bulos-infoxicacion-informaciones falsas-mentiras-pcr-reaccion en cadena de la polimerasa-test diagnostico covid 19-coronavirus-sars cov 2-rt pcr-falsos positivos-falsos negativos

Dossier “HOAXES OF THE PANDEMIC”. The lies about PCRs

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In crisis situations, fear and unease find a very pleasant niche in which to prosper. So do those who feed and promote those fears. Complexity is unpleasant, and our world, fortunately or unfortunately, is complex. All the events we experience involve a myriad of factors, so it is not easy to explain them or find a cause for them, a source of unease for many people. Conspiracies come into play in these situations: reassuring balms that explain the complexity of the world at a stroke.

Some of these conjectures are supported by rigorous analysis and end up coming true. Let’s not forget: conspiracies have always existed, exist and will always exist. They are an important agent of change in history. However, many others are nonsense that seek to feed on the anguish of people. The wise words of the master of science fiction, Isaac Asimov, apply perfectly to them:

Denying a fact is the easiest thing in the world. A lot of people do but fact remains a fact.

Moreover, conspiracies and their sympathizers are quickly characterized:

  • They use different types of fallacies to argue, such as authority fallacy. We must be very cautious with authorities. It is totally logical to think that a person, because of his or her degrees, awards, intellectual background, and experience in a specific field of knowledge, will give credible and true information on certain topics. For example, whatever a doctor or a virologist says about the pandemic or the virus will automatically be true for many people, because they know what they are talking about. This may be the case and, in fact, there are very professional people who disseminate information of unbeatable quality. But, I insist, we must be careful, because the authorities are human beings like any of us. And I am not only saying this because they can make mistakes or because different authorities can have different opinions or interpretations on a subject. Like anyone else, authorities also have their beliefs, personal judgments, interests, and levels of honesty, which can significantly interfere with the validity of their statements. Indeed, there are physicians and health professionals who deny the reality of the pandemic or coronavirus. Or Nobel Laureates who deny the relationship between AIDS and HIV, to give another example.

It is essential to distinguish between an opinion and a fact based on objective data. And for that it is necessary to investigate and contrast. Precisely because critical investigation is not the virtue of conspiracists, they often take an opinion as an irrefutable dogma of faith only because it comes from a certain authority. However, if opinions are not supported by data, they are just that: opinions, and should therefore be treated with caution. One clue that should invite us to be skeptical of a statement from the outset is whether the person behind it bases the validity of the statement on his or her authority.

Another very typical fallacy of the denialist argument is that of incomplete evidence or cherry-picking. It is common to observe (especially in social networks) the exposure of biased data. Logically, these data are the ones that support the denialists’ arguments. On the other hand, data that contradict or destabilize their arguments do not appear in their expositions. We are therefore witnessing a blatant manipulation of reality and misrepresentation of facts. For example, the pandemic or vaccine denialists reject any information coming from the scientific community (it would be part of the tyrannical shadow power that caused the pandemic). However, when there is a scientific fact that they can use to support their reasoning, they use it.

  • It is impossible to find a coherent narrative among all the existing conspiracy theories. While some denialists consider that SARS-CoV-2 exists and is a laboratory creation, others directly deny its very existence and thus that of the pandemic. Contradictions, therefore, constitute another sign of identity of conspiracies.

  • Sources of information used by conspiracy theorists are often laughable in terms of their seriousness. The dissemination of memes with brief, clear, schematic, and forceful denialist messages is frequent. They are made to be engraved in the retina and easy to memorize and reproduce in a conversation. When not, they use videos of recognized people (influencers, scientific, and political authorities). In general, all of them are sources of zero credibility, although they are useful for denialists. At the end of the day, it is information that is not published by the media or scientific journals because it contains sensitive data that they are not interested in disclosing, as they would uncover the great global conspiracy. Everything that does not receive adequate attention from the manipulation tools of the elites is legitimate for conspiracists. Finally, less often than not, they resort to some credible sources, such as a published, peer-reviewed scientific article. Unfortunately, the information they usually extract from them is often misinterpreted, as we will see later.

