FILE - In this Tuesday, May 5, 2020 file photo, a health worker draws blood from a patient for a COVID-19 coronavirus antibody test in DeLand, Fla. Scientists are still working to figure out how well antibodies for the new coronavirus may shield someone from another infection, or how long that protection might last. (AP Photo/John Raoux)
health

Bold hopes for virus antibody tests still unfulfilled

9 Comments
By MATTHEW PERRONE

At the height of the coronavirus lockdown, President Donald Trump and his top health advisers trumpeted a new test that would help Americans reclaim their lives — one that would tell them if they already had the virus and were protected from getting it again.

Their arrival would help “get Americans back to work” by showing those who might have “the wonderful, beautiful immunity,” said Trump, a point repeated at the daily briefings last April.

Months later, the U.S. is awash in the tests but the bold predictions about their usefulness have yet to materialize.

“There was definitely a lot of wishful thinking that there was going to be a magical test that was going to save us all, but we’re not there yet,” said Dr Jennifer Rakeman of New York City’s Public Health Laboratory.

The tests check the blood for antibodies the body makes to fight off an infection. Scientists are still working to figure out how well antibodies for the coronavirus may shield someone from another infection, or how long that protection might last. Some early studies suggested any immunity fades fast; research published last week was more promising, suggesting that antibodies last at least four months after diagnosis and do not fade quickly.

For now, the Centers for Disease Control and Prevention and the American Medical Association explicitly warn that antibody tests should not be used to make decisions about returning workers to the office or students to school, though some labs still promote them for those uses. The CDC recommends everyone — even those who were sick and recovered — take precautions to prevent getting and spreading the virus.

Experts say it was probably unrealistic to expect answers to key immunity questions early in the outbreak. Those questions have traditionally been answered only through long-term animal or human studies, said Marc Jenkins of the University of Minnesota.

The National Institutes of Health and universities are conducting some of this work, but much of it has taken a back seat to the rapid development of vaccines in the middle of a pandemic.

“Everyone’s impatient and I can see why,” Jenkins said. “But there’s no easy path to this knowledge” about immunity.

Antibody tests are different from the standard nasal swab tests that diagnose active infections. Instead, they use a blood sample or finger-prick of blood to look for signs of a past infection, whether the person was sick or had no symptoms at all. Based on other viruses, experts expect those with coronavirus antibodies to be at least partly immune for several months, if not longer.

Dr Anthony Fauci and other members of the White House task force said early on it was a “reasonable assumption” that if “you have the antibody, you’re protected” but added that there wasn’t proof.

To get that proof, scientists first run experiments in animals. Human trials come next and can take even longer. Researchers track people who had an infection and developed antibodies to see if they become reinfected. Their antibodies are measured to to gauge the level needed for immunity.

Jenkins and others said it's entirely possible that an effective vaccine will arrive before coronavirus antibody studies are completed, helping answer some of the key questions. Vaccines spur the production of antibodies, and a number of coronavirus vaccines are now being tested around the world.

In the meantime, experts say antibody tests are useful for two things: Large studies in the general population to see how widely the coronavirus has spread, and screening people who may be able to donate their antibody-rich blood plasma, which is used as an experimental treatment for COVID-19.

But those uses were not the focus of White House briefings last spring, which attracted between 8 million and 10 million cable TV viewers daily, according to Nielsen. A spokesperson for the White House coronavirus task force did not provide a response to requests for comment.

Expecting massive demand, the Food and Drug Administration chose a “flood-the-zone” strategy, allowing more than 170 tests to launch with little oversight.

At the same time, Trump highlighted his administration’s “fantastic progress” bringing antibody tests to market, some officials were raising concerns. Reports of European governments forced to discard millions of faulty tests raised alarms.

“We’re going to be very careful to make sure that when we tell you you’re likely immune from the disease ... the test really said that,” said Admiral Brett Giroir, the administration’s “testing czar.”

