[paragsachania]

Originally Posted by The Rationalist

My experience getting Covid-19

Phew!! I really don't know how to react Doc but I must say that you fought like a true warrior and came out unscatched.

Positivity, fear of loss, complacency, faith, medical science, family bonding and most importantly uncertainty ; all of these have revolved around your experience of dealing with Covid and none of these can be ignored.

Apart from the way you dealt with the symptoms medically, you very well have narrated the other important aspect of life on dealing with uncertainties, on managing your near and dear ones when the emotions are running high.

In a single minute, we come across extremely opposite experiences of this very precarious virus that reading more of positive experiences is what we want to better understand how to deal with it.

Thank you Doc for penning down your experience and thank you again (along with the rest of the docs on the forum) who have helped immensely the readers here over the last 6 months. Needless to say, you have been the true warriors during this pandemic.

[ObsessedByFIAT]

Originally Posted by The Rationalist

My experience getting Covid-19
--snip--
What helped you to stay positive during the illness?
--snip--
What would you have to say to others if faced with similar situation?
--snip--
What did you gain from this experience?

Thank you Doctor for sharing this with all of us!
Really happy that one more life is saved! I do not know what it is / how it is to be with a person with Dementia. All I can say is - All will be good!

I loved the way you have organized your life! Everything is either black or white. No grey areas! So to say!

The way you handled the entire phase and have put down your learning, I am sure, just like me, a lot of others will also benefit from it a lot! Thank you!

Finally, just like you said, I too hope and pray that the government takes some measures to improve the health care system and overall well being of the people. As much a the government, I hope and pray that people learn lessons for life about cleanliness, social distancing and maintaining hygiene.

[Fordlover88]

Originally Posted by The Rationalist

My experience getting Covid-19

Congratulations for recovering from covid-19 & thanks a lot for penning down your experiences and sharing it with us.I have been through a similar phase & can relate to your experiences. But i have never thought about the other aspects of it because i dreaded it the most. Or maybe i was too positive or overconfident. Sorry to hear about uncle. I can just hope that things will be alright soon.

[Thad E Ginathom]

Originally Posted by The Rationalist

My experience getting Covid-19

Thank you for your post. It must have been terrible to have the family worries at the same time.

Would I be right that your covid-19 could be called fairly mild, but was still a very unpleasant experience?

I think you mentioned feeling ordinary. You are not ordinary. I strongly feel that no doctor of medicine is ordinary. You have all achieved an amazing feat to accomplish the study and pass your exams, and that before you even set foot in a hospital where you have to survive a long, hard apprenticeship. I have the greatest respect for all of you.

[vivek95]

Originally Posted by Gansan

^^ How much does it cost? Can we directly go for the test or doctor prescription required?

As @Antibody Velumani tweets often, a positive test can remove our stress.

This is the "Total antiboy test" ( IgG+IgM as mentioned in my previous post ) and costed me 850/- at Metropolis, Vashi, Navi Mumbai. I am not sure how much SRL, Thyrocare are charging in Mumbai. I purposely didn't get it done at my own hospital as I didn't want this to be highlighted. In Mumbai, doctor's prescription is not required for any kind of COVID-19 tests including RT-PCR/Rapid antigen and antibody tests.

Originally Posted by Lobogris

Really glad that you were able to deal with the virus without any major difficulties. I will be taking this test myself in a couple of days. In your learned opinion, how accurate are these tests? I hear different percentage numbers regarding their accuracy. I know this is meant just for information but still, if it shows positive, can we be confident that it is say, 90% accurate? If we do another test a few days later and both show the same result could we then conclude that the result is accurate?

Thanks for the kind words Since the longevity of antibodies is not yet known with SARS--Cov2, the chance of contracting a second infection cannot be entirely ruled out. Only 1 in 1000 patients admitted at my hospital has had a Covid-19 infection twice but both times the presentation was a simple flu, virus antigen detected "positive" by RT-PCR method.

Coming to antibody tests, as mentioned in one of my earlier posts long back, the sensitivity/specificity varies with different company kits. Switzerland based Roche diagnostics firm is the one who has supplied its kits for Covid-19 testing in India to chains like Metropolis, SRL, Thyrocare etc. Roche claims a specificity of 99.8% for its Antibody test kit and the test was done using ECLIA - Electrochemical luminescence assay method. Some of the articles that I read said that ECLIA has an acceptable agreement with ELISA method of testing antibodies. (ELISA - Enzyme linked immunosorbant assay).

