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Day 86, COVID-19: I Take an Antibody Test
A SARS-CoV-2 antibody test kit being administrated, from Arcpoint Labs
The image is from the Arcpoint Labs website and shows both the SARS-CoV-2 antibody test kit and the way it is administered. Alcohol wipe the finger. Use a lancet to prick the finger and start oozing blood. Use a capillary tube to draw in some blood from the wound and place a droplet in the test kit port marked “lgG.” Repeat the draw and place a droplet in the test kit port marked “lgM.” Add reagent to the port marked “B” ( I think). Wait five minutes for results. They didn’t show me the kit when the test was completed so I can’t describe what it looks like when a result is given. Maybe it is some coloring of points marked “C” and “S” on the kit?
Mind you, this is not a test for the presence of the virus, like they give to symptomatic people. This is a test for antibodies against infection by the virus — and indicator that the virus has been in the system and defeated.
OK, what were my results? Negative for both lgG and lgM. The paper they handed out to explain the test results state as follows:
Negative lgG, Negative lgM (two possibilities):
• Patient has never encountered COVID-19 and is healthy, but susceptible. Continue social distancing protocols.
• Early latent infection — too early for antibody detection. Continue social distancing approx. 2 weeks.
Because they are testing for two antibodies there are four possible outcomes. The other three are:
Negative lgG, Positive lgM:
• Early stages of antibody response. Possible virus carrier/latent infection. Continue social distancing for
approximately 5-7 additional days.Postive lgG, Positive lgM:
• Recent infection. Suggests functional immunity. Discontinue social distancing.
Positive lgG, Negative lgM:
• Past infection. Suggests functional immunity. Discontinue social distancing.
Arcpoint is one of over 70 commercial labs that have or are developing COVID-19 antibody tests. I asked what was the minimum titer required to generate a positive test result? The technician did not know but said that was a good question.
None of the tests are FDA-approved at this point. And the fine print also says “Negative results do not rule out SARS-CoV-2 infection, particularly in those who have been in contact with the virus. Follow-up testing with a molecular diagnostic should be considered to rule out infection in these individuals.” That quote is FDA-mandated boilerplate along with “Results from antibody testing should not be used as the sole basis or diagnose or exclude SARS-CoV-2 infection or inform infection status,” “Positive results may be due to past or present infection with non-SARS-CoV-2 coronavirus strains, such as HKU1, NL63, OC43, or 229E,” and “Not for the screening of donated blood.”
So where does that leave me? It is suggestive that whatever else is going on, my particular perambulations have not brought me into contact with the virus. And, no, the flu-like symptoms all three of us in the household experienced in January was not COVID-19. We all had the seasonal flu vaccine and the illness we did have was pretty mild.
The county where we live in California, Contra Costa, is part of the greater Bay Area and has been in lockdown since March 17. We currently have 615 confirmed cases in the county, with 44 hospitalized and 14 deaths. The county’s population exceeds 1.1 million.
My community is away from the large population centers of the county. Which is just as well. The household is comprised of a 66-year-old female (Mrs. Rodin), a 70-year old male (me), and a 90-year-old female (Mrs. Rodin’s mother). Our infection control protocol is pretty much what you would expect from people our age — whatever our energy permits and whatever we can remember to do. Over the last couple of months, I filled up what had been bare freezers in case we had to be quarantined. We made sure we had 90 days of meds. I am the only one who goes to the grocery store or the pharmacy. I wear a mask when I am in any store and add gloves at the supermarket or gas station.
Mrs. Rodin’s mother accompanies me on as many trips as possible but only stays in the car. It keeps her from going stir crazy — and no one wants her to be stir crazy. As no one in the household was working outside the home when the health emergency was declared, the main impact has been the inability to do sit-down dining in the restaurants we frequented or the occasional visits to retail shops. It has scuppered any possible family visits for the time being. And broader excursions to Carmel, Monterey, Lake Tahoe, or regional and national parks are out of the question.
But we are not the ones I worry about. I fear for the many people who provided services to us that are now idled. I fear for people who need group support but who are barred from gathering. Mrs. Rodin asked me last night what are the people who need meetings to control their addictions doing? Fortunately, we do not have personal experience of this, but one of our favorite comedies, Mom, is centered around recovering addicts, so no doubt this prompted the thought.
