Coronavirus Fight

Dr. Fauci Continues To Battle Administration On Covid-19 Handling

Dr. Anthony Fauci has acted at the US’s figurehead in regards to the Covid-19 pandemic and ways we as a country can curve the spread. President Donald Trump and his administration, however, are continuing to sideline Fauci as a Covid-19 expert and contradict his advice by expressing their skepticism about the severity of the virus/treatments for the virus. 

More recently, Trump claimed that he “disagreed” with Fauci’s claim that the US was in a bad place in its coronavirus response, despite the fact that the US is one of the only countries in the world that’s still seeing an increase in case numbers and deaths. Trump went on to claim that Fauci was the one who’s been “making a lot of mistakes” in terms of Covid response. 

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The public has generally stayed on Fauci’s side as he, along with the rest of the countries healthcare professionals, have been basing their claims off the national/international data that’s been collected regarding the virus and how it works, however, that hasn’t stopped the administration from trying to take Fauci down. 

Trump retweeted a call for Fauci to be fired back in April after he continuously has had to correct the president specifically on his false claims regarding the virus; for example, when Trump was telling individuals that taking hydroxychloroquine could kill the virus, despite the FDA’s warning against doing exactly that. 

Trump can’t actually fire Fauci, and if he did the public would likely be very outraged; Fauci currently has a 67% approval rating for how he’s handled the pandemic, which is about three times the approval rating for Trump’s response. White House officials instead have taken to the media and internet to damage Fauci’s reputation, one recent example being an official telling CNN that “several White House officials are concerned about the number of times Dr Fauci has been wrong on things.” 

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Fauci himself has had enough of standing on the podium after Trump to disprove the false claims he’s spread about the pandemic, so much so that according to insiders Fauci hasn’t briefed Trump on the coronavirus since the first week in June. 

For those who may not be aware, Fauci has had a long career in public health. His name first entered the public eye during the AIDS epidemic where he also, at the time, contradicted the president’s handling of the virus. In a recent podcast interview, Fauci delivered an assertive assessment of the US’s handling of the pandemic in comparison to the rest of the world.  

“You have to be having blind-folders on and covering your ears to think that we don’t live in a very politically divisive society now, from a political standpoint. So I think you’d have to make the assumption that if there wasn’t such divisiveness, that we would have a more coordinated approach.”

The pushback from the president and his administration has been continuously detrimental to the way in which the US has fallen victim to this virus. More American citizens have been killed by Covid-19 than in World War 1. America alone makes up about 28% of all Covid-19 cases in the world as well. 

Regardless of your opinions on Fauci, we can’t deny that America is currently enduring one of the biggest crises it’s ever seen. Listening to your own healthcare professionals/providers is of the utmost importance right now and regardless of political beliefs, make sure you do your research and see for yourself what the facts are.

HIV Drug Medicine

Over 70 Countries Experiencing Shortage In HIV Medication Due To Pandemic

More than 70 countries in the world are currently at risk of running out of essential HIV medication due to the coronavirus pandemic and the multitude of vaccine trials using drug cocktails that involve said medication. 

According to a survey conducted by the World Health Organization (WHO), twenty-four countries currently claim to have a “critically low” stock of antiretroviral medicine, more commonly known as ARVs. ARVs are largely used around the world as a therapy to treat HIV, and now a majority of these countries are seeing disruptions in their supply chains as a direct result of the pandemic. 

WHO Director-General Tedros Adhanom Ghebreyesus stated recently that the organization thinks “the findings of this survey are deeply concerning.”

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SUDAN – JUNE 18: Sudanese pharmacists, holding banners protesting against medicine shortage

“Countries and their development partners must do all they can to ensure that people who need HIV treatment continue to access it. We cannot let the COVID-19 pandemic undo the hard-won gains in the global response to this disease.”

In May of this year the WHO and the Joint United Nations Program on HIV/AIDS estimated that AIDS-related deaths in sub-Saharan Africa specifically could double due to a six-month disruption of access to ARV medication.  

The estimation itself applies only to 2020, however, that doesn’t make it any less staggering. While there may not be a direct cure for HIV/AIDS, ARVs and drug treatments like it have made it so individuals can get to a place where they’re completely undetectable, and therefore, untransmittable, which is remarkable when you think about what the AIDS epidemic looked like in the 1980’s and how bleak the future looked in terms of the virus. 