The FDA pulled back on its lax policy for antibody tests in May, requiring companies to begin submitting data on accuracy. The FDA has authorized about 40 thus far, while dozens more await review.

Despite the precautions from regulators, some testing companies continue to advertise the tests for workers and others. Big laboratories, including LabCorp and Quest, offer the tests to employers, along with other services like temperature checks.

“We are aware of the CDC’s guidance," Quest spokeswoman Kimberly Gorode said in a statement. “That is why we recommend that employers use antibody testing as part of a holistic approach to bringing their employees back to the office.”

LabCorp said in a statement: “As knowledge grows there may be benefit in having access to this information."

At testing sites in New York City in April, doctors with Somos — a medical non-profit serving low-income communities — told people who tested positive for antibodies that they could safely return to work, although they acknowledged “nothing is 100%.” In a recent interview, the group's founder, Dr. Ramon Tallaj, defended the testing. He said the workers would have been expected to go back anyway. The antibody tests simply provided “one extra layer of protection,” he said.

The CDC and state public health agencies continue to use antibody testing to track the spread of the virus in the U.S. So far, in most areas studied, fewer than 5% of the population have antibodies. That's far below the levels that most experts think will be needed for herd immunity against coronavirus, underscoring the need for a vaccine.

For now, Jenkins doesn't recommend spending the money to get tested for antibodies unless a doctor recommends it.

"Even the research community can’t really tell you what the result means,” Jenkins said.

© Copyright 2020 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed without permission.

©2020 GPlusMedia Inc.


9 Comments
Login to comment

Those who recovered from the 1st SARS CoV (17 years ago) still have the memory cells that would protect them from a second attack.

I get the feeling the purpose of the above article is get everyone to get vaccinated, including those who recovered from Covid19 (they don't need it).

I really would like to get an antibody test. Many of us have likely caught the virus already and don't know it.

-4 ( +2 / -6 )

I get the feeling the purpose of the above article is get everyone to get vaccinated, including those who recovered from Covid19 (they don't need it).

That makes no sense, antibody levels dropping or remaining elevated is not something that is specific for natural infection nor vaccines. In both cases it can be observed. Nothing in the article can be interpreted as an advantage for vaccines.

On the other hand memory cells are an excellent argument for vaccines, because even if it is not simple to determine reactivity in human patients (and that is why antibody tests are much more common) in animal experiments it is routine to do it, so frequently you can observe reports about vaccine candidates efficacy not only about antibody production but also length and strength of cell activation.

That includes many vaccines for SARS and MERS that have demonstrated long lasting protection and no negative side effects, not even after viral challenge to corroborate the protection.

3 ( +5 / -2 )

"Some early studies suggested any immunity fades fast; research published last week was more promising, suggesting that antibodies last at least four months after diagnosis and do not fade quickly."

I think it is time govs and media came up with a proper definition of what immunity is. Science suggests that immunity is a permanent protection against a disease and sometimes boosters are needed to guarantee permanent protection. However, when it is NOT permanent then it is misleading and potentially fake news to talk about immunity after being infected with this virus.

-3 ( +0 / -3 )

I think it is time govs and media came up with a proper definition of what immunity is.

Neither governments nor media are the ones coming up with a definition of immunity. And the problem is not that the term is misleading, but that people simply don't understand what the term actually is and get confused even when it is used as intended.

Immunity does not have to be permanent, nor it has to be perfect, the same as "infection" does not mean the pathogen will be present for a specific amount of time, sometimes it does not even mean getting a disease.

If you get cured from a viral infection then you developed immunity to it, it is an indispensable condition; because it is your immune system the one that kills the bug that is constantly reproducing in your body. This immunity could last a few months, years or all your life but it is immunity.

3 ( +3 / -0 )

For months we've had articles mentioning that antibodies against the Covid19 virus decrease to very low levels within months. This was generally followed by recommendations to get regular vaccinations, even for those who have recovered from Covid19.

