Speaker 1: Pushkin from Pushkin Industries. This is Deep Background, the show
Speaker 1: where we explore the stories behind the stories in the news.
Speaker 1: I'm Noah Feldman. As the COVID nineteen pandemic continues, antibody
Speaker 1: tests are gradually becoming increasingly available to ordinary people. You
Speaker 1: can get one online, and some employers are even requiring
Speaker 1: that people take them to go back to their jobs.
Speaker 1: But how accurate are these tests really? And if it
Speaker 1: turns out that you do have antibodies that show you've
Speaker 1: been exposed to coronavirus, what does that actually mean about
Speaker 1: what you should or shouldn't be doing. Next. Here to
Speaker 1: answer these questions is doctor Alex Marson. He's a biologist
Speaker 1: and an infectious disease doctor. He's a tenured professor of
Speaker 1: microbiology and immunology at the University of California in San Francisco,
Speaker 1: where he's the director of the Gladstone Institute of Genomic
Speaker 1: Commune Knowledge. Alex, thank you so much for joining me. Alex,
Speaker 1: your lab ordinarily does high throughput genomic engineering research, which
Speaker 1: is very cutting it stuff. And then when the COVID
Speaker 1: nineteen pandemic started, you went to your lab team and
Speaker 1: you said, okay, we're completely changing course. We're going from
Speaker 1: the highest tech to relatively lower tech, and we're going
Speaker 1: to look at the antibody tests that are out there
Speaker 1: and we're going to see if they work. So, first
Speaker 1: of all, what gave you the idea to do this?
Speaker 1: It's a great question, and looking back, it was really
Speaker 1: it was a confluence of a few things. It was necessity,
Speaker 1: and it was really in many ways motivated more by
Speaker 1: the people in my lab, or equally by the people
Speaker 1: in my lab as it was by me. Our lab
Speaker 1: was shut down. People weren't able to go in and
Speaker 1: work on their normal projects, but there was a real
Speaker 1: feeling in the lab that people had expertise and motivation
Speaker 1: to try to figure out what they could to be
Speaker 1: useful in the midst of this pandemic. It was really
Speaker 1: inspiring for me to see grad students and post docs
Speaker 1: and technicians who were looking for ways to contribute, and
Speaker 1: if anything, I was able to help channel and put
Speaker 1: together collaborations to enable their desire to help out. And
Speaker 1: so we saw a huge flood into the market of
Speaker 1: antibody tests that were becoming available. And actually one of
Speaker 1: the motivations for me was I got a text message
Speaker 1: from a friend of mine not in science here in
Speaker 1: the Bay Area, who showed me that she was testing
Speaker 1: herself for antibodies on one of these home diagnostic kits,
Speaker 1: And so I started wondering, what are the basic test
Speaker 1: performance characteristics of these kits? There were so many that
Speaker 1: were becoming available. We wanted to see could we assign
Speaker 1: some rough numbers to how reliable these tests actually are?
Speaker 1: And so that was really the fundamental goal of this
Speaker 1: study was to say, could we get our hands on
Speaker 1: as many of these test devices as possible and see
Speaker 1: what kind of information they actually give and don't keep
Speaker 1: us in suspensey longer? How were they so? There was
Speaker 1: a range. They're so polite. This is the boring answer
Speaker 1: that which was not totally unexpected. Some were reasonably good
Speaker 1: and some were not going to be very useful in
Speaker 1: this And one of the major determinants is how specific
Speaker 1: they are. And especially in a disease like this, where
Speaker 1: there's in many parts of the world is still relatively
Speaker 1: low prevalence, the chance of misinterpreting these results due to
Speaker 1: false positives is very high, and so one of the
Speaker 1: major things that we wanted to check was are these
Speaker 1: giving us results that are going to be confused by
Speaker 1: false positives, perhaps because they're misinterpreting antibio against other viruses,
Speaker 1: like other common coronaviruses that cause common colds. So we
Speaker 1: wanted to see, in a population where we know there's
Speaker 1: no Saris CoV two infection, how many people in that
Speaker 1: negative population had antibodies on each of these devices, And
Speaker 1: so this was really, in many ways the meat of
Speaker 1: this study. We took one hundred and eight blood specimens
Speaker 1: that had been frozen down well before the pandemic, going
Speaker 1: back to twenty eighteen and before, and we asked how
Speaker 1: many of those blood samples showed evidence of antibodies with
Speaker 1: these commercial tests that were popping up, and we saw
Speaker 1: a range. Many of them found a lot of evidence
Speaker 1: of antibodies against saris CoV two in these samples where
Speaker 1: we know that it shouldn't be there, and so those
Speaker 1: results are really disabling for a proper interpretation of these tests.
