COVID 19 had hit Andorra significantly......
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Round two of the antibody test results
9.44% of the 69,987 people tested were exposed to the virus at some stage and tested positive (subject to 92% accuracy of the tests), 89% were negative.
In breaking down the results of the tests:-
- IgM - and IgG + 804 persons or 1.15% (This is the long term antibodies so they were infected at some stage much earlier, they might be immune to further contact
- IgM + and IgG - 4,192 persons or 6% (This is the short term reaction antibodies that means they may still have active virus - see PCR tests below)
- IgM + and IgG + 1,593 persons or 2.29% (This means the short term antibodies are in transition to IgG long term and the subject should no longer be infectious but round 2 of the tests will confirm)
Round one antibody test results
A total os 68,326 tests were carried out in the second test bringing the total tests to 137,987 tests. In the second round it was found that 8.5% had had some exposure to the virus ( see round one below).
In breaking down the results of the tests:-
- IgM - and IgG + 650 persons or 0.95% (This is the long term antibodies so they were infected at some stage much earlier, they might be immune to further contact
- IgM + and IgG - 3,813 persons or 5.58% (This is the short term reaction antibodies that means they may still have active virus - see PCR tests below)
- IgM + and IgG + 1,278 persons or 1.87% (This means the short term antibodies are in transition to IgG long term and the subject should no longer be infectious but round 2 of the tests will confirm)
In the above figures of the 1,550 health professionals tested 11% had had some positive exposure.
Update on the change of policy of releasing the first test result...
Due to intense criticism of not releasing any tests results until after the second test two weeks later, the Governement has changed policy and will make available results of the first test. What we do not know at the moment is how this may be done. They are stressing that the results though are preliminary and also should NOT be regarded as diagnostic. Now this brings into question what happens if there are results in the category 1. and 2. as explained below in the test result. In category 1. if the IgM is high and IgG is negative which my indicate a current active virus then it should be essential as a precaution to isolate the person and proceed to the active virus test to confirm diagnosis, A category 2. result which may indicate a recent infection may also require the above attention.
It is not yet clear how results may be "made available" and how the follow up actions as above will be conducted, and that that possibly may be the delay in the appointment schedule in the form of emails from the Comus which were due to start being released a couple of days ago.
The reason why the Government were unwilling to release the first test results without those of test 2 was and still is the unknown in all of this and what the results of the population may reveal. Also the matter of false readings and the areas of unreliability need to be factored in (see below). There are rumours around that companies may also compel employees to reveal their results and that is under discussion with the Labour sector. Currently these results are destined to be for personal and statistical use only.
The planned tests...
The Government has taken delivery of 150,000 tests for antibodies, that is two for each person of the population. They have cost over 1.5 million euros and are reported to be 92-95% accurate. They have been made in China.
Every Comú is now ready as are the 500 or so volunteers each day to take the tests in more than 50 collection points across the country. They are scheduled to start with the most vulnerable first this Wednesday 29th April 2020. on Monday 4th May 2020. The actual test takes 10 - 15 minutes for the results which will be logged directly into the system. The tests will be free of charge. They are intending to test 5,000 persons per day collectively. The 50 collection points are spread across the Comus and you should take steps to identify where to go. Each Comú has split the testing stations into those that can go by car, "stop Labs", with the family (where no-one will be required to get out of the car) and those without cars who will be tested at the "foot stations". For the vulnerable or special needs home visits can be arranged through the respective Comú.
There will be two tests, finger prick blood tests two weeks apart (you will be notified of the appointment by email). It has been advised that no-one will be appraised of the results until after the second test. This is where matters become unclear so let us examine the science and what the findings may tell
What are these tests results going to tell us?
In a nutshell nobody knows !
Individually they tell very little about the person and the possibility of having been in contact with the virus in the past but when 60,000 (the latest figures for those who have agreed to the tests) or so are put together the scientists and mathemeticians may be in a better position to gauge the depth of the virus within the country and map a way forward for getting back to normal, that is why the Government understandably needs as full commitment as possible across the country. The more persons that do not undergo these tests the less reliable the "herd immunity", and also which parts of the community or commerce sectors are safer than others can be identified. The test cannot be made obligatory due to human rights and the Constitution etc. but if in doubt get your finger out !!