If you noticed I didn't use the word "accuracy" because this proper statistical term i.e "accuracy of a test" means that the test correctly measures what it is supposed to.

However what really counts for a lab test is the sensitivity and specificity of a test. Sensitivity detects "true positive" patients and specificity detects "true negative" patients. Better way of looking at this is , Specificity excludes "true negatives" and Sensitivity excludes " true positives". Concentrate on the words "detects" and "excludes" to clear the confusion I just created For your question, no need of testing twice if you are turning "positive" by a certain method which claims a specificity of 99%. That's exactly what we are doing with Rapid antigen test for SARS-Cov2 as well. A person testing " positive " on Rapid antigen method indicates he/she is certainly a Covid positive patient, the reason being 99% specificity of the test. However, if someone turns "negative" on Rapid antigen test, we DO NOT establish it as a Covid negative patient because the "sensitivity" of that test is in the range of 66-70%. We subject such people for further RT-PCR method which is highly sensitive and specific both.

[PaddleShifter]

Good explanation Dr. Vivek.

I would like to offer a bit from my side as well.

In the simplest terms for a non-medico, as Dr. Vivek has already explained, sensitivity sort of measures how well a test can identify those who are truly infected. Specificity sort of is a measure of how well a test can identify those who do not have the disease/are not infected.

Higher the sensitivity, lower the chances of missing a positive patient.
Higher the specificity, lower the chances of labeling a non infected patient as positive.

e.g. A test has a performance characteristic, where it is only able to detect around 55% of those who truly are infected but never labels any non infected person as positive. This test will have 55% sensitivity and 100% specificity.
If we test 1000 people using this kit who are truly infected, it will only detect 550 thereby missing 450 positive ones. In other words, we can not rely on this kit for ruling out infection in a patient. But those who detected positive can be comfortably labelled as infected since this kit has very high specificity, i e. it does not falsely label anyone as positive.

An ideal test has 100% sensitivity and specificity. However, this is not practically achieveable for most tests. In such scenarios, more than one test can be combined. First we need to screen people. For this, it is best to use a test that offers very high sensitivity so no positive patient is falsely missed as negative. The ones that test positive can then be confirmed with another test of very high specificity. Hence the terms, screening test and confirmatory tests.

[DCEite]

Originally Posted by Gansan

As @Antibody Velumani tweets often, a positive test can remove our stress.

A positive test can remove our stress but can make us more complacent. One might go soft on social distancing/masking if he/she learns that they have antibodies.

Also, what about a negative test? That would put some people at more distress and unnecessary anxiety.

I think its best to avoid voluntarily testing for antibodies for general public. Perhaps its more suitable for medical personal and front-line workers. Or if the authorities are conducting a sero-survey and you wish to participate (or have to participate).

[Fordlover88]

Originally Posted by vivek95

Tested from Metropolis Vashi, Navi Mumbai outlet and my Antibody levels are pretty high As I used to mention earlier, I had contracted Covid-19 sometime 3 months back for sure. By God's grace, I passed it uneventfully and now the antibodies are significantly produced in my body.

The higher the reactive value, the better it is? Is there any particular timeline of antibody test after recovering for covid-19?

[am1m]

Originally Posted by DCEite

Or if the authorities are conducting a sero-survey and you wish to participate (or have to participate).

I hope the government does conduct more and regular sero surveys. I think they are good indicators (and doctors please correct me if I'm wrong) of how the pandemic is actually spreading in India.

But yes, there is certainly the risk that the same rubbish media and whatsapp 'news' that so far was pushing a covid positive result as a virtual death sentence (that trend having being initiated by early government communication/overreaction of course) might now start swinging the other way and interpreting sero survey antibody results as a form of 'immunity passport'!

[Thad E Ginathom]

Originally Posted by DCEite

Also, what about a negative test? That would put some people at more distress and unnecessary anxiety.

The anxious (for good reason or not) might start making it a weekly event.

[ninjatalli]

Originally Posted by vivek95

Coming to antibody tests, as mentioned in one of my earlier posts long back, the sensitivity/specificity varies with different company kits. Switzerland based Roche diagnostics firm is the one who has supplied its kits for Covid-19 testing in India to chains like Metropolis, SRL, Thyrocare etc. Roche claims a specificity of 99.8% for its Antibody test kit and the test was done using ECLIA - Electrochemical luminescence assay method.
...
However, if someone turns "negative" on Rapid antigen test, we DO NOT establish it as a Covid negative patient because the "sensitivity" of that test is in the range of 66-70%. We subject such people for further RT-PCR method which is highly sensitive and specific both.

