladies the cooks the loan mowers. They have no choice. And they catch it and give it to their mothers who live with them. That is why the numbers in OC (Orange County) are rising.
Dr. Why: I understand your points but you’re looking at this as a layman, while I am looking at this as a professional and I can assure you that vast majority of professionals who actually attended medical school and got at least average grades know that this is nothing unusual and we will have this in the future and we had many in the past. Do not watch news!
Patient: I don’t watch the news. I look at raw data. The average time people are sick is 4x longer than the flu.
Dr. Why: That is even worse! If you like you can send me data that you’re looking at and the way you look at it and we will discuss. I’m interested to see where is the fault line.
Patient: The people that get hospitalized are sick 6x longer than the average flu with 8 weeks being the norm.
Dr. Why: We still look at different data, or we look at the same data differently... The calculation of mortality of cannot be trusted, because official policy is to record mortality with the virus as mortality from the virus and they even add hypothetical/probable deaths without ever testing people, or those who passed away.
Patient: I know that. Still the numbers are up there.
Dr. Why: Show me the numbers you are definitely not looking at the numbers I am looking at or you are looking at the same numbers differently.
Patient: 1,126,000 tested positive in the US. 900,000 active cases after 7 weeks of closure. I have been following this statistics to figure out what is the average sick time. These numbers are current. But I have been following those continuously;
Dr. Why: This if a wrong data. This is not the data to look at.
Patient: The infection rate in the US is pretty constant now for the last 3 weeks.
Dr. Why: I have to do something else now, but we can continue tomorrow. if you like to write a one-pager to outline your logic, or a spreadsheet, I will look at that and tell you what I disagree with, and we can discuss. it will be an interesting exercise!
Patient: Ok. Have a great evening. Thanks for talking to me.
Dr. Why: I like when you challenge me! Thank you very much! this is great!