Antibody Testing.. Fact or Schiznick??


Since there are no sports to entertain us, let’s play a new sport we can do from our homes….we call it “Covid FACT or SCHIZNICK??”  Ok; we COULD call it TRUE or FALSE but what fun is that?

We will make a statement about Covid and you have to figure out if it is FACT..a true-ism, or SCHIZNICK- we are just fooling around. 
OK, ready?  Let’s commence!

The antibody test for Covid will confirm you cannot get re-infected…Got your answer? 
OK… Soooo the answer is-
SCHIZNICK!
Fine; we cheated a little on this one. Yes, if you have IgG antibodies it implies immunity—i.e. you are not going to get re-infected….but three problems;

1. The Covid virus may have mutated, in which case you can still get the mutated form.
2. Covid looks like other corona viruses and the antibody test may have picked up the wrong corona virus.
3. No one knows how long the antibody lasts; experts are guessing 1-3 years. Key word-guessing.
We still advise you get the antibody test–so far it’s been a good marker for immunity.

The antibody test will tell you if you’ve had Covid19 lately.
And drumroll….
SCHIZNICK!
Unfortunately, data is telling us only 60% of Covid victims will turn IgM positive–and even then it may take four weeks from infecton. But that is the idea of getting the antibody test. If your IgM is positive, you did have Covid lately.

If my Covid antibody is positive, I will still need the vaccine when it is available.
and……
FACT! 
We told you above that it’s unlikely the antibody to Covid will give lifelong immunity —1-3 years is about it. The vaccine may not give lifelong immunity either, but they are shooting for at least five, maybe 10 years–kind of like a tetanus shot. 

The antibody test may not be “free;” not all insurances are covering it…
Is this a trick question? Doesn’t the law require it to be covered?…well…..
FACT!
Here we have the classic case of conflicting facts.  Federal law relieves patient responsibility for “Covid testing” but health plans are allowed to not cover tests that are not FDA approved. Most antibody tests available now are FDA “authorized” as opposed to “approved.” Yes; as Chick Hearn would say, “ticky-tack”. So far, our experience is around half of payors are covering it outright and half are “working on it.” For those plans, you may be asked to pay $75 and be reimbursed if and when they do pay, which we predict will happen.  We doubt payors will refuse once the Feds give them a call. 

If someone has had Covid, they will be immune eventually.
Hmmmm and…..
FACT!
Using data from SARS1, MERS, and from Asia and Europe, it appears about 99 % of Covid19 cases will turn IgG positive, implying immunity. But unlike other viruses, it is taking 30-90 days for this to show up. 
So if you tested positive on April 1, it may take until late June to turn the antibody test positive. We say be prepared for a retest if you are checking the antibody too early.

Employers who want to test their staff prior to them returning to work should have them get the antibody test.

Seems obvious right?   Noooooooooooooooooo…
SCHIZNICK!!
This is a double edged sword. To test immunity and know if the staff will not be infected; yes, the antibody test is indicated. But less than 10% of the population is testing positive so far. For the employer to assure customers the staff is not contagious; they should actually get the nasal PCR swab for the actual virus. Ideally they would order BOTH the antibody test for immunity AND the nasal swab for active virus.

How did you do?  Here is the scale-
0-7 correct – You need to keep reading the blogs to increase your Covid knowledge 
8 correct -CONGRATS! You know more than Dr. Fauci and Bill Gates combined!

Gregg DeNicola MD 
Chief Medical Officer 


If you would like to schedule an antibody test or for other any other medical needs including annual exams, urgent care, or medication refills please email us at videovisits@caduceusmedicalgroup.com.