Speaker 1: If we want to use these antibody tests to measure
Speaker 1: in a population how many people have actually been infected,
Speaker 1: they would cloud that picture strongly, and many of the
Speaker 1: cases detected would actually be false positives. And if we
Speaker 1: wanted to give an individual patient information. We could give
Speaker 1: them very misleading information if we gave them false positives
Speaker 1: and said that they had been infected with stars Cove
Speaker 1: two when in fact they had it. But I want
Speaker 1: to caveat that there were a handful that seemed reasonable,
Speaker 1: and even one test showed one hundred percent specificity, meaning
Speaker 1: no false positives at all, meaning no false positives in
Speaker 1: the limited number that we tested. I've been thinking about
Speaker 1: the fact that in many ways, the way that people
Speaker 1: responded to our results was a Rorschach test of how
Speaker 1: they wanted to see these results or how they were
Speaker 1: predisposed to see these results. And I've been struck by
Speaker 1: some of the news coverage, which really ranged from saying
Speaker 1: antibody tests show great promise to these are complete hooks.
Speaker 1: And my true interpretation is actually somewhere in between that
Speaker 1: in some ways we got out in front of ourselves
Speaker 1: where in response to a pandemic, many many suppliers started
Speaker 1: racing into this market, and it wasn't a total shock
Speaker 1: to me that we saw arrange. I think what was
Speaker 1: a bit surprising was that these tests were becoming available
Speaker 1: to individuals in some cases before this basic information was available,
Speaker 1: and so we felt like we were just building in
Speaker 1: that gap. One thing I've been sensing a lot of
Speaker 1: recently is that as more and more states begin gradual
Speaker 1: kinds of opening, lots of people are now saying, gee,
Speaker 1: you know I was sick in March at one point,
Speaker 1: or I had a long lunch with someone whom I
Speaker 1: found out later turns out to have had it. Maybe
Speaker 1: I should look into having an antibody test now. And
Speaker 1: one question that they asked me, probably because they have
Speaker 1: heard me talking about your results, is how reliable are
Speaker 1: these tests now? I don't know what to tell them,
Speaker 1: So I'm asking you, what would you say under these circumstances.
Speaker 1: I have companies on the whole taken the lessons of
Speaker 1: your research and figured out so that more of the
Speaker 1: tests that are available now are like the better ones
Speaker 1: that you saw. So there were probably at least one
Speaker 1: hundred different companies that are offering different tests, and these
Speaker 1: will pop up in different in different settings. We tested
Speaker 1: sampling of these. We tested about twelve of these different tests,
Speaker 1: and we have a website available so that people could
Speaker 1: compare our results to whatever test information may be becoming available.
Speaker 1: How would people find that website? What should they be
Speaker 1: looking for the COVID Testing Project dot org. Now, keep
Speaker 1: in mind it's a preprint, it has not yet been
Speaker 1: peer reviewed, and it's a small sample, and so it's
Speaker 1: not intended to guide any kinds of clinical interpretation, but
Speaker 1: it provides some basic information. We've been in conversation with
Speaker 1: a larger testing effort that has now come up as
Speaker 1: part of a governmental effort. The National Cancer Institute is
Speaker 1: now doing a large test in concert with the FDA,
Speaker 1: where FDA is going to be assessing tests for antibodies
Speaker 1: going forward with the National Cancer Institute. And there's another
Speaker 1: website on the National Cancer as website and on the
Speaker 1: FDA website that you can look and find information about
Speaker 1: commercial tests that are now undergoing evaluation by the FDA.
