Sweden introduces new guidelines for people who have tested positive for antibodies

[scarby]

New guidelines were published by the Public Health Authority of Sweden yesterday.

They state that based on current knowledge, a positive antibody test most likely means that the person is protected from reinfection for up to six months from the date of receiving the test result.

Under the new guidelines, people belonging to risk groups who have tested positive for the antibody can now socialise in the same way as people outside risk groups can do. Likewise people not in risk groups who have received a positive test can meet people in risk groups who have not tested positive - such as grandparents, for example.

The authority stresses that this is not to be seen as 100% risk-free and judgements should be made according to each individual situation. Also that even with a positive antibody test, people should still follow general recommendations such as good hand-washing hygiene and not mixing with people if they feel unwell.

"The new coronavirus has only been studied for a limited number of months and therefore it is reasonable to have an estimated time period of up to six months," said Karin Tegmark Wisell, head of the Public Health Agency's department for microbiology. "There are no confirmed re-infections today."

You can read more here from The Local, Sweden's news in English:

https://www.thelocal.se/20200630/th...people-who-have-taken-covid-19-antibody-tests

Obviously the "anti-Swedish approach" sections of the media have remained silent about this, as of course this natural immunity acquired by a controlled spread through the population is currently one of the best tools we have to assist a return to normality.

 

[yorkie]

This sounds very sensible.

 

[island]

I would be very happy to have something such as this in place.

 

[Domh245]

Sensible, but if anything a little on the cautious side.

We've heard the reports of people who've almost certainly had it, but who've tested negative on antibody tests (as @Bletchleyite says - positive means you definitely had it, negative means absolutely nothing), but it's definitely a good step. So long as it doesn't result in people actively trying to infect themselves to try and get a positive antibody test!

 

[Mag_seven]

The authority stresses that this is not to be seen as 100% risk-free and judgements should be made according to each individual situation. Also that even with a positive antibody test, people should still follow general recommendations such as good hand-washing hygiene and not mixing with people if they feel unwell.

And there we have it - tell people what the risks are and allow them to make decisions for themselves rather than impose them. Its what we do with practically every other risk that we face. I would like to have seen the world adopt Sweden's approach.

 

[yorkie]

Sensible, but if anything a little on the cautious side.

We've heard the reports of people who've almost certainly had it, but who've tested negative on antibody tests (as @Bletchleyite says - positive means you definitely had it, negative means absolutely nothing),.....

Indeed; it appears that some people have T-cells that can can fight Sars-Cov-2 without necessarily having to produce antibodies.

 

[AdamWW]

And there we have it - tell people what the risks are and allow them to make decisions for themselves rather than impose them. Its what we do with practically every other risk that we face. I would like to have seen the world adopt Sweden's approach.

But surely there's a big difference here.

I can choose whether or not to wear a seat belt or to start smoking, and I'm the person most likely to be impacted.

Tell people it's up to them whether or not they go to the pub etc. and if there's a "second wave" it puts everyone at risk.

So I don't think saying that we should treat the same as other risks is the right argument.

If I fancy my chances at driving in the wrong direction down the M1 at 80 mph, I think most would agree that isn't a decision I should be left to make myself.

 

[Richard Scott]

But surely there's a big difference here.

I can choose whether or not to wear a seat belt or to start smoking, and I'm the person most likely to be impacted.

Tell people it's up to them whether or not they go to the pub etc. and if there's a "second wave" it puts everyone at risk.

So I don't think saying that we should treat the same as other risks is the right argument.

If I fancy my chances at driving in the wrong direction down the M1 at 80 mph, I think most would agree that isn't a decision I should be left to make myself.

So next time flu comes around you're staying at home otherwise you could be putting someone at risk, where does it end? Reality is this disease will have to go around sooner or later and when we realise that Sweden will be laughing!

 

[yorkie]

But surely there's a big difference here.

I can choose whether or not to wear a seat belt or to start smoking, and I'm the person most likely to be impacted.

Tell people it's up to them whether or not they go to the pub etc. and if there's a "second wave" it puts everyone at risk.

So I don't think saying that we should treat the same as other risks is the right argument.

If I fancy my chances at driving in the wrong direction down the M1 at 80 mph, I think most would agree that isn't a decision I should be left to make myself.

By that logic, the entire human race should stay at home indefinitely.

So next time flu comes around you're staying at home otherwise you could be putting someone at risk, where does it end?

Quite!

 

[Bletchleyite]

The difference with flu would appear to be that it is infectious mostly only when you have symptoms, so rather easier to control.

If you have symptomatic flu (rather than just a cold) and you go out to a public place and spread it, then yes, you need to take a look at yourself and why you're so inconsiderate.

 

[AdamWW]

So next time flu comes around you're staying at home otherwise you could be putting someone at risk, where does it end? Reality is this disease will have to go around sooner or later and when we realise that Sweden will be laughing!

I give up.

I was trying to point out the difference between risk to individual and public health risks but I seem to have failed.

 

[MikeWM]

The difference with flu would appear to be that it is infectious mostly only when you have symptoms, so rather easier to control.

I'm not convinced that is true. See eg.

https://www.influenza.org.nz/sites/default/files/Asymptomatic influenza transmission 20170421.pdf

Influenza transmission by infected but asymptomatic people

Influenza is caused by different strains of influenza viruses. The ability to spread influenza viruses and infect others is usually equated to how much influenza virus is shed by an infected person.

Exposure to influenza virus can lead to infection but not every infected person will have symptoms or feel unwell.

Studies have compared viral shedding by asymptomatic individuals, i.e. those who are infected but have no symptoms, with symptomatic individuals, i.e. those who are infected and have symptoms such as fever, sore throat, muscles aches and pains. Viral shedding by asymptomatic persons occurs for around 3–4 days and by symptomatic persons for around five days. The amount of virus shed by asymptomatic persons was only slightly less than that shed by those with symptoms.

Asymptomatic persons shed influenza virus and can infect others despite a seemingly more robust immune response to infection that stops development of symptoms.

(emphasis mine)

 

[Richard Scott]

I give up.

I was trying to point out the difference between risk to individual and public health risks but I seem to have failed.

We're quite aware of the difference but life comes with risks both personal and public health and flu is in the later. We don't stop for that.

 

[scotrail158713]

So long as it doesn't result in people actively trying to infect themselves to try and get a positive antibody test!

Is that not pretty much what herd immunity relies on though (i.e. a large number of us have to get infected)

 

[Domh245]

Is that not pretty much what herd immunity relies on though (i.e. a large number of us have to get infected)

Indeed it does, but ideally you achieve this through people naturally getting infected over time so that the number of cases that require hospitalisation is within your healthcare capacity (flattening the curve!). The worry is when you start getting people offering to infect others deliberately, but then again the Swedes do seem to be eminently sensible so this worry is probably misplaced!

 

[AdamWW]

We're quite aware of the difference but life comes with risks both personal and public health and flu is in the later. We don't stop for that.

It's clear that at first we weren't going to stop for this either - whether you call it 'herd immunity' or not, the government was going to let it work its way through the population like they do with flu.

Then it became clear there was a serious risk of our healthcare capacity being overwhelmed.

We locked down, and we coped.

Of course we can't know for sure what would have happened if we hadn't, but I haven't seen much since to make me think that all would have been well.

I suspect that if the Swedish approach could have worked here, it would have had to happen quite a bit earlier than the lockdown, and probably we would have had to stop people flying off for ski-ing holidays in half term (or at least quarantined them when they got back).