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Pharmacy owner Abdulaziz Othman speaks about the acute shortage of medicine at his drugstore in the Sudanese capital Khartoum

The fact that we’ve gotten to a place where HIV and AIDS can practically disappear from an individual’s body goes to show that we should all remain hopeful for a Covid-19 treatment/vaccine, however, it’s important that we continue to provide resources to parts of the world that need HIV/AIDS relief the most. 

According to the WHO survey some of these main “disruptions” that are causing so many countries to struggle with their ARV supply includes the closure of air and land transportation, failure for suppliers to deliver the medication as a result of that, and a limit on access to health services due to Covid concerns. 

In 2019 alone more than 25 million people received ARV treatment; which is around the average every year for HIV treatment using antiretroviral medication. Now, the WHO is predicting that number will be much smaller because of the pandemic. 

This past weekend the WHO also announced that they would be discontinuing a Covid-19 vaccine trial that involved a drug cocktail using lopinavir and ritonavir; two HIV medications. While both drugs are regularly used in ARVs and successfully help treat individuals with HIV, the medications produced “little or no reduction in the morality of Covid-19 patients.” 

Drug and vaccine trials are continuing to develop throughout the world, but in the meantime it is imperative that we continue to listen to our healthcare providers and remain indoors as often as possible. If we want to get to a place where Covid-19 becomes completely undetectable and untransmittable, we have to take every necessary precaution.

U.S. Coronavirus Pandemic

Official U.S. Covid-19 Death Toll Higher Than Initial Reports Suggest

The number of confirmed positive Covid-19 cases and deaths in America that is circulating throughout the media everyday is substantially much lower than the actual number, according to a recent study posted this Wednesday in the JAMA Internal Medicine Journal. 

Researchers from Yale University, who have been collecting data on the pandemic since it began, used information from the National Center for Health Statistics to compare the number of weekly US deaths from March 1st to May 30th to previous years as well; when the country/world was covid-free. 

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What they found was that there was an obvious excess in the number of deaths this year compared to normal death rates in America for the spring. The excess was likely caused by the coronavirus, although it’s difficult to know which portion of the deaths were unrelated to Covid, however, this evidence is what led the researchers to believe that such a sharp increase in deaths when compared to what’s normal shows that the number may be undercounted. 

Dan Weinberger, an epidemiologist at Yale’s School of Public Health and one of the lead authors of the study told the media that other factors could contribute to this increase in deaths outside of just Covid-19; he gave the example of people avoiding emergency treatment for serious medical conditions out of fear of contracting the virus. However, Weinberger doesn’t think that’s what’s mainly driving the numbers up. 

“Our analyses suggest that the official tally of deaths due to Covid-19 represent a substantial undercount of the true burden.”

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The United States reported 781,000 deaths between the months of March and May this year. That number is approximately 19% higher than the average amount of deaths in America for this time of year (or 122,300 more deaths). Of those 122,300 excess deaths, 95,235 were recorded as being related to Covid-19 in one way or the other. Researchers believe that the remaining deaths were also brought on by Covid, but could’ve also been attributed to pre-existing conditions in the patients that the virus further intensified. 

Covid-19 affects almost every system within the body, but it’s impact on the circulatory system has doctors seeing an increase in heart attack and stroke in older patients who contract the virus. Heart attack, stroke, and cardiovascular illnesses in general are already such a heavy killer every year all around the world, so Covid has only made that issue much larger. 

The reports publishing is a direct result of the massive spikes in cases the US is currently seeing due to premature reopenings of businesses, and lack of enforcement over health and safety protocols meant to halt the spread. New cases in the US grew by 5% in 40 states, but even that statistic is likely to be undercounted. A lack of access to testing facilities is also a major reason researchers believe the number of confirmed cases is much higher than the public thinks. 

Researchers also claimed that some of the inconsistencies in the data was likely related to the intensity and timing of increases in testing in particular states. The main reason for releasing this report was to get Americans who have been acting casually throughout the past few months to start grasping the reality of this pandemic. There’s likely a lot more positive cases out there than we think so continue to listen to your health care professionals and abide by proper social distancing/lockdown protocols. 