Speaker 1: So the short answer is, let the buyer beware. Right,
Speaker 1: you may not even be able to find reliable information
Speaker 1: online about whether a given test you're taking is reliable
Speaker 1: or not. That's true. I think we're starting to see
Speaker 1: now some of the larger commercial vendors that have traditionally
Speaker 1: been major suppliers of lab diagnostics entering into this field
Speaker 1: and playing a bigger role. That these large vendors get
Speaker 1: into it. There's a hope that there's more consistency and
Speaker 1: more quantitative information on the levels of antibodies and also
Speaker 1: on the test performance characteristics. With the rapid diagnostics, not
Speaker 1: only is there variation among the different vendors, but there's
Speaker 1: some anecdotal reports that even within something bearing a label
Speaker 1: of one particular vendor, there may be batch variation, and
Speaker 1: so the picture is even more clouded with these rapid diagnostics.
Speaker 1: So the one takeaway there would be, if you really
Speaker 1: really feel like you have to get the test, send
Speaker 1: it away. Don't do one of these rapid diagnostic tests
Speaker 1: at home. If it looks like a pregnancy test, probablesion
Speaker 1: rely on it. So we've been thinking a lot about
Speaker 1: this going forward, about what are the possible ways that
Speaker 1: you could have an efficient testing algorithm. So if someone
Speaker 1: does a home pregnancy test, what's the first thing they
Speaker 1: do with that information. If it's a positive, well, they
Speaker 1: go to their doctor and they get a lab based test.
Speaker 1: And so maybe there's some opportunity to do something like
Speaker 1: that where there's a more complex algorithm that could be devised,
Speaker 1: where there's multiple tests that are used for confirmatory testing,
Speaker 1: where it's either a combination of home diagnostics or a
Speaker 1: combination of home diagnostics and lab based to expand the
Speaker 1: testing infrastructure without sacrificing sensitivity or specificity. That requires some
Speaker 1: more thought about exactly how that algorithm is designed, but
Speaker 1: I think these types of test performance numbers are the
Speaker 1: basic building block that you would use to design an
Speaker 1: algorithm like that. Going forward, let's talk about what someone
Speaker 1: could actually do if they did one of these tests
Speaker 1: it was reasonably reliable and they got a positive. Given
Speaker 1: the relative uncertainty that's out there, what would it mean
Speaker 1: for someone who said, well, I've tested positive. If anything.
Speaker 1: I think that there's really two measurements of what it means.
Speaker 1: One is how likely is it that it's actually giving
Speaker 1: reliable information about whether or not you've been infected? And
Speaker 1: the other implicit question, which I think is what people
Speaker 1: really care about, is what information is it giving you
Speaker 1: about how likely you are to get reinfected in the future.
Speaker 1: And so let me tackle both of those. The first
Speaker 1: is we are getting to a point where some of
Speaker 1: these better tests, especially the lab based diagnostics, are starting
Speaker 1: to give reasonably reliable information about whether or not there
Speaker 1: are in fact antibodies present in an individual's blood. The
Speaker 1: second piece is much more complicated, What do we actually
Speaker 1: hell someone who has a positive antibody test. I think
Speaker 1: no matter how many times we say in the news
Speaker 1: that we can't yet tell someone if they have a
Speaker 1: positive antibody test, they're actually protected from future infection. People
Speaker 1: have such a strong intuition and desire for antibodies to
Speaker 1: mean immunity that I'm concerned that there will be an
Speaker 1: implicit behavioral message that people are safe from prior infection
Speaker 1: and should take on risks and go into the community
Speaker 1: and do things that they wouldn't otherwise do without real
Speaker 1: science to back up to that behavior. So I think
Speaker 1: right now we're starting the next round as a community
Speaker 1: of scientific fact finding to start saying how can we
Speaker 1: advise people about risk of future infection if they do
Speaker 1: test positive for antibodies. There's really a big range of
Speaker 1: what infectious disease doctors can come to expect from what
Speaker 1: antibodies and prior infection mean for the prospects of symptoms
Speaker 1: and contagion on reinfection, there's a few lines of evidence
Speaker 1: that we as scientists are really looking for that will
Speaker 1: firmly tell us that we can give the recommendation to
Speaker 1: someone that they will be protected. The first are starting
Speaker 1: to emerge now, and these are animal studies. There have
Speaker 1: now been a few animal studies, including one published just
Speaker 1: recently in Science by Dan Baruk's group that looked at
Speaker 1: Reese's macaques infected with SARS CoV two and then reinfected
Speaker 1: upon infection, The monkeys developed signs of immunity and reinfection
Speaker 1: was far less severe. There might be small amounts of
Speaker 1: virus that actually infected the monkeys, but they seem to
Speaker 1: clear it relatively and quickly and didn't have signs of
Speaker 1: infection similar to the first infection, So that's highly promising.