These tests are NOT a test for the active virus, they will NOT confirm whether you are infected or infectious, and a positive result will require a swab test that has been widely used to date, or a gene test. The test is for the detection of two types of antibodies, IgM and IgG.
- IgM is the first reaction to a new virus, and high levels may indicate a recent or possibly current infection.
- IgG is the longer antibody that develops later (just how much later is different in each person) in reaction to having defeated the virus and which may offer possible immunity.
The test results
- If immunoglobulin tests are all negative, the test indicates the person has not been recently exposed to the COVID-19 virus.
- If the test shows only IgM, the person is likely in the early stage of the virus infection and may be infectious;
- If IgM and IgG are positive, the person is likely in the middle stage of infection and not likely to be infectious,
- If the person is only positive for IgG, then the person is either over the infection or in its last stage.
The swab test is for those displaying symptoms or who are known to be in close contact with an infected person, the antibody tests are for those who have no current symptoms or who are not considered to have been in close contact with an infected person. The antibody tests are therefore to test the other part of the population who have not yet figured in any tests. By doing this the truer level of infection asymptomatically and subsequent possible immunity can be gauged en masse.
On 20/04/2020 it was announced that they have tested first all hospital workers and those involved in medical care. There have been some positive results and these have been followed up with the swab test to check if they are infectious, and some have been ordered into isolatuion pending further results of the swab tests. They have also tested 90 odd of those who have already been diagnosed with the virus on average ten or more days since diagnosis and found 96% positive for IgM with 88% positive for IgG, so looking at the section above these results were predictable falling into 3) above as expected after fighting the infection.
The reliabilty of tests have caused controversy around the world
In the absence of follow up swab or other diagnostics (and it has not been made 100% clear what will happen to those who are tested and say land in the positive IgM category 1) above), the tests are only an indication and the following factors also need to be considered:-
- The tests are reported to be 92% accurate, that means approximately 8 out of every 100 may be false positives or false negatives,
- The virus is new, there are no figures in the world as to how or even whether each individual may produce antibodies in reaction to the virus,
- Any antibodies detected may not be specific to COVID 19,
- There are no figures as to how long any immunity (if any at all) lasts in each individual (Tests on SARS patients indicated an average of 2 years immunity in most cases),
- There are no figures to detect what levels of immunity are required for the individual to actually have immunity,
- It takes an estimated 7 to 12 days for IgG antibodies to be produced by the body in reaction to an infection by COVID 19)
Antibody test results so far (to 11/05/2020)
Of the 66,234 people who have volunteered, 56,635 tests have been completed. The first round will be completed this Wednesday and the second round of tests also begin Wednesday. The known results to date:-
- IgM negative IgG negative 90.8% (37,241 persons) - Probably have had no contact with the virus
- IgM negative IgG positive 1.26% (515 persons) - May have had contact but only showing long term antibodies (possible immunity)
- IgM positive IgG negative 5.41% (2,216 persons) - May have had more recent contact as showing no long term antibodies
- IgM positive IgG positive 2.38% (974 persons) - May have had recent contact but also showing long term antibodies and possible immunity
Follow up tests for some with IgM positive on 229 active virus tests have confirmed that 20 of these are positive and they are NOT included in the national figures released daily ( Am not sure why!?)
Anyone who has not put down for the tests can only do so by calling the Comú directly, the online booking system is no longer available.
Andorra receives a few positive mentions in the UK and Foreign press
From Germany to the US and even ANDORRA: Mass antibody testing schemes are being carried out around the world. (Although this original heading has now been replaced)
I like the use of the CAPITALS " even ANDORRA" !!!
There have been quite a few mentions in foreign press all of them that I can find have been positive about how Andorra is dealing with the pandemic and how the residents too are strictly adhering to isolation....