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Antibodies only come up much later in infection and typically too late to be useful for diagnosis. E.g., IgM likely takes 10+ days after infection to develop, while IgG takes longer still (likely at least 14+ days). 3/n
Typically when we talk about "rapid diagnostic tests" (RDTs) those tests detect the antigen derived from the pathogen, not the antibodies against it. RDTs are typically blood-based tests and can often be done doing a simple fingerstick. 4/n
The main issue trying to do this to diagnose COVID-19, is the fact that the virus typically can't be found in the blood, so these blood-based tests won't work for diagnosis. 5/n
RDTs could instead be made to work with sputum or nasal aspirates, but those fluids can be hard to handle compared to blood, which is typically quite 'clean'. That said, I'm quite sure we'll see those tests pop up, only it'll take time. 6/n
In summary: RDTs = measure pathogen antigens (by having antigen-specific IgGs on the test itself). Serology tests = measure antibodies (IgM and/or IgG) to pathogen antigens (by having pathogen-derived antigens (proteins) on the test itself). 7/n
Both of these tests are great and critical, but they serve different purposes - RDTs for diagnostics; Serology tests for understanding previous exposures (e.g., in populations, healthcare workers, etc.) - these can give us estimates of the real number of infected people. 8/n
One comment specific to IgM - these *can* at times be used to diagnose patients that are late in their disease course. This can happen if somebody has had symptoms for quite some time, but no PCR-based diagnostic taken. 9/n
I thought the acute diagnostic tests were PCR tests for covid-19 RNA, not antigen tests. The CEO of Public Health England, Duncan Selbie, said "antigen test" in his latest Friday message and I've had no response to my querying it as yet!
At what point in the infection would this test detect the antigen?
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