Antibody testing: A tool for determining when and how to safely reopen communities

BOSTON — After more than a month of the coronavirus restrictions and business closures, Governor Charlie Baker announced last week the state will re-open in phases.

But, deciding which sectors of the state can safely resume activity and when will require a clear picture of how far the virus has spread. To do that local governments and employers are turning to antibody testing to gain the information they will need to make those important decisions. Antibody tests reveal who has already been infected and potentially immune.

Unlike the coronavirus testing, antibody tests are more readily available and can be produced more quickly. But they are not perfect. They can produce false positives and wrongly give people a sense of security.

The test does not look for the virus itself, instead it identifies antibodies – or proteins the body creates to fight it off.

“And so what we're looking for with the antibody test is do you have some antibodies, have you been exposed to the virus? That's it.,” said Dr. Eric Dickson, Emergency Room Physician and CEO at UMass Memorial. “You're now making these antibodies They will neutralize the virus and that's the hope with the body testing.”

Dickson says antibody testing could be crucial for easing restriction and returning people to work. More importantly, he says, it is an important complement to coronavirus testing because so many carriers are not even aware they have the infection.

“When you add the antibody testing to that it’ll tell you this is what’s going on today,” said Dickson. “So when you add those two things together, you get a really powerful set of data to understand what’s going on with this infection.”

According to Dickson, that information could go a long way to determining which pockets of the population are most susceptible to catching the virus and whether enough herd immunity is present. Herd immunity is collected immunity that could prevent the virus from taking hold in a community.

“Think of it as, you're in a forest and you look in these dry kindling all around you, it's easy to get a big fire going and get something out of control. Every person that tests positive for the antibody, it's like picking up that dry kindling, and it's no longer available,” added Dickson.

A simple blood draw can reveal how far the virus has spread in a community and who can safely go back to work while the virus remains a threat. The test will detect the presence of important antibodies.

A person with IGM antibodies is in the early phase of the disease and contagious, while someone with IGG antibodies is in the latter stages of the virus and may have some temporary immunity. However, an individual with neither of these antibodies has never been exposed to coronavirus and is most likely to get infected. People in this category, say experts, are most at risk for infection and are least safe to return to work.

Massachusetts’ second largest city is turning to antibody testing to determine if the city is ready to ease restrictions.

“We think it’s going to be a very important part of figuring out how to reopen our community,” said Dr. Michael Hirsh, medical director of Worcester’s Division of Public Health.

Hirsh says the city will likely start by offering antibody testing to city employees in batches or groups. His goal is to make the test available for people who work in factories, construction sites, office buildings and anywhere else in the private sector.

“If that does work, we think we could save a lot of dollars and time in getting these workplaces back online. So it's probably maybe two three weeks away from getting all the approvals it needs,” said Hirsh.

Researchers at MIT, Harvard, Beth Israel, Mass General and Brigham and Women’s are also working to bring antibody testing to the masses in Massachusetts.

Unlike coronavirus tests, which can take about a week to get results, antibody test results are available with 48 hours and production of the tests can be quickly ramped up. There are dozens of FDA-authorized antibody test currently in the market; only one has received government approval so far.

But the tests are not perfect. Some have been known to produce false positives.

Also, experts are still not sure if a positive antibody means absolute immunity to reinfection. So they recommend taking precautions and continue practicing social distancing even if you test positive.

The City of Boston last week announced it will test a thousand residents of hard hit communities for antibodies, while Baker has shot down the idea of statewide antibody testing.

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RESOURCES:

- Massachusetts Coronavirus Information

- Boston Coronavirus Information

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