First of the test PCR, which came first: an analysis for the presence of virus in the body, making the patient the diagnosis – COVID-19 or some other infection. These tests, if the doctor prescribes them, is required. While the medical community is actively discussing the topic that this testing is not effective enough, a lot of false negatives. As a result doctors COVID-offices even agreed to diagnose COVID-19, without waiting for the test results if a CT scan produces a “picture” of viral pneumonia.
Alexander Gorelov: test Results depend on the quality of diagnosis and methods used. In pneumonia is the causative agent in sputum or in biological material taken from the bronchi. If the test PCR for rent is so, then the diagnosis will be confirmed. But many patients with pneumonia swab taken from the nasopharynx, and it is meaningless. Is the power phase of the disease, and it must be taken into account. At the initial stage of the disease the test PCR from the nasopharynx will show a positive result, but if the patient has developed pneumonia, virus, relatively speaking, has “descended” into the lower Airways, and “search” it should be there.
as for What the diagnosis COVID-19 put another to the test results, because we are talking about the preliminary diagnosis, to start treatment. But when the test results become known, the diagnosis is confirmed.
the Second type of tests – for antibodies, which produces the body’s immune system in response to the virus spread, they are used to diagnose COVID-19?
Alexander Gorelov: To determine Coveney pneumonia can be used and the antibody diagnostic. But this test can also talk about the fact that a person is already infected with a coronavirus. Early specific antibodies of class IgM appear on the fifth to seventh day of illness, starting two to three weeks later the body produces IgG antibodies. First circulate up to two months, the second six months and possibly more.
the presence of antibodies IgM is possible to judge whether a person is sick or not at the moment, and the presence of IgG antibodies indicates that he has already suffered the disease. This testing also helps to identify those who are ill COVID-19 without symptoms.
are Now actively discussing the version that those 80 percent of the population who are not sick COVID-19, or those who have the disease is easy, could have had other coronavirus infections, and developed antibodies that protect them from COVID-19. What is your opinion?
Alexander Gorelov: I Think it’s an absolute fallacy. Seasonal coronaviruses circulate constantly, causing Ari and diarrhea in 10-20% of the population every year. That is a long persistent IMMUnitate after suffering a coronavirus infection (as, indeed, in the case of the flu) in humans does not occur. Not by chance, we should do an annual flu vaccine. So there is no reason to believe that had been ill informed by another coronavirus, we are protected from the new.
the Second point: the widespread coronaviruses so far have not led to such serious complications, as a new SARS-CoV-2.
Therefore, before the population on these infections so not widely tested. So we don’t know how long a person once had, it remains protected against new infection. Such studies are now just coming, including in Russia.
antibody Tests, we are told, need to recover from COVID being able to donate plasma. But opponents warn of a method: if we pour “fresh” plasma with antibodies to COVID, there is a risk to the patient bring other dangerous infection.
Alexander Gorelov: Concerns related to the violation of the terms of quarantine plasma, justified. But it is necessary to consider the specifics of the moment. Plasma transfusions are allowed during the period of the pandemic on the vital, i.e. the vital indications. So now we are not talking about massive plasma transfusion to all patients in a row, but only those that are between life and death. For their salvation and experimenting with such methods.
But it is best to minimize the risks: plasma must be checked-sensitive Express-methods for different infections (including HIV, hepatitis) and disinfected. These procedures are strictly regulated to ensure maximum safety of the method.
If you strictly follow the logic of evidence-based medicine, any medications and medical technologies, have not yet obtained reliable evidence of their efficacy and safety in clinical trials, should not be applied. But the epidemic is a special case, you get hundreds of thousands of people. They are not left without help, and in such conditions it is allowed to use medicines that you previously created for the treatment of other infections, if there is reason to believe that they can help.
Another argument in favor of testing is that the results stating that the person has been ill and not dangerous to others. Some countries are discussing the introduction of “immune passports”, although who and said that this is not sufficient grounds. Do not?
Alexander Gorelov: with regard to initiatives on the issuance of “immune passports”, in my opinion, this is a pretty pointless idea. You can have a large number of IgG antibodies (late antibodies that say that man had a disease), but the ability to neutralize the viruses they possess, and their presence does not give guarantyth from re-infection.
Besides, as I said, no one knows how long immunity after a previous infection. And what is immune memory cell, humoral? Serological testing (testing for antibodies) allows us to understand just what in the next two months you are protected from infection. But to understand a more distant prospect, we should wait for the research results.
there is much talk about the threat of the “second wave” of the epidemic.Do you think that we have still the chance that the immunity against “the crown” will be long?
Alexander Gorelov: I Think, to expect the formation of stable, long-lasting immunity to the coronavirus unlikely. It’s not measles, not mumps, not rubella, a refresher that once most people become immune for the rest of my life. Unfortunately for respiratory infections, including influenza, is a classic example, even after vaccination, the immunity more than six months is not saved. The new coronavirus is a respiratory infection too. We have yet to figure out how long to it immunological memory.
Vaccination of newborns in Russia has mandatory vaccination of children of other ages are not canceled, but regions are encouraged to make a decision about her suspension, if required by the epidemiological situation, has informed “RG” the assistant to the Minister of health Alexey Kuznetsov.
Deputy health Minister Oleg Gridnev at the meeting of the Federation Council Committee on social policy reported that the system of immunoprophylaxis in Russia after the pandemic coronavirus will need to be revised to reflect the fact that viruses have become the greatest threat to humans. “All vaccinations are certain effects on the human immune system. The reaction in this period is the virus COVID-19 on the body is very problematic,” said Gridnev (quoted by “RIA Novosti”).
the health Ministry noted that in the decision on the continuation of vaccination is necessary in advance to inform the population about the time of vaccination, providing preliminary visits to medical organizations.
Previously, the CPS in his letter noted the expediency of suspending routine vaccination of the adult population within netcalendar vaccination and vaccination schedules in epidotization, with the exception of immunization in epidemic outbreaks.
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