Should I get tested for COVID19 antibodies in NYC yet?
May 3, 2020 10:09 AM   Subscribe

This is mostly about understanding the reliability of currently available testing and partly about risk assessment. I teach in one of the harder hit areas of Brooklyn, and was exposed early on to multiple colleagues who have since either tested positive or had telltale symptoms or both.

It seems like some urgent care facilities are now offering an antibodies test.

I think there is a real chance I had it. I didn't have any telltale symptoms myself, though, just a bit of under the weather feeling that was pretty ambiguous.

I am not at any elevated risk that I know of. 40f. But the last week or so, I've been having more anxiety about getting seriously ill myself. I think a positive antibody test would provide some ease of mind.

It would also let me feel comfortable being more of a helper. There is plenty of need in neighborhood for grocery deliveries and volunteering at food banks and so on, and I would like to be able to help.

On the other hand, if the tests currently available in NYC are not reliable enough to base a behavior change on, then it's an extra risk and use of resources with no real benefit.

So, what should I be thinking about for this decision? Are there particular tests that are more reliable and are they available in NYC? Should I get tested?

Thank you!
posted by Salamandrous to Health & Fitness (13 answers total) 4 users marked this as a favorite
I can't answer your question, but did notice that this new Roche test [WSJ link] appears to be very accurate-Roche says 100% accurate. Maybe you can find out where it's available.
posted by pinochiette at 10:29 AM on May 3, 2020

If it's a rapid antibody test, I would maybe take a miss. Their false positive/false negative rates are just too high to be used to inform behavior. However, if they're sending it out to a facility that is doing an ELISA test, then especially with your likelihood of exposure, that may be useful. Especially if they re-run all positives a second time.
posted by lizjohn at 10:49 AM on May 3, 2020 [4 favorites]

My understanding is that there's not a guarantee that you can't get get the virus again, in addition to available tests not being terribly reliable, so I don't see the upside in getting one. :(
posted by ferret branca at 12:17 PM on May 3, 2020 [4 favorites]

I think you should seek medical advice about What coronavirus antibody tests tell us — and what they don’t (Science News, Apr. 28, 2020) and the ongoing challenge to find accurate coronavirus antibody tests (CBS News, Apr. 28, 2020).
posted by katra at 12:51 PM on May 3, 2020 [1 favorite]

I'm in Queens, and did come down with something in early March but recovered before testing became accessible or advisable for the level of symptoms I had, so I have been considering the same question.

CityMD does have a FAQ entry for their offering, What platform do you use for testing?

All Serology (Antibody) and Molecular/PCR tests are sent to our national commercial lab partners (Quest, Sunrise, or Lab Corp). For serology, our lab partners use the Abbott platform which has FDA Emergency Use Authorization. For PCR, our national lab partners use the Roche platform which also has FDA Emergency Use Authorization.

CityMD says they have a 3-5 day turnaround on results, and it doesn't seem like the Abbott test is among those called out as wildly unreliable, for whatever that's worth. It is also worth noting that the antibodies this specific test are looking for take up to 14 days to develop, so it's explicitly not reliable for very recent exposure.

Since I'm more than a month past when I had symptoms and recovered, I probably will get it to answer the nagging question: Did I already have it?

The question of what antibodies do in terms of future protection is still unanswered, so a positive result shouldn't be taken to provide any immediate reassurance. On the other hand, that mystery will be become better understood over time, so knowledge of a positive result now could become more useful in the future.
posted by Pryde at 1:29 PM on May 3, 2020 [2 favorites]

A friend recently became sick and tested positive around the same time in Brooklyn so the test seems to have some value. Plus, you can get tested multiple times if you're still concerned a few weeks from now. You can call to make an appointment at (888) 364-3065 and explain you are beginning to show symptoms and have been exposed through your job.

I understand the nasal test itself was relative quick and the results come back after a few days.
posted by cowlick at 2:00 PM on May 3, 2020

[Purely ancedotal]. I asked an infectious disease friend of mine about this the other day. She said that although the test will tell you if you've had it (or been exposed enough to make antibodies), it doesn't necessarily mean you're immune. It *would*, however, mean that your antibody-carrying plasma would be interesting to researchers if you're interested in helping in a meaningful way. (Although there are questions about whether the antibodies are part of your innate immunity -- and thus can reproduce over and over again -- or whether the antibodies are just short-term -- in which case giving plasma would mean you are depleting any immunity you might have).

Personally I would find a positive antibody test very helpful -- to know that I had definitely been exposed, or had it, and not ended up in the hospital. And would probably give plasma as a result. But the antibody test is not available in my area yet without significant hoops.
posted by wearyaswater at 2:33 PM on May 3, 2020 [2 favorites]

A friend of ours in Queens was similarly sure she had gotten it, and did get a referral to a nearby Quest location from a doc she made an appointment with online, and the whole thing took about 20 minutes. Confirmed she had the antibodies within a couple days to no ones surprise based on the fact that she had just about every typical symptom.
posted by Exceptional_Hubris at 5:37 AM on May 4, 2020 [1 favorite]

If you do get a serology test, only get one that has FDA authorization. For some reason I do not understand, FDA authorization is not necessary to market a COVID-19 serology test.
posted by grouse at 6:24 AM on May 4, 2020 [1 favorite]

Note that there's been an announcement today of a more accurate antibody test on the way from Roche.
posted by nicwolff at 4:13 PM on May 4, 2020 [2 favorites]

Response by poster: So I ended up waiting long enough that the city sent out links to free testing sites. I signed up for an appointment and went.

There was a long but fast moving line around three blocks (I'm glad it wasn't as hot as it is now). They did scan my appointment confirmation so it was necessary, but I'm not sure whether the time mattered at all, or even the date, to be honest.

It was somewhat odd that some of the staff processing people had their masks below their noses, but there was fairly effective social distancing.

It was a blood test. They said results within 3 days, but it came back in two. It came back negative, which was kind of a disappointment.

To make matters more confusing it seems like false negatives *are* a thing for antibody tests (though a smaller thing than false positives). But I am treating it as correct because all my symptoms could have been a very regular teacher cold/exhaustion spell, with nothing telltale for COVID.

Hopefully this is useful to some! Thank you so much for all your help, thoughts, links, advice!
posted by Salamandrous at 8:28 AM on June 7, 2020

Salamandrous thank you for coming back to this.

Without disclosing too much personal info - can i ask where you got your test (like what the facility was). We've gone out to a couple protests and now want to be responsible about getting tested but theres some competing anxieties in this household about whether having a q tip stuck into your brain or needle in your arm would be the less desirable way to get it done . . . and it would be helpful to have as much recent info as possible. thanks!
posted by Exceptional_Hubris at 6:49 AM on June 8, 2020

Response by poster: I got the antibody test at the East New York center, which seemed to be inside a police precinct. It was a blood test.

This morning I went to get a test for the virus (also been protesting). I went to one of the NYC Health and Hospital Sites - at Kings County Hospital Center. There were only a few people in line ahead of me and it went pretty fast. That was a swab in the nose and it was very strange. To me it was worse than the blood test because I have no issues with drawing blood, but it also wasn't so bad and I would have no hesitation about repeating it.

Hope that helps!
posted by Salamandrous at 9:14 AM on June 12, 2020

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