Speaker 1: How that will translate to humans remains to be seen,
Speaker 1: and there's two levels of questions. One is will people
Speaker 1: clear the virus and not have severe symptoms and will
Speaker 1: they be contagious because that's also something people care about.
Speaker 1: Can you go back to work and not worry about
Speaker 1: spreading it to more vulnerable people that you also come
Speaker 1: in contact with, and that will require time. We'll be
Speaker 1: right back in the monkey studies. Were they able to
Speaker 1: determine whether they were infectious to others or were they
Speaker 1: only able to determine how much they showed symptoms or
Speaker 1: clear the virus. It looked like they were really only
Speaker 1: able to see evidence of symptoms and quick viral clearance
Speaker 1: and really pretty limited levels of virus infection, if any.
Speaker 1: Because that seems hugely significant, right, I mean, if it
Speaker 1: were to turn out that what was observed in monkeys
Speaker 1: was also replicated in humans, so that you would get
Speaker 1: a much milder case the next time around, that would
Speaker 1: be very reassuring to individuals. But if you had a
Speaker 1: mild case and we're still infectious to others, we don't
Speaker 1: want you going back out into public at that point.
Speaker 1: And we definitely don't want you walking around and thinking
Speaker 1: that you're effectively immune because you could be as much
Speaker 1: of a spreader as the next person. Right, So that
Speaker 1: these data are incredibly important and to my knowledge or
Speaker 1: not yet available for this particular virus. So the upshot
Speaker 1: of that for an ordinary person, just to bring it
Speaker 1: back to the you know, our hypothetical person who's thinking, So,
Speaker 1: now this person takes a test, it's a send away
Speaker 1: test from a reliable deliverer. Having done due diligence, our
Speaker 1: person now thinks that he's been exposed and has antibodies,
Speaker 1: and he says, Okay, now I'm going to go out
Speaker 1: and go about my business and interact with people, and
Speaker 1: the takeaway for that person is not so fast. Yeah,
Speaker 1: you know this was brought home poignantly to me recently.
Speaker 1: I had a conversation with a close family friend who
Speaker 1: called me up and said, should I take an antibody test?
Speaker 1: I really want to be able to see my grandson?
Speaker 1: And I said, look, I would love to be able
Speaker 1: to tell you that a positive antibody test could safely
Speaker 1: mean this, that you could you would be protected, but
Speaker 1: we don't yet have that information. I so deeply understand
Speaker 1: the yearning to have that level of security, but trained
Speaker 1: as a doctor, I don't feel that I yet have
Speaker 1: enough information and to say that the test result would
Speaker 1: allow me to actually recommend that you'd be safe to
Speaker 1: go and change your behavior in any way that you
Speaker 1: wouldn't otherwise. And although it's hard to put numbers on
Speaker 1: these things, how confident would you have to be? I mean,
Speaker 1: I understand that as a physician, you want to be cautious, right.
Speaker 1: You don't want to say to somebody you know what,
Speaker 1: you'll be fine and then have it turn out to
Speaker 1: be the case that they're in some small tale of
Speaker 1: the data where they actually were still able to get
Speaker 1: it again or to give it again. But how confident
Speaker 1: would you have to be to say to somebody, yeah,
Speaker 1: you know what on the whole once you've had the
Speaker 1: positive antibody test, this is basically almost certainly going to
Speaker 1: be all right. Though I'm making you no promises. I
Speaker 1: would like to see the human data. So I just
Speaker 1: told you in detail about the experiment in the monkey model.
