The information in this article is true and its conclusions are logical as of today, April 23, 2020. As COVID-19 testing guidelines are changing very rapidly, future recommendations may differ from those expressed here today.

The development of an antibody test for COVID-19 is an important tool in the grand scheme of managing the current pandemic. Understanding the true epidemiology of the infection is crucial from a public health perspective, and so antibody testing plays an undeniably vital role for surveillance purposes. For this reason, the CDC, various hospital systems, and other academic groups are appropriately using the antibody test as a data gathering tool for research purposes. In addition, the antibody test is necessary for various experimental clinical uses, such as using the serum of previously infected people to help treat newly infected people. However, the role of antibody testing for general use, outside of research purposes, remains very undefined. At this time there is no indication for antibody testing in the general community. The remainder of this article will explain why.

In order for a test to be used in a general clinical setting it must pass, at the least, three major tests: accuracy, accessability, and applicability. At the current time, the COVID-19 antibody test passes none.

Accuracy. Some ninety companies have quickly produced antibody tests. In the preliminary studies, the sensitivity and specificity of the test varied greatly. Apparently, some were highly non-specific, being “fooled” by the common cold. None has been FDA approved.

Accessability. Yes you can probably get yourself an antibody test by going to a non-academic commercial lab which advertises and markets the test online and has strong business incentives. However, I am not aware of any academic facilities, practicing evidence based medicine, offering the test to the public at this time.

Applicability. We have no idea what to do with the results. How long does immunity last? We don’t know. Does a low level of antibody really confer immunity? We don’t know. Can you become infected with Coronavirus more than once? We don’t know. Is it possible that those with some antibodies may become brief carriers? We don’t know. Will the virus mutate rendering today’s antibody test essentially useless? We don’t know.

I am looking forward to the day when the role of antibody testing becomes defined. It is exciting, it is important, and I hope that it may be soon. For now, though, there is no recommendation for testing outside of research purposes.

To read the CDC statement on antibody testing, click here.

Yours in health,
Dr. Van Dam