  • Arrogance, egocentrism and sectarianism are other very conspicuous signs of identity. Conspiracists consider all those who do not follow their doctrines to be blind sheeps. Of course, they are just the opposite: the awakened and wise ones who have brought to light the top-secret plans of the global synarchy (which could not be very secret either if anyone can divulge them).

In a way, a certain sectarian component can be appreciated in these groups of people in relation to their social “hermeticism”, since you are not accepted if you do not believe in the same things as them, and to the fact that their members feed back between them. For example, I have come across several times in a specific social network denialist profiles that had their account visible but, later on, have privatized it so that only their ideologically related followers can see their publications.

However, the saddest thing is the persecution mania that many denialists suffer from. They are obsessed that someone is going to force them to take the vaccine which, of course, is a ploy to carry out genocide or global sterilization (they don’t agree on this either). The funny thing is that they then call you a coward for following the prevention measures or for wanting to get vaccinated, when they are the ones who are afraid of masks because they may cause asphyxiation or vaccines because they will modify our DNA…

To avoid being victims of deception, it is essential to contrast the information we receive. I am aware that this request is complicated for many people because of their accelerated pace of life and the data bombardment to which we are all exposed. But if we do not have time to contrast the information with other sources, the least we can do is to doubt, to practice a healthy skepticism until we take the next step. If a publication has appeared in any of our social networks or messaging services, let us refrain from sharing it until we have certified its verisimilitude.

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We must be very cautious with misinformation. Lies can put the lives of many people at risk. Stopping them is in our hands. We should interrupt the chains of transmission and dismantle hoaxes when the opportunity arises. Computerworld University

However, in addition to the “guide” to detect a conspiracist that we have just developed, there are other guidelines. For example, if the news item, tweet, post, etc., that we have just read does not indicate from which sources the data was obtained, this is a first sign that this information is suspicious and has a more than doubtful credibility. Sometimes they may contain links to other websites or news, but if you follow that trail you will usually reach a dead end. Surely, the original source has no other sources and, moreover, it will be a copy of what we have read in the first instance.

The spelling and formatting of the text are also effective predictors of fraud. If the author uses excessive capitalization (to give importance and highlight certain issues), if the text is poorly written, has little coherence, or uses an overly grandiloquent style, the author is giving us more reasons to doubt.

What we must also be very careful with is the viral memes that reach us through social networks or messaging applications: the typical brief posters, audios, or tedious paragraphs should be quarantined immediately. In fact, if you take a look, all these elements practically do not meet any of the above-mentioned verification criteria.

hoaxes of the pandemic-frauds-social media-wassap-wattsapp-sars cov 2-coronavirus-pandemic
Example of a classic hoax. It fulfills many of the typical characteristics: excessive and incorrect use of capital letters, absence of sources, exaggerations, etc… ITV

Having made this introduction, let’s start this dossier to do some informative justice and banish fallacies and hoaxes to the well of oblivion. Let’s start by analyzing the hoaxes about PCRs, one of the substantial tests for detecting the insidious SARS-CoV-2.

PCRs are non-specific and give many false results.

Many prophylactic strategies are available to deal with the pandemic. Along with face masks and social distancing, coronavirus detection tests have emerged as essential tools to monitor the infection rate in a region and to track it in detail. Specialists have placed great emphasis on this. According to conspiracy theorists, it is to make it easier to establish the New World Order and keep us under control. Because what does a positive antigen or PCR test entail? Confinement, being locked up with our close contacts in our homes and deprived of our basic freedoms (we are temporarily prevented from going to work, shopping, traveling, meeting our loved ones and other typical activities of an anti-system…).

We are going to focus on the PCR test, because it is the one that has accumulated the most myths. The PCR stands for Polymerase Chain Reaction. As the name suggests, this technique employs the enzyme polymerase to perform multiple reactions in order to amplify a sample of a nucleic acid, to make it more abundant. Polymerase is naturally present in living organisms and viruses, although there is actually a great diversity of types with very different functions: some are responsible for making copies of DNA strands (replication), others synthesize RNA from DNA (transcription), others manage the opposite process, the reverse transcription (they synthesize DNA from RNA); others make copies of RNA (like the one in SARS-CoV-2)…

The PCR was developed by the biochemist Kary Mullis in 1986. We will talk about this scientist later, because the conspiracists have put in his mouth a series of statements that have been misinterpreted or are outright false. Since then it has been used in numerous fields of science. Its discovery was almost a Copernican revolution in molecular biology and genetics, but only in the current pandemic context has it aroused suspicion. Once good and harmless, it is now bordering on the most abject Satanism. Among other uses, it has served to detect and diagnose genetic diseases, to identify and know the genome of various infectious agents of all kinds (it is one of those techniques that has gone beyond Koch’s postulates by being able to identify pathogens that cannot be cultivated in cellular media), to characterize fossils and paleontological remains from very degraded DNA remains, to identify criminals, etc.

