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Initial antibody results just in from San Miguel County. PCR tests had shown just 8 positives out of 8,000 residents 1/1000.Initial antibody tests on 986 show 8 positive, 23 borderline, balance negative. Potentially 31/986 or 1/32 positive vs 1/1000 based on PCR testing. 30X more
sanmiguelcountyco.gov/590/Coronavirus
Second round testing may show borderline results are positive and initial negatives become positive as it takes as much as 10 days for antibodies to emerge from exposure to the virus. Anecdotal evidence in NYC is similar. Many in NYC with symptoms choose not to get tested.
San Miguel quarantined early which explains less widespread exposure. NYC is a very different story. Northern Italy estimates 60% exposure.
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Bill Ackman
@BillAckman
medrxiv.org/content/10.110…
This Stanford antibody test suggests that infected population is 50 to 85 times larger than confirmed cases; therefore death rate is much lower, asymptomatic population much higher. Very positive if proven true.
Issues in the study about true randomness of the volunteers; are they are true representative sample of the community? Not yet peer reviewed so we should not jump to optimistic conclusions yet.
Subjects opted in based on Facebook ads. Seems likely that participants more likely to opt in if they believed they had previously been exposed. This alone may materially affect the accuracy of the results and the conclusion.
Read 3 tweets
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Bill Ackman
@BillAckman
A theory: It has been accepted scientific wisdom that the virus’ R0 is ~2.4 and the CFR between 1-2%. The data and common sense suggest to me that the R0 is much higher, perhaps approaching measles at 12-18. If this is true, the CFR must be much lower perhaps similar to the flu.
Estimates of the R0 are based on extremely limited testing. If one is asymptomatic, there is no incentive to be tested. In NYC now, even if you are symptomatic, your doctor will discourage you from getting tested as there is no benefit in doing so as the treatment is the same.
If in fact the R0 is high and the asymptomatic % is high, this suggests a much lower than estimated fatality rate and a much greater probability of herd immunity developing. The fact that approaching 5% of Telluride may be infected with no symptoms suggests higher density cities
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Bill Ackman
@BillAckman
I am beginning to get optimistic. Cases appear to be peaking in NY. Almost the entire country is in shutdown. Hydroxychloriquine and antibiotics appear to help. There is increasing evidence that the asymptomatic infection rate could be as much as 50X higher than expected.
If this is true, the severity and death rate could be much lower than anticipated, and we could be closer to herd immunity than projected. Highly accurate antibody tests are scaling production and distribution which will definitively answer this question hopefully soon.
One could imagine a world in the next few months where everyone is tested and all but the immune compromised go back to a socially distanced but more normal life. We wear bracelets or carry a phone certificate which indicate our status, and track infections where they emerge.
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