NEW: Antibody Testing
My office has begun consulting with patients about the SARS-CoV-2 Antibody (IgG) test.
THIS IS NOT A TEST FOR ACTIVE INFECTION.
But this test is great news, for so many reasons:
We need to know who has antibodies to SARS-CoV 2 so that we can understand what level and duration of immunity these antibodies provide. If immunity is conferred, we can choose our first-line workers with this in mind.
We need antibody testing to help in vaccine work.
We need to work on using plasma donations as treatments for critically ill COVID-19 patients.
We need to know how many of us have antibodies to help determine the potential level of herd immunity in the community at present.
Yes, we need to be cautiously optimistic about any new test; this article summarizes the data from University of Washington very well.
Okay, let's get to specifics:
THE TEST: The test is NOT FDA approved, but has emergency-use authorization and has amazing, amazing promise – nearly 100% sensitivity and 99% specificity. Translation: it really does not miss truly positive patients unless testing is done too soon*, AND if antibodies are found, they are 99% of the time due to this COVID-19 virus.
*If the test is done less than 14 days after the onset of symptoms, it MAY NOT be positive.
This is not, I repeat, NOT a test for those who are currently sick with COVID-19 symptoms.
GETTING THE TEST: This blood test must be ordered by your doctor. You cannot just show up to a Quest lab. In our practice, the workflow will go like this: (no exceptions, no whining, please)
Call our office at (610) 363-0100. Call once; leave a message (one message) if you get our answering machine. Repeat calls will only increase volume, and will not speed up our reply.
Set up a visit (televisit or in-office) with one of our ten providers. We will discuss your request and the implications of the results, positive or negative. (If you are in the office, we can draw your blood right then.)
Results will take at least 2 to 3 days. We will notify positives immediately, If you don't hear right away (within three days), you can assume you are negative, though we will still let you know as soon as we are able.
IMMUNITY: If you are found to have antibodies, you can reasonably expect, based on past viruses that have been studied, that you have some level of immunity. The degree and duration will be determined over time. If you are a balloon popper, holding your breath and sharpened pin, just dying to post a comment about the S. Korean cases of "reinfection," please don't. No one in the respected infectious disease community believes these cases were truly reinfections. Work is being done to identify the causes for repeat positive testing (faulty testing, persistent viral debris etc.)
“Does a positive antibody test mean I can ignore social distancing rules?” ABSOLUTELY NOT. Having antibodies in no way suggests a free for all. There are millions of unknown and vulnerable people without antibodies. It is our duty to do everything right to protect those people. Secondly, antibody presence while so so encouraging does not guarantee full or permanent immunity. Caution must prevail. And third, we all need to accept the fact the some version of social distancing is here to stay—antibodies or not.
WHO SHOULD GET THE TEST? The test IS for the following:
people who had or think they had COVID-19 AT LEAST 2 weeks ago.
people who may be asymptomatic carriers.
If you add those two criteria up, EVERYONE except for those who are currently or recently ill, is a candidate. So practically speaking; if you know or suspect you had COVID-19 at least 14 days ago, or are asymptomatic but concerned about exposure, you are eligible for testing. This applies most critically to those essential workers who may be exposed every day. Otherwise, if you are not an essential worker, you should still be tested, but to manage testing supplies and wait times, you could wait a week or two to call for your antibody consultation.
INSURANCE AND COPAYS: We will draw your blood here and send to the proper lab based on your insurance (Quest, or LabCorp for IBC patients). All uninsured/underinsured costs should be covered by the CARES act; the out-of-pocket cost is $55. We will not be charging fees for your visit with our providers.
A few final, important notes:
KIDS/HEALTHY STEPS: I only speak for patients of any of the providers at CMMD and Associates. I learned about 27 years ago NOT to speak for my husband so if your child goes to HSP, you need to check in with them.
NEW PATIENTS: While I am flattered by the flurry of new patient inquires this news has brought, please be kind to your long-time docs — call them. Give them a chance to respond to your questions before switching to another practice. You MUST have a visit with one of us before we can authorize the test. It can be a televisit or in office visit. Yes, we can see you soon.
My team is ready to answer your calls. We will not stop until we have accommodated every possible patient in our practice. If I personally have to talk to patients 24 hours a day to get this done (provided I can still function soundly) I will, and I know my team is with me.
It is quite possibly the most important test we will authorize in the course of our careers.
We do not take this lightly — you can count on that.
-Christine & Team