Where are you COVID-wise?

My family recently went through the COVID journey. Of eight in the household, six of us got it. One in mid-2020, and five of us, one after the other, starting about three months ago. Those in the younger generation were sick fairly mildly for a few days. Both my wife and I were down for a week with continuing fatigue and sinus issues for 2-3 weeks more.

We all had COVID the weeks of Christmas and New Years. I don’t intend to get the vaccine (but I have never gotten a flu shot, either). For us, COVID was less of a challenge than the flu.

My wife and I don’t know for a fact we have had Covid, as we have never been tested, although early last year after international travel, we both came down with something flu-like, with a fever and fatigue for about 5 days.

If we don’t get anything with similar symptoms or others that indicate possible Covid, we’re still not going to get tested.

Vaccination is a bit more complicated. Right now, we have no intention of going out to get vaccinated. That may change if my job ends up requiring it, or if it’s required for international travel. If the authorities would change the mask policy to prohibit requiring masks of people that have been vaccinated, I might sign up. Without any of those conditions, getting vaccinated is very low on my priority list and will stay that way.

To this day I still do not personally know one person who has gotten COVID. I guess I’m excluding the above posters because I do not really know them.

Somehow I got COVID in January. No one else in the family, or my daughter’s BJU roommate whom we picked up at the airport right before I got sick, has tested positive or been sick. My wife works as a nurse and occasionally sees COVID patients. She gets tested about every week, always negative, and now she has both doses of the vaccine. I was signed up to get it but got sick and now have to wait. I plan to get it as soon as I’m able. My symptoms were pretty mild, mainly fatigue, slight fever, and headache.

About a day napping for myself and my wife, two kids diagnosed but without much symptoms except my son lost his sense of smell, as did my wife and I, for a few days. The only lingering thing was an irritation in my lungs for a couple of months, since abated. My 101 year old grandmother and her 103 year old roommate also got it and recovered quickly—the nurses around them, half their age or less, all got it far worse (their nursing home was basically a COVID ward for a while) and were amazed how well they recovered. I’m glad I’ve got some of my grandmother’s genetics!

Regarding the vaccine, I’ll listen to what my doctors recommend when they offer the vaccine to me. My gut feeling is that if I have good odds of developing immunity and reducing the rate at which the disease progresses with a relatively minor risk to myself, I’ll do it.

But that said, there’s something very weird about this disease. My wife had clear symptoms and a few antibody tests, but never showed positive. That’s probably one big reason I’d take the vaccine—as a good friend of mine in Mayo pathology notes (he specializes in immunity and such)—is that evidently there are different levels of immunity that are often enhanced by repeat injections of the vaccine (or exposure to a virus/bacteria). That’s why many childhood vaccinations are two or three steps.

So it isn’t a guarantee of long term immunity (whether that means 1 year, 5 years, or life), or that COVID won’t mutate or be replaced by something against which vaccines provide no protection, but at least it’s a start.

You have to be careful with what I am going to say, because there is some kookism out there about this, but it is true that the definition of what “positive” means has changed for COVID over time. Tests “amplify” the DNA in the sample taken to see if there is COVID DNA present. The less amplification needed to get a positive result, the stronger the diagnosis. The problem is, many labs were running several dozen amplifications and labeling people positive when at that level of magnification all kinds of things go wrong. The CDC I believe recently increased the threshold for a positive result (ie less amplification was tolerated). So, a positive test could have been a false positive very easily in the past.

I had symptoms just before new year’s day and got a positive test on 1/2. I quarantined for 10 days (assuming that I had had COVID for a few days before I tested). I had a mild fever, but aches and chills as though I had a severe fever. I also had a cough and slept about 16 hours a day for 6 days. No one else in my household got symptoms.

I had very mild cold symptoms in late January and reluctantly stayed home from church while the family went. I was mostly over it by that Monday. But based on a platelets donation from two weeks later, the Red Cross antibodies test showed positive for antibodies.

