WEBVTT - Should You Take an Antibody Test?

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<v Speaker 1>Welcome to Prognosis. I'm Laura Carlson. It's day since coronavirus

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<v Speaker 1>was declared a global pandemic. Our main story what can

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<v Speaker 1>an antibody test actually tell you? But first, here's what

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<v Speaker 1>happened in virus news today. New York City is on

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<v Speaker 1>track to enter the second phase of reopening on Monday.

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<v Speaker 1>That's the phase that allows restaurants to offer outdoor dining

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<v Speaker 1>and could be a major step for the economy. Statewide.

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<v Speaker 1>Less than one percent of New Yorker's tested positive for

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<v Speaker 1>the novel coronavirus yesterday, the lowest percentage since the start

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<v Speaker 1>of the pandemic. Governor Cuomo said there were seventeen deaths

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<v Speaker 1>on June sixteenth, which was also a new low. New

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<v Speaker 1>York's progress comes as at least twenty other states see spikes.

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<v Speaker 1>Texas reported a record number of hospitalizations and new cases

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<v Speaker 1>in Florida rose to the highest level since the pandemic began.

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<v Speaker 1>Sweden's Grand COVID experiment isn't having the effect the country's

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<v Speaker 1>top epidemiologists had hoped for. The country's strategy was to

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<v Speaker 1>leave schools, shops, and restaurants open throughout the pandemic. The

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<v Speaker 1>theory was that the country would quickly reach a high

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<v Speaker 1>level of immunity to the virus, where enough people have

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<v Speaker 1>contracted the virus to protect most of the population. Contagion

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<v Speaker 1>rates in Sweden are much higher than anywhere else in

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<v Speaker 1>the Nordic region. It's COVID nineteen mortality rate is among

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<v Speaker 1>the worst in the world. Scientists have been eager to

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<v Speaker 1>learn whether the flip side of widespread contagion is a

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<v Speaker 1>higher level of immunity, but only about fourteen percent of

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<v Speaker 1>people tested in Stockholm had COVID nineteen antibodies. That compares

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<v Speaker 1>with the study published this month about Bergamo, once the

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<v Speaker 1>COVID nineteen epicenter in Italy, which showed that fifty seven

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<v Speaker 1>percent of that city's residents had developed antibodies. Finally, governments

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<v Speaker 1>and industry groups from the US to Chile are insisting

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<v Speaker 1>that food poses little risk of spreading the coronavirus. Some

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<v Speaker 1>consumers were skittish after an outbreak in Beijing was blamed

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<v Speaker 1>on imported fish. Chile the top seller of salmon after

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<v Speaker 1>Norway sought to persuade China that its fish was safe

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<v Speaker 1>to import after orders had been canceled. The Norwegian Food

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<v Speaker 1>Safety authority also said there were no known cases of

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<v Speaker 1>infection via contaminated food, and although there is no evidence

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<v Speaker 1>that COVID nineteen can be transmitted through food, experts say

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<v Speaker 1>more research is needed. And now for today's main story.

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<v Speaker 1>It's now relatively easy to get tested to see if

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<v Speaker 1>you carry the antibodies for COVID nineteen. Urgent care centers

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<v Speaker 1>and many doctors offices are offering the tests widely, but

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<v Speaker 1>the signs are still out on whether or not people

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<v Speaker 1>who have COVID nineteen become immune to it. Not to

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<v Speaker 1>mention the possibility that we've reported on before that the

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<v Speaker 1>test you take may not be accurate, so reporter christ

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<v Speaker 1>and V. Brown has tried to answer the question is

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<v Speaker 1>it worth taking the test at all? In March, as

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<v Speaker 1>the world was preparing to go into lockdown, Eve was

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<v Speaker 1>having one last hurrah with grad school classmates in London

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<v Speaker 1>before flying home to San Francisco. Eva's asked us to

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<v Speaker 1>not use her last name to protect her privacy. Vibe

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<v Speaker 1>there in the beginning of March, which I assume it

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<v Speaker 1>was similar, and a lot of America was like coronavirus

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<v Speaker 1>is coming party as hard as we can now before

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<v Speaker 1>this big bad thing comes. They had canceled a ski

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<v Speaker 1>trip to Austria because of the virus, so they made

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<v Speaker 1>the best of it. Beacurely. The last thing I did

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<v Speaker 1>there was I spent like five or six hours in

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<v Speaker 1>a pub with people um and it was like it

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<v Speaker 1>was a fairly crowded pub where I was very good

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<v Speaker 1>about washing my hands, but like otherwise we weren't like

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<v Speaker 1>they were definitely shared drinks, shared utensils, like we just

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<v Speaker 1>had no idea. The thing is, the virus wasn't coming,

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<v Speaker 1>it was already there. A few weeks later, after a

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<v Speaker 1>stopover to see some friends in Dubai, Eve was home

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<v Speaker 1>in San Francisco eating a blue cheese and truffle oil omelet.

