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Interpreting a covid-19 test result

BMJ 2020; 369 doi: (Published 12 May 2020) Cite this as: BMJ 2020;369:m1808

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Re: Interpreting a covid-19 test result

Dear Editor!

In the article it says, "clinical adjudication MAY BE the best available 'gold standard,' based on repeatswabs, history, and contact with patients known to havecovid-19, chest radiographs, and computed tomography scansI" First, what does "may be" mean--that the authors do not think there is any perfect comparator to verify the both positive and negative test results?

Moreover, claiming that COVID-19 diagnosis "may be" the best gold standard is definetely not scientifically sound, not least because there are no distinctive specific symptoms for COVID-19, as even people such as Thomas Löscher, former head of the Department of Infection and Tropical Medicine at the University of Munich, conceded to me.

That is to say, why do the authors do not mention that the virus itself, that is virus isolation, in fact would be only gold standard that deserves to be called "solid"? And if the authors think that virus isolation does not deserve this imprimatur, what scientific justification is there to call the RT-PCR a test for the COVID-19 virus?

Competing interests: I am co-author of “Virus Mania” (“Virus Wahn”), whose main thesis is that there is no solid proof that viruses (alone) are the primary cause of various diseases such as COVID-19, SARS, bird flu, swine flu, hepatitis C, etc. Instead, several causes must be considered.

30 May 2020
Torsten Engelbrecht