Mild cold symptoms went through the whole family, slowly actually (in ones and twos…we have 5 children). We stayed home when we were sick just in case. We didn’t suspect anything more than a cold until my wife and daughter couldn’t smell things. Eventually my wife got tested even though we were treating it as if we had it. It took 6 days to get her results back, and that was positive.

What’s strangest is how long it took for each member to get it. Assuming I had it first, why didn’t everyone else get it about the same time? I was looong over it before the last children showed symptoms. Also: I had been out to breakfast with a guy on the day I started showing symptoms. I checked in with him and he has been fine the whole time. On the one hand, this seems ot be a very catchy sort of germ; on the other…we made 0 efforts to isolate from each other within the family and it still took a while to go through the family members.

I have no idea where I picked it up.

My wife ‘won’ the Minnesota COVID ‘lottery’ and received her 1st shot today. Me: still waiting.

https://twitter.com/jrpeet/status/1365039557436198920

Everyone in my family tested positive except for me. Three out of four of us got noticeably sick, including me.

So one who tested positive had no symptoms and one who tested negative had symptoms… In the same family.

It’s a weird illness.

As for the vaccine, I’ll certainly get it as soon as it’s available for my age etc., especially if I can get the Johnson & Johnson. I’m not extremely concerned about mRNA technology but the traditional virus vaccine is slightly less risky and only one shot, rather than two, so… that’s appealing.

Edit: I personally know probably two dozen or so people who have had covid. They’ve all come through okay. Some had a really hard time; most did not. So far.

Curious, @Aaron Blumer: if i were you, I would infer that I had it despite my negative test. Do you infer that of yourself?

Only my wife actually got tested. In theory I could have had my antibodies from some unknown case much earlier, and all of us had a cold but only my wife had COVID. But…seeing as i had the antibodies, we all got sick one after the other, and then my wife tested positive…we infer that we all had it around that time.

Incidentally, only one of the seven of us would count toward Philadelphia / PA numbers. I suspect actual case counts are much, much higher than official counts.

Incidentally, only one of the seven of us would count toward Philadelphia / PA numbers. I suspect actual case counts are much, much higher than official counts.

I think this is why the guy from Johns Hopkins is saying we will be at herd immunity in April. And I imagine if that is true, that a lot of the handwringing of the past year will be seen to have been overreaction. The serious illness rate and death rate will be even lower than it has been imagined to be.

Here is a fascinating podcast interview well worth the time about how we have done an awful lot the wrong way. https://www.econtalk.org/john-cochrane-on-the-pandemic/

[Larry]… at herd immunity in April. And I imagine if that is true, that a lot of the handwringing of the past year will be seen to have been overreaction. The serious illness rate and death rate will be even lower than it has been imagined to be.

Overreaction?

* 9 times more deadly than seasonal flu (Contrast John Mac )

* 500,000 dead

[M. Osborne]

Curious, @Aaron Blumer: if i were you, I would infer that I had it despite my negative test. Do you infer that of yourself?

I actually tested negative three times about a week apart and felt sickest on the occasion of my third test. I wanted to ease minds at work and maybe end quarantine quicker…. And also curiosity was a big factor. I wanted confirmation. Didn’t get it.

As it stands, it seems likely that I had it, but I’m not confident.

Overreaction?

* 9 times more deadly than seasonal flu(link is external) (Contrast John Mac (link is external))

* 500,000 dead

Yes, overreaction. There is more involved than simply the lives lost to death. There has been economic devastation in many ways … lost businesses, lost jobs, lost wages, lost education. And that lost year is never coming back. As Thomas Sowell likes to ask, “Compared to what?” and “At what cost?” At some point in every situation there is a bridge too far.

And the evidence shows that we knew early on that these things were overreactions.

Calling it an overreaction doesn’t require one to agree with MacArthur. We can simply look at the numbers. It is likely that far more people had it than we know.

@Aaron… yeah, I’d be readily inferring I had COVID if only one test were negative. But three tests… I’d just be confused.