There has been discussion on our Nextdoor local group about a shortage of produce in our local store. Speculation is that farmers are having problems getting the crops into the supply chain, or that maybe truckers are in short supply. I don’t know. This is probably temporary but I worry that a lot of damage is being done to the economy in ways that are not always apparent … until they are.
So, let’s get those antibody tests rolled out and getting a better picture of the level of infection and the true risks of getting this disease.
[Note: Links to all my COVID-19 posts can be found here.]
Published in General
I never realized you were a fellow Californian, Rodin.
Yesterday the big thing for our household was to find a store with toilet paper, as we never went out and hoarded it and were down to our last 3 rolls. The dollar store was almost stripped of it, but we took three of the last four packages.
I don’t know which antibodies test would be the best, and I have so little faith in our medical situation that I doubt I would be tested. (Unless the state of Calif comes to my door and drags me off.)
If I had the antibodies test and found I was negative, it might make me worry that I could get it. If I found out I was positive as far as antibodies, with my knowing how closely aligned Gov Newsom is with Bill Gates and that both men are really wanting to have total surveillance of who has been exposed to COVID, who has had it, who has been vaxxed (once the vax is released), I would probably be more nervous about being tracked than feeling relieved that I had experienced COVID and beaten it.
Here is the link to The Cosnervatie Tree House’s great article on the stringent controls Newsom is proposing:
https://theconservativetreehouse.com/2020/04/14/terms-and-conditions-california-outlines-six-requirements-before-lifting-home-detainment-and-reopening-the-economy/https://theconservativetreehouse.com/2020/04/14/terms-and-conditions-california-outlines-six-requirements-before-lifting-home-detainment-and-reopening-the-economy/
This type of test is going to be key to our moving forward.
They can’t get these out there fast enough.
So what happens after you continue to isolate and remain neg/neg for 2 weeks, 3 weeks, 4 weeks? How long do you have to prove you’re not a danger to yourself or others? Isn’t that the likely result after your disciplined application of your own protocol?
In California I believe you become a Morlock.
That link to the California proposal is downright scary.
Yup. When I heard it on the news I said, “Thank you, one-party state.”
Yes but which test from which company? Who is making the tests; what reassurance do we have they were not rushed into development and would not necessarily have any validity?
Have you yet seen the video showing how the third world workers are churning out the masks we need? More toe jam than could be believed possible is rubbed on the masks, as they fall off the tables where the cutting and sewing occurs, onto the unsanitary floors of that workplace.
With no idea of quality control, the fallen masks are then gently massaged by the bare feet of the workers closest to them.
I ask because I’m likely to be one: my protocol has been completely free range. Since end of February I’ve been to NOLA – for Mardi Gras week including the Quarter and a parade where 4 people fell off a single float and one person on another float died, the North Shore, Metairie and Slidell – North Carolina, Virginia, MD, PA, NY, CT, MA, NH and ME. Flying twice, driving, walking around and doing anything open. I’m one of the ones who never get viruses and doesn’t get flu shots (I get all the outlier side effects of most medications so avoid any I don’t really need.) So – I’m not likely to get this either but if/when I have to show my “papers” I’m also likely to flunk the test. That I resent having to take, maybe. And I’m getting really cranky about all the ways TPTB are planning to keep the economy from functioning anywhere near normal until after the election. So my question wasn’t sarcastic but self-serving: CA seems to me to be the Big Kid model all the Little Kid lefty states want to follow. NH has a nominally Republican Gov, but he just wants people to like him…..
Life hack for people getting gas without gloves: shoot a handful of gas onto your offhand, when your remove the nozzle from the filler and rub this on both hands vigorously. I don’t know if that will affect any virus on your hands, but you will be much less likely to touch your face.
You’ve got that right. And it will also promote social distancing when everyone else exits the vehicle.
Well, sunlight kills viruses, so outdoor pumps are likely very safe.
@eodmon, I don’t know the real answer. In a rational world we wouldn’t be milking the crisis to deprive liberty and maximize political advantage.