However, a variant is used to detect SARS-CoV-2: the RT-PCR. RT stands for retrotranscriptase. It is another enzyme. The PCR works with DNA, but the coronavirus is made of RNA, so somehow it has to be transformed into DNA. That is the job of this enzyme, which some viruses have by nature to complete their reproductive cycle (these are the retroviruses, such as HIV-1). It is clear then that the PCR detects the virus through its genetic material.

In case you are curious about how the RT-PCR works, here is a summary:

  • First, a sample must be obtained from the person suspected of being infected with SARS-CoV-2. It can be a nasopharyngeal sample, a bronchoalveolar lavage, a sputum…

  • Of all that this sample may contain, we are only interested in the genome of the virus in question, so it must be extracted and the remaining residues removed. To do this, a nucleic acid extraction kit is used.

  • To make DNA from RNA, a kit containing reverse transcriptase is used.

  • We already have the DNA strand complementary to the viral RNA. To this sample are added a series of elements known as primers that act as very specific markers of certain genes of the coronavirus in case it is present. They make the test highly specific. What is achieved with the primers is to delimit the regions of the DNA that we want to amplify. What are these regions? Those that are specific to SARS-CoV-2 and no one else, such as those coding for the Spike protein or other structures or molecules characteristic of the virus (to detect this virus, three very specific genes are marked). Herein lies the specificity of the test, in avoiding cross-reactivity, i.e., that a false positive may occur because the test has identified any element with SARS-CoV-2.

*Note: the primers make the test so specific that, in certain situations, it can be counterproductive. If the virus undergoes significant mutations in any of the three tagged genes, the PCR may not detect the changed gene. This is what happened initially with the VUI 202012/01 variant detected in the UK, which has suffered mutations in the Spike protein gene and many PCR techniques do not detect that protein, which can make epidemiological monitoring of this variant difficult.

  • The sample is now ready to be introduced into an RT-PCR apparatus, where the polymerase will act, making millions of copies of the DNA fragments delimited by the primers during a series of hot and cold cycles. This is the amplification of the sample.

  • The same apparatus will report the presence or absence of the coronavirus. It does this by measuring the fluorescence emitted by the DNA markers when they have bound to the corresponding genes. When the fluorescence intensity exceeds a certain threshold, the result will be positive.

RT PCR-PCR polymerase chain reaction-inverse transcriptase-kary mullis-false positives
Simplified scheme of the RT-PCR technique. The Objective

This technique is very interesting because it can also provide information on the patient’s viral load. We have said that in the RT-PCR apparatus there are a series of cycles (usually 35-40) in which the initial sample is progressively replicated. The higher the initial viral load, the earlier a high number of copies will be obtained and, therefore, a more intense fluorescence in a smaller number of cycles than if the viral load were low (it would take more cycles to reach the minimum required fluorescence).

This method is somewhat complex and the analysis is time consuming, so the results take several hours to arrive (usually about 3 hours). Also, it is normal to perform two or three assays to confirm the results, although this is not always possible.

Well, now we know a bit more about the PCR, but what we are interested in is its reliability. Does it detect SARS-CoV-2 with specificity or can it be confused with any other virus? Can it give false positives or negatives? For conspiracists, as their goal in life is to deny everything, the PCR is no exception. According to this group, the PCR is not very specific and usually gives false positives, that is, the PCR confuses anything with the coronavirus. The authorities thus have a subterfuge to impose “house arrest”.

