1 00:00:06,680 --> 00:00:12,920 Speaker 1: Welcome to Prognosis. I'm Laura Carlson. It's day since coronavirus 2 00:00:12,960 --> 00:00:17,840 Speaker 1: was declared a global pandemic. Our main story what can 3 00:00:17,880 --> 00:00:23,360 Speaker 1: an antibody test actually tell you? But first, here's what 4 00:00:23,440 --> 00:00:31,520 Speaker 1: happened in virus news today. New York City is on 5 00:00:31,600 --> 00:00:34,519 Speaker 1: track to enter the second phase of reopening on Monday. 6 00:00:35,440 --> 00:00:38,440 Speaker 1: That's the phase that allows restaurants to offer outdoor dining 7 00:00:38,760 --> 00:00:42,960 Speaker 1: and could be a major step for the economy. Statewide. 8 00:00:43,360 --> 00:00:46,320 Speaker 1: Less than one percent of New Yorker's tested positive for 9 00:00:46,360 --> 00:00:50,720 Speaker 1: the novel coronavirus yesterday, the lowest percentage since the start 10 00:00:50,760 --> 00:00:54,880 Speaker 1: of the pandemic. Governor Cuomo said there were seventeen deaths 11 00:00:55,040 --> 00:01:00,279 Speaker 1: on June sixteenth, which was also a new low. New 12 00:01:00,360 --> 00:01:04,280 Speaker 1: York's progress comes as at least twenty other states see spikes. 13 00:01:05,120 --> 00:01:09,000 Speaker 1: Texas reported a record number of hospitalizations and new cases 14 00:01:09,000 --> 00:01:12,679 Speaker 1: in Florida rose to the highest level since the pandemic began. 15 00:01:14,840 --> 00:01:18,959 Speaker 1: Sweden's Grand COVID experiment isn't having the effect the country's 16 00:01:19,000 --> 00:01:23,560 Speaker 1: top epidemiologists had hoped for. The country's strategy was to 17 00:01:23,640 --> 00:01:28,679 Speaker 1: leave schools, shops, and restaurants open throughout the pandemic. The 18 00:01:28,680 --> 00:01:31,240 Speaker 1: theory was that the country would quickly reach a high 19 00:01:31,360 --> 00:01:34,600 Speaker 1: level of immunity to the virus, where enough people have 20 00:01:34,680 --> 00:01:39,920 Speaker 1: contracted the virus to protect most of the population. Contagion 21 00:01:40,040 --> 00:01:42,920 Speaker 1: rates in Sweden are much higher than anywhere else in 22 00:01:42,920 --> 00:01:47,319 Speaker 1: the Nordic region. It's COVID nineteen mortality rate is among 23 00:01:47,400 --> 00:01:51,080 Speaker 1: the worst in the world. Scientists have been eager to 24 00:01:51,200 --> 00:01:54,640 Speaker 1: learn whether the flip side of widespread contagion is a 25 00:01:54,800 --> 00:02:00,080 Speaker 1: higher level of immunity, but only about fourteen percent of 26 00:02:00,160 --> 00:02:05,480 Speaker 1: people tested in Stockholm had COVID nineteen antibodies. That compares 27 00:02:05,480 --> 00:02:09,280 Speaker 1: with the study published this month about Bergamo, once the 28 00:02:09,360 --> 00:02:13,560 Speaker 1: COVID nineteen epicenter in Italy, which showed that fifty seven 29 00:02:13,680 --> 00:02:20,120 Speaker 1: percent of that city's residents had developed antibodies. Finally, governments 30 00:02:20,120 --> 00:02:23,280 Speaker 1: and industry groups from the US to Chile are insisting 31 00:02:23,360 --> 00:02:27,680 Speaker 1: that food poses little risk of spreading the coronavirus. Some 32 00:02:27,800 --> 00:02:31,960 Speaker 1: consumers were skittish after an outbreak in Beijing was blamed 33 00:02:31,960 --> 00:02:36,480 Speaker 1: on imported fish. Chile the top seller of salmon after 34 00:02:36,600 --> 00:02:40,000 Speaker 1: Norway sought to persuade China that its fish was safe 35 00:02:40,040 --> 00:02:44,440 Speaker 1: to import after orders had been canceled. The Norwegian Food 36 00:02:44,480 --> 00:02:47,760 Speaker 1: Safety authority also said there were no known cases of 37 00:02:47,840 --> 00:02:54,919 Speaker 1: infection via contaminated food, and although there is no evidence 38 00:02:54,960 --> 00:02:58,600 Speaker 1: that COVID nineteen can be transmitted through food, experts say 39 00:02:59,000 --> 00:03:07,720 Speaker 1: more research is needed. And now for today's main story. 