In Florida, the “re-opening date” is bouncing all over the place. Now it’s May 3 or 6. It will likely change again–I hope for an earlier date. Although I’m not sure how much that would affect us.
I can’t shake the feeling that testing is not going to be as helpful as we hear. It would certainly be helpful to individuals who are positive, to confirm a diagnosis. And also mass random testing to determine how far the virus has spread. But to get the economy going again, no. If you are in a workplace and they test you and all your coworkers and everyone is negative, then you can all go back to work without worrying, right? Wrong. This virus isn’t like HIV. It’s far easier to get. If your coworker tests negative, they could get exposed to it the next day. Are they going to test everyone twice a week? For how long? Or maybe they will try to get everyone in the country to get a test on the same day? Good luck with that.
Trump was right when he said we will know everything is ok when no one is getting sick anymore. Testing alone isn’t going to get us to that point.
@bobw, that is why it is important to have antibody tests. In contrast to the tests to confirm an active case of COVID-19, the antibody test can determine that you have immunity from the disease. There are those that believe that many millions have had mild cases of COVID-19. If true they can be identified through the antibody test and cleared for work. If a co-worker who has a negative antibody test outcome later comes down with COVID-19 that does not prevent the workers with immunity from continuing to work.
Link works just fine, @eodmom. Yes, it is becoming clear that the lock-downs are no longer justified by the threat to overwhelming the health care system, at least not most places.
@kozak I just watched a Stanford Grand Rounds video from last week where they described an in-house serology test they’ve developed, validated against known samples and compared to results from a test targeting a different part of the spike protein, that was developed in Europe. All looked good and they are deploying it.
However, they also said, and here’s the biggy with respect to restart: No one at this point really knows what level of immunity is conferred by having positive IgG for this virus, and what titer is ‘positive’ in that regard. They specifically said that testing of known asymptomatic or mild case patients has showed low levels, so those conditions may or may not create immunity.
We’re going to be figuring this out on the fly, like everything else.
Video link, if anyone else wants to check it out. Lots of other interesting stuff at the beginning: https://www.youtube.com/watch?v=Xm76adKULY4
Edit 2: See also this UCSF video from about 28:00:
The medical people have been warning about wearing gloves, and they actually help cross contaminate. Masks, and hand sanitizer are prefered.
AND, the governors of both Washington and Oregon have agreed to coordinate with California in planning for reopening the economy. I fear that “coordinate” means “fall in line behind”.
@rodin – I’m glad you got the test but I’m sorry you are not immune (yet)
Regarding California’s 6 conditions for re-opening, my advice for all Californians (myself included) is to follow Michigan.
If everyone leaves the house, the state and local police can’t arrest everyone.
Also have the police been tested? Are they all negative and immune?
George Stigler: Americans obey good laws and ignore bad laws.
I dislike this for any purpose other than peace of mind on the one hand, or scientific study on the other. So we require that you have antibodies before going back to work… do we even bother to count the ways that will backfire? Maybe we put apps on everyone’s phones or issue licenses so that you can be cleared to go to baseball games, again? I’ve actually heard a lot of these sorts of ideas thrown around, and they are flat-out ludicrous. We should test for antibodies so that we have a better understanding of risk, but that’s about the only legitimate reason I can think of.
I don’t think this is as important as you think. You’re not looking for full immunity (as in, virus just bounces off of you), you’re looking for the ability to defeat the virus if you ever encounter it again.
It’s not going to happen anyway. Here’s why:
Testing is going to be very important, but not in that way. More for allowing tracing in areas that have reasonable caseloads, so we can get them back to work.
Corollary: No herd immunity for the near future.
The point is that we don’t know the correlation of either of those – full immunity or just resistance – to the antibody level. Only one way to find out, but decision makers aren’t going to lean on those tests too hard until we have more data. Fortunately, the RNA (PCR) tests seem to be quite solid and are getting faster and more widely deployed.
