COVID-19 Antibody Testing, Mortality, and Statistics

Antibody test data helps us understand how many “unreported” cases exist (people that had it and didn’t get tested; people who didn’t understand what they had was COVID19; people who felt nothing but had it). Unreported cases can make fatality rates appear higher than reality. Antibody tests can help us also understand what percentage of a population has already recovered and how far up the “herd immunity” curve the population has become. Generally, the more recovered in a population, the less likely it is that an uninfected person will become infected because those with immunity do not make good transmitters of the virus.

The antibody test data below appears to show Infection Fatality Rates (IFR) of COVID19 are in the range of 0.12% to 0.58% which can be compared with Dr. Fauci’s quote of 0.1% for seasonal flu. This is far lower than some early COVID19 mortality estimates of 3%.

The data also shows that millions in the US have already recovered from COVID19 but were never tested for viral presence when they were sick and therefore were not captured by the PCR viral presence test statistics we see everyday. The data suggests that the actual number of US recovered could be somewhere in the range of 4 to 30 million as of late April 2020.

This viewpoint assumes the antibody studies were reasonably correct and the results are not radically different from the unknown realities at other major US population-centers / cities. NOTE: This data was last reviewed early May. It is subject to change as more studies are performed and improvements in existing studies are made.

Antibody Study LocationCOVID Positive Antibody Study Result Extrapolation Error BandCOVID Positive Antibody Result Fraction (Error Bounded to Extrapolated  Study Population)Study Population Adult Recovered ExtrapolationUS Wide Adult Recovered Extrapolation (not properly error bounded)Approx. Confirmed Cases Positive PCR Viral Presence Test Around Study DateConfirmed To Extrapolated MultiplierApprox. Deaths As Of Study DateApprox. Mortality Rate (given adjustments from study)Sources / ReferencesTest SupplierTest Specificity (lower value means more false positives)
LA County 1Low0.0282210006132000799427.6600.00.00271http://publichealth.lacounty.gov/phcommon/public/media/mediapubhpdetail.cfm?prid=2328&fbclid=IwAR23Mk08UdYZo43oqgt3S6mi1V-KlNgu0a4BC-V8LOq4miBt5THfzC5D-IEPremier Biotech / Hangzhou Biotest Biotech95-99%
Median0.0413315008979000799441.5600.00.00181
High0.05644200012264000799455.3600.00.00136
Stanford / Santa Clara 1Low0.01848000394200095650.2100.00.00208https://www.medrxiv.org/content/10.1101/2020.04.14.20062463v1.full.pdf?fbclid=IwAR2ZQe5qCvv6xCmCNykxPcNA1HpOV58yulyQYdeurU4twfc4Qx6OjLDVPDsPremier Biotech / Hangzhou Biotest Biotech95-99%
Median0.024964500545310095667.5100.00.00155
High0.031781000694230095684.7100.00.00123
New  York 1Low015700.0 https://coronavirus.health.ny.gov/system/files/documents/2020/04/nysdohhcpwebinar4.23.20.pdfWadsworth Center’s Assay SARS-CoV-2 IgG 
Median0.13927000003044100025700010.515700.00.00581
High015700.0 
Miami Dade 1Low0.04412300096360001060011.6900.00.00732https://www.miamidade.gov/releases/2020-04-24-sample-testing-results.asp?
Median0.06165000131400001060015.6900.00.00545
High0.079221000173010001060020.8900.00.00407
Chelsea Mass 1Low07120.039.0 https://www.foxnews.com/science/third-blood-samples-massachusetts-study-coronavirusBioMedomics91%
Median0.3212851.27008000071218.039.00.00303
High07120.039.0 


Peer reviewed and formally published LA County antibody seroprevalence study


Testing Overview – 2 VERY different types of tests.

PCR viral presence (nasal / throat mucous swab) tests, when positive, indicate that the virus is present in the mucous swab. This likely means the person is infected unless they are lucky enough to just have a random virus in their mucous but not actually in their body (not likely). Sometimes people who have recovered will have mucous remnants that contain viruses which may be the cause of some “had COVID, recovered, tested negative, then later retested positive again” cases. The PCR viral presence test uses an “amplification” technique that enables the most sensitive equipment to detect fewer than 50 viruses in a sample.