Speaker 1: I think that we really need some basic information from humans. Now.
Speaker 1: Some people have been advocating strongly for actually doing what
Speaker 1: I just told you was done to the monkeys, to
Speaker 1: actually doing that in humans, and there's been a group
Speaker 1: of scientists that have signed letters talking about advocating for
Speaker 1: human trials of actually active infection. Now, this has been
Speaker 1: done for other coronaviruses in the past, the kind that
Speaker 1: caused common colds, and for something that causes mild symptoms
Speaker 1: like a common cold, that may be an acceptable risk.
Speaker 1: The question is would it be an acceptable risk here,
Speaker 1: perhaps in a young, healthy individual. I would advocate that
Speaker 1: that's not necessary and perhaps not ethical. In this case.
Speaker 1: I think that there's still high enough rates of transmission
Speaker 1: that well designed studies and high risk individuals should be
Speaker 1: able to give us this information, not quite as rapidly,
Speaker 1: but rapidly enough that we can interpret them. So I
Speaker 1: think what we really need is a carefully designed epidemiological
Speaker 1: study that aggregates all the data from everyone who's had
Speaker 1: antibody testing and watches them carefully over time, especially in
Speaker 1: situations where they'd be high risk if they're healthcare workers
Speaker 1: and high incidence regions, and ask the question very carefully
Speaker 1: and numerically, what degree of protection do we actually see
Speaker 1: in the people who have antibodies? Do they get infected
Speaker 1: and do they spread to their context? Are we moving
Speaker 1: in a direction where we're going to have to rely
Speaker 1: on two kinds of tests simultaneously, where we're going to
Speaker 1: have to rely both on swab testing of whether people
Speaker 1: have the virus in real time and also on an
Speaker 1: antibody test. Or are we heading for a world where
Speaker 1: one of these will predominate over the other. I strongly
Speaker 1: believe that we need both, and we need to be
Speaker 1: very clear about what information we'll get from each of
Speaker 1: those types of tests. The virus testing is the gold
Speaker 1: standard for seeing who is infected with this virus SARS
Speaker 1: CoV two, and that is what happens when people get
Speaker 1: the nose or throat swab. Increasingly this is moving to
Speaker 1: saliva testing, which I think is very promising and perhaps
Speaker 1: more scalable. Those are looking for the presence of the
Speaker 1: virus itself inside of an individual. After about a week
Speaker 1: on average, we start to see the evidence of the
Speaker 1: virus itself will wane, and by about two weeks or
Speaker 1: three weeks with some variability, we'll see that people who
Speaker 1: have been infected will start to produce antibodies against the
Speaker 1: stars covi two and that's where we'll be able to
Speaker 1: detect the presence of antibodies, and those will stay up
Speaker 1: for some period of time, although the exact period of
Speaker 1: how long they'll be detectable we still don't know. We
Speaker 1: have to trace that out farther. But by looking at
Speaker 1: both of those, we'll get information both about early infection
Speaker 1: and later information about who had been infected in the past.
Speaker 1: And if we want to accurately put together measurements of
Speaker 1: prevalence across a population, transmission dynamics, mortality, we really need
Speaker 1: information from both of those, and likewise, for back to work,
Speaker 1: we also need information from both of those. We've talked
Speaker 1: a lot now about will the antibody testing help us
Speaker 1: determine who's safe to go back to work, and we've
Speaker 1: talked about the pieces of knowledge that we still need
Speaker 1: about immunity which will start to guide whether antibody tests
Speaker 1: can tell us whether some people are safe to go
Speaker 1: back to work. But virus testing itself is also important
Speaker 1: for knowing who it goes back to work. One of
Speaker 1: the key things that we know about transmission of this
Speaker 1: virus is that it often occurs from asymptomatic individuals before
Speaker 1: or they even know that they have symptoms, or even
Speaker 1: some people who may never go on to have symptoms.