40 00:03:10,000 --> 00:03:12,760 Speaker 1: It's now relatively easy to get tested to see if 41 00:03:12,800 --> 00:03:17,560 Speaker 1: you carry the antibodies for COVID nineteen. Urgent care centers 42 00:03:17,560 --> 00:03:22,080 Speaker 1: and many doctors offices are offering the tests widely, but 43 00:03:22,400 --> 00:03:24,720 Speaker 1: the signs are still out on whether or not people 44 00:03:24,760 --> 00:03:28,880 Speaker 1: who have COVID nineteen become immune to it. Not to 45 00:03:29,000 --> 00:03:32,680 Speaker 1: mention the possibility that we've reported on before that the 46 00:03:32,720 --> 00:03:36,839 Speaker 1: test you take may not be accurate, so reporter christ 47 00:03:36,880 --> 00:03:39,960 Speaker 1: and V. Brown has tried to answer the question is 48 00:03:40,000 --> 00:03:46,560 Speaker 1: it worth taking the test at all? In March, as 49 00:03:46,600 --> 00:03:49,880 Speaker 1: the world was preparing to go into lockdown, Eve was 50 00:03:49,960 --> 00:03:53,120 Speaker 1: having one last hurrah with grad school classmates in London 51 00:03:53,600 --> 00:03:56,960 Speaker 1: before flying home to San Francisco. Eva's asked us to 52 00:03:57,000 --> 00:04:00,520 Speaker 1: not use her last name to protect her privacy. Vibe 53 00:04:00,520 --> 00:04:03,120 Speaker 1: there in the beginning of March, which I assume it 54 00:04:03,160 --> 00:04:06,480 Speaker 1: was similar, and a lot of America was like coronavirus 55 00:04:06,560 --> 00:04:11,920 Speaker 1: is coming party as hard as we can now before 56 00:04:11,960 --> 00:04:14,960 Speaker 1: this big bad thing comes. They had canceled a ski 57 00:04:15,000 --> 00:04:18,880 Speaker 1: trip to Austria because of the virus, so they made 58 00:04:18,920 --> 00:04:21,240 Speaker 1: the best of it. Beacurely. The last thing I did 59 00:04:21,279 --> 00:04:23,800 Speaker 1: there was I spent like five or six hours in 60 00:04:23,839 --> 00:04:26,800 Speaker 1: a pub with people um and it was like it 61 00:04:26,839 --> 00:04:29,280 Speaker 1: was a fairly crowded pub where I was very good 62 00:04:29,279 --> 00:04:32,160 Speaker 1: about washing my hands, but like otherwise we weren't like 63 00:04:32,160 --> 00:04:35,640 Speaker 1: they were definitely shared drinks, shared utensils, like we just 64 00:04:36,120 --> 00:04:40,000 Speaker 1: had no idea. The thing is, the virus wasn't coming, 65 00:04:40,960 --> 00:04:44,800 Speaker 1: it was already there. A few weeks later, after a 66 00:04:44,800 --> 00:04:48,160 Speaker 1: stopover to see some friends in Dubai, Eve was home 67 00:04:48,200 --> 00:04:51,960 Speaker 1: in San Francisco eating a blue cheese and truffle oil omelet. 68 00:04:52,720 --> 00:04:56,640 Speaker 1: Despite that strong flavor profile, she couldn't taste anything. I 69 00:04:56,680 --> 00:04:58,679 Speaker 1: initially thought it was the truffle oil because I thought 70 00:04:59,000 --> 00:05:00,880 Speaker 1: I bought a twenty all our bottle of truckle oil 71 00:05:00,920 --> 00:05:02,880 Speaker 1: instead of a thirty dollar bottle. And so it's like 72 00:05:02,920 --> 00:05:04,560 Speaker 1: this is what I get for being cheap, Like it 73 00:05:04,640 --> 00:05:15,279 Speaker 1: must be bad trouble oil. Losing your sense of taste 74 00:05:15,360 --> 00:05:18,360 Speaker 1: or smell is a symptom of the virus. So you've 75 00:05:18,400 --> 00:05:22,560 Speaker 1: got tested. It turned out she had COVID nineteen, and 76 00:05:22,600 --> 00:05:26,279 Speaker 1: so did basically everyone from the pub that night. So 77 00:05:26,360 --> 00:05:29,560 Speaker 1: imagine her surprise when a few weeks later, two separate 78 00:05:29,560 --> 00:05:37,719 Speaker 1: antibody tests came up negative. Eve had definitely had COVID nineteen. 