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Probability of detection of SARS-CoV-2 by the PCR from samples collected from different patient sites over time. The PCR is most successful when symptoms appear (5-8 days after infection on average), while during the pre-symptomatic phase it is very difficult for the test to detect the coronavirus (the same is true for antigen tests). El médico interactivo

Actually, the PCR test is a highly specific and moderately sensitive test. A test is specific when it has a high probability of detecting healthy persons as such (true negatives) and, consequently, has a low probability of generating false positives. Likewise, a test is sensitive when it detects infected persons as such (true positives), generating few false negatives. The specificity of the PCR varies around 95% (so there is only a 5% chance of false positives), and can be improved by using certain primers, but the sensitivity is a different matter.

A preprint signed by Dr. Yang Yang and colleagues established a range of sensitivities between 65 and 90%. The question is that the sensitivity of the RT-PCR is significantly influenced by the sampling site (in the aforementioned study, the sensitivity obtained was approximately 60, 72 and 90% depending on whether the sample was taken from the oro-pharynx, nasal cavity, or sputum respectively; on the other hand, lower respiratory tract, nasopharyngeal, and saliva samples give accurate results of more than 90%) and the patient’s viral load.

In fact, the viral load, which logically depends on the stage of infection, influences the sensitivity of all tests. A relatively high viral load is required for the tests to detect the virus. In a paper published in August 2020 in the Annals of Internal Medicine journal, Lauren M. Kucirka, M.D., and colleagues analyzed 7 studies involving more than 1300 people. They were able to conclude that, on the first day after infection, the rate of the RT-PCR resulting in a false negative was 100%. On the fourth day, that failure rate dropped to 67%. When symptoms appeared (and thus when the viral load was high, around days 5 – 6 post infection on average), false negatives dropped to 38%, until day 8 post infection when they reached their minimum: 20% (which is still a considerable failure rate). After that day, sensitivity began to decrease again as the viral load decreased due to the body’s immune response.

RT PCR-PCR polymerase chain reaction-inverse transcriptase-kary mullis-false positives
The upper figure shows the probability of obtaining false negatives over time after the infection. The lower figure shows the probability of being infected after receiving a negative result. These representations are based on 1330 samples from 7 studies. Looking at the top figure, we see that the probability of false negatives decreases in the days when symptoms appear and develop, but increases before and after those days, when the viral load is lower. Kucirka et al. (2020)

In addition to an insufficient sample, false negatives can also be explained by a series of “technical” problems: the sample was poorly taken, the using of deteriorated reagents, the RNA could not be adequately extracted from the sample…

In conclusion, the most frequent problem of the RT-PCR is false negatives and not false positives. It is the sensitivity and not the specificity. On the contrary, the probability that this test generates false positives is low (let’s also take into account possible human errors: sample contamination, cross-reactivity, labeling failure, etc., can accidentally cause the appearance of false positives). Therefore, the PCR test is unlikely to confuse the virus with other germs.

We could go on and debunking hoaxes about the PCR false positives, but they are all derived from the above actually. I will simply end this section with a case of cherry-picking and manipulation of information. Take a look at the following tweet from the user “The Laughing Man”:

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Twitter

The user uses fragments of a CDC report to discredit the PCR test. From the outset, it is highly suspicious that a serious institution such as the CDC supports the conspiracy theorists’ thesis. Let us turn to the document from which these passages have been extracted, entitled CDC 2019-Novel Coronavirus (2019-nCoV) Real-Time RT-PCR Diagnostic Panel (the link is in the references). It was made effective January 12, 2020, practically in the beginning of the pandemic.

This document is an instructional guide to properly proceed with the PCR and interpret its results. The marked lines belong specifically to the “Limitations” section, where, among other things, emphasis is placed on the factors that may influence the obtaining of false positives or negatives, etc. The document at no time criticizes or invalidates the PCR technique, and this is no exception.

Let us keep in mind the following principle: positivity does not imply infectivity. That is, if a person tests positive in the PCR for coronavirus and the result is correct, it means that he/she has the “bug”, but this does not imply that the coronavirus has infectious capacity. Surely you have read on some occasion that there are people who, after having recovered from the symptoms and having generated immune defenses, continue to test positive several days or even weeks later. This is totally plausible: that person still has traces of the virus in his or her organism, but those viruses have their hours numbered: they are unviable as they cannot infect cells; the neutralizing antibodies prevent them from doing so. This is the implication of the first point made by the Twitter user. This limitation is nothing new by the way. It is the same with measles, for instance. There are cases in which a person infected with measles can test positive several months after the disease has passed.