Speaker 1: And the only way that we could really tell whether
Speaker 1: people are infectious is if we screen for the presence
Speaker 1: of the virus itself. Now this may sound unusual, but
Speaker 1: there was an article in stat News recently about a
Speaker 1: model for this from the adult film industry. It's almost
Speaker 1: too good, yes go on. In response to the HIV
Speaker 1: epidemic in a group of very high risk workers, there
Speaker 1: had to be a model for how to figure out
Speaker 1: how to pe get people back to work with relative safety,
Speaker 1: because most HIV testing that done is actually based on
Speaker 1: antibodies against HIV, but those come up relatively late. Again,
Speaker 1: they don't come up in the earliest acute phases of
Speaker 1: infection for HIV, they wouldn't come up for the earliest
Speaker 1: phases of SARS CoV two. So that means that there
Speaker 1: would be an individuals who could be acutely infected with
Speaker 1: HIV who would be infectious before they would be detectable
Speaker 1: with an antibody. And so the adult film industry has
Speaker 1: come up with a very aggressive testing strategy that depends
Speaker 1: not on the antibody tests used for most individuals, but
Speaker 1: on actual viral testing that would sensitively detect the presence
Speaker 1: of virus at earlier time points. And individuals have to
Speaker 1: get tested at very regular intervals to be cleared to
Speaker 1: go back to work. On the set of an adult
Speaker 1: film industry, I think it's every fourteen days they have
Speaker 1: to get clear to go back to work. And there's
Speaker 1: a whole infrastructure set up with thought about privacy and
Speaker 1: also coming up with a plan for how individuals would
Speaker 1: get treated if they were to test positive, and also
Speaker 1: how contact tracing would be done to identify people that
Speaker 1: have been exposed. And so all this has been actually
Speaker 1: carefully thought about in one industry where there's a high
Speaker 1: risk of viral infection. Now, as a result of this pandemic,
Speaker 1: all industries are at high risk of infection as people
Speaker 1: go back to work, and I think we have to
Speaker 1: give some similar thought. I don't mean to over extend
Speaker 1: this analogy. HIV is a chronic virus, sarrys. CoV two
Speaker 1: is not is something that will get cleared, and so
Speaker 1: the dynamics are quite different. But I think we have
Speaker 1: to think about how can we detect early cases, asymptomatic
Speaker 1: cases and have infrastructure in place to make sure that
Speaker 1: positive cases get treated and traced, to limit the spread
Speaker 1: of infection and to limit mortality and morbidity. The idea
Speaker 1: that we could borrow a protocol from the adult film
Speaker 1: industry is its delicious and it would certainly be fascinating
Speaker 1: if that ended up being being applied more broadly. Can
Speaker 1: I see a totally outside the box quirky question that
Speaker 1: I've noticed in talking to different people, I've noticed that
Speaker 1: serious scientists all say stars CoV two, and they almost
Speaker 1: never say COVID nineteen. Why it seems to me like
Speaker 1: a little insider outsider code. I've actually realized this recently
Speaker 1: talking to some people that this is confusing. I think
Speaker 1: the simplest way to explain this is by analogy to
Speaker 1: HIV and AIDS. AIDS is the disease caused by HIV
Speaker 1: and STARS. CoV two is the virus that causes COVID
Speaker 1: nineteen the disease, And so when we're really talking about
Speaker 1: the mechanics of infection, scientists will gravitate to talking about
Speaker 1: the name of the virus rather than the syndrome that
Speaker 1: it causes, since there's a wide range of outcomes of
Speaker 1: what the virus may actually do, and so COVID nineteen
Speaker 1: is actually just the name of the syndrome. So it's
Speaker 1: the person is suffering from COVID nineteen having been infected
Speaker 1: with the stars CoV two exactly. And I think that
Speaker 1: actually has been a genuine source of confusion. When will
Speaker 1: your lab be able to be up and running and
Speaker 1: doing its ordinary but not normal science. We have started
Speaker 1: going back to work now at a drastically reduced capacity.
Speaker 1: One eighth of the lab is able to work now,
Speaker 1: and we're able that people are going in with masks
Speaker 1: and keeping their distance from each other and working in isolation.