79 00:05:38,520 --> 00:05:41,720 Speaker 1: Multiple tests had confirmed the diagnosis, as did the fact 80 00:05:41,760 --> 00:05:44,279 Speaker 1: that so many people she had shared food and drinks 81 00:05:44,279 --> 00:05:48,120 Speaker 1: with contracted the virus too, But at least, according to 82 00:05:48,240 --> 00:05:51,800 Speaker 1: these tests, her immune system had not created antibodies to 83 00:05:51,880 --> 00:05:55,599 Speaker 1: fend it off. Then a third test said she did 84 00:05:55,640 --> 00:05:59,960 Speaker 1: have antibodies to the virus. This obviously was really confused. 85 00:06:00,000 --> 00:06:03,000 Speaker 1: Sing There's no point in doing an antibody test because 86 00:06:03,000 --> 00:06:04,800 Speaker 1: if you get an answer that you want, you're gonna 87 00:06:04,839 --> 00:06:06,640 Speaker 1: believe it, and if you get an answer that you 88 00:06:06,640 --> 00:06:08,599 Speaker 1: don't want, you're going to decide that the test was flood. 89 00:06:16,480 --> 00:06:20,960 Speaker 1: Antibody tests are everywhere right now. Doctor's offices are sending 90 00:06:20,960 --> 00:06:24,000 Speaker 1: out text and email blasts urging patients to book an 91 00:06:24,000 --> 00:06:28,159 Speaker 1: antibody test. Today. In some places, even botox clinics have 92 00:06:28,279 --> 00:06:32,920 Speaker 1: opened their doors to offer the tests. But as Eve experienced, 93 00:06:33,080 --> 00:06:37,960 Speaker 1: the tests can offer more confusion than answers. Antibody tests 94 00:06:37,960 --> 00:06:41,160 Speaker 1: measure signals in a person's blood that indicate whether they 95 00:06:41,160 --> 00:06:44,000 Speaker 1: have been exposed to the novel coronavirus. In the past, 96 00:06:45,080 --> 00:06:48,120 Speaker 1: the tests have been plagued by questions about their accuracy, 97 00:06:49,040 --> 00:06:52,160 Speaker 1: and even if a test is accurate, experts have no 98 00:06:52,320 --> 00:06:55,760 Speaker 1: solid proof yet the antibodies mean a person is immune 99 00:06:55,760 --> 00:06:59,719 Speaker 1: to the virus, or for how long that immunity might last. 100 00:07:00,760 --> 00:07:03,400 Speaker 1: So the availability of these tests has really wound up 101 00:07:03,400 --> 00:07:07,360 Speaker 1: creating more confusion than anything. I talked about this with 102 00:07:07,440 --> 00:07:11,200 Speaker 1: Andrew Diamond, the chief medical officer of the primary care 103 00:07:11,320 --> 00:07:15,239 Speaker 1: chain One Medical. He says the company struggled with whether 104 00:07:15,280 --> 00:07:19,080 Speaker 1: they should even offer antibody test to patients. We did 105 00:07:19,120 --> 00:07:21,400 Speaker 1: not take this light list, and we had a We 106 00:07:21,440 --> 00:07:24,320 Speaker 1: had a team of people working on this literally around 107 00:07:24,320 --> 00:07:26,560 Speaker 1: the clock for weeks to make sure that we did 108 00:07:26,560 --> 00:07:30,240 Speaker 1: this the right way. Back in March, the FDA said 109 00:07:30,240 --> 00:07:33,840 Speaker 1: that antibody tests didn't require any kind of regulatory sign off, 110 00:07:34,400 --> 00:07:38,080 Speaker 1: and dozens and dozens of tests immediately flooded the market. 111 00:07:39,080 --> 00:07:42,320 Speaker 1: One major concern was that if the tests weren't specific enough, 112 00:07:42,760 --> 00:07:45,960 Speaker 1: they might tell people they had COVID nightteen when really 113 00:07:46,000 --> 00:07:49,920 Speaker 1: they had encountered a related virus. In other words, people 114 00:07:50,000 --> 00:07:53,280 Speaker 1: might think they were immune when they weren't, and that 115 00:07:53,520 --> 00:07:57,000 Speaker 1: could be a big problem. Andrew said that One Medical 116 00:07:57,080 --> 00:07:59,560 Speaker 1: had a whole team of people whose full time job 117 00:07:59,800 --> 00:08:04,760 Speaker 1: was event these tests. We knew that everybody, ourselves included 118 00:08:04,880 --> 00:08:09,440 Speaker 1: as clinicians and all of our members and public health officials, employers, 119 00:08:09,480 --> 00:08:13,000 Speaker 1: everybody wanted to know from the very beginning of this pandemic. 