California Coronavirus

California Governor Prepares For Second Statewide Lockdown Amid Spikes In Covid-19 Cases

California Governor Gavin Newsom claims that the state is setting daily records this week for new cases of Covid-19.

Florida State Coronavirus

Florida Continues To Report Massive Spikes In Covid-19 Case Numbers

Florida was one of the states that recently lifted its coronavirus lockdown, it’s also one of the states that’s seeing a massive surge in new Covid-19 cases due to that premature reopening. The Florida Department of Health reported an additional 3,286 cases of coronavirus this past Tuesday, bringing the entire state total to 103,503 cases. 

Medical experts in the state are attributing the rising numbers to younger Floridians participating in summer vacation activities, an increase in testing facilities which led to an increase in knowledge of case numbers, more social contact brought on by multiple businesses reopening to the public, and potentially the multiple large protests that have been occurring throughout the past month, however, the protests may have nothing to do with the rise in numbers according to experts

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Carlos Gimenez, mayor of Miami-Dade Count

Data compiled by researchers at Florida International University within the past two weeks has shown that in the Miami-Dade County, Florida’s most populated county (2.7 million residents), citizens are experiencing about 35 new cases of Covid-19 every day. A rise in hospitalizations, ICU visits, and ventilation use has also paralleled this increase in case numbers. 

“Municipalities received guidelines on reopening but they do not have guidelines on when to pull back, which is why it is so critical to monitor the cases closely before the hospitals and ICUs start to have capacity issues — which is something we have avoided so far in Miami-Dade County,” said Dr. Mary Jo Trepka.

While there isn’t a direct reason behind this increase in case numbers, health experts are attributing most of it to the reopening of Florida in general. Children are also now on summer vacation and were previously in quarantine for an extended amount of time, so it makes sense that they would want to be outside as much as possible, however, as the numbers show, the country just isn’t there yet. 

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Health experts have continued to urge Floridians, even with all the reopenings, to continue to wear a mask, practice social distancing, wash your hands, and stay home if you feel sick or symptomatic in any way. Florida as a state, however, does not legally require masks to be worn in public places, despite the state’s health department strongly recommending it. 

Florida is one of many states that are now reporting record-breaking single-day highs for new Covid-19 cases. One ICU unit in Miami-Dade county has already reported they’re at maximum capacity. 

“A week ago we had eight patients, none on a ventilator, and within 10 days we’re now at over 40-plus patients, four on ventilators. We’ve had to find a second Covid unit and are looking for a third Covid unit right now,” said Dr. Andrew Pastewski.

The biggest concern in Florida, and the rest of the country, is a second-wave of the virus occurring in the fall, as experts have warned that a second-wave would likely be much worse than what we’ve endured throughout the past few months; over 2 million cases of Covid-19 and over 120 million deaths. The reopenings of multiple states and the almost automatic spikes in case numbers two weeks after those reopenings is evidence enough that the US is nowhere close to ready to return to a life of normalcy, and this virus will continue to be a problem for the nation until a vaccine or proper drug treatment is discovered.


US Government Stuck With Stockpile Of 63 Million Doses Of Hydroxychloroquine

The US federal government is now stuck with 63 million doses of hydroxychloroquine after the Food and Drug Administration (FDA) revoked permission for the drug to be distributed and taken as a Covid-19 treatment. The government began stockpiling the drug back in March when this pandemic first began and we weren’t aware of any solid treatment options to combat it. 

The FDA officially revoked their authorization of hydroxychloroquine use this past Monday, stating that “there was no reason to believe the drug was effective against the virus, and it actually increased the risk of side effects such as heart problems.” 

The government, however, initially ignored the FDA and any other warning against the use of the drug, especially after President Trump went on record stating hydroxychloroquine was a “very encouraging and powerful game-changer” in the fight against the coronavirus. 

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Now, the US is dealing with a stockpile of 63 million doses of hydroxychloroquine, plus another 2 million doses of the drug chloroquine, which is a drug similar to hydroxychloroquine that pharmaceutical company Bayer donated to the US back in March. 

“Nationally, we put a great emphasis on one drug, hydroxychloroquine. I worry that history will judge this as having over-invested in one treatment pathway as opposed to looking more broadly at a larger number of treatment candidates,” said David Holtgrave, the dean of the School of Public Health at the University at Albany before the FDA ended up unauthorizing the use of the drug. 