The implication was that antibody levels equals immunity. While the decrease in antibodies is typical, memory lymphocytes generally remain for a long time, perhaps a lifetime. These memory cells offer protection (immunity) against future infections even if the actual antibodies are low. That is the case for those who recovered from the 1st SARS CoV (17 years ago); they still have the memory lymphocytes. So far, it appears to also be the case for Covid19, but its too soon to know for sure.

-3 ( +0 / -3 )

For months we've had articles mentioning that antibodies against the Covid19 virus decrease to very low levels within months. This was generally followed by recommendations to get regular vaccinations, even for those who have recovered from Covid19.

The same as the articles you saw being investigated for "massive" doses of HCQ? because those you ended up bringing had neither massive doses nor they were investigated for malpractice.

With that antecedent it is perfectly likely you simply misunderstood the articles and projected that misunderstanding into something the articles never said. Just like this one.

While the decrease in antibodies is typical, memory lymphocytes generally remain for a long time, perhaps a lifetime. These memory cells offer protection (immunity) against future infections even if the actual antibodies are low.

Yes, something we now understand about also covid19 thanks to the preclinical studies done in laboratory animals, so once again memory cells are one of the strongest arguments for vaccination. Much more than antibodies, we don't know how many of the infected people (specially asymptomatic people) actually have a preserved activation function and how long, but for preclinical trials (and some of the clinical ones) the laboratory analysis includes isolation and examination of the memory cells, letting us know that vaccines successfully stimulate them and provide protection that apparently is long lasting.

To be more simple, in the case of antibodies both the natural infection and vaccines are the same, including waning levels. But for memory cells vaccines have more evidence that they work.

1 ( +2 / -1 )

The same as the articles you saw being investigated for "massive" doses of HCQ? because those you ended up bringing had neither massive doses nor they were investigated for malpractice.

The British study I brought up had doses that were way above the maximum dose listed in the British National Formulary ("provides authoritative & practical information on the selection & clinical use of medicines").

Look at the papers again; your dose comparisons of the Belgium and British studies were wrong. Your numbers were wrong.

-2 ( +0 / -2 )

The British study I brought up had doses that were way above the maximum dose listed in the British National Formulary ("provides authoritative & practical information on the selection & clinical use of medicines").

No, it does not, they make the specific point in the materials and methods, as you would know if you had read them, that the treatment produce concentrations in blood "at the upper end of those observed during steady state treatment of rheumatoid arthritis with hydroxychloroquine". You really need to understand (or read on the first place) the things you link about.

Look at the papers again; your dose comparisons of the Belgium and British studies were wrong. Your numbers were wrong.

Done, they are perfectly right, the problem then is that you could not understand the texts you linked and assumed mistakenly that a difference between 600 and 800 mg/day was "massive" when in reality is not really that important.

And more importantly none of the studies you linked are under investigation for scientific malpractice as you said they were, both of the reasons you cited the articles were wrong. Most likely because you could not understand them.

Once again, the most likely explanation why you think this article and many others say things that only belong to your imagination is that you also could not understand them. You demonstrated this with HCQ and now with the meaning of the levels of antibodies. Most people do not have these kind of troubles, so the article only appears to have a hidden agenda for you. Something easily corrected by improving your understanding of it.

1 ( +1 / -0 )

Look at the papers again; your dose comparisons of the Belgium and British studies were wrong. Your numbers were wrong.

Oh you're looking well out of your depth here. It's never a good idea to take on a specialist when you've got no knowledge of the subject you're dabbling in.

1 ( +1 / -0 )

Login to leave a comment

Facebook users

Use your Facebook account to login or register with JapanToday. By doing so, you will also receive an email inviting you to receive our news alerts.

Facebook Connect

Login with your JapanToday account

User registration

Articles, Offers & Useful Resources

A mix of what's trending on our other sites