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So @peston roasted for Q’s re: #COVID #antibodytest and told tests unreliable until 28days by #PHE #DCMO - this was NOT correct.
This paper from @nature ow.ly/6TDz30quY7V published 2 days ago shows 50% antibody +ve at 7days from symptom onset & all by 2 weeks 1/x
The dogmatic resistance to #antibodytest by PHE & the failure of their experts to be properly briefed about emerging evidence is potentially damaging. #COVID19 Patients presenting to hospital have typically had symptoms for several days & may therefore be #antibodytest +ve 2/x
...& the test may therefore have some utility- even in an intensive care setting where PCR tests may also be (false) negative ow.ly/ZQUM30quYU0 - antibody positive test results would moderate clinical decision making in latter clinical stages (>1-2weeks) 3/x
The key issue is not how many false -ve (if you recently had infection antibodies may not yet be present) but whether if you test +ve you have definitely HAD (or have later stages of) the disease - i.e. that the test is specific for CV19 & not other CV ... 4/x
As a surgeon - if #antibodytest on a patient, done a few days pre-op is positive it would completely change not only whether PPE is required for staff in operating theatre, but in some cases will change the operation we actually do ow.ly/brib30quYut 5/x
Particularly for operations involving access to the brain via nasal passages deemed extremely high risk for neurosurgeons & their teams. Alternative approaches - less ideal from patient perspective - are currently being recommended during #covid19pandemic 6/x
#COVID19 #antibodytest would allow best operation to be done in patient who is known to have had #SARSCoV2 infection with immunity to it and therefore posing no #COVID19 infection risk to clinical team. 7/x
Where #SARSCoV2 antibody status of patient is unknown or negative members of surgical team who have had the disease (antibodytest +ve) would not need #PPE - preserving supplies for those who need it. Bear in mind that cost of test less than cost of 1set of full disposable PPE 8/x
Validation of tests should not take long - stored serum banks from pre-#SARSCoV2 era could be utilised to estimate risk of false positive due to cross-reactivity with other coronavirus types...9/x
On a wider scale - members of the public testing +ve on #antibodytests - provided test has a very low false +ve rate could return to work sooner and get the #UKeconomy going. 10/x
Senior healthcare/PHE leaders need to rapidly roll out #COVID19 #antibodytest or give a cogent explanation/evidence for not doing so. Journalists including @peston should not be fearful of robustly challenging clinicians/experts for the decisions they are making. 11/x - ends
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