Everything we know so far about coronavirus antibody tests, according to experts
About two months ago, my partner and I got sick. We experienced high fevers and chills that lasted days, exhaustion, general malaise, and loss of appetite. I even—unfortunately and unmistakably—temporarily lost my senses of taste and smell. But out of fear and misinformation (at the time we thought we had the regular flu), we did not get tested for coronavirus (COVID-19). Instead, being stable and able to care for one another, we hunkered down and self-quarantined for the prescribed 14 days until we felt well again. Now, we’re faced with another decision: Should we be tested for the coronavirus antibodies?
There’s been a lot of talk on the news lately about the antibody tests, along with a debate about how accurate they are. In some states (like New York, where we live), they’ve even been heralded as a key tool for policymakers to determine the safety of re-opening. But whether or not the current state of antibody testing can accomplish that remains to be seen.
If tracked properly, the tests have the potential to give medical professionals and government officials a better idea of how widespread the virus is and help inform when it’s safe for people to return to work or school without the risk of becoming sick or getting others sick. Since we’re still months away from having a proper vaccine (vaccines must pass three to four clinical trials in order to be approved by the Food and Drug Administration (FDA)), antibody tests may be our best bet for mapping out when things will be able to get back to “normal.”
Unsure of what to do myself, I decided to tap doctors to get more information about what the antibody test is, who can and should get it, and what it means if you test positive for COVID-19 antibodies. TBH, we’re still in the early stages of figuring these tests out, and more information about the virus is being discovered daily, but here’s what we know so far.
What is the antibody test?
Unlike the initial COVID-19 diagnostic tests that use a cotton swab in the nasal passage to trace the presence of the virus via fluids, antibody tests (also known as serology tests) don’t detect an active infection. Instead, these tests look for signs that someone was previously infected or exposed, even if they had no symptoms, shown by the presence of antibodies, or specific proteins made by the immune system to fight the virus.
It’s often easiest to detect the presence of these proteins in the blood, so the current tests for coronavirus antibodies require a blood sample (usually drawn from a vein or a finger prick). If you test positive for having the coronavirus antibodies, it means you’ve had an immune response for the infection and likely had the virus at some point.
However, since the FDA has granted emergency authorization to allow certain drug developers to bring their tests to market without standard validation, there are almost a hundred different variations available from different companies. The goal was to get tests out quickly to provide a better understanding of how the virus has spread, but that means there is no one precise test yet, even if all tests are looking for present antibodies. According to the FDA website, some drug companies are falsely claiming that their serological tests are FDA-approved or authorized, or falsely claiming that they can diagnose COVID-19. So, there is still a lot of misinformation surrounding testing.
At the publishing of this article, Dr. Tania Elliott, M.D.—a telemedicine and immunology expert; associated attending at NYU Langone Health; and national spokesperson for the American College of Allergy, Asthma, and Immunology—tells HelloGiggles, “There are only two tests for antibodies that have passed the sniff test from the FDA, of more than 90 available worldwide.”
Additionally, because there are so many tests and the results vary, it’s been difficult to track how many people actually have the antibodies.
Currently, the Centers for Disease Control and Prevention (CDC) are working on implementing a strategy to evaluate the performance of commercial antibody tests and study the spread, but the federal government instructed states to develop their own testing plans, which has made it harder to regulate and communicate results. With little regulation at the moment, the rollout and tracking of these tests have been a bit confusing.
Who should get the antibody test?
“Anyone can get the COVID antibody test, as we now know that asymptomatic infection is common,” Dr. Jennifer H. Haythe, M.D., a critical care cardiologist at New York-Presbyterian Hospital, tells HelloGiggles. She explains that the antibodies can usually be detected 14 days after symptom onset, so if you think you’ve had it and successfully recovered, you can go and get the test to check. Just be sure to check on the availability in your state.
However, just because you can get tested doesn’t necessarily mean you should. Though some workplaces may require that employees receive a test before being able to get back on the job, for others, testing may be optional. Because the accuracy of the tests still varies so much, debates on how necessary they are right now are ongoing. Not to mention, the lack of regulation with the tests themselves provides a chance to receive a false positive, according to the Infectious Disease Society of America (IDSA). And some people have even reported receiving different results based on different tests. The lack of accuracy is proving difficult for government and medical professionals to get an accurate picture of what the infection rate looks like overall.
One benefit to the test that is still being explored is the ability for people who have recovered from COVID-19 to donate plasma, a part of the blood that could be used to treat others with the virus and potentially assist with the creation of a vaccine. Since plasma contains antibodies, it could be used to keep patients from developing more severe respiratory symptoms. This treatment study is still being explored, though, so we currently don’t know how useful a treatment option it is.
Ultimately, while you may have the option to get tested, you should definitely do your research beforehand.
What is the availability of the antibody tests right now?
The availability of the tests depends on where you live. Some states have drive-by antibody testing available, while others are making the tests easy to access via local medical clinics where no appointment is necessary. You’ll need to check on what is available in your area, usually on your state’s website.
The good news is that as of April 24th, per the CARES Act, all antibody testing will be covered for both insured and uninsured patients, so it shouldn’t cost you anything out of pocket.
Does testing positive for antibodies mean you’re immune to COVID-19?
“It’s important to understand that antibody tests can tell you whether you have been exposed to the virus but not whether or not you are immune,” Dr. Elliott says. “We don’t know about the function of these antibodies and if they are strong enough to fight off another infection, nor how long they will last.”
That means that even if you do test positive for the antibodies, you can’t assume you’ll never come down with the virus again. For the time being, you’ll still need to abide by mandates surrounding social distancing, wearing a mask, and washing your hands.
Dr. Haythe agrees, saying that the presence of the antibody does not necessarily confer immunity and that further studies are necessary. She says, “It is likely that when an effective vaccine is developed, all people—regardless of antibody status—will need vaccination.”
As information about the coronavirus pandemic rapidly changes, HelloGiggles is committed to providing accurate and helpful coverage to our readers. As such, some of the information in this story may have changed after publication. For the latest on COVID-19, we encourage you to use online resources from CDC, WHO, and local public health departments, and visit our coronavirus hub.