The other point has a very simple explanation. Imagine that you have some of the symptoms that SARS-CoV-2 shares with other respiratory viruses and that you are infected with both the coronavirus and another respiratory virus. Furthermore, you know for sure that you have coronavirus because the specific PCR tested positive. Who is causing your illness: SARS-CoV-2 or the other virus? That is what the PCR cannot determine, a limitation that in no way invalidates the diagnosis. As the CDC report states in another paragraph:

“The agent detected may not be the definitive cause of  disease.”

How important it is to keep things in their respective contexts…

The inventor of the PCR did not believe in his own invention.

Or at least that is what the viral memes claim, based on a series of statements attributed to Kary Mullis, the aforementioned inventor.

kary mullis-pcr no cuantifica-carga viral-falso positivo-coronavirus-sars cov 2-conspiracion
Quoting Nobel Laureates is the favorite hobby of conspiracists, though they still have a long way to go to avoid decontextualization and fallacy. Facebook

It is said that Mullis (who died in 2019) denied his discovery, claiming that it was useless for detecting viruses and/or inferring viral loads. In relation to the previous hoax already disproved, PCRs, therefore, test always positive because they detect other elements, but not the coronavirus (false positives), that is why the elite use it massively, to have an excuse and lock us at home. And of course, if this is said by a Nobel Prize in Chemistry (he won it in 1993 for the invention of the PCR), it would be foolish not to believe such an authority. Indeed, it would not be strange if these words were truly his own. Mullis was an avowed denier of the anthropogenic climate change and of AIDS being caused by HIV (he argued that the real etiological agents of AIDS were a set of pathogens). But I insist: opinions are one thing and facts are quite another.

Be that as it may, Mullis may have said a lot of crazy things, but he never mentioned that his invention was nonsense. In fact, the words usually attributed to him were not even said by him. They come from a text published in December 1996 by John Lauritsen (link here), another AIDS-HIV denier. In this article, Lauritsen mentions his colleague and quotes alleged statements by Mullis, according to whom “quantitative PCR is an oxymoron” (italics are mine). Lauritsen denounced that the PCR (at least that of his time) could not be quantitative, since it was incapable of detecting the number of viruses circulating in a person. In any case, he claimed, it is a qualitative test: it identifies the pathogen in question from its genetic material, but not its quantity. These are Lauritsen’s words, not Mullis’. In other words, the quotations used by conspiracists are not only taken out of context, they do not belong to Mullis either.

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Kary Mullis giving a TED talk. Agencia SINC

As a curiosity, there is now a variant of the PCR, the quantitative PCR (qPCR), which allows the estimation of a patient’s viral load. This is essential to determine the effectiveness of a treatment by means of the evolution of the viral load. It follows that the sensitivity of the qPCR is very high (higher than that of the conventional PCR), as it has to detect small viral loads.

The PCR causes brain damage

Although more than the PCR, the neurological damage would come from the nasopharyngeal sampling. Put crudely, conspiracists believe that our skull can be impaled with the flexible swab, which may open a leak in the blood-brain barrier and facilitate access to viruses and all kinds of agents harmful to the nervous system.

It is evident that this type of beliefs denotes an important cultural deficiency. Anyone with a minimal knowledge of anatomy knows that between the nostrils and the brain there is a bony barrier, a region known as the cribriform plate of the ethmoid bone. It is impossible for something as flimsy as a swab to pierce the bone. A drill would be needed in any case, which is precisely what is used in pituitary operations. There is no other way. There is not much more to say…

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The cribriform plate of the ethmoid bone prevents any Vlad Tepes from skewering our brains with his draconian swabs. Wikimedia Commons

The reader should not expect that in the following articles we are going to unravel more complex or intricate arguments. They are all along the same lines. The level is very low and therefore it is surprising that there are people (who, to make matters worse, consider themselves critical and open-minded) who swallow these fallacies. I understand that the pace of life does not leave much time to analyze all the information that reaches us, but what less than quarantine the data until we can contrast them.

Anyway, we look forward to seeing you in the following chapters of this dossier. If you think there is any suspicious information that we should analyze, do not hesitate to let us know.

REFERENCES

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