Speaker 1: To start returning to their long term projects. I again
Speaker 1: was inspired during this period until this where people were
Speaker 1: so excited to have a chance to do the science
Speaker 1: that they're passionate about, even if it wasn't their actual
Speaker 1: PhD project, to be able to take the underlying skills
Speaker 1: that they're cultivating and apply them, and people express real
Speaker 1: gratitude to have the ability to work on stars copy
Speaker 1: two testing, COVID nineteen testing during this epidemic. And so
Speaker 1: we're continuing some of this but also transitioning back to
Speaker 1: the more long term science that we've been focused on
Speaker 1: on crispergino engineering of human immune cells to try to
Speaker 1: think about treating a wide range of human diseases. And
Speaker 1: I think people are also glad to be continuing to
Speaker 1: work on this pandemic, but think broadly about how they
Speaker 1: can make contributions to human health even beyond that too. Well,
Speaker 1: let me take the opportunity to thank your lab members
Speaker 1: and you for the contribution you've made on czars Cove two,
Speaker 1: but also for the work you're doing all the time,
Speaker 1: and to wish you guys a good opportunity to get
Speaker 1: back into the lab at more than one eighth and
Speaker 1: go back to continuing to try to make the world
Speaker 1: a little bit of a better place. Thank you very much,
Speaker 1: Alex for your time. I walked away from my conversation
Speaker 1: with Alex with a kind of mixed picture of developments
Speaker 1: in the antibody testing space. On the one hand, I
Speaker 1: heard some measured optimism from Alex that the originally not
Speaker 1: that impressive tests that he discovered when he and his
Speaker 1: lab went to measure the effectiveness of the antibody tests
Speaker 1: at first are starting to get a little bit better,
Speaker 1: especially those that are send away laboratory tests. That said,
Speaker 1: despite this progress, Alex thinks it is still not soon
Speaker 1: enough to tell people that once they have those antibodies
Speaker 1: that they can go around treating life as normal, because
Speaker 1: we still do not know what degree of immunity, if any,
Speaker 1: is being conferred by the antibodies. For that will need
Speaker 1: more time and more research. Alex also points out that
Speaker 1: going forward, to get people back to work and get
Speaker 1: the world open, we're going to need much more testing,
Speaker 1: both testing of people who currently have the virus and
Speaker 1: also antibody testing. So more tests remain a crucial desideratum
Speaker 1: for reopening the economy, and last and definitely not least
Speaker 1: Alex suggested that we may actually already have an available
Speaker 1: model from industry that helps us know how to get
Speaker 1: people back to work, the model of the HIV testing
Speaker 1: protocols put in place by the adult film industry. If
Speaker 1: it turns out that the adult film industry has something
Speaker 1: significant to contribute to getting people back to work, that
Speaker 1: will be one of the great surprises. Let us just
Speaker 1: say of this entire strange COVID nineteen pandec and although
Speaker 1: this may sound a little different immediately following a conversation
Speaker 1: of adult films, until the next time I speak to you,
Speaker 1: be careful, be safe, and be well. Deep background is
Speaker 1: brought to you by Pushkin Industries. Our producer is Lydia
Speaker 1: gene Cott, with research help from zooe Win and mastering
Speaker 1: by Jason Gambrel and Martin Gonzalez. Our showrunner is Sophie mckibbn.
Speaker 1: Our theme music is composed by Luis Guerra. Special thanks
Speaker 1: to the Pushkin Brass, Malcolm Gladwell, Jacob Weisberg, and Mia Loebell.
Speaker 1: I'm Noah Feldman. I also write a regular column for
Speaker 1: Bloomberg Opinion, which you can find at Bloomberg dot com.
Speaker 1: Slash Feldman. To discover Bloomberg's original slate of podcasts, go
Speaker 1: to bloomberg dot com slash podcasts. And one last thing.
Speaker 1: I just wrote a book called The Arab Winter, A Tragedy.
Speaker 1: I would be delighted if you checked it out. You
Speaker 1: can always let me know what you think on Twitter
Speaker 1: about this episode, or the book or anything else. My
Speaker 1: handle is Noah R. Feldman. This is deep background