120 00:08:13,880 --> 00:08:17,760 Speaker 1: Are people immune once they've been sick? Are people immune 121 00:08:17,880 --> 00:08:21,640 Speaker 1: who haven't even had symptoms? Is there more immunity out 122 00:08:21,680 --> 00:08:24,200 Speaker 1: there than we realized? Do we are reclose to her immunity? 123 00:08:24,200 --> 00:08:31,440 Speaker 1: I mean, the curiosity was borderline hysterical. One Medical ultimately 124 00:08:31,520 --> 00:08:34,280 Speaker 1: did decide to offer a test. Once the company found 125 00:08:34,320 --> 00:08:36,960 Speaker 1: one that seemed good enough. Then the issue was how 126 00:08:37,000 --> 00:08:41,400 Speaker 1: do we explain to people what this actually does. Because 127 00:08:42,120 --> 00:08:46,640 Speaker 1: just having a high specificity test that will dramatically reduce 128 00:08:46,760 --> 00:08:49,760 Speaker 1: this risk of a false positive result, but it doesn't 129 00:08:49,760 --> 00:08:53,040 Speaker 1: take that risk of false positive to zero. We started 130 00:08:53,040 --> 00:08:56,040 Speaker 1: asking ourselves, how are we going to explain what that 131 00:08:56,200 --> 00:08:58,839 Speaker 1: risk is and why it matters whether you get a 132 00:08:58,880 --> 00:09:03,520 Speaker 1: false positive? And then, more importantly, how do you interpret 133 00:09:03,679 --> 00:09:07,280 Speaker 1: a true positive result? So let's say the antibody test 134 00:09:07,320 --> 00:09:09,760 Speaker 1: actually gives you the true positive that you really do 135 00:09:09,880 --> 00:09:13,920 Speaker 1: have antibodies, and it's just it's a real result. Then 136 00:09:13,960 --> 00:09:16,520 Speaker 1: what do you do. We don't know that they confer immunity. 137 00:09:16,840 --> 00:09:19,640 Speaker 1: We haven't proven that just because you have antibodies you're immune, 138 00:09:20,200 --> 00:09:23,319 Speaker 1: Andrew said. The Ultimately one medical hopes that the test 139 00:09:23,400 --> 00:09:27,040 Speaker 1: might actually lead people to be more cautious, not less. 140 00:09:27,800 --> 00:09:30,080 Speaker 1: If you were previously thinking, you know what, I already 141 00:09:30,080 --> 00:09:32,600 Speaker 1: had COVID. I was super sick in February. I already 142 00:09:32,640 --> 00:09:34,720 Speaker 1: had COVID. I don't need to worry about this. But 143 00:09:34,760 --> 00:09:37,400 Speaker 1: then you get a negative result, that's going to change 144 00:09:37,400 --> 00:09:41,840 Speaker 1: your behavior, guarantee it. And we've already seen that people say, oh, shoot, 145 00:09:42,320 --> 00:09:45,640 Speaker 1: I guess I didn't have it. And that's actually a 146 00:09:45,920 --> 00:09:49,480 Speaker 1: vastly more likely scenario, more likely outcome that from the 147 00:09:49,480 --> 00:09:52,760 Speaker 1: antibody test, because most people end up with a negative test. 148 00:09:53,320 --> 00:09:55,960 Speaker 1: The number of people who think they had it is 149 00:09:56,480 --> 00:09:58,720 Speaker 1: far greater than the number of people who actually had it, 150 00:09:59,160 --> 00:10:01,439 Speaker 1: so dorusful to do change their behavior. They say, you 151 00:10:01,480 --> 00:10:03,440 Speaker 1: know what, I should take this more seriously. I was 152 00:10:03,480 --> 00:10:05,640 Speaker 1: getting cavalier out there, but now I am going to 153 00:10:05,720 --> 00:10:09,480 Speaker 1: wash my hands and wear this mask, et cetera. Last month, 154 00:10:09,640 --> 00:10:13,280 Speaker 1: the FDA made changes to its policy and now requires 155 00:10:13,320 --> 00:10:19,320 Speaker 1: that antibody test developers seek emergency authorization from the agency. Immediately, 156 00:10:19,600 --> 00:10:22,520 Speaker 1: more than two dozen tests were pulled from the market. 