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The new coronavirus test for antibody detects antibodies Immunoglobulin G and M. It is designed for people with symptoms and is a quick test used in China, and to be deployed in Britain. The FDA approved the first antibody test for coronavirus developed by Cellex. Immunoglobulin M is made a few days after infection. Immunoglobulin G is made later and is designed by nature in the human body to neutralize the invading virus. The test gives a positive or negative answer whether these antibodies are present to overcome the virus. Unlike the swab test for the nose this test takes only a pin prick and is quick with quick results. For asymptomatic people the swab test is needed as it detects the material in the nose which carries the virus itself.

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The contrast between lack of effective measures taken in the Lombardy region with the aggressive action in Veneto that has proved effective. Veneto followed the method of quarantining, mass testing for clusters and isolating the affected people.  The Italian government took the first steps to close off northern Italy Feb 22, and it was not till March 10 that a nationwide lockdown was done. The action taken in the Veneto region is shown here in this WSJ report with the town of Vo as an example of steps taken that worked. A microbiology professor and infectious diseases expert at the University of Padua, Dr Crisanti, developed a test for the coronavirus as early as mid-January using the information made public by Chinese doctors. Dr. Crisanti oversaw the testing of 95% of residents of Vo, a town of 3400 people in Veneto region. He found 3% of the population was infected, with half testing positive asymptomatic. Following the aggressive lockdown the tests were done two weeks later and the rate of infection had fallen to 0.1% with only 8 new infections. "The main lesson from VO is that when you have a cluster of infected people, you should do a very aggressive lockdown and then test as many people as possible," Dr Crisanti says. The results from Vo led to Veneto increasing testing in the rest of the region carrying out 80,000 tests, compared to 88,000 in Lombardy, with double the population and 5 times more infections. Lombardy followed government directives to test only those with symptoms. When it spreads it is harder to do the test isolate clusters, test isolate clusters, in a continual loop, yet this remains the method cited by Dr. Brx in the U.S. today as the right way to target clusters in a laser approach. In yesterday's briefing at the White House Dr Brx said this is a method the U.S. is familiar with and has used in Africa to tackle HIV, Ebola Virus. It is possible using GPS to target down to a specific clinic in a specific place, which is how it was successfully done in Africa. ...

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 South Korea has run about 300,000 coronavirus tests, double that in Italy and ten times that in the U.S., says this report in the WSJ. This report shows how the South Korean testing works and the workday of Lee Hyuk-min, a clinical microbiologist at a testing lab of Yonsei University Health System Severance Hospital in Seoul, who is working from 4.45 am to 11 pm. South Korea's effectiveness in controlling the spread is based on a strategy of efficient testing that enables isolating quickly people and areas. South Korea's testing network is a legacy of the MERS coronavirus outbreak in 2015, and the government failure at that time to control it.  It brings together doctors, medical staff, labs, and political leaders in roles following the protocols established since then. Dr Lee and others are the final checkpoint in the system which coordinates a diagnostic operation that combines together 633 test sites and 100 labs. The protocol includes a uniform setup- same testing equipment, same training, same decision making process. At 8 am each day all labs upload results to a shared database, which allows public and private hospitals to monitor patient results and report them to Korea Centers for Disease Prevention and Control. Hospitals upload testing details to an online directory. This surveillance allows South Korea to predict where to concentrate its efforts for controlling spread, says Dr Lee who advises the South Korean government on lab testing issues. Action plan took 2 years for the new rules to be implemented following MERS in 2015. The plan included accelerated bio testing company approval for tests. The first company got approval on Feb 4, followed by 4 other firms. Dr Lee says testing is only part of the equation as labs are needed to process and confirm results. Another key is innovation. South Korea setup testing in drive thru locations, that limit contact and speed up testing, which the U.S. is adopting. Dr Lee says early identification is key, and identifying the first coronavirus patient which was done in South Korea on January 20. Other countries including the U.S. took too long to identify the first patient, says Dr. Lee. ...

