#MSCOVID19 Dr Angry asked me to add another layer to the COVID-19 testing story…Its getting quite wet at the bottom:-)

Bladder filling

BoJo should be wearing wellies

No sooner have we heard the Oxford test is a problem, Imperial College have their hose pipe out, peeing on Pharma.

So, DrA said add anothe layer. The Imperial test is according to them….wonderful…that is… until one shows that it isn’t.

Imperial or is that Colonial College enter the fray

Indeed, they (Rosadas C, Randell P, Khan M, McClure MO, Tedder RS. Testing for responses to the wrong SARS-CoV-2 antigen? Lancet. doi:10.1016/S0140-6736(20)31830-4) said “The UK Government’s decision to facilitate use of pharma assay was intemperate……. Those who might still design to use this assay as the sole marker of past infection would be wise to consider confirmatory algorithms to better inform individuals”…….However…xx “declare an interest in the…..patent file IRN.FID4816059”

However, it depends on the samples you are testing it seems that if you have had rip roaring COVID-19 the tests seem to work well no matter what antigen it is detecting.

Prince HE, Givens TS, Lapé-Nixon M, et al. Detection of SARS-CoV-2 IgG Targeting Nucleocapsid or Spike Protein by Four High Throughput Immunoassays Authorized for Emergency Use [published online ahead of print, 2020 Aug 18]. J Clin Microbiol. 2020;JCM.01742-20. doi:10.1128/JCM.01742-20

I would say that the central problem is to detect antibodies in the asymptomatic and mildly affected individuals and this is where the importance lies…not in the weeing contest above. You can argue that you need antibodies to the receptor binding domain of the Spike protein to have a neutralizing response and I buy that because this bit is how the virus infects cells and so we have done that too, but antibodies to nucleocapsid suggests you have a T cell response which helps antibody responses, to nucleocapsid and to get immunity a T cell response to nucleocapsid may be desirable, if not more desirable

Frontiers | Serological Approaches for COVID-19: Epidemiologic Perspective  on Surveillance and Control | Immunology

If you want an opinion about the Imperial test, which assays S1 and receptor binding domain, someone will come and say why assay against just one or two different parts of the virus when you can test against a larger panel. It’s been done already and it does work better. So put your umbrella up mates. Some one is already standing on your shoulders and you know what’s coming. Even I have a bladder full already.

In this study they say the companies have made a mistake because they are testing to see if people make nucleocapsid specific antibodies.

However other people would say they are wrong with a focus on the spike protein.

This paper says the Imperial test fails as you can see the negative RBD and the negative S1 when the N are all positive.

Varnaitė R, García M, Glans H, et al. Expansion of SARS-CoV-2-Specific Antibody-Secreting Cells and Generation of Neutralizing Antibodies in Hospitalized COVID-19 Patients [published online ahead of print, 2020 Sep 2]. J Immunol. 2020;ji2000717. doi:10.4049/jimmunol.2000717

 The patients exhibited typical symptoms of COVID-19 and presented with reduced lymphocyte numbers and increased T cell and B cell activation. Importantly, we detected an expansion of SARS-CoV-2 nucleocapsid protein-specific Ab-secreting cells in all 20 COVID-19 patients using a multicolor FluoroSpot Assay. Out of the 20 patients, 16 had developed SARS-CoV-2-neutralizing Abs by the time of inclusion in the study. SARS-CoV-2-specific IgA, IgG, and IgM Ab levels positively correlated with SARS-CoV-2-neutralizing Ab titers, suggesting that SARS-CoV-2-specific Ab levels may reflect the titers of neutralizing Abs in COVID-19 patients during the acute phase of infection.

HC healthy control. ASC=antibody secreting cell, PBMC peripheral blood mononucelar (Lymphocytes and monocytes) cells

Why report this stuff? Well it is topical and it is stuff we have been doing. However, we were too slow, in so many departments and so they will be student projects for next year.

Is the DoCA under the red tape

However, I would say DocA is in need of an anti-diuretic. His bladder is secretly sprinkling away already, but we don’t need to join the Weeing contest. The big papers have gone and unlike the rest, patents were not a motivating factor as we figured we will give this one away to humanity and have made supplies for our friends in Pakistan and some Dentists.

Can Pharma feel their head getting wet yet?

We can use what we have done COVIDwise to adapt to otherstuff. So the aim of the research is to apply what we have learned to MS and other diseases. So as you help ProfG get a new titanium hip, you will be helping people with MS. It is bigger than COVID but you will have to wait to see if this goes somewhere or not, it depends on how well ProfG does. However, ProfG is right we need support, so please encourage him to in his long distance run

However perhaps rather than worrying if we have had the virus with antibodies, perhaps we should repeatedly and widely test with a cheap but not great antigen test. So the argument goes if you have a good test but you can only test 900,000 people a day why not use the cheap 15 minute test and test 20,000,000 a day. It has a false positive rate of 1% so you have to test only 200,000 with the good test but you are testing 20,000,000 people and you can find out who is infective. The ones going to infect people are likely to have high levels of virus so the test does not need to be super sensitive. If you are positive you remove yourself from circulation whilst you have the high sensitive test, but you are not out and about to infect people.

Maybe we should be weeing on the heads of government to get them to wake up.

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