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<v Speaker 1>Despite that strong flavor profile, she couldn't taste anything. I

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<v Speaker 1>initially thought it was the truffle oil because I thought

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<v Speaker 1>I bought a twenty all our bottle of truckle oil

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<v Speaker 1>instead of a thirty dollar bottle. And so it's like

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<v Speaker 1>this is what I get for being cheap, Like it

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<v Speaker 1>must be bad trouble oil. Losing your sense of taste

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<v Speaker 1>or smell is a symptom of the virus. So you've

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<v Speaker 1>got tested. It turned out she had COVID nineteen, and

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<v Speaker 1>so did basically everyone from the pub that night. So

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<v Speaker 1>imagine her surprise when a few weeks later, two separate

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<v Speaker 1>antibody tests came up negative. Eve had definitely had COVID nineteen.

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<v Speaker 1>Multiple tests had confirmed the diagnosis, as did the fact

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<v Speaker 1>that so many people she had shared food and drinks

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<v Speaker 1>with contracted the virus too, But at least, according to

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<v Speaker 1>these tests, her immune system had not created antibodies to

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<v Speaker 1>fend it off. Then a third test said she did

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<v Speaker 1>have antibodies to the virus. This obviously was really confused.

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<v Speaker 1>Sing There's no point in doing an antibody test because

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<v Speaker 1>if you get an answer that you want, you're gonna

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<v Speaker 1>believe it, and if you get an answer that you

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<v Speaker 1>don't want, you're going to decide that the test was flood.

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<v Speaker 1>Antibody tests are everywhere right now. Doctor's offices are sending

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<v Speaker 1>out text and email blasts urging patients to book an

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<v Speaker 1>antibody test. Today. In some places, even botox clinics have

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<v Speaker 1>opened their doors to offer the tests. But as Eve experienced,

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<v Speaker 1>the tests can offer more confusion than answers. Antibody tests

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<v Speaker 1>measure signals in a person's blood that indicate whether they

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<v Speaker 1>have been exposed to the novel coronavirus. In the past,

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<v Speaker 1>the tests have been plagued by questions about their accuracy,

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<v Speaker 1>and even if a test is accurate, experts have no

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<v Speaker 1>solid proof yet the antibodies mean a person is immune

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<v Speaker 1>to the virus, or for how long that immunity might last.

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<v Speaker 1>So the availability of these tests has really wound up

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<v Speaker 1>creating more confusion than anything. I talked about this with

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<v Speaker 1>Andrew Diamond, the chief medical officer of the primary care

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<v Speaker 1>chain One Medical. He says the company struggled with whether

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<v Speaker 1>they should even offer antibody test to patients. We did

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<v Speaker 1>not take this light list, and we had a We

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<v Speaker 1>had a team of people working on this literally around

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<v Speaker 1>the clock for weeks to make sure that we did

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<v Speaker 1>this the right way. Back in March, the FDA said

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<v Speaker 1>that antibody tests didn't require any kind of regulatory sign off,

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<v Speaker 1>and dozens and dozens of tests immediately flooded the market.

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<v Speaker 1>One major concern was that if the tests weren't specific enough,

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<v Speaker 1>they might tell people they had COVID nightteen when really

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<v Speaker 1>they had encountered a related virus. In other words, people

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<v Speaker 1>might think they were immune when they weren't, and that

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<v Speaker 1>could be a big problem. Andrew said that One Medical

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<v Speaker 1>had a whole team of people whose full time job

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<v Speaker 1>was event these tests. We knew that everybody, ourselves included

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<v Speaker 1>as clinicians and all of our members and public health officials, employers,

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<v Speaker 1>everybody wanted to know from the very beginning of this pandemic.

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<v Speaker 1>Are people immune once they've been sick? Are people immune

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<v Speaker 1>who haven't even had symptoms? Is there more immunity out

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<v Speaker 1>there than we realized? Do we are reclose to her immunity?

