Medical Examiner

I Kind of Regret Getting an Antibody Test

It was easy to get one. It was difficult to take any meaning from it.

A health worker handles a blood sample on the first day of a free COVID-19 antibody testing event at the Volusia County Fairgrounds in DeLand, Florida on Monday.
A health worker handles a blood sample on the first day of a free COVID-19 antibody testing event at the Volusia County Fairgrounds in DeLand, Florida, on Monday. Paul Hennessy/Echoes Wire/Barcroft Media via Getty Images

It’s easy to get a test for the novel coronavirus these days. At least, one kind: an antibody test. This one essentially looks to see if the virus has left its mark in your bloodstream, evidence of a past infection. A couple weeks ago, antibody tests were newfangled and hard to find—“I know a guy,” juggernaut tech commentator Kara Swisher wrote in the New York Times on April 15 to explain how she got her hands on one. There were rumors on my local Nextdoor group about where Gov. Andrew Cuomo’s statewide testing would be taking place. For a couple random days in late April, it was at a local grocery store; people scrambled to stand in the long socially distanced line before the tests ran out for the day.

Now, antibody tests are widely available. You don’t have to make an appointment with your doctor nor do you need to have had a bona fide COVID scare to get one—they’re at quickie medical centers across America. CityMD started offering them last week. GoHealth Urgent Care announced that it would be performing them as of Tuesday, available for people to check if they had been exposed to the virus “whether or not you experienced symptoms.” You can even get approved for an antibody test from your couch: Doctor on Demand, a telehealth platform, is advertising antibody tests, too. (You’ll need go somewhere in person to get the blood draw).

On Monday, I myself put some things in a purse—thrilling—and headed around the corner to a local CityMD to get one. I got in line outside behind one other person, and a few minutes later was ushered in. I checked myself in at a touch-screen kiosk, then sat down in a waiting room chair, between two empty ones sporting signs that read, “This chair reserved for social distancing.” I wanted to ask other people why they were there, but I also didn’t want to open my mouth to talk, or force anyone to open their mouths to talk to me; we were of course wearing masks, but I am acutely aware that masks are imperfect.

As is the test I was there to take: Antibody tests are, right now, a tool for scientists and politicians to get a grip on what’s happening on a populationwide level, over time. But for one individual, they just aren’t accurate enough to really tell you much at all. They won’t allow you to go back to work, or visit a friend worry free. And though I live in the national epicenter of the pandemic, I haven’t even been sick lately. But I can’t help but want the data point. Also, my editor asked if I would do this.

Here’s how getting an antibody test goes: A nurse calls me back and does the usual: asks for height and weight, takes my blood pressure. She asks if I’ve been sick, and I tell her I was coughing a lot back in February. This is enough! She puts some needles on a tray for the blood draw, then leaves, with all the fanfare of a routine STD test. A doctor comes in a few minutes later, asks the question about if I was sick again, then starts picking up the materials on the tray to get started. They’re doing lots of these tests now, yes, he tells me. It takes forever for the needle to go in as it always does—I worry that I will pass out, as has happened in the past with me and needles, especially now that it’s dawning on me that I came to a health center, where there are sick people, in the middle of a pandemic—but then it’s over, and the doctor is moving toward the door. The results will be ready in three to five days. Maybe in a few months they will be useful, he explains. As to what they will mean now, what they will mean for me personally … he just shrugs.

In spite of myself, I felt great walking home, a Band-Aid and a cotton ball in the crook of my arm. Soon, I would finally have some information. A little data point, for me! If I got a positive, I could look into donating plasma. And I have to be honest: I thrilled at the idea that if I got a positive, I might be able to go to the grocery store or go on a walk with a friend without feeling as much fear of catching or spreading it. Even though I, a science journalist who has read and written extensively on the fact that antibody tests are not immunity passports, knew that even if the test returned positive, I shouldn’t change anything about my daily behavior. “As the tests are new, the exact accuracy is currently unknown,” said an info sheet that CityMD gave me on my way out. It’s possible the test would miss antibodies from the virus (a false negative), or pick up on ones from a different virus (a false positive); it’s possible that even if I had antibodies from the novel coronavirus, those wouldn’t make me perfectly immune.

My worry, as more and more people get antibody testing, is that the results will be used to loosen our personal restrictions on what we do and don’t do. That should give folks offering tests pause, as it did for Rite Aid chief operating officer Jim Peters. “The science at this point has not arrived at a conclusion that antibody testing will create more benefit than potential harm,” he said on Good Morning America on Thursday, explaining why his drugstore chain is not offering antibody testing at this time. “Sending people back to work, for example, after a positive antibody test may not be appropriate and may be dangerous.” I brought the concern to Todd Latz, the CEO of GoHealth, which is currently offering the tests. Latz is based in Georgia, where relaxed stay-at-home orders and open restaurants mean that individuals are left to make a lot of choices for themselves about how much they will distance. He said that he believes by offering people the antibody test, “we [can] properly inform them, in a discussion context, about what this means and what it doesn’t mean,” said Latz. In other words, people won’t overinterpret the results, because doctors will remind them not to.

I find that answer unsatisfying. Going back to work could be especially tempting for folks who really need to get back to work at, say, an hourly wage job at a restaurant. It’s also easy to see how bosses might use antibody tests to put pressure on people to get back to work, as opposed to continuing to offer the flexible work from home hours, and sick time, that we all would ideally have access to in our national group effort to not transmit the virus.

Yes: There are scientific upsides to more antibody testing. The more people who take them, the better we’ll start to get a handle on the true spread of the virus (though doing this via a statewide testing program seems like a better way to supply that data than going to a for-profit chain). In the near future, we might even have more knowledge about what the tests mean, as both Latz and the doctor who took my blood pointed out, allowing us to have a deep backlog of people who have test results and are ready to receive some clear direction. That we’re in this bind at all is because we failed to do what we really needed to: widespread testing at the onset. But barring a clear reason from your doctor or a specific situation, getting an antibody test at this point is, at best, a somewhat inessential reason to leave the house.

If you are still craving a test, consider this: Getting my results—they were negative—put a huge damper on the rest of my day. It felt like being waitlisted for my dream college, or rejected after a promising first Tinder date. I was surprised at the weight of my disappointment. I sat staring at the CityMD portal feeling like I’d been battening down the hatches for nothing—so much staying inside and mask wearing and not making plans to visit my parents for their birthdays. And I had nothing to show for it. My body hadn’t seen my hard work and quietly handled the virus for me. I know logically that all the staying at home had helped me avoid the thing, after all, potentially slowing spread and saving other people, too. We’re in a group populationwide effort, trying to all follow similar rules, and getting an antibody test for the purpose personal knowledge is kind of beside the point right now, no matter how the test turns out. I know if it had been positive, it wouldn’t have meant anything for me either, really. That would have been hard to grapple with, too.

For more on antibody tests, listen to this week’s What Next: TBD.