to think it's going to be very difficult to get a positive antibody test if we don't get exposed to the virus

[chomalungma]

Regardless of the fact that the 'hone' antibody tests aren't that reliable at the moment anyway
And the fact that immunity may not last

There seems to be a plan to see if people have a positive antibody test and maybe give them more freedom after lockdown ends.

But if you don't have more 'freedom', then you are not going to be exposed to many people with the virus, especially if you take as many health precautions as you can.

So it may take a long time to get exposed - and then even longer to get a positive antibody test...

What is your AIBU?

If everyone gets exposed at the same time or at a fast rate then those who survive will have immunity faster (how long for is unknown) but at the cost of many more deaths as the health systems get overwhelmed with emergency care.

If everyone gets exposed gradually and slowly then yes individuals may have to wait longer for immunity but health care systems will be better able to cope.

What’s your point OP? Clearly the government’s strategy is all about controlling the numbers of people who have it at any one time, specifically how many people need critical care at any one time. The whole world is also trying to learn about what this virus does - but are you saying we should risk more people’s lives by letting us all loose again so that we can expedite the experiment about antibodies?

My AIBU is how is this going to work as a 'going back to work / normality' test.

Because if we are going to wait to get a positive test to get back to normality, then some people may have to be waiting for a very long time.

They are talking about this antibody test - and seem to be very focused on it and getting people to test positive.

But no talk about what this actually means in practical terms.

but are you saying we should risk more people’s lives by letting us all loose again so that we can expedite the experiment about antibodies

I am saying that where is this antibody test going?
People will test negative
People will test positive

What happens then?

They’ll develop a ‘flu jab’ as we have with ‘standard flu’ for the vulnerable people in society. This could take a year to develop and roll out so yes, this will take a long time and in the meantime lots of people remain at risk of being very poorly/critically ill. Even after the jab is rolled out, people will still be affected by this virus, as people are with flu and pneumonia.

Totally agree about the reasons for the lockdown and the effect on the NHS and the numbers of people needing treatment.

Totally agree we need a vaccine - which needs time to develop and test

The antibody test - assuming it's reliable enough, has enough sensitivity and specificity, may well give an indication of whether you have had Covid-19 and whether you have immunity to it.

But then what happens if you test negative for it - or if you test positive for it?

If you test negative, will you have to stay in self distancing isolation, which will keep your chances of exposure very low - so you are unlikely to catch the disease for a while - at least until the vaccine is developed.

I would be interested to see how they plan to use the antibody test and what they aim to do with the results - i.e. positive and negative people.

If you test positive you stay at home. What do you expect will happen? Of course it sucks, but do you have a better solution? Can you magic negative people into immunity?

If you test positive you stay at home. What do you expect will happen

Which means that you are not going to become infected because you aren't being exposed to it....

So you will always test negative

So it continues...until when?

you don't become immune to the virus once you have had it

ou don't become immune to the virus once you have had it

There is evidence that you might not be immune to it once you've had it.

But there is also evidence that many people do have immunity to it after you've had it.

But who knows how long that immunity lasts.

I am just concerned because all the talk is about developing a reliable antibody test - but I have seen little talk about what to do with the results.

Are we still doing 'track and trace' - tracking close contacts of infected people, self isolating them and testing? Or has that totally gone now as the numbers infected have increased too much?

I sort of see what you’re getting at OP. It will create some sort of split society - those who can go out and those who can’t. We seem to be waiting for either herd immunity or a vaccine, neither of which seem particularly close by.

The idea is that if the test proves that you've already had it, then you could start back at work and get back to some kind of normality.

They wanted to control the spread of the virus so that we built up an immunity to it and to enable the nhs to manage things. There are over 100 vaccination projects underway around the world working on a vaccine for this virus and I read this morning that there is hope of one in oxford. It's going for human trial in the next week or so I believe.

There is talk of the 'track and trace' app - so if you have been near someone who is infected, it tells you and then you can self isolate - and hopefully get tested.

