So @peston roasted for Q’s re: #COVID #antibodytest and told tests unreliable until 28days by #PHE #DCMO - this was NOT correct.
This paper from @nature http://ow.ly/6TDz30quY7V  published 2 days ago shows 50% antibody +ve at 7days from symptom onset & all by 2 weeks 1/x https://twitter.com/itvpeston/status/1245609994772287488

The dogmatic resistance to #antibodytest by PHE & the failure of their experts to be properly briefed about emerging evidence is potentially damaging. #COVID19 Patients presenting to hospital have typically had symptoms for several days & may therefore be #antibodytest +ve 2/x

...& the test may therefore have some utility- even in an intensive care setting where PCR tests may also be (false) negative http://ow.ly/ZQUM30quYU0  - antibody positive test results would moderate clinical decision making in latter clinical stages (>1-2weeks) 3/x

The key issue is not how many false -ve (if you recently had infection antibodies may not yet be present) but whether if you test +ve you have definitely HAD (or have later stages of) the disease - i.e. that the test is specific for CV19 & not other CV ... 4/x

As a surgeon - if #antibodytest on a patient, done a few days pre-op is positive it would completely change not only whether PPE is required for staff in operating theatre, but in some cases will change the operation we actually do http://ow.ly/brib30quYut  5/x

Particularly for operations involving access to the brain via nasal passages deemed extremely high risk for neurosurgeons & their teams. Alternative approaches - less ideal from patient perspective - are currently being recommended during #covid19pandemic 6/x https://twitter.com/paedneurosurg/status/1241808227949580291

#COVID19 #antibodytest would allow best operation to be done in patient who is known to have had #SARSCoV2 infection with immunity to it and therefore posing no #COVID19 infection risk to clinical team. 7/x

Where #SARSCoV2 antibody status of patient is unknown or negative members of surgical team who have had the disease (antibodytest +ve) would not need #PPE - preserving supplies for those who need it. Bear in mind that cost of test less than cost of 1set of full disposable PPE 8/x

Validation of tests should not take long - stored serum banks from pre- #SARSCoV2 era could be utilised to estimate risk of false positive due to cross-reactivity with other coronavirus types...9/x

On a wider scale - members of the public testing +ve on #antibodytests - provided test has a very low false +ve rate could return to work sooner and get the #UKeconomy going. 10/x

Senior healthcare/PHE leaders need to rapidly roll out #COVID19 #antibodytest or give a cogent explanation/evidence for not doing so. Journalists including @peston should not be fearful of robustly challenging clinicians/experts for the decisions they are making. 11/x - ends