In the early stages of the COVID-19 pandemic, much of the conversation focused on diagnostic testing, a crucial tool for identifying
people who could transmit the disease. Diagnostic testing is still an enormous
priority now, but more recently, the second type of testing has emerged on the
scene: antibody testing, a very different tool that provides different information.
It can be confusing to keep track of the two, so here’s a brief guide to what
makes each important.
Diagnostic tests are used to diagnose people who currently
have COVID-19 — and they’re especially important because many people who have
the disease show no symptoms. The diagnostic test that the United States
currently relies on involves taking a nasal swab from a person and then
searching for traces of the virus in that sample using a laboratory technique
called a polymerase chain reaction, or PCR. This is the gold standard for
diagnostic testing, but it takes a long time to complete — about six to eight
hours. As a result, there’s a growing backlog of people waiting to get their
results.
Diagnostic testing across the United States continues to fall
short of what’s needed to effectively track the spread of COVID-19. According
to the COVID Tracking Project, roughly 150,000 people have been tested each day
over the past week. Recent research from Harvard University suggests that
500,000 to 700,000 tests must occur each day in order to safely reopen The United States by mid-May. Scientists are racing to develop faster and cheaper
tests, but the vast majority of them have not yet been approved by the Food and
Drug Administration.
Antibody tests search a sample of blood for antibodies,
which are molecules produced by the immune system in response to a COVID-19
infection. In theory, antibody tests can identify whether a person has been
infected and has started to build immunity against the disease (even if they
weren’t aware they had the illness). This type of testing is considered crucial
to reopening the country, since the presence of antibodies could mean that a
person is immune to COVID-19, at least temporarily.
However, the science behind antibody tests for COVID-19 is
not yet considered sound. On April 8, the World Health Organization warned that
there is no evidence that antibody tests can show immunity to COVID-19 and said
it “does not recommend” their use for patient care, though it encouraged further
development of these tests. Relatedly, there are concerns about the
effectiveness of the various consumer antibody tests available on the market,
many of which are considered dubious. Nevertheless, the FDA has allowed 90
companies to sell these tests, none of which have been vetted by the U.S.
government, but the FDA has also warned that some of these companies may make
false claims about the products.
In some places, broad antibody testing is being cautiously
rolled out. One of the first U.S. efforts took place in San Miguel County,
Colorado, in early April, New York Gov. Andrew Cuomo said 3,000 people will be
tested for antibodies starting Monday, and Germany is beginning widespread,
random antibody tests as it looks to reopen its economy. The effectiveness of
these efforts, however, remains to be seen.
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