People called Elon Musk irresponsible for tweeting about his 2 positive / 2 negative tests. As if 2 positive and 2 negative tests aren’t sufficient cause to start asking some questions. As Christians, my family defaulted to loving our neighbors by staying home due to symptoms as such. But I reserve the right to be somewhat suspicious of the accuracy of the data. (But as I said above, whatever the accuracy of the tests, I actually suspect COVID is underreported, not overreported.)

Among the books I read during 2020, one was Thomas Sowell’s A Conflict of Visions. It was timely. The contrasting pandemic responses, and the way the narrative was shaped, illustrated perfectly what Sowell was saying. It lay under all the empirical debates about testing, mask wearing, social distancing, gathering, how long people were infections, etc. The underlying question is how much society, and its leaders, can or should do to manage a pandemic. Some applied themselves to solutions, and framed the missions as keeping as many people as possible from dying, and took every measure possible to solve it, down to micromanaging which products could be sold at big box home and garden stores. I think ironically, the micromanaging of which products could be sold stemmed from a recognition that mandated shutdowns were causing harm, and it was some effort to “make it fair” that if mom and pop garden centers were shut down, the big box stores wouldn’t be able to benefit from the lack of competition. But the whole question becomes a hydra and nearly impossible to manage or manage fairly. Another approach recognized that the virus is out there, that people will die whether we like it or not, and that we’ll never be able to compare (well) what would have happened if we had done X to what actually happened when we did Y. I don’t envy the governors because the media is ready to hang them for every misstep, and to pin every death on their policies. And what Sowell calls “the unconstrained vision” leads people to think that they can blame a governor for deaths, for somehow not anticipating everything that might happen when a germ is on the loose. The “constrained vision” says there are no solutions, only trade-offs.

Two other books I read in 2020: Living Life Backwards on Ecclesiastes, my favorite book in the Bible. Ecclesiastes 11, in light of the book as a whole, says you can do everything just right, and things will still go badly for you, so really you ought not to be paralyzed trying to perfect your plans. Just get on with your mission in life and enjoy the good things God gives along the way. My wife underwent an unexpected 10-hour brain surgery to remove a 7-cm benign meningioma in July. She did great. But COVID wasn’t really on our radar. Along the way, we lived our lives. We got back to church as soon as possible; had some great ministry opportunities with people who came to church hungry for spiritual encouragement; we got together with people who were willing; we did walks in the park and trips to the beach and a trip to Knoebel’s Amusement Park. We wore the masks and took basic precautions. After 11 months, I brought COVID home from who-knows-where. I had fully expected to get COVID eventually. I soooooooo do not regret living in 2020, and I feel sorry for all those who stopped living to avoid dying.

The third book that had some bearing on the pandemic was Dorothy L. Sayers The Nine Tailors. It’s a mystery novel, by someone in the Christian tradition (not sure of her spiritual state). It is set during an influenza outbreak, it involves a girl who has lost both her parent, and it involves a parish minister whose daily job is rubbing shoulders with people who can’t presume to live out the year. They walked to church past the graveyard for their deceased family members, and probably past the grave marker that had their name, one date, a dash, and a blank. That world was so different from 21st century America. They were accustomed to shock and tragedy. We are pretty soft compared to them.

[M. Osborne]

@Aaron… yeah, I’d be readily inferring I had COVID if only one test were negative. But three tests… I’d just be confused.

People called Elon Musk irresponsible for tweeting about his 2 positive / 2 negative tests. As if 2 positive and 2 negative tests aren’t sufficient cause to start asking some questions. As Christians, my family defaulted to loving our neighbors by staying home due to symptoms as such. But I reserve the right to be somewhat suspicious of the accuracy of the data. (But as I said above, whatever the accuracy of the tests, I actually suspect COVID is underreported, not overreported.)

Part of what Elon didn’t know at the time, any many still don’t realize, is that in medical tests of any kind there isn’t necessarily parity between false negatives and false positives. I did some research during my “do I have COVID or not” phase and found a few studies on test reliability. In some, false negatives were quite high, though false positives were consistently much lower. One expert said that he considered loss of sense of smell to be a more reliable indicator than a test. But I didn’t have much context for his observation.