157 00:10:23,880 --> 00:10:27,360 Speaker 1: It's not the antibody tests don't have any use. The 158 00:10:27,480 --> 00:10:30,440 Speaker 1: tests can be really useful for researchers and public health 159 00:10:30,440 --> 00:10:33,480 Speaker 1: officials who are trying to answer questions like how many 160 00:10:33,520 --> 00:10:37,599 Speaker 1: people with COVID nineteen or asymptomatic, or how deadly is 161 00:10:37,640 --> 00:10:41,439 Speaker 1: the virus. But I talked with a lot of doctors, 162 00:10:41,920 --> 00:10:44,800 Speaker 1: and none of them suggested that for the average individual 163 00:10:45,120 --> 00:10:47,920 Speaker 1: the test might be useful for anything other than to 164 00:10:47,960 --> 00:10:53,360 Speaker 1: satisfy a personal curiosity. This was echoed by Congressman Rajna 165 00:10:53,440 --> 00:10:57,080 Speaker 1: Krishna Morty, the chairman of the Subcommittee on Economic and 166 00:10:57,120 --> 00:11:01,679 Speaker 1: Consumer Policy, and a hearing on antibody test recently. The 167 00:11:01,720 --> 00:11:06,320 Speaker 1: truth is many people mistakenly view anybodies as a get 168 00:11:06,320 --> 00:11:09,720 Speaker 1: out of jail free card to return to normal life, 169 00:11:10,160 --> 00:11:13,960 Speaker 1: a dangerous misconception used as a selling point by bad actors. 170 00:11:17,720 --> 00:11:21,120 Speaker 1: Eve says that knowing she had the virus and tested 171 00:11:21,160 --> 00:11:25,600 Speaker 1: positive for antibodies has changed her behavior, even if science 172 00:11:25,640 --> 00:11:30,720 Speaker 1: hasn't fully determined how much immunity antibodies confer. Coronavirus is 173 00:11:30,760 --> 00:11:33,760 Speaker 1: the disease that no one wants to have, but everyone 174 00:11:33,800 --> 00:11:37,160 Speaker 1: wants to have had. And yeah, because you want to 175 00:11:37,160 --> 00:11:39,680 Speaker 1: you want to be past it. But it almost felt 176 00:11:39,679 --> 00:11:43,280 Speaker 1: like I'd like gotten across this like really really really 177 00:11:43,400 --> 00:11:46,920 Speaker 1: dangerous bridge, and I was on the safe side, just 178 00:11:46,960 --> 00:11:49,520 Speaker 1: like waiting for the rest of the world to figure 179 00:11:49,520 --> 00:11:56,280 Speaker 1: out how to get across. A few days after we talked, 180 00:11:56,720 --> 00:12:01,400 Speaker 1: Eve hopped another plane back to London. There, she said, 181 00:12:01,760 --> 00:12:03,280 Speaker 1: at least she would be able to hang out with 182 00:12:03,320 --> 00:12:07,079 Speaker 1: her friends from the pub her own personal immunity heard. 183 00:12:18,200 --> 00:12:21,520 Speaker 1: That was Kristin V. Brown And that's our show today. 184 00:12:22,120 --> 00:12:25,560 Speaker 1: For coverage of the outbreak from one bureaus around the world, 185 00:12:25,960 --> 00:12:30,600 Speaker 1: visit Bloomberg dot com slash coronavirus and if you like 186 00:12:30,720 --> 00:12:33,480 Speaker 1: the show, please leave us a review and a rating 187 00:12:33,600 --> 00:12:37,160 Speaker 1: on Apple Podcasts or Spotify. It's the best way to 188 00:12:37,160 --> 00:12:42,000 Speaker 1: help more listeners find our global reporting. The Prognosis Daily 189 00:12:42,120 --> 00:12:46,280 Speaker 1: edition is produced by Topher Foreheads, Jordan gas Pure, Magnus 190 00:12:46,320 --> 00:12:51,520 Speaker 1: Henrikson and me Laura Carlson. Today's main story was reported 191 00:12:51,520 --> 00:12:56,640 Speaker 1: by Kristin V. Brown. Original music by Leo Sidran. Our 192 00:12:56,760 --> 00:13:01,360 Speaker 1: editors are Francesco Levi and Rick Shawn. Francesco Leavie is 193 00:13:01,400 --> 00:13:06,439 Speaker 1: Bloomberg's head of podcasts. Thanks for listening. H