Before the FDA revoked its authorization a major stockpile of 31 million doses had already been distributed throughout the US. Major pharmaceutical companies from around the country began “donating” their doses to the stockpile once the announcement was made. In general, hydroxychloroquine is used to treat diseases such as malaria, rheumatoid arthritis, and lupus, in fact, it’s been a successful treatment for all of these ailments for many years now. 

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Once Trump began praising hydroxychloroquine for its ability to combat the coronavirus, individuals who have any of the above illnesses claimed to have trouble accessing the drug, as individuals and companies began stockpiling it to redistribute for a profit. 

“[The FDA’s] decision to authorize hydroxychloroquine in March was based on evaluation of the EUA criteria and the scientific evidence available at that time. However, many infectious disease experts, including those who’ve studied the drug for coronavirus, say there was never any evidence that the drug worked for the virus,” FDA Commissioner Dr. Stephen Hahn stated.

Every infectious disease expert/healthcare worker who studies the drug has claimed that there was never any evidence to suggest that it could help kill the coronavirus. Trump’s consistently emphasized, however, that the drug had “a real chance to be one of the biggest game changers in the history of medicine,” and for some, hearing that from the president of the United States in the middle of a global pandemic was enough to regain some hope and want to stock up on some hydroxychloroquine.

Since the FDA’s renouncement of their authorization, two major studies have been published that fully proved hydroxychloroquine was ineffective against Covid-19. So for now, it’s important that we continue to listen to our health care professionals directly for all medical updates regarding the coronavirus, and continue to abide by social distancing/quarantine measures.

Corona Virus 3D

Healthcare Officials Fear Massive Second-Wave Of Covid-19 After 19+ States Report Spikes In Cases

Weeks after stay-at-home orders have been lifted across the nation fears of an even worse second-wave of Covid-19 appear after 20+ states report record numbers of hospitalizations within this past week. Many scientists and health care experts are already claiming that states will have to go back under shut down within the next few months if the curve continues to increase at the rate that it is. 

The emphasis on re-closing these states lies in the fact that many of these experts strongly believe a second wave of the coronavirus will hit the US much harder than the first time; America’s now lost over 115,000 citizens, for comparison around 116,000 American lives were lost during World War 1. 

“The pandemic is far from over. More than 115,000 Americans have died from coronavirus, and hundreds more are dying from the virus every day. Covid’s not taking a summer vacation, it’s actually having new opportunities to spread,” said Dr. William Schaffner, an infectious diseases expert and professor at Vanderbilt University Medical Center.

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The biggest concern over a second shutdown is the economic impact, as of right now more than 44 million Americans have lost their jobs since March when this pandemic initially began. Unfortunately, the fear over shutting down the economy again is driving the decision making in the White House, as more states and cities are continuing to open. 

Health care experts have been quick to point out that places like Hong Kong, China, and Singapore, have all had to endure a second wave of shutdowns due to new cases of Covid reappearing after they reopened. Japan’s second largest island, Hokkaido, also reopened too prematurely leading to a resurgence in cases, however, after their second shutdown they completely eradicated the island of the virus. 

If American citizens want to avoid a second shutting down of the economy, they simply need to continue to abide by the CDC’s health and safety guidelines, regardless of what establishments are reopening in their particular state. This virus is still very much a pandemic issue especially in America, which has been one of the most impacted countries in the world due to its casual response to the virus. 

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“People must observe the safety guidelines, social distancing must be observed. Face coverings in key places must be observed. We’ve got to take action now so that we avoid a shutdown in the future,” said top White House economic adviser Larry Kudlow.

The more recent spikes in cases are likely due to the many Memorial Day Weekend gatherings that occurred a few weeks ago based on the timeline of how this virus works and moves; hence the emphasis on continuing to wear a mask and socially distant. 

The economic impact of a second-wave of shutdowns will likely destroy a majority of our economy unless our federal government takes more direct action to fund the proper resources and facilities to help combat this virus. However, we can still continue to do our part in remaining vigilant and protecting ourselves and loved ones from potential infection.

Mom & Daughter with Face Masks

World Health Organization Says Asymptomatic Spread Of Covid-19 Is ‘Very Rare’

Asymptomatic coronavirus patients, or patients who contracted the Covid-19 virus without exhibiting any symptoms, are not likely to spread the virus as easily as someone who would be showing symptoms, according to the World Health Organization (WHO), which made an official statement this past Monday. 