Antibody (blood-sample) serology tests, when positive, indicate that a person has antibodies. Antibodies form very early during infection, usually becoming measurable right around the time symptoms occur and can remain at measurable levels for years after the infection is gone and recovery is complete such that the person has had an acquired immune system response (the part of the immune system that learns how to target specific viruses and “remembers” them). If a person has no symptoms (and/or no PCR viral presence test positive), they are likely in the “recovered” state, have measurable antibodies, and those antibodies likely afford some level of future immunity. Antibodies are what enable someone to recover and many people have had such recoveries. If people still have antibodies well after having recovered, it would be exceptionally odd to think that those antibodies will not perform some immune response as they did in during recovery from the first infection.

According to the following article regarding military COVID-19 cases, it appears that the generally healthy military population had a hospitalization / serious-case rate of about 2.8% and a mortality rate of about 0.09% (3/(6221*0.55). Again these figures are for a generally healthy military population that does not have any part of it’s population on hospice and otherwise in a category of pre-active dying / old-age. The military population may contain some with life-long asthma preconditions but relatively few of the other COVID-19 high risk groups. Data for this analysis is taken from the following article.

Also see Daily Reporting Is Misleading.

If the number of reported deaths are inflated as suspected, the mortality rates stated above need to be adjusted downward accordingly.

Antibody Test Information.

The Abbott Antibody Rapid Test Kit appears to have excellent specificity.

Only tests with very high specificity are accurate enough to ensure a false positive result does not occur. A false positive could occur from an antibody to a virus besides SARS-CoV-2 triggering a positive. This could falsely lead someone to believe that they are immune to SARS-CoV-2 / COVID19 when really they are immune to some other virus. High specificity means that the test ONLY detects antibodies to the specific virus that the test targets.

The simple rapid test kits lack sensitivity to find antibodies in people who recovered long ago from their infection (>20 to 90 days). So a negative result from these rapid test kits does NOT mean that antibodies do not exist in the blood sample. It does mean that there were insufficient quantities to detect with that inexpensive test. A lab grade, high sensitivity, “titrate”, quantitative test is needed to test for older infections. For example, if you think some flu symptoms you had 2, 3, or more months ago may have been COVID19, the rapid test kit finger-prick test will probably not detect it. You will need a higher lab grade “titrate” quantitative high-sensitivity test.

And again, to ensure that the test is highly SPECIFIC only to SARS-CoV-2 / COVID19, the test must have very high specificity.

Assure COVID-19 IgG/IgM Rapid Test Device – Assure Tech. (Hangzhou Co., Ltd)
“Positive results may be due to past or present infection with non-SARS-CoV-2 coronavirus strains, such as coronavirus HKU1, NL63, OC43, or 229E”.

Is this the same as the BD Biomedomics?

ELISA method may be more sensitive than CLIA method in detecting old infections. Certainly the finger-prick lateral flow rapid test kits are not sensitive enough to detect older infections (> 30 to 60 days).

The study below appears focused on “near date of infection” results. Need a study that is “several months after infection”.

Quest has good info on their site and may be among the best?

It appears their Abbott test is a CLIA type which may not be as sensitive as an ELISA type test (see above). They also have tests from 2 other manufacturers. Still researching.

The Solution appears to use the Abbott test which has low false positives (good specificity), but perhaps less than best sensitivity such that it cannot detect recovered infections that occurred more than 1 or 2 months prior.

While this test data is not well reviewed, the average fatality rate from all these test results is about 0.33% which correlates to the better reviewed but narrower statistical sample data shown near the top of this page.

