COVID Testing

• First – what is COVID? COVID-19 aka SARS-CoV-2, aka Corona is a Virus that infects body through the respiratory tract primarily and leads to Flu-like symptoms in many people. It is part of the Corona family of viruses, of which most cause the common cold. There are a couple of more serious variants, SARS and MERS. It is thought to spread through contact with the membranes of the nose and mouth in most people and cause illness for a week or two before the body eliminates it. It can however lead to severe illness and death in those people who have risk factors of obesity, poorly controlled diabetes and hypertension, respiratory disease, and frailty from old age.

• How infectious is COVID? It seems this virus is pretty easily transmitted and so it is at least as contagious as the Flu and can spread quickly. Part of the reason it is highly infectious is because it is rather mild in severity of symptoms – deadly viruses tend to kill off the host organisms before they can spread.

• How lethal is COVID? The lethality of COVID is 0.65% for those who get infected overall, but the lethality is much higher for the elderly. For the younger and healthier population, the lethality is pretty close to seasonal Flu, but remember that a significant portion of the population receives an annual Flu vaccination. Once the anticipated COVID vaccine is rolled out the lethality of a COVID infection will likely drop even more.

• How effective is mask wearing? It is estimated that wearing a mask can reduce the chance of infection by close to 70%, regardless of the composition of the mask. This is because mask wearing primarily keeps users from touching their noses and mouths. It is not because of complete blockage of the airborne passage of the virus. The COVID virus size is tiny compared to the passages in most masks, so the mask preventing the virus from passing would be like preventing an ant crawling across a divided highway with some traffic cones. The point is to prevent one from surface contamination of the virus from being transported from door knobs, handles, etc. to one’s nose and mouth by your hands, and to reduce the ID50 or inoculum dose. Your immune system is less likely to be overwhelmed by a small dosage of the virus versus a large dosage upon exposure

First line of defense of the immune system is your skin and membranes which act as a physical barrier.

The second line is the antibodies on patrol – these are like guard dogs. They recognize strangers, alert the body and try to slow down and surround the invading virus. The guard dogs are trained by the body to sniff specific invaders, and are produced in mass to respond to invasions.

The third line is the T cells which are like the “Terminator” cells of the body. They ruthlessly seek and destroy all invaders, and are alerted by the antibodies and have memory of prior invaders. Because the T cells have already been educated to destroy the cold virus, it is estimated that 40% of the population has T cells that can already recognized and destroy CoVID-19 even before the outbreak of CoVID.

Vaccine cross-protection – studies have shown that prior immunization with Pneumovax, Polio, Small Pox have some ability to boost immune system function against CoVID and thus provide some immunity

ACE2 receptor significance – CoVID-19 attaches to the ACE2 receptors as its entry point into the host cells. Both children and people with asthma are more resistant to CoVID and it is postulated that it is because both children and asthmatics have reduced ACE2 receptors in their body.

What are the tests and how are they different? Two tests exist – one is antibody testing of the blood to see if your immune system has produced antibodies to CoVID, and Second is CoVID virus detection in nasal and oral fluids.

Antibody testing detects the presence of immune system soldiers – the antibodies in the blood stream that are made specifically to destroy the CoVID virus. There are two kinds tested for – IgM and IgG. IgM are the early responders in the immune system made to go start the fight against the CoVID infection. IgG is the main troops trained to destroy wipe out the CoVID from the body and take over the fight from the IgM once its deployed in force. The antibody tests detect both IgM and IgG so it will tell you if the infection is recent or older, depending on which antibodies are detected. The antibody test may not detect antibodies in the first 1-3 weeks of infection

COVID virus tests use genetic analysis technology to detect the presence of genetic material from the COVID virus. The COVID virus test will only be positive if an active virus is in the body fluids tested. The CoVID virus test may not be able to detect the virus in the first 2-14 days of infection.

How does one use the two tests to figure out what to do? How does one interpret the tests?

1. People with no symptoms, no known exposure– initial antibody test. If positive antibody test then take CoVID virus test. If negative antibodies can retest every 2 – 3 weeks to ensure not missing the delay in antibody production after first infected

2. People with known recent exposure or recent symptoms– CoVID virus test plus antibody test

3. People with positive CoVID test–  stay in quarantine until 1-2 days after symptoms are gone take CoVID virus test every 1-2 days until two consecutive negative test results before ending quarantine.

4. People with positive antibody test– you are likely to have some built up resistant defenses or possible immunity to another CoVID infection. This may not be true if the CoVID virus mutates into a different strain.

The best defense against infection apart from total isolation is maintaining a strong immune system. Eating a healthy diet, taking time to get regular exercise, avoiding smoking/vaping/alcohol cannot be overemphasized. Nutrition is very important and ensuring that your immune system has adequate supply of Vitamin C, Zinc, Magnesium, and Vitamin B12 can keep your immune system at peak performance.

– Gene Lou, MD