Originally Posted by PaddleShifter

In the simplest terms for a non-medico, as Dr. Vivek has already explained, sensitivity sort of measures how well a test can identify those who are truly infected. Specificity sort of is a measure of how well a test can identify those who do not have the disease/are not infected.

Higher the sensitivity, lower the chances of missing a positive patient.
Higher the specificity, lower the chances of labeling a non infected patient as positive.

Thank you gentlemen - it really took both your combined posts for this to get through my thick skull!

One follow-up question - does the specificity improve if we do the antigen test more than once. I remember this scenario happening for stars/etc; in such cases, news articles keep hammering the # of times they have been tested to validate they are actually not positive.

I'm asking with regards from an (still planning) upcoming trip to home after nearly 6+ months. Wondering what should be my next step if the test results come out positive (which means I was already affected and survived) or negative (questionable result due to 66-70% specificity).

[PaddleShifter]

Originally Posted by ninjatalli

One follow-up question - does the specificity improve if we do the antigen test more than once. I remember this scenario happening for stars/etc; in such cases, news articles keep hammering the # of times they have been tested to validate they are actually not positive.

I'm asking with regards from an (still planning) upcoming trip to home after nearly 6+ months. Wondering what should be my next step if the test results come out positive (which means I was already affected and survived) or negative (questionable result due to 66-70% specificity).

1. With regards to increasing specificity by doing antigen test multiple times, one might get more confused if the two tests have varying results.

Secondly, antigen test for COVID-19 suffers sensitivity issue. So a positive patient can be missed by this test. A less sensitive test will miss positive cases while a less specific test will miss negative individuals (means it will falsely label them as positive).

Forget the celebrities, they are in limelight so things work differently for them.

2. Regarding getting tested before an outstation trip, less specific test might label a person positive (since has less ability to detect true positive).

If antigen test comes positive, it means that person is presently infected (antigen comes from virus) but if IgG antibody test is positive, it means person has developed immune response against the virus.

The best test is still RT PCR. We are doing only RTPCR. Today we have completed 24000 tests in our lab. Being a free test for the public, many people get PCR tests done at our lab before going outstation.

Those who get a paid test in private labs etc., usually go for cheaper, rapid tests as long as they just want to get tested only for avoiding any hassles during checking etc. by police.

[hserus]

Two new categories for TN e-pass -

https://www.thenewsminute.com/articl...ls-here-130361

1. Job interviews
2. Office work / meetings

[am1m]

https://www.deccanherald.com/city/to...op-871901.html

"With hundreds of beds empty across the 11 Covid-19 Care Centres (CCC) operated by the government in the city, officials are considering shutting down as many as five including the ambitious Covid-19 Care hub set up at Bangalore International Exhibition Centre (BIEC)."

"BIEC, in a distant Dasanapura, is already dealing with a reduced capacity. It has only 5,000 operational beds out of the 10,100 originally slotted. Out of these, only 1,500 beds in one hall are operational."


Wow, first the headlines warned of a ventilator shortage, then last month we allowed export of ventilators because they were not needed. Then they foretold an acute bed shortage, which is why the BIEC center was fast-tracked. And now...

Happy that the cases (and panic) are declining in Bangalore (and I have always been of the opinion that we all overreacted), but I think this is too early to think about shutting down covid care centers. After doing so much work to get them up and running, I think it makes sense to keep them on standby for a month or two till the case trend shows a definite decline.

[DigitalOne]

Originally Posted by DigitalOne

My guess there will be a turnaround of perception in the general public happening by Aug 1st week. Right now, the public hear of 'rising cases' only. They don't hear of 'rising recoveries' or realize the fact that this disease is fatal only for a very very small percentage. Once they come to be aware of recoveries of people they personally know, they will gradually stop worrying of 'number of cases'.

Originally Posted by am1m

Happy that the cases (and panic) are declining in Bangalore (and I have always been of the opinion that we all overreacted), but I think this is too early to think about shutting down covid care centers.

I had predicted this a month back. Good to see some panic and paranoia subsiding. More people are talking of high recovery rates than rising cases. The positive news coming from Delhi and Mumbai also helping a lot in Bengaluru.