We sent two journalists for antibody tests – one with a Covid-19 diagnosis, one without

Glen Murphy (diagnosed in March) and Conor Pope (symptom-free) take an antibody test

Testing for antibodies for Covid-19. Photograph: Epa/Farooq Khan

Testing for antibodies for Covid-19. Photograph: Epa/Farooq Khan

 

Conor Pope

When my phone alerts me to the arrival of my test results, I stop what I’m doing and rush to open the email, silently willing the news to be positive.

It’s not that I want to have been infected with Covid-19, but I do want the antibodies that would mark me out as one of the lucky few to have had the illness but no symptoms – even if that comes with a side order of fear that I may have inadvertently infected others.

I click on the mail. Access is denied. The correspondence with the results of my virus antibody test contains a password-protected attachment but the password means The Irish Times security software can’t screen an email about an actual virus for virtual viruses, so it won’t let it pass. My wait continues.

Forty-eight hours earlier: my blood is taken by Dr Simon Collins at the Travel Health Clinic on Dublin’s Dawson Street. Collins says the chances I’ve had asymptotic Covid-19 are slim, but there is a chance.

In fact, he says, antibodies have been detected in about 12 per cent of the 750 people who have taken the test at his clinic since he started offering it as a service at the end of May, and none of them had first tested positive for Covid-19.

I brighten as I lie waiting for the needle, and I calculate my chances: slightly better that one in 10, I reckon. I’d back a horse at those odds.

The doctor shakes his head. “The 12 per cent positive result isn’t a reflection of the level of infection more broadly,” he explains. “Those seeking the antibody test are self-selected and come in because they felt ill or had strange symptoms linked to Covid-19 in March, April or May but did not meet the increasingly strict testing criteria.”

While there are people seeking to obtain documentation proving they have had the illness and thus – hopefully – some immunity for travel, that number has been small

He says the rate of infection in the broader community is likely to be less than 3 per cent based on research in Spain and elsewhere. He puts my odds at closer to 90 to 1. I’d still back a horse at those odds, I think. But then again I am a hopeless optimist and a rubbish gambler.

Collins first started offering the antibody test on May 22nd, and while it might be a stretch to say the queues have been out the door, the level of interest has been high and allowed him to reopen the clinic.

As the clinic’s name suggests, its core business is vaccinations for travel purposes. With planes grounded and travel restricted, Collins had little to do once the pandemic hit. After his clinic closed in March, he registered with the Health Service Executive to serve on the frontline and was posted to the ICU in St James’s Hospital because he had experience of fighting deadly infections while in full personal protection equipment.

He had worked as a doctor with aid agencies in South Sudan, DR Congo, Darfur, the Central African Republic, Haiti and Sierra Leone and was in Africa at the height of the Ebola epidemic in 2014, where he learned about staying as safe as possible while dealing with a deadly, almost invisible enemy.

After a couple of weeks in St James’s, the number of Covid patients in ICU stabilised and, with the unit fully staffed, he returned to his clinic and started preparing to reopen.

Collins assessed all the Covid antibody tests coming on stream and, using research from the UK authorities, decided that the test developed by pharmaceutical giant Abbot was reliable.

“It took off almost as soon as we reopened,” he says. “At first I was the receptionist, the nurse and the doctor. It was so odd working on Dawson Street [in Dublin city centre] when there was no-one else around; there wasn’t a soul about the place.”

He initially thought the largest number of patients would be people taking the test for travel purposes because, in the early stages of the crisis, there was much talk of immunity passports and antibody screening.

But it hasn’t panned out that way, and while there are people seeking to obtain documentation proving they have had the illness and thus – hopefully – some immunity for travel reasons, that number has been small.

The test is proving most popular among people who want to know what was wrong with them weeks ago. “Many were on the list for testing when the criteria changed and they just wanted to know. Most people want to have had it but there are others who are just as pleased not to have had it because they have read about all these weird side affects of the virus,” he says.

I was repeatedly asked in the weeks after recovery was, 'are you immune now?' It was a question I couldn’t answer

Mostly what the test provides is “a little bit of certainty” at a most uncertain time, although Collins acknowledges that the positive few will only get that “little bit” of certainty as it is too early in the life of this virus to know exactly what having antibodies means.

We still don’t know if, or for how long, a person with antibodies will have immunity or how much immunity they will have. There are, he says, so many variables.

“Virus memory” is likely to be critical too. At a most simple level, the immune system’s memory of viruses can vary wildly, as can the way viruses try to make us forget. The body’s memory of measles for example endures and a person infected will be permanently protected from the illness.

The immune system of a person with tetanus antibodies will “forget” it after 10 years, which is why booster shots are needed. The flu virus by contrast is forever changing, so vaccines have to be administered every year. The immune system’s memory of the common cold is useless, so repeated infections can happen.

It is too early to know where Covid-19 will fall in the spectrum, Collins says, while expressing hope that antibodies will offer at least some protection to some in the months ahead.

He has also started offering a test for Covid-19 but is at pains to stress it us not for the sick. “We are not trying to replicate the HSE but it is too busy to carry out elective tests for people who need negative results to be allowed to travel. We are in a position to be able to do that.”

And so