According to experts, we already knew that young people or adults who are considered to be very healthy were the least likely to show any symptoms if they were to contract Covid-19. Others may not develop symptoms until days after they get infected (up to 14 days). As we know, and have seen, this virus spreads very easily, and quickly, from person-to-person contact. Even if an individual wasn’t exhibiting symptoms, health experts still believed they could transfer the virus to another individual, because that infected person could just be in their 14 incubation period before symptoms actually appear.

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Now, WHO isn’t as convinced that individuals who don’t exhibit any symptoms can spread the virus; but it’s important to note that this does not mean you should start taking the pandemic any less seriously if you haven’t exhibited any Covid-19 symptoms within the past few months, if anything, it means the opposite. 

“From the data we have, it still seems to be rare that an asymptomatic person actually transmits onward to a secondary individual. It’s very rare,”  Dr. Maria Van Kerkhove, head of WHO’s emerging diseases and zoonosis unit, said.

Again, WHO doesn’t want the world to start taking the severity of this virus any less seriously, instead, they made this announcement as a means to shift the focus of some health experts throughout the nation. They’re urging government officials to prioritize their responses on detecting and isolating infected people exhibiting clear Covid-19 symptoms, this way, experts can more easily start tracking anyone else who may have come in contact with the infected individual. 

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From that point forward, individuals who the symptomatic patient has come in contact with can become aware that they may also be infected, but asymptomatic, and while they may not be able to spread the virus as easily, they should self-quarantine for at least 14 days to ensure that no symptoms end up appearing. 

Van Kerkhove also emphasized that asymptomatic or pre-symptomatic spread of the virus has been the main cause of outbreaks in America’s nursing homes, however, as we know individuals in nursing homes are more likely to be infected simply due to their age and any pre-existing conditions they may have. 

“More research and data are needed to truly answer” the question of whether the coronavirus can spread widely through asymptomatic carriers. We have a number of reports from countries who are doing very detailed contact tracing. They’re following asymptomatic cases. They’re following contacts. And they’re not finding secondary transmission onward. It’s very rare,” Van Kerkhove added.

Again, this claim doesn’t change the severity of the pandemic, but instead will shift the way the US handles it moving forward. The findings themselves could suggest that in order to control the virus, we shift our focus onto those with symptoms, while continuing to emphasize that seemingly healthy individuals should also stay home. 

As new developments continue to be made everyday there’s one fact that’s held completely true; this virus is very unpredictable, so continue to listen to your health experts, wash your hands consistently, practice social distancing if you need to go out, and continue to remain in lockdown for as long as you can.

Doctor with Coronavirus Vaccine

Researchers Predict Covid-19 Vaccine Will Require Two-Doses To Be Effective

Researchers and scientists alike are predicting that when a vaccine treatment is developed for the coronavirus, it likely will be two-dose series. The two doses will likely occur a month apart with the possibility of another booster shot several years into the future. 

We still don’t know a lot about the virus that causes Covid-19; specifically referred to as SARS-CoV-2 by experts. Scientists all across the globe are working on dozens of potential vaccines for the coronavirus, and now that many are getting close to a breakthrough, they’re also able to better understand what the treatment itself will look like. 

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The two doses are a direct result of that lack of knowledge. Since this is a newly emerged virus that no one person has developed full on immunization/antibodies for, two vaccine doses would provide that extra level of protection. This practice occurs a lot with new vaccines, for example, when the gardasil treatment to prevent HPV first emerged a little over a decade ago, it started as a three dose treatment, and has remained as such to this day because doctors realized those three doses protect the body from most strains of HPV. 

Multiple strains of Covid-19 are obviously another major concern, so like the HPV vaccine treatment, doctors want to ensure they have as many bases covered as possible. The first shot would prime the patient’s immune system by giving it a small dose of the virus’ antibody so that the body’s immune system can recognize it. The second shot would do the same thing with an even higher dose of antibodies to allow your body to really fight it off. 

“Of the more than 100 vaccine candidates in various stages of testing, almost all are expected to be a two-dose regime. As far as I am aware, with one set of exceptions, all the front-line vaccine developers are contemplating two shots. The one exception is Merck, which last week pushed forward on two vaccines, each of which they hoped would be one-shot vaccines,” said Barry Bloom, an immunologist and professor of public health at the Harvard T.H. Chan School of Public Health in Boston.

