Summit County Public Health Officials Caution Against Antibody Testing

This article and photo first appeared in the Summit Daily on May 5, 2020

FRISCO — Summit County public health officials have said they will not provide antibody, or serological, testing until it’s proven accurate and reliable, but that doesn’t mean people can’t get one right now.

Quest Diagnostics and LabCorp both operate in Summit County and can provide and analyze the tests. Dr. Kim Nearpass from the Mountain-River Naturopathic Clinic said her practice plans to start providing the IgM and IgG serological test once the clinic opens for in-person appointments May 18. Nearpass said she isn’t the only one in the community offering antibody tests as a number of other doctors have expressed interest in doing so.

Centura Health, which owns St. Anthony Summit Medical Center and High Country Health Care, is against providing the serological tests until researchers know more. Dr. Kirk Doing, the director of clinical microbiology for the Centura Health system, said the tests that are currently available are not able to tell patients anything about their health.

“We just do not understand what serology results mean right now with the virus,” he said.

Vail Health in Eagle County has offered antibody tests at its clinics since April 22, spokesperson Sally Walsh said. The hospital has tested 2,200 people using the antibody tests, CEO Will Cook wrote in a guest column for the Summit Daily News.

Most people who have been tested for the novel coronavirus have received the viral test, which takes cells from the inside of a person’s nose using a cotton swab.

The serological test looks for antibodies, or protein cells, that are used to fight off coronavirus within a person’s blood. The problem is antibody tests vary in accuracy and often can provide false negatives and positives. In a recent study of 14 coronavirus antibody tests, only three proved to be reliable.

The coronavirus has an antigen, which the antibodies react to in order to fight it off, but doctors know virtually nothing about the COVID-19 antigen, Doing said.

“We’re very concerned when we don’t know the antigen makeup because we don’t know what (the antibodies are) going against,” he said.

Without knowing more about the antigen, researchers don’t know if a person is immune from the virus or if they’ve even had COVID-19. Even if tests could determine whether people were immune, researchers still would need to figure out how long that immunity lasts, Doing said.

“We’re giving patients a potential false sense of security thinking, ‘Oh, I’ve had it. I can’t get it again,’” he said.

Not FDA approved

Commercial providers must receive an emergency use authorization from the Food and Drug Administration to distribute antibody tests. The authorization doesn’t mean the FDA has approved the test, only that the manufacturers have sufficient data for the test to be used in an emergency like the coronavirus pandemic. The FDA has granted 12 emergency use authorizations to providers as of Tuesday.

“You’ve been exposed to a coronavirus if you’ve had a cold,” said Dr. Richard Zane, chief innovation officer at the UC Health. “So, if I tested you for antibodies to a coronavirus, you probably will have them.”

Summit County officials are hesitant to provide the tests because they aren’t always specific. Nurse Manager Sara Lopez said the county has been monitoring the development of antibody tests closely to wait for the moment when they are proven to be reliable.

“Eventually, we think this antibody blood test may play a large role in helping us determine who was infected and also, perhaps, allow people with this test to return back to work and school,” she said. “Unfortunately, the technology is just not there yet.”

Because Mountain-River Naturopathic Clinic practices holistic medicine, Nearpass’ philosophy often differs from doctors who practice Western medicine. However, on the topic of COVID-19, both sides agree that the serological tests aren’t at the point of being reliable.

“At this point, there isn’t sufficient data to be confident that the test results provide accurate information about viral exposure or immune status,” Nearpass said.

Many of her patients have been asking for the test; however, and that is why the clinic will start offering them.

“There’s a lot of interest and inquiry from the patients’ end because they’re reading about antibody testing, and they’re wanting to get information about whether they’ve actually been exposed to the coronavirus or not,” she said.

Nearpass will provide patients with an informed consent form before drawing blood, so they are aware that the tests haven’t been approved by the FDA.

“We really want patients to understand that antibody testing cannot be used to diagnose current or past COVID infection, nor can it be used as evidence to conclude immunity status,” she said.

Researchers still don’t know if a person who has the antibodies for the new coronavirus is immune, which would be a critical piece of information for county officials to know before they offer the test in the community. Some county officials are worried people will stop practicing social distancing because of their antibody test results, Lopez said.

“No matter if someone receives a positive or a negative antibody test, they still need to practice social distancing, they still need to be very mindful of washing their hands, wearing face coverings in public spaces to protect themselves and their community members,” she said.

Experts also recommended that people avoid using at-home or other commercial antibody tests, as those have not been approved in any capacity by the FDA.