So What Now Orange County...Covid PCR, Antibody, Vaccine FAQ's
Sometimes, trends change just because that's what trends do....think -popcorn ceilings. We like them (ok, our parents liked them) then we don't - and prefer a different trend.
Other times, the new trend is due to a change in circumstances---think -gas powered SUV’s replaced by electric cars as being in vogue to reduce carbon footprints as well as avoiding gas stations.
Let’s revisit 1953 and the film The Wild One. Pogo sticks were featured and before you could say Tutti Frutti Ice Cream, Pogo sticks were all the rage. For those unfamiliar with the 20th Century, a pogo stick was a device for jumping off the ground in a standing position, consisting of a pole with a handle at the top and footrests near the bottom, and a spring located somewhere along the pole. Ok, I agree it sounds underwhelming, but if you were a ten year old in a housing tract in the Eisenhower 50's, and had a Pogo Stick, you were “King of the Neighborhood.”
Yet, by 1960, Pogo sticks started rusting in the back of the garage next to the linseed green linoleum leftover from the kitchen floor remodel. (Yes, another trend that didn't last; thank God!) Although Pogo sticks still had a lot going for them, in 1958, the Wham-O Corporation started production of a plastic hoop, inspired by a bamboo exercise hoop popular in Australia. To use it, you pretended you were doing the Hula with the hoop around your waist....a Hula Hoop! This began one of the largest fads America has seen, before or after.
They were much less expensive than Pogo sticks. And anyone, from a kindergartener, to an adolescent, to a teen, and even Mom and Dad--heck, even Grandma and Grandpa, had their own Hula Hoop. They could be used to exercise, have endurance contests, and- once you learned the trick- even toss it away, and it would "walk" itself back to you.
Sometimes, a new fancy needs a little boost-especially when it can improve the health and well-being of our community. That is where today’s blog comes in.
In 2020, testing for Covid was all the rage---we promoted it here with the “TEST TEST TEST” mantra. And it became more and more essential as the numbers rose toward the last three months of the year.
We had the rapid test. The gold standard PCR test. The saliva test. The expedited test, all with different accuracies, prices, and difficulty in finding somewhere to do it.
At Caduceus and PDQ we were militant about getting enough tests for our patients, not requiring symptoms to test, and demanding a test of cure (a negative test after a positive one) to be cleared.
People used the PCR to get back to work, travel, gain entrance to a family party, and even be reassured visiting the seniors in their lives. People would wait in their cars for hours, plead on Facebook for sites they could get a Covid test, TODAY!
Now, in 2021, it is still important to keep an eye on whether your contagious ---and by all means, check a PCR if you have symptoms of Covid. But we have a candidate for a new Covid fad--the forgotten antibody tests.
First, we must clear up one falsehood about Covid antibodies. They DO protect against catching Covid. Somewhere, social media picked up on the CDC’s and the WHO’s advice that said we weren't sure. But we are. Antibodies fight off Covid; period. How would a millennial type it?
Antibodies. Do. Work.
That's what antibodies do. It would be like saying, we aren't sure that blood carries oxygen, or the kidneys don't filter our blood... They work, well, because they are antibodies.
If they didn't, we just wasted trillions of dollars and time developing and giving vaccines. Because that's how the vaccine works; it stimulates Covid antibodies which in turn fight off the Covid virus.
But when we discuss commercially available antibody tests, we are talking about checking the antibodies we form after exposure or an infection. What about the antibodies we form from a vaccine? As they say in OZ, "That's a horse of a different color!"
The experts told us the antibodies from the vaccine are a different type of antibodies, which probably don't show up on normal antibody testing. So no need to check antibodies after a vaccine, right?
Well....a lot of people did anyway, and guess what? A lot of them have antibodies. What do we do with this info? No one has any idea.
At Caduceus, we have diagnosed over 3,000 patients with current or past Covid infections. Only ONE was diagnosed with a positive PCR swab with positive antibodies, but he had no symptoms. A new study in progress will show NO Covid infections with 11,000 patients with antibodies. We are not saying antibodies are 100% protective. However, looking at available data, it is highly unlikely you will contract Covid if you have Covid antibodies.
If you look it up, the CDC as well as all the major research centers in the US, will say something like-
"We don’t have enough information yet to say how protected someone might be from being infected if they have antibodies to the virus.”
That's fair. Also cowardly.