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Successful vaccine treatments obviously won’t be available until human trials begin and healthcare experts can really see how this virus, the vaccine, and the average person’s body reacts. One of the other main concerns is if two doses will even be enough to provide proper immunization against Covid-19. It’s unclear as to whether or not this vaccine treatment will work like the measles vaccine and everyone only has to get it once every several years, or if it’ll be more like the flu shot where it needs to be annually updated. 

Bloom claims that based on the research they have now, it’s more so looking like the vaccine will remain effective for several years before an individual has to get another booster shot. It’s mainly dependent on the individual’s antibody response, as some people with pre-existing respiratory/auto-immune illnesses may need to get the booster earlier than others. 

“In the common coronaviruses that cause the common cold, immunity tends to last from three to six months to almost always less than a year. It may be completely different with this coronavirus, with SARS-CoV-2, it may be that they induce a response that’s quite durable. But if it acts like other common coronaviruses, it’s not likely going to be a very long duration of immunity,” said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, in an interview.

There may be no way around a two-dose vaccine, however, compared to what the world is currently enduring, two shots a year sounds like child’s play. These facilities are working tirelessly everyday to develop a vaccine as quickly as possible, so for now, make sure you’re continuing to listen to your healthcare experts about how to practice proper hygiene and social distancing.

Covid Antibody Test

New Report From CDC Claims Half Of All Coronavirus Antibody Tests Are False

The US Centers for Disease Control and Prevention recently listed a compilation of new guidance on their website that stated antibody tests used to determine if an individual has been infected with Covid-19 may be wrong half the time. The tests specifically look for evidence of an immune response in the body to determine, and now the CDC is claiming that they shouldn’t be used to “make decisions about grouping persons residing in or being admitted to congregate settings, such as schools, dormitories, or correctional facilities,” according to their website. 

The CDC is now encouraging health officials not to use these tests to make decisions about when essential workers can return to their workplace if they’ve been infected. Health care providers should also ensure that when they do give patients an antibody test that they’re using the most accurate test possible and are able to test the individual twice to be sure that the result is accurate. 

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“In most of the country, including areas that have been heavily impacted, the prevalence of SARS-CoV-2 antibody is expected to be low, ranging from less than 5% to 25%, so that testing at this point might result in relatively more false positive results and fewer false-negative results. The higher the sensitivity, the fewer false negatives a test will give. The higher the specificity, the fewer false positives. Across populations, tests give more accurate results if the disease being tested for is common in the population. If an infection has only affected a small percentage of people being tested, even a very small margin of error in a test will be magnified,” the CDC said.

One of the biggest concerns is the false positives that some individuals are receiving. A false positive could lead someone to believe that they had the virus and have a certain level of immunity over it when they could’ve actually never had it at all. It’s also extremely important to note that even if the positive test result is accurate, no one is immune from this virus, and you shouldn’t believe that you have no chance at getting it again simply because you have the antibodies. We still don’t know how this virus fully works and mutates, so everyone must continue to ease on the side of extreme caution. 

“It cannot be assumed that individuals with truly positive antibody test results are protected from future infection. Serologic [antibody] testing should not be used to determine immune status in individuals until the presence, durability, and duration of immunity is established,” (CDC). 

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In general, the CDC doesn’t want anyone to use antibody testing as a means of making certain policy decisions. We need to be looking at actual case numbers and rates of infection more than anything when it comes to loosening quarantining measures. They claim that this testing can be wrong so often because of how common the virus is now. 

“For example, in a population where the prevalence is 5%, a test with 90% sensitivity and 95% specificity will yield a positive predictive value of 49%. In other words, less than half of those testing positive will truly have antibodies. Alternatively, the same test in a population with an antibody prevalence exceeding 52% will yield a positive predictive greater than 95%, meaning that less than one in 20 people testing positive will have a false positive test result,” (CDC).

The best way to receive an accurate test result is to take a test with higher sensitivity. High sensitivity antibody tests are much less likely to give a false positive specifically. The Food and Drug Administration has joined the CDC in expressing their hesitation in using antibody results for policy change. For now, both organizations encourage double-testing, and remaining diligent on all other social distancing measures as well.