Study/ReleaseTest TypeInfected (%)Undercount/
Ascertainment Bias
Regional
IFR (%)
PopulationLink
Northern France StudySerological25.95820Oise high school studentshttps://www.medrxiv.org/content/10.1101/2020.04.18.20071134v1
Gibraltar StudyPCR270Gibraltar Regionhttps://www.youtube.com/watch?v=FnlMRUWSX2Q&fbclid=IwAR1UO7j5YD_QQnaBwCJRyk1fxr1j0_Vkr7pLJCmqvbvXHPt1FMB82BpYr0U
San Miguel SampleSerological2150Sample of whole Colorado townhttps://www.sanmiguelcountyco.gov/CivicAlerts.aspx?AID=511&fbclid=IwAR3XfQkv1OCSuOY-w1FkDCu0BDGnG07yf-D9_Ilne_Bd8oYAnJ80S6w2QZU
LA County Flu SurveillancePCR51000.01LA Flu Surveillancehttps://jamanetwork.com/journals/jama/fullarticle/2764137?guestAccessKey=525fc308-4cd3-4670-ad73-15b8b019f2a8&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=033120&fbclid=IwAR002a6aaBUV-_4OMIzIofWAjp_DAbB8hZejGVA5BLOvrEUR68tVb1prP8A
International Medical Cluster StudySerological10500.03Moscow Residentshttps://www.reuters.com/article/us-health-coronavirus-russia-antibodies/up-to-one-in-10-residents-of-moscow-may-have-had-coronavirus-infections-laboratory-idUSKCN2262Z7?utm_source=reddit.com
Flu-like SurveillancePCR101000.05Flu Surveillancehttps://www.medrxiv.org/content/10.1101/2020.04.01.20050542v2?fbclid=IwAR0ccDKohage1txFGvJ7kSZavLbhx1xUg_-UcxT_Kjq43rAKXh2GB-0Ttxc
Pregnant SamplePCR71430.05Pregnant Women in Swedenhttps://www.svt.se/nyheter/inrikes/coronatestar-alla-gravida-pa-forlossningen-sju-procent-smittade?fbclid=IwAR2nGl4OLF0rduQVKr3YF4C1K54s45jIym8Y0eEpQTNlfriIkGKrDveCcG0
Denmark StudySerological700.05Capital Regionhttps://www.sst.dk/-/media/Udgivelser/2020/Corona/Status-og-strategi/COVID19_Status-6-uge.ashx?la=da&hash=6819E71BFEAAB5ACA55BD6161F38B75F1EB05999&fbclid=IwAR0yF9-CVqtvldch1wRB0d2esxDwzH-rjv3XRJq62Qt1WWAkR48BIMauvbI
Kobe Serology StudySerological2.76270.06Kobe, Japanhttps://www.medrxiv.org/content/10.1101/2020.04.26.20079822v1.full.pdf
Danish Blood Donor StudySerological1.7110.08Danish Blood Donors < 70 years oldhttps://www.medrxiv.org/content/10.1101/2020.04.24.20075291v1
Homeless SamplePCR36370.08Boston Homelesshttps://www.wbur.org/commonhealth/2020/04/14/coronavirus-boston-homeless-testing?fbclid=IwAR0Ai5luXYXKOGLB8Y-znlk0yXakg5Q_R_mowEV1bU8AGt15VaC2a99Ft7g
Swedish StudyPCR2.5200.08Stockholmhttps://www.folkhalsomyndigheten.se/nyheter-och-press/nyhetsarkiv/2020/april/resultat-fran-undersokning-av-forekomsten-av-covid-19-i-region-stockholm/?fbclid=IwAR2YDRAod3hXJ8CB0-2n3VB2ei30LFB3jsN6Ek9MolXitelycNv6ZpIrm-g
Swedish StudySerological201050.11Swedish Hospital Workershttps://www.ds.se/om-oss/press2/#/pressreleases/var-femte-medarbetare-har-haft-covid-19-2994310
Iranian StudySerological335430.12Guilan province, Iranhttps://www.medrxiv.org/content/10.1101/2020.04.26.20079244v1
Wuhan RepatriationPCR34460.12Repatriation Flightshttps://www.medrxiv.org/content/10.1101/2020.02.12.20022434v2?fbclid=IwAR0xX_0fZLr2K0DCh9X8uIlbE1GJPnRpDikxBrah3UD14vRP21yI3kHDBR8
Greek Repatriation FlightsPCR6.359.650.15Repatriated Barcelonianshttps://academic.oup.com/jtm/article/doi/10.1093/jtm/taaa054/5820895
Private SF StudySerological0.5100.15Self-Selected SF Residentshttps://twitter.com/friedberg/status/1245461209542868992?s=20&fbclid=IwAR2gmBbFnTMcp4pl2d-x8nkvQDXVRB3q-4h3Og3etHmxXZ4W5-g_NbyaABE
Slovenia StudySerological3410.16Slovenian Populationhttps://www.rtvslo.si/zdravje/novi-koronavirus/prekuzenost-z-novim-koronavirusom-pri-nas-nizka/522756
Idaho StudySerological/PCR1.79130.17Boise Populationhttps://www.medrxiv.org/content/10.1101/2020.04.27.20082362v1
Santa Clara CountySerological2.824.50.17Santa Clara Countyhttps://www.medrxiv.org/content/10.1101/2020.04.14.20062463v2
Swedish Serological StudySerological10250.18Stockholmhttps://www.kth.se/aktuellt/nyheter/10-procent-av-stockholmarna-smittade-1.980727
Miami-Dade StudySerological6150.2Miami-Dade Residentshttps://www.miamiherald.com/news/coronavirus/article242260406.html?fbclid=IwAR2svgTSw4gmNvTrCl35bG1lYQtmqkMXOc4Sre_92zLdJx1Uyr1T6FeaR2U
LA CountySerological4.141.50.2LA Countyhttp://publichealth.lacounty.gov/phcommon/public/media/mediapubhpdetail.cfm?prid=2328&fbclid=IwAR3MpnIeX6earYrGRwAGrMWpEr3K5MOk7zB29hgNHJW4krvpyeGJRGEHqT8
SF StudyPCR1.47.040.25Mission District Latinx Populationhttps://www.ucsf.edu/news/2020/05/417356/initial-results-mission-district-covid-19-testing-announced
Iceland Continous SamplingPCR10.28Icelandhttps://www.nejm.org/doi/full/10.1056/NEJMoa2006100
Median Averages23.30.28