Vaccinations are great - but they take a long time to develop and they take a long time to ensure they are effective. I was listening to Radio 4 this morning - you need to give it to a group who is more likely to be exposed, such as front line NHS staff - and see what happens.

Then we have to step up manufacturing of it - which is an issue in itself.

All this takes time.

there was talk on the radio yesterday of letting the young get back to work... which of course is good insome ways, but if you have a vulnerable family member, popping out for exercise then becomes more risky as more people will be out and about, catching it, getting it mildly, spreading it. At least at first.

I don't think that it will work like that, other countries ending lockdown are not using antibody tests. Antigen tests and contact tracing will be really important. We don't have testing capacity for this yet, but that is what's happening in Korea where they've avoided lockdown. All across countries looking at ending lockdown they are developing phone apps to support contact tracing. The idea being that if you've had significant contact with someone who has tested positive your phone will alert you and presumably you need to isolate for 14 days.
Antibody tests will be useful to measure exposure across a community. We don't yet know how much immunity antibodies will give you. I presume we may get to a point where those with antibodies can avoid isolation if they've been exposed. Useful particularly for medical professionals, but I think we're a way off that.

Antigen tests and contact tracing will be really important. We don't have testing capacity for this yet

I think we do - we have capacity for 100,000 RT-PCR tests a day (apparently) and these will tell you if you have the virus at the moment.

The debate if your actually going to be immune and how long it lasts for is still going on.

Your only immune for other corona viruses (common cold variations) for 3-6 months.

100,000 tests per day is what they are aiming for by the end of April, we've not got that capacity yet.

Currently that might not be enough either, we need to get down to a smaller number of people who are infected or suspected to be infected. Because really you need to test anyone with a temperature or a persistent cough. That's got to be a huge number.

What test are you referring to? A test to check if a person currently has covid? That only helps with identifying whom to isolate. A test to check for antibodies that confer immunity (one hopes and long term one hopes even more) would be what is needed to have covid passports so that those with positive tests could circulate freely while those with negative tests would be subject to restrictions until the vaccine became available.

The virus is still spreading during lockdown, as anticipated. As herd immunity increases, the spread will slow down even more. But most of us are already out and about enough to catch it eventually. And as the herd immunity increases we'll get to a point where most of us will be able to get back to something nearer normal life without the rate of spread skyrocketing.

Those who are doing serious shielding because of vulnerability will have to wait for either a much higher level of herd immunity, or the vaccine, in order to reduce their risk of infection to an acceptable level, which will be a different level for everyone. We have always lived with diseases which are easily transmittable, not dangerous to most people, and which some people have to take greater precautions to avoid. Coronavirus will become just another one of those.

OP we are still being infected with the virus just at a slower rate. The idea of lockdown was to slow it's spread to within a manageable amount not completely rid us of the virus.

I think there are quite a few ethical implications.

1. will people be incentivised to try and get the virus so they can get back to normal?

2. if the vulnerable have to remain shielded, how will they earn money to live? My friend has a transplant at 18. She will absolutely be a vulnerable and can’t possibly return to work when the rest of her peers in their 20s and 30s are. What will happen to people like her?

3. families or households with one vulnerable person will have some very difficult decisions. Will there be support/protection for those with a sick child for example?

4. will lockdown be eased for work but families expected not to see grandparents etc. It will be very tough mentally on those staying at home knowing their grandchildren are at school, seeing friends but not them. There is a risk that older people become segregated and isolated.

All of this is assuming there is some immunity from having had it. The evidence there seems quite mixed. I agree that some of these issues need to be discussed by government as part of publishing an exit strategy.

Antigen ( RT-PCR) testing capacity is a more complex picture than is being painted. This testing requires trained people and suitable labs. Those people need kits and instruments to do it, the people making the kits need reagents to make them that everyone else in the world wants. There are labs everywhere trying to make more tests.