COVID-19 antibody test plan shelved over accuracy questions
Too many concerns and not enough answers about a COVID-19 antibody test and the results it might yield led local public health officials Thursday to halt plans for an initial round of community-wide virus screening.
“We’re still working to see if this is an accurate test,” said Gabe Muething, one of the commanders of the team managing the local response to the virus outbreak. “We’re still missing a few pieces to effectively say, ‘This is worth our time.’”
Local officials had gone so far as to stage a dry run April 17 of the COVID-19 antibody test they were able to procure from an Englewood company called Aytu Bioscience. The 10 tests they ran on people with virus symptoms who reported to the Aspen Village Fire Station were in preparation for testing 1,000 county residents.
And while officials felt like the testing “went well,” they forwarded results to Aytu for accuracy analysis and were still waiting for those answers Thursday, Muething said. They have not been told the tests are not good, he said.
Dr. Brad Holmes, a physician at Aspen Valley Hospital, said questions about the test’s accuracy is the main concern. The FDA and Colorado’s health department have both cautioned against using antibody tests, which led AVH to decide not to use them on hospital patients, Holmes said Thursday during an online COVID-19 community meeting.
Antibody or serology tests are a surveillance tool for public health officials because they show who’s had the virus and the prevalence of the infection in a particular community, said Karen Koenemann, county public health director. That is important information to know, especially when it comes to loosening restrictive public health orders, though modeling can provide some of it, she said.
PCR tests — which show who actively has the virus — do not provide the same information as antibody tests, Koenemann said.
The other thing antibody tests can help determine is immunity. They are often mentioned in connection with proposals like government-issued certificates indicating someone has had COVID-19 and, theoretically, could go back to work because they can’t get it again.
However, immunity, if it exists, when it comes to COVID-19 and how long it lasts is unknown, Koenemann said. When that data is determined, the antibody tests will become more important.
“That is a long time out,” she said.
Further, public health orders can be gradually, safely unwound without the use of serology tests, Konemann said. PCR tests — which will begin being provided Friday to every Pitkin County resident with COVID-19 symptoms — offer a better route to unwinding public health orders and a return to quasi-normal life, she said.
“(PCR tests) are a better option,” he said. “They are more what people want — to open up the community and allow us to go back to our normal lives.”
Pitkin County Manager Jon Peacock said the antibody tests might still be used in the future if Aytu and the FDA provide further validation.
The one question mark in the strategy is what to do about asymptomatic people, which some recent studies have indicated could be much higher than has been reported.
Holmes and Koenemann both agreed that continued social distancing is the tool to keep asymptomatic people from spreading the virus.
“Ideally we’d like to test everyone,” Holmes said. “But that’s not feasible.”
Instead, he said, we’re just going to have to accept that a certain percentage of people are walking around with the virus but not showing any symptoms of it.
“That’s why it’s very important to continue social distancing and the other things that limit the spread,” Holmes said.
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