Super-spreader StudyPCR15.550.36Super-spreader event in Germanyhttps://www.ukbonn.de/C12582D3002FD21D/vwLookupDownloads/Streeck_et_al_Infection_fatality_rate_of_SARS_CoV_2_infection2.pdf/%24FILE/Streeck_et_al_Infection_fatality_rate_of_SARS_CoV_2_infection2.pdf
Wuhan HospitalSerological1022.10.36Wuhan Regionhttps://onlinelibrary.wiley.com/doi/10.1002/jmv.25904
German SurveySerological14200.37Gangelthttps://www.uni-bonn.de/news/111-2020?set_language=en
Finnish InstituteSerological3.460.39Helsinkihttps://thl.fi/en/web/thlfi-en/-/number-of-people-with-coronavirus-infections-may-be-dozens-of-times-higher-than-the-number-of-confirmed-cases?fbclid=IwAR3bDYNRIQBQFxhJdrmjypoHtbk_thqb5E_ayR9IUU3FUGeXrP3oc6GwpS0
Italian Epidemic ReportPCR10.7300.4Italian Healthcare Workershttps://www.epicentro.iss.it/coronavirus/bollettino/Bollettino-sorveglianza-integrata-COVID-19_16-aprile-2020.pdf#page=13
Switzerland StudySerological5.5100.4Genevahttps://www.hug-ge.ch/medias/communique-presse/seroprevalence-covid-19-premiere-estimation
Second Switzerland StudySerological9.79.550.5Genevahttps://www.medrxiv.org/content/10.1101/2020.05.02.20088898v1.full.pdf
Total COVID-19 Mortality in ItalyPCR67350.5Italy extrapolated to NYChttps://www.medrxiv.org/content/10.1101/2020.04.15.20067074v2
Northern France StudySerological3690.5Oise blood donorshttps://www.medrxiv.org/content/10.1101/2020.04.18.20071134v1
Pregnant SamplePCR14170.53Pregnant Women in NYChttps://www.nejm.org/doi/full/10.1056/NEJMc2009316?fbclid=IwAR0MOuMrCb3xe0lfiNMZwND4FN_HSDimM_fLdBrmDXuWeJzLVc4bnKlH48M
London HCW ScreeningPCR7.1350.54London Health Care Workershttps://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31100-4/fulltext
Madrid StudyPCR11.6310.54Madrid Hospital Workershttps://www.medrxiv.org/content/10.1101/2020.04.07.20055723v1?fbclid=IwAR0mg2DXxFZUNuzYuGuQOkwgQySH5_bUpwODJdWeWFONjCAbheml28hxPCs
HCW Madrid StudySerological/PCR11.2310.56Madrid Hospital Workershttps://www.medrxiv.org/content/10.1101/2020.04.27.20082289v1
New York StudySerological13.911.20.56New York State Residentshttps://www.governor.ny.gov/news/amid-ongoing-covid-19-pandemic-governor-cuomo-announces-statewide-antibody-testing-survey-will
Ohio Prison DataPCR660.57Marion Correctional Institution https://drc.ohio.gov/Portals/0/DRC%20COVID-19%20Information%2005-03-2020%201253.pdf
Czech StudySerological0.450.59Czech Populationhttps://medicalxpress.com/news/2020-05-czech-covid-incidence-population.html
Covid-19 SimulationPCR0.6Repatriation Datahttps://www.medrxiv.org/content/10.1101/2020.03.09.20033357v1.full.pdf?fbclid=IwAR3ATHWmq2CQRMGy95V-YV6LZ4hBZcXt2WJuKhmEBxuvcoHY9mdNM-HsB8E
Dutch SurveySerological3310.67Netherlandshttps://www.researchsquare.com/article/rs-25862/v1
Chelesa DataSerological3330.10.71Chelesa Street Surveyhttps://www.bostonglobe.com/2020/04/17/business/nearly-third-200-blood-samples-taken-chelsea-show-exposure-coronavirus/?fbclid=IwAR3XQlYzGz7cMfc3nmQSAbG8jTICJ7nkG8ZMfH-fObf8QmQ2FYthvSiAEkQ
Continous New York State StudySerological19.9910.060.77New York City Residentshttps://www.governor.ny.gov/news/amid-ongoing-covid-19-pandemic-governor-cuomo-announces-results-completed-antibody-testing
Early French AnalysisPCR80.8Simulationhttps://www.medrxiv.org/content/10.1101/2020.03.22.20040915v4
Italy Town SamplePCR70101Sample of whole Italian townhttps://www.lastampa.it/topnews/primo-piano/2020/04/02/news/coronavirus-castiglione-d-adda-e-un-caso-di-studio-il-70-dei-donatori-di-sangue-e-positivo-1.38666481?fbclid=IwAR2w8-93Obhq4uRHpZYbbn-yEO_LjmCPMtQdXQ-wkkmCInIj9rxXJeEAwJc
Italian AnalysisPCR51Repatriation Datahttps://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30227-9/fulltext?fbclid=IwAR3b9eOpxeQLbUxmxjFHGK2b2M2tM7dRerS0Y5cWPV6H6B1QPqZsN_GzDX0
Ohio Prison DataPCR731.44Pickaway Correctional Institutionhttps://drc.ohio.gov/Portals/0/DRC%20COVID-19%20Information%2005-03-2020%201253.pdf
Scottish Blood DonorsSerological0.620Scotlandhttps://figshare.com/articles/Serological_analysis_of_1000_Scottish_blood_donor_samples_for_anti-SARSCoV2_antibodies_collected_in_March_2020/12116778/2?fbclid=IwAR1wkF1QVZeAt6jDNmeWVJwBmK6Bo8zYPnBRJruvfOYqYO9qFEXuMndjpI8
Wuhan Flu SurveillancePCR1.420Wuhan Flu Datahttps://www.nature.com/articles/s41564-020-0713-1
Covid-19 SimulationPCR5Simulationhttps://science.sciencemag.org/content/early/2020/03/24/science.abb3221.full?fbclid=IwAR3NQ_ybQnjzyysGQPvLsb-9zfKOoHYY22CJMMbry7-mCGEC1LYcTjQf0Z0
17.690.333774


