Don’t do wrong antibody test—many early commercial #COVID19 antibody tests look for antibodies to nucleocapsid, or N, protein. But N antibodies are not as powerful, & not produced by spike protein vaccines (most Western vaccine). @DavidLat’s story.…
2) “Most people shouldn’t even be worrying about this,” said Akiko Iwasaki, an immunologist at Yale University.
But antibody tests can be crucial for people with weak immune systems or on certain meds—
3) “encompassing millions w/ organ donations, have certain blood cancers, or who take steroids or other drugs that suppress the immune system. Mounting evidence suggests that a significant proportion of these people do not produce a sufficient antibody response after vaccination.
4) If you must get tested, or just want to, it’s essential to get the right kind of test, Dr. @VirusesImmunity said: “unless they really understood what the test is doing, people might get this wrong sense of not having developed any antibodies.”
5) “If people who were never infected are vaccinated and then are tested for antibodies to the N protein instead of to the spike, they may be in for a rude shock.
6) @DavidLat , a 46-year-old legal writer based in Manhattan, was hospitalized for Covid-19 for three weeks in March 2020, and he chronicled most of his illness and recovery on Twitter.
7) “Over the following year, Mr. Lat was tested for antibodies numerous times — when he went to his pulmonologist or cardiologist for follow-ups, for example, or to donate plasma. His antibody levels were high in June 2020 but steadily fell over the following months.”
8) “The decline “didn’t worry me,” Mr. Lat recalled recently. “I had been told to expect that they would naturally wane, but I was just happy that I was still positive.”
Mr. Lat was fully vaccinated by March 22 of this year.
9) “But an antibody test on April 21, ordered by his cardiologist, was barely positive. Mr. Lat was stunned: “I would have thought a month after being immunized, I would have antibodies through the roof.”
10) “Mr. Lat turned to Twitter for an explanation. @florian_krammer, an immunologist at the Icahn School of Medicine at Mount Sinai in New York, responded, asking Mr. Lat which test had been used. “That’s when I looked at the fine print on the test,” Mr. Lat said.
11) “He realized it was a test for antibodies to the N protein, not to the spike.

“It seems that by default, they just give you the nucleocapsid one,” Mr. Lat said. “I never thought to ask for a different one.”
12) “In May, the Food and Drug Administration recommended against the use of antibody tests for assessing immunity — a decision that has drawn criticism from some scientists — and provided only bare-bones information about testing to health care providers.
14) “Many doctors are still unaware of the differences between antibody tests, or the fact that the tests measure just one form of immunity to the virus.”

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More from @DrEricDing

22 Jun
Donald Trump wanted to stop CDC tests & once proposed to detain & quarantine Americans at Guantanamo Bay. “Don’t we have an island that we own?” Trump asked aides in the Situation Room in Feb 2020. “What about Guantánamo?” 🧵

Book review by @ddiamond…
2) “Aides were stunned, and when Trump brought it up a second time, they quickly scuttled the idea, worried about a backlash over quarantining American tourists on the same Caribbean base where the United States holds terrorism suspects.”
3) ““Testing is killing me!” Trump exclaimed in a phone call to HHS Sec Alex Azar on March 18, yelling so loudly that Azar’s aides overheard every word. “I’m going to lose the election because of testing! What idiot had the federal government do testing?” …(wait for it)
Read 7 tweets
21 Jun
📍Gee—a second “fleeting” exposure in NSW🇦🇺 #DeltaVariant outbreak. Security camera shows “they just passed each other in the store—never came into contact.” Just like other shopping mall. “This obviously caused some concern” by @NSWHealth govt. #COVID19🧵
2) This follows the other shopping mall case in which the index case passed within 60 centimeters of another man for mere “seconds”. This is the #DeltaVariant that is dominating UK 🇬🇧, ravaged India 🇮🇳, and surging across Europe and US right now.
3) Let this sink in — both fleeting exposure infections with #DeltaVariant were from the **same man**, the same index case. They know for certain it came from him also via genomic sequencing match of the strain of the virus. It definitely came from him.
Read 7 tweets
21 Jun
45% of all #DeltaVariant deaths in England🏴󠁧󠁢󠁥󠁮󠁧󠁿 in the past 1 week (June 8-14th) where among those fully vaccinated with 2 doses & post +14 days. Total Delta #COVID19 deaths up +31 in one week—of 31, 14 deaths in fully vaxxed. #Delta breakthrough concerning🧵… ImageImage
2) To be clear, this is still a large benefit of vaccination. But we cannot say for certain that #DeltaVariant is “nothing to worry” about anymore. It is much faster transmission & 2.5x greater hospitalization risk than #Alphavariant which implies 4x hospitalization vs original.
3) We have to be worried when we see such numbers and the exponential rise of #DeltaVariant worldwide — especially in low vaccinated countries, and under vaccinated parts of US that are vaccine hesitant.
Read 16 tweets
21 Jun
Switching vaccines—the 2nd dose of AstraZeneca vaccine is no longer recommended in Canada 🇨🇦. The mRNA Pfizer or Moderna now considered a better second dose for someone who had AZ. #COVID19

Other big question now is 1-shot J&J against #DeltaVariant.… Image
2) “National Advisory Committee on Immunization (NACI) is now recommending that people who received a first dose of the Oxford-AstraZeneca vaccine receive a second dose of an mRNA vaccine, such as Pfizer-BioNTech or Moderna.”…
3) “NACI’s latest advice takes into consideration the most recent evidence on the rare instances of blood clots associated with the AstraZeneca shot and the increase of mRNA vaccine supply arriving on Canadian soil.”
Read 9 tweets
21 Jun
“NO MORE THAN MERE SECONDS” of exposure in 10-60 centimeters where one man triggers several #DeltaVariant infections with brief “fleeting” contact. Thousands of shoppers at NSW🇦🇺 mass tested. Delta called “near & present danger”.

HT @lizziepearl. #COVID19
2) he “brushed past a man” in his 50’s… who became case #4. Ummm, wow. 👀 Image
3) Like geez, we know #DeltaVariant is basically the fastest transmitting variant to date. But this kind of “fleeting contact” infection is all the more reason for masks and improved ventilation and air disinfection.
Read 23 tweets
20 Jun
It’s coming—#DeltaVariant is now >96% dominant in 3 major counties (UK, Russia, Portugal). It is surging exponentially in the US at now 31% of all cases, up from ~10% just a week ago. The #COVID19 rise & divergence hidden by fast dropping #AlphaVariant. 🧵
2) Notice the strong divergence of #DeltaVariant vs #Alphavariant. This was why the rise of Delta was hidden so long underneath total case counts dropping and plateauing
3) this was hospitalization in the UK one week earlier. Very different than before #DeltaVariant domination. ~30% of deaths even among those fully 2 dose vaccinated, according to PHE (England’s CDC). This is the Delta.
Read 20 tweets

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