Sometimes you have to tell the Emperor he has no clothes on.
We get many FAQ’s....I will post a few here and forewarn you we have the same answer for all of them...
Q: I have had Covid. Do I still need the vaccine?
A: Not sure.
You should definitely check for antibodies. If you have them, you may want to save the vaccine for those without antibodies.
It is apparent we have no idea if Mother Nature’s antibodies are "better" than vaccine antibodies.
In most other viruses, Mother Nature’s antibodies are always better--or at least as good- as vaccine induced antibodies.
Remember Chicken Pox? "Natural and wild" antibodies were much more protective than the vaccine.
But some studies are telling us the vaccine is more protective than simply testing positive for antibodies post-Covid.
Yours truly just had an antibody test, and I paid extra to get a "quantitative" number, and I was off the chart.
I have so many antibodies I swear I saw a couple crawl out of my ear last night. Am I going to get the vaccine?
I need more data, which will be forthcoming as more people get both natural antibodies as well as vaccine antibodies.
Q: I have had the vaccine. Do I need to check my antibodies?
A: Not sure.
It appears the vaccine may trigger antibodies not picked up by the conventional testing done by commercial labs. No "expert" has officially advised checking antibodies. The concern is you will test negative and conclude the vaccine failed, when in fact it worked perfectly; the antibodies just need a different test. Since we do not know how long the vaccine lasts, just stay tuned and the WHO/CDC/Dr. Fauci will let us know if and when we need a booster.
Q: How about Mother Nature’s antibodies? If I have them , how long will they last?
A: Not sure. (See a trend here?)
We have had patients lose IgG in a month. Others are still IgG strong seven months from their infection. The only way to know is “TEST TEST TEST.”
So do we have any specific advice for you?
You're darn tootin’. (Recovering from Covid, I saw a lot of old Westerns)
There is a 100% chance you fit into one of these five buckets. Follow along for your fortune…I mean advice... feel free to pass it along to friends or family who may be in a different bucket.
You have not had Covid, not been exposed, nor had any Covid type symptoms over, say, the past year. You have not been vaccinated.
ADVICE- No antibody test necessary. Find a way to get a vaccine. Then just sit back and wait as we find out how long the vaccine lasts.
You were exposed to Covid--through a roommate-partner-coworker etc., at any time over the past year. I'm talking about a close exposure.
ADVICE- If the exposure is recent, start with a PCR swab. Otherwise, check your antibodies. You may be surprised to find out you are IgG positive. Then check your antibodies monthly through 2021 to confirm your (probable) immunity. If the IgG disappears, or your antibody test is negative, take the vaccine.
You have had Covid in the past year (but not currently).
ADVICE- Check your antibodies, now and monthly through 2021. Same logic. Since we do not know how long they will protect you, keep a close eye on them, and get vaccinated as soon as they disappear.
You currently have Covid, or have symptoms of Covid. You have a positive PCR swab.
ADVICE- Wait at least a month from when your symptoms started, then check your antibodies. Check your PCR regularly also, to be sure your clear of the virus. Check your antibodies monthly through 2021, using the same logic from Buckets 2 and 3.
BUCKET # 5
You have been vaccinated (apply this advice even if you also are a member of Buckets 1-4).
ADVICE- Sit back, relax, and read this blog for advice as to a possible booster. Of course, still wear a mask, social distance, and avoid super spreader events. If your personality allows for it, you may want to check antibodies, but do not be concerned if they are negative, even after the vaccine.
PCR Covid testing?
That is SOOOO 2020.
In 2021, Let’s make antibody tests all the rage. It’s good data to know.
Oh! Also... as long as we are discussing fads, a Hula Hoop on Amazon goes for $29.99. Just in case you are feeling nostalgic. (I swear my Mom got mine at Zody's for a dollar!)
Gregg DeNicola MD, Chief Medical Officer
PS. I again want to thank all of our loyal readers and patients for their prayers, cards, gifts, and messages of goodwill as I continue the slow recovery from a serious Covid pneumonia.
It is a slow daily fight, but I am getting slowly better, as the doctors predicted. If you are post-Covid yourself, you are aware of the danger of blood clots, long term lung damage, and a continuing cytokine storm to keep you alert.
It would be a lonely road if not for all the support, and I want to thank you from the bottom of my heart.
And yes, I still enjoy a shot of Kahlua.