Larry Brilliant Says Covid Rapid Tests Are Bad for Public Health

Second, the longer this virus continues, the more variants we will have. We don’t know exactly what makes a variant, but certainly a factor is immunocompromised people having the virus in their system longer, not for 17 days like I did, but for months. The body cannot completely eliminate the virus. You have created the ideal circumstances for regrouping, recombination.

Another problem is that we don’t have a good handle on numbers because we’ve never done testing, right?

What if I told you that the antigens, those rapid at-home tests we use now, were bad for our public health? It is stupid that the antigen tests were approved without the requirement to report positive cases.

How would you enforce it?

Through technology. It is not that difficult to create the technology to do automatic reporting. Now there is a class of at-home molecular tests that can already do that. They are almost as good as PCR tests.

Aren’t they more expensive?

The only thing that makes them expensive is the lack of scale. Right now we can get antigen tests for as little as $5. If you do a billion molecular tests, you can also reduce the cost.

When these molecular tests go to the FDA for approval, they say all positives must be reported. This makes them much better than antigen tests, which are great later in the illness when you’re trying to determine if you’re still infectious. But the first two days are terrible, when the false negative rate is so high. Between false negatives and not reporting to public health, antigen tests are dangerous to public health.

Would you ban them?

I would regulate them.

To vaccines. What we have works against the original version of Covid, which no one gets anymore. So why didn’t we have a “warp speed” effort for aa specific vaccine directed towards the newest variants?

we did it Both Pfizer and Moderna are close to launching vaccines specific to Omicron. You seem to be wondering why we don’t have warp speed for BA.5? We call this process whack-a-mole.

So will the new vaccine do a better job of protecting us from getting it?

I hope. You will have more immunity to Omicron. But BA.5 itself does not necessarily respect a previous infection with Omicron. The vaccine, however, will better prevent you from being hospitalized or from dying. But we should start talking about BA.2.75. It appears to be the next train car. And it comes very quickly.

Are we already on the next one?

It has already been detected in several states. We are just getting more variants.

There is some controversy over whether people who need a booster should get it now or hold off until this new vaccine comes out in the fall.

I am very cautious. I don’t want anyone to have it in the next two to three months before you can get the new vaccine. [Note: White House officials have said that anyone immunocompromised or over the age of 50 should get a second booster if they haven’t done so already.]

If you go back to our first conversation in March 2020, it seemed unlikely that we would be talking two and a half years later and still facing huge numbers.

Why are you surprised? I wrote an article called “The Forever Virus”.

Will we ever go back to Before Times? When do we not have to be careful and can we eat inside and go to a Broadway show without a mask and feel safe?

These are two separate questions. Will we ever reach a point where there will be no Covid? No. There will always be Covid.

Will we ever get to a point where we go to a Broadway show without a mask? Yes. We’ve probably had coronavirus infecting the world in a pandemic-like fashion before. And then the virus entered the coronavirus retirement home, and we called it the “cold virus.” And a kind of rotation. That’s why you can get two or three colds a year. They feel the same to you, but they are different viruses. And that’s because the immunity they give you is only good for a year or two.

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