Have I had Covid? A guide to current antibody testing

At this point in the current Covid-19 pandemic, there is still so much unknown about the virus that is wreaking havoc on all our lives.  It seems like nearly every time there is information conveyed as fact, something else appears to contradict it.  This has been true with symptom presentation, timing of onset, capacity to transmit, and unfortunately even reliability of testing. 

The availability of diagnostic testing for the coronavirus is still frustratingly limited in most places.  Additionally, it is important to keep in mind that due to high false negative rates, it is possible to test negative despite being infected by the virus.  These two combined facts have driven us into diagnosing “presumed positive” patients when the constellation of symptoms is present.  But even after an individual then recovers, they are still left wondering if they in fact had the virus – and whether that might then convey protection in the future.

Antibody testing is now available, but is it useful?

Recent weeks have seen an increased roll out of these tests across the country.  The promise is wholly captivating – a way to determine if you have had exposure to Covid -19 and subsequently developed antibodies to the virus.  The implied goal here is that antibodies convey immunity and protection from future infection.  People are understandably seeking these tests out to convey a sense a security about the future in such an uncertain time.

Unfortunately, the science doesn’t yet play out.  These tests have not been validated by the FDA and vary widely in their efficacy.  There are major concerns about the current antibody tests available on the market. 

Positive antibodies do not mean immunity.

While the test may tell you whether you have antibodies to the virus, it is not a test of immunity.  Not all antibodies are the same, and in many instances only identify a history of exposure.  The notion of using a positive antibody test to permit an individual to relax social distancing measures and put their mask away is just plain wrong.  Unfortunately, we all need to continue these measures of isolation and exposure avoidance, both for our own safety and that of our communities.  No get-out-of-jail card on that. 

The lack of accuracy of the current tests make it not helpful….yet.

A more appropriate use of antibody testing is to determine how much disease is present in a larger population.  This is done in hopes of better determining the severity of the virus.  Varying calculations put the rate of asymptomatic infection between 25-50%, and this is vital to know in order to eventually allow the country to get back to business.  But still, most scientists believe that false positive rates on current antibody tests are still too high to be an accurate measure of infection.  As tests become more reliable and are more vigorously evaluated, this will be a major part of our transition back to normal living. But we are not there yet.

This screenshot from Quest’s website highlights the problems with current testing. If you have had other coronoaviruses (aka the common cold) it maybe falsely positive. Even if it is positive, it does not mean you are now immune to the current novel coronavirus.

So the bottom line is this – for now be wary of individual antibody testing.  We all want to know whether we are protected from future viral infection, but currently there is no reliable way to assess that.  Fortunately, the bulk of our scientists and researchers are working furiously on the production of better, more accurate, more reliable tests.  It is with these antibody tests that we will eventually get the upper hand on this virus.  Humankind has faced severe adversity in the past, and we will rise above this just as we have done in the past – with our ingenuity, imagination and skill.  And we will keep you updated and informed in every step along the way.  As always, be sure to contact your doctor if you have any concerning symptoms or want to discuss your individual case further. Your doctor can help you decide if testing of any kind can help you make decisions on your health, symptoms or concerns.

We want to offer answers to our patients and create more stability and certainty for our community. Please know that we will be reaching out resources- from testing to treatment as we deem them effective, safe and appropriate.

Read more on this topic below:

https://www.npr.org/sections/health-shots/2020/04/15/834497497/antibody-tests-for-coronavirus-can-miss-the-mark

https://www.nytimes.com/2020/04/19/us/coronavirus-antibody-tests.html

https://www.nature.com/articles/d41586-020-01095-0

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