@lockeon, this is very important data. (Sorry for the ellipsis, I needed space for the comment.) Do you have a reference to share for me to read more about point 1? I do not make the argument that people have to demonstrate immunity to work or attend events, only that if the broad antibody testing we can fill in the missing denominator in IFR calculations that should drive our cost/benefit analysis. With good data and information people can make decisions about risk — not government.
The course of the flu each year is a useful comparison to covid-19 in some ways. However, I can’t help wondering why we have been so nonchalant about the high death toll from the flu each year. I hope that changes and that we become newly committed to helping patients have better outcomes from the flu.
I think there are a few reasons covid-19 got our attention while the flu does not, the main one being that we’re simply used to the flu. It’s change that gets our attention.
I think that one good thing that will come out of this winter’s covid-19 attack will be new and better treatments for flu patients who develop pneumonia. :-) I’ve seen several stories such as this one over the last few weeks of doctors trying some innovative treatments for pneumonia. Perhaps in the future more people will get a flu vaccine, and more people will be saved by some of these new treatment methods. We’re learning a lot about upper-respiratory disease.
I read an interview years ago with our local hospital administrator in which he said our bed capacity is geared to a bad flu season. In an odd turn of events, Cape Cod Hospital last fall explored the idea of doubling our hospital size from three floors to six. In December, they decided not to pursue it. I have a feeling the idea is back on the table. :-) My point is that we have a system in place to handle a certain number of flu cases each year. Because of our system, we never talk about the flu anymore. In our minds, we’ve taken care of it.
It’s kind of like our court and prison system. As long as our courts and prisons can accommodate the number of crimes and criminals, we don’t pay any attention to those issues. If there is, for some reason, a spike in crime such that our systems can’t accommodate the additional cases, then we start to notice.
I think that’s kind of what happened with the flu versus covid-19.
But most importantly, we are visual. And this entire global event kicked off with the horrific scenes of the initial outbreak in Wuhan. Without those pictures, I’m not sure if the rest of the world would be reacting the way it is to this pandemic. Those early stories and pictures scared the heck out of everyone who saw them. The flu does not turn cities upside down the way this disease did to Wuhan and Lombardy, and now New York.
It would be interesting to see, certainly. Especially since I’ve never read about “many hospitals” in WA and CA doing testing and finding no indication of COVID, but I have heard of anti-body testing that has showed many more cases than previously supposed.
What would be particularly interesting would be to see when these samples came from. It may not be likely at all that samples from November and December would turn up covid, whereas tests from January and February may very well. It may also be that covid (if nearly as transmissable as claimed) has widely circulated in just the past 2 months, which would change a lot about what we know with respect to this disease. Your confidence is misplaced.
Also – don’t go around resting your case. Take it from an attorney who has both won and lost plenty of times, even in the best of circumstances, you ought not rest your case until all the evidence is in. If there is one thing that seems pretty much consistent across the board, on which virtually everyone studying this agrees, we are lacking much information.
(Even more ellipsis.)
I’ve seen a citation to a retrospective study done in Washington State
but didn’t save a link, I’ll see if I can find it again. Here’s the link:(Also posted at thread end.) Second, the Stanford Grand Rounds linked upthread, in the serology presentation, discusses using pre-COVID samples as negative controls. They wouldn’t be doing that if they hadn’t been screened for COVID RNA previously. Stanford and UCSF are the places to watch for any breaking news on this, since they are collaborating on serology tests, and are located right in the area that the ‘Wuflu was here earlier’ theory points to. That dog isn’t barking.
I’ll have to dig for a cite on this too, but I believeThere’s a standing program to collect some number of flu samples each year, in various locations around the country and world, so they can eventually be RNA screened. This determines the flu virus mix from the past season to be compared against what the vaccine makers forecast, and used to guesstimate what will show up in the following year. That would suggest there’s a pool of such pre-COVID samples out there that could be (and may have been) retested for COVID RNA. Another dog that hasn’t barked. Update: See the CDC programs linked here and here. Those are capturing thousands of samples, plus whatever hospitals and labs do for internal monitoring.Keep in mind… I was not saying that I want antibody testing to show us that this thing has been around since November, and that our “bad flu season” was really covid, which seems to be what you are arguing against. I was saying that it will tell us how widespread covid presenly is. That is equally important.