A second factor often overlooked is that there are two types of tests, and one has a much higher false negative rate than the other. There are two main types of tests (good read here), and one has a significantly higher false negative rate than the other… If memory serves, the antigen tests.

I tried to find out which test type the clinic I went to use for testing and wasn’t successful… but didn’t try very hard. Part of the illness is malaise, and I definitely had a lot of that at the time. It was hard to care about much of anything.

But I get that way sometimes… I suppose we all do.

So did I have it or not? I really don’t know. Seems unlikely that everyone in our household got it but me. But the tests… and mild symptoms. On the other hand, all three tests were at the same facility, so if there was some quirk of that particular method in my case, all I did was make the same mistake three times. We’ll never know. In retrospect, might have been worth it to drive a bit further and try another facility… but at the time, I didn’t even feel like leaving my room. :-) So there’s that.

We just had a missionary whose return to their field had to be postponed because of a posytive test (a day or so after a negative test). When they questioned it, they found out it was a false positive. But the money and time had already been lost.

This reminds of a back surgery I had years ago. I asked the doctor, “What are my chances of getting infection?” He said, “It’s 50%. Either you will or you won’t.” Technically, not the true answer but his point was clear: These probabilities are relatively useless. A test is either accurate or it’s not. Percentages play no role in that.

It has been known for a long time that there were a number of false positives. How many? We don’t know. It’s also been known for a long time that a lot of people who have had the virus were never tested and thus, don’t show up in the statistics. We are probably far closer to herd immunity than many believe.

I think we are still at a place where we are putting too much hope in the wrong thing. This, like so much other stuff, has become so politicized on both sides.

. A test is either accurate or it’s not.

Percentages play no role in that.

Almost nothing works that way in the world of tests!

It’s a good thing. I would have failed seminary… and grad school as well.

All a test is is a measurement of some indicator or other (or multiple indicators) held up to a standard. In pathogen tests, you have several places in the process where a test can fail or partially fail, especially if there’s a lot of automation to help get through a lot of people quickly.

• Getting a good sample
• Measuring the indicator in the sample (whether virus molecules or antigens or whatever method)
• Comparing that to the standard (even this is often not binary, whether we’re talking about covid or diabetes or something else entirely)

Lots of nonmedical things in life are like this as well.

• My rather old vehicle has wheel speed sensors. Most of the time they work. Sometimes one doesn’t for a while, and the system declares it a ‘fail’ resulting in AWD, anti-lock brakes, traction and stability control all going offline. (There are tons of sensors like this in cars—they all work on the same principles: test something, hold it to a standard, notify if it fails.)
• Washing machine has a load balance sensor. Most of the time it works. Sometimes not… and things get pretty bouncy in there!
• Students take lots of tests that can act as future academic success indicators. Some work better than others. None work 100% of the time.

But medical testing is the easiest sector to multiply examples in. You can take a test for strep, and most people don’t think much about it, but those tests are not 100% reliable.

My daughter tests her own blood sugar multiple times per day. There are various methods, with differfent tradeoffs for convience, speed, accuracy, etc. Zero of them are 100% reliable 100% of the time.

They put the blood pressure cuff on you. Sometimes those units fail. True, at this point it’s a very mature diagnostic, and fail rates are quite low, but still, it’s “either they work or they don’t.”

Even something as simple as measuring fever isn’t 100% effective or 0% effective. There are different kinds of temp measurement devices, different levels of sensor accuracy, and people have some variations in their “normal” range.

This is already a long post, but no, it’s not reasonable to think a COVID test either works or doesn’t work. All tests have percentages of effectiveness relative to a purpose.

The COVID challenge meant trying to get reasonably accurate tests that could be administered quickly, get quick results, and get the into production and distribution quickly. It’s amazing they work as well as they do. The purpose was to try to identify as many as possible that should quarantine and try to slow the spread.