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<v Speaker 1>I mean, the curiosity was borderline hysterical. One Medical ultimately

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<v Speaker 1>did decide to offer a test. Once the company found

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<v Speaker 1>one that seemed good enough. Then the issue was how

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<v Speaker 1>do we explain to people what this actually does. Because

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<v Speaker 1>just having a high specificity test that will dramatically reduce

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<v Speaker 1>this risk of a false positive result, but it doesn't

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<v Speaker 1>take that risk of false positive to zero. We started

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<v Speaker 1>asking ourselves, how are we going to explain what that

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<v Speaker 1>risk is and why it matters whether you get a

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<v Speaker 1>false positive? And then, more importantly, how do you interpret

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<v Speaker 1>a true positive result? So let's say the antibody test

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<v Speaker 1>actually gives you the true positive that you really do

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<v Speaker 1>have antibodies, and it's just it's a real result. Then

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<v Speaker 1>what do you do. We don't know that they confer immunity.

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<v Speaker 1>We haven't proven that just because you have antibodies you're immune,

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<v Speaker 1>Andrew said. The Ultimately one medical hopes that the test

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<v Speaker 1>might actually lead people to be more cautious, not less.

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<v Speaker 1>If you were previously thinking, you know what, I already

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<v Speaker 1>had COVID. I was super sick in February. I already

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<v Speaker 1>had COVID. I don't need to worry about this. But

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<v Speaker 1>then you get a negative result, that's going to change

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<v Speaker 1>your behavior, guarantee it. And we've already seen that people say, oh, shoot,

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<v Speaker 1>I guess I didn't have it. And that's actually a

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<v Speaker 1>vastly more likely scenario, more likely outcome that from the

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<v Speaker 1>antibody test, because most people end up with a negative test.

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<v Speaker 1>The number of people who think they had it is

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<v Speaker 1>far greater than the number of people who actually had it,

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<v Speaker 1>so dorusful to do change their behavior. They say, you

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<v Speaker 1>know what, I should take this more seriously. I was

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<v Speaker 1>getting cavalier out there, but now I am going to

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<v Speaker 1>wash my hands and wear this mask, et cetera. Last month,

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<v Speaker 1>the FDA made changes to its policy and now requires

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<v Speaker 1>that antibody test developers seek emergency authorization from the agency. Immediately,

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<v Speaker 1>more than two dozen tests were pulled from the market.

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<v Speaker 1>It's not the antibody tests don't have any use. The

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<v Speaker 1>tests can be really useful for researchers and public health

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<v Speaker 1>officials who are trying to answer questions like how many

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<v Speaker 1>people with COVID nineteen or asymptomatic, or how deadly is

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<v Speaker 1>the virus. But I talked with a lot of doctors,

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<v Speaker 1>and none of them suggested that for the average individual

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<v Speaker 1>the test might be useful for anything other than to

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<v Speaker 1>satisfy a personal curiosity. This was echoed by Congressman Rajna

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<v Speaker 1>Krishna Morty, the chairman of the Subcommittee on Economic and

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<v Speaker 1>Consumer Policy, and a hearing on antibody test recently. The

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<v Speaker 1>truth is many people mistakenly view anybodies as a get

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<v Speaker 1>out of jail free card to return to normal life,

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<v Speaker 1>a dangerous misconception used as a selling point by bad actors.

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<v Speaker 1>Eve says that knowing she had the virus and tested

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<v Speaker 1>positive for antibodies has changed her behavior, even if science

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<v Speaker 1>hasn't fully determined how much immunity antibodies confer. Coronavirus is

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<v Speaker 1>the disease that no one wants to have, but everyone

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<v Speaker 1>wants to have had. And yeah, because you want to

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<v Speaker 1>you want to be past it. But it almost felt

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<v Speaker 1>like I'd like gotten across this like really really really

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<v Speaker 1>dangerous bridge, and I was on the safe side, just

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<v Speaker 1>like waiting for the rest of the world to figure

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<v Speaker 1>out how to get across. A few days after we talked,

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<v Speaker 1>Eve hopped another plane back to London. There, she said,

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<v Speaker 1>at least she would be able to hang out with

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<v Speaker 1>her friends from the pub her own personal immunity heard.

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<v Speaker 1>That was Kristin V. Brown And that's our show today.

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<v Speaker 1>For coverage of the outbreak from one bureaus around the world,

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<v Speaker 1>visit Bloomberg dot com slash coronavirus and if you like

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<v Speaker 1>the show, please leave us a review and a rating

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<v Speaker 1>on Apple Podcasts or Spotify. It's the best way to

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<v Speaker 1>help more listeners find our global reporting. The Prognosis Daily

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<v Speaker 1>edition is produced by Topher Foreheads, Jordan gas Pure, Magnus

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<v Speaker 1>Henrikson and me Laura Carlson. Today's main story was reported

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<v Speaker 1>by Kristin V. Brown. Original music by Leo Sidran. Our

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<v Speaker 1>editors are Francesco Levi and Rick Shawn. Francesco Leavie is

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<v Speaker 1>Bloomberg's head of podcasts. Thanks for listening. H