In a small population of generally healthy navy sailors, as of mid-May, 1 death occurred in 1156 PCR viral presence test confirmed positive cases, resulting in a mortality rate of 0.087%. If another death occurs, that would double to 0.17%. Again, keeping in mind Dr. Fauci’s stated rate of 0.1% for seasonal flu across all population including those at higher risk. While asthma is considered a risk factor, it is not known if the navy screens out asthma sufferers and personnel with potential risk factors. But we do know that good general health is a screen for active duty.


Immune System Function


Some great introductory material on the immune system. In about an hour, many people could develop a good fundamental understanding of the immune system.

After reviewing all of the Khan videos, the following videos will strengthen the fundamentals and introduce additional levels of knowledge.


Back To Some Simple Statements From WHO

The WHO’s EXTREMELY MISLEADING statement:

“There is currently no evidence that people who have recovered from COVID-19 and have antibodies are protected from a second infection” – 24 April 2020

When antibodies and specific B / T cells are present, it would be the rare case that some level of immunity is not exhibited.

For the WHO to say there is NO EVIDENCE ignores all data we have with viruses in general, the general function of antibodies and the immune system, various related coronaviruses, SARS-CoV-1, and MERS related viruses.

Antibodies are what enable someone to recover and many people have had such recoveries. If people still have antibodies well after having recovered, it would be exceptionally odd to think that those antibodies will not perform some immune response as they did in during recovery from the first infection.

The WHO statement which has been quoted vociferously is horribly misleading and creates concern about WHO’s ability to communicate accurately.

Additionally, if there was no immunity, then we would expect the millions of recovered in the US alone to be complaining of re-infections, rather than a small number of re-infections that have been documented. These small number of re-infections that have occurred appear to be statistical outliers – rare occurrences.

Also See: Immunology

Jung Eun-Kyeong, Director of the Korean Centers for Disease Control & Prevention
Findings from investigation and analysis of re-positive cases

While not able to find the underlying study at this time, this is an interesting avenue to research further. If true, it could help explain why some Asian countries which were more exposed to SARS-CoV-1 appear to possibly be more resistant to SARS-CoV-2. This is being watched.

Was this the underlying study or is there another?

Is SARS-CoV-2 similar enough to SARS-1 that immune response is of similar behavior? Probably true, so potentially useful to apply SARS-1 learning.