Can't you almost hear the chanting chorus of "False Positives" flowing from the IDSA towers?
I fear that chant of false positives may be a recurring theme in the new Guidelines. It's going to be increasingly difficult to deny the surging number of individuals that test positive -- pre- and post-treatment -- even with the outrageously high thresholds often currently set.
I think a possible stance might be, "If you test negative, you can feel confident you don't have Lyme. If you test positive, measure against the backdrop of a specific symptom set (reduced to five or so), limited geography (what's the probability that YOUR neighborhood has Bb), etc, and maybe re-test in a bit, depending."
A real conundrum these folks may have, imo, is explaining away, comfortably, the numbers of people who test positive post-treatment. They won't be able to keep to the party line that some folks will just keep snaring positives. Most meaningful studies demonstrate titers decline after treatment. The incidences where that isn't the case are only going to mount.
It would seem China couldn't care less about the IDSA scriptures, thank goodness.