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Coronavirus testing is taking off in the U.S. for the first time after the U.S. Federal Drug Administration relaxed testing regulations on February 29, and as more universities and hospitals develop their own testing technology and apply it. The FDA has approved more than 15 tests and many more are awaiting approval. 

This includes UC Davis, Washington University School of Medicine, Brigham and Women's, Harvard Medical School, Mount Sinai Medical Center in New York City, centers that are running the tests limited only by the shortage of reagents supplies.

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Two divergent approaches to the coronavirus are shown in this report in the WSJ. One in Italy which relies on quarantine and lockdown and mandatory social distancing, and the other on keeping borders open and aggressively tracking down the infected using data and testing. In South Korea infections have stabilized at 8000, and in Italy the are rising at 15,000. The divergent approaches and the results vary with the people's history, culture and recent experience. The cultural difference in Asian societies with people willing to cooperate and work together with health authorites for the social stability and good of the country is different from the more individualistic nature of western societies. In addition Italy has a long period of foreign rule of Hapsburgs nd French that has created an attitude of working around authority, the tendency to being furbo which prime minister Conte referred to in a nationwide address.  South Korea and Taiwan also have experience with the SARS and MERS virus during which public health regulations were instituted and comprehensive databases setup that are now being used to combat the new health crisis by tracking down people with health needs. The precedents have taught people in South Korea and Taiwan of how serious this kind of crisis can become, which was absent in Italy in the early stages. Both South Korea and Italy are democracies. The difference being that one has experience with public health crises from experience with SARS, MERS, H1N1, and has developed policy tools, broadened public support and increased state powers in anticipation of such crises. In South Korea there were fines of $8300 for those not willing to be treated and the government aggressively tracked down people. Public support and awareness also helped in controlling the situation. Taiwan has done better than South Korea as covered in a separate article in the WSJ, and shown here, controlling the situation from the beginning including shutting down flights from China early because of its close proximity to China.  ...

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The first home testing kits approved by the FDA are on their way in coming weeks to healthcare workers from LabCorp, says this report in NYT. A test is done at home and returned in an insulating packet to the lab. Cost $119. President Trump says the testing costs will be reimbursed.

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WSJ looks at the significant impact on the presidential race as Mr. Trump is taken to Walter Reed hospital for coronavirus. A lot depends on whether it is mild or severe.

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Soaring numbers of false negatives in coronavirus testing are risking the effectiveness of the British testing program say scientists and doctors. This has reached a high of 30%. The results of testing are skewed because the testing has to be done properly with the swab inserted deep into a person's throat and nose to the point of it being uncomfortable.

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Biotech firm CureVac is developing a vaccine for coronavirus that should be available by fall 2020. It hopes to develop the vaccine using mRNA (messenger ribonucleic acid) as a source of information. Managing director of Hopp Biotech the holding company for CureVac, says mRNA has several advantages, including one related to a vaccine developed by CureVac for rabies. He says 1 microgram could suffice to vaccinate 1 million people because it is very potent, and because it can be mass produced quickly.

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Queen Elizabeth's words on April 5, 2020 during the depths of the coronavirus pandemic will always be remembered, when she said reminding one of of her words in 1940- "We will meet again." "I hope in the years to come everyone will be able to take pride in how they responded to this challenge. And those who come after us will say the Britons of this generation were as strong as any. That the attributes of self-discipline, of quiet good-humored resolve and of fellow-feeling still characterize this country. The pride in who we are is not of our past, it defines our present and our future." "And though self-isolating may at times be hard, many people of all faiths, and of none, are discovering that it presents and opportunity to slow down, pause and reflect, in prayer or meditation. "It reminds me of the very first broadcast I made in 1940, helped by my sister. We, as children, spoke from here at Windsor, to children who had been evacuated from their homes and sent away for their own safety. Today once again, many people will feel a painful sense of separation from their loved ones. But now, as then, we know deep down, that it is the right thing to do. While we have faced challenges before, this one is different. This time we join with all nations across the globe in a common endeavour, using the great advances of science and our instinctive compassion to heal. We will succeed- and that success will belong to every one of us. "We should take comfort that while we may have more still to endure, better days will return, we will be with our friends again; we will be with our families again; we will meet again."   ...

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Tour de France director tests positive. French prime minister takes test after sharing car with the director of Tour de France.

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Slovakia hopes to complete testing of the entire population in 2 days and conduct mass tests again the following weekend.

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Quidel Corp. gets the first FDA approval of an antigen test which tests for the disease itself. Quidel is a company specializing in tests for the flu and infectious diseases. It uses an older technology to detect the disease. Quidel CEO Douglas Bryant, says he will ramp up the manufacturing of the test to go from 200,000 tests a week in the week of May 11, to more than a million a week in several weeks. The current testing technology has several shortcomings. The most common test so far is the PCR test which magnifies virus particles to ease their detection. It is cumbersome technology because it takes time to run the test and analyze the results. The new antigen tests have several advantages. They have a simpler design, are easier to process, and can be produced at lower prices because of the simpler design. They are designed to identify the virus in people in real time, to process results quickly in minutes in Quidel's Sofia analyzers. Because of the simple design and proven technology it can be scaled up quickly to do millions of tests.  The U.S. currently has the problem that it is not able to do enough testing- about twice the current rate is needed to do what health experts recommend. A minimum of 4 million tests weekly is needed and followed up with contact tracing to make it safe for people to go back to work, says Ashish Jha of the Harvard Global Health Institute.   The U.S.   ...

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The testing shortages in the states and the lack of enough cartridges provided by the U.S. government for Abbott Labs testing machines is causing much frustration, as shown here in the WSJ. Illinois one hotspot is an example. Illinois governor Pritzker says he spoke to Abbott Labs a week ago and thought he had an agreement to conduct 3000 tests a day. He then learned that the U.S. government was taking over the purchasing and distribution of the tests.  He  received 15 Abbott machines and 120 cartridges for all of Illinois which would enable 120 tests from the U.S. government. Abbott currently is making 50,000 test cartridges a day for the rapid test. Detroit which had better experience with the Abbott machines says it has conducted 1000 Abbott rapid tests, shortly after Abbott got approval on March 27. With the 1000 tests Detroit was able to test first responders and bus drivers in quarantine. Detroit recently purchased another 4000 additional tests from Abbott which it wants to use in nursing homes and homeless shelters, vulnerable populations in the city. The Abbott test provides result in 15 minutes making it very effective in implementing fast quarantine action when the virus is spreading quickly in a specific population.  Other governors say they are banging their head against a wall trying to get more tests. ...

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This analysis from The Times of London provides critical information on the strategy for successfully tackling the coronavirus following the example of South Korea and progress in Britain.

The random community testing is key to getting an idea of the scale of infections in the community at large. The critical ratio called reproduction ratio tell one if the virus is under control and how lockdowns can be lifted. For Britain this 0.7 estimated by Imperial College. It has a 2 week lag. 1.0 or close to 1.0 is not good. Germany after being at about 0.7 has moved up to 1.0 with 2 week lag in information says the Robert Koch Institute. This means a lot of work ahead, it won't be easy.

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Why the lessons of Wuhan have not been understood correctly says this WSJ report. Merely putting lockdowns is not enough, systematic testing and quarantining of the affected persons is needed for controlling the outbreak. The outbreak in Wuhan was controlled by sending affected persons to makeshift hospitals and temporary quarantine centers. Two hospitals were quickly setup in Wuhan in 2-3 days to isolate affected people from the rest.

It is slow but this is being done as New York sets up a makeshift mobile hospital with 1000 beds at the Jacob Javits Convention Centre. And London sets up 4000 beds at a conference centre in the city.

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In India for the whole country about 500,000 samples are being tested each day at the end of July 2020. This is leading to a jump in cases. It also ensures people who test positive are being asked to isolate to stop the spread of the virus.

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The huge surge in demand for coronavirus testing equipment that has results provided in a short time. The nasopharyngeal swab test is the most in demand. The inability of the manufacturing system to deliver these tests in large enough numbers is still a major problem in fighting coronavirus.