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3 reasons why seroprevalence studies underestimate proportion of population with some form of immunity to COVID

1) False negative: lower titer antibodies, or antibodies not targeted by assay
2) Cross immunity from prior corona virus infection
3) T cell only response to COVID
1) We have data that almost half the persons with PCR positive COVID who are asymptomatic or found by screening studies can become sero negative. Becoming sero negative doesn’t automatically mean they are not immune.
First this @NatureMedicine study: nature.com/articles/s4159…
Second is this screening study from Germany. medrxiv.org/content/10.110…
2) & 3) Several studies now suggest possible cross immunity from prior corona virus infections, or T cell only responses to COVID exposure.
See thread by @PSampathkumarMD for list of studies.
And observations from trends in hotspots that provide support to this idea of a larger % or relatively immune population than seroprevalence studies suggest.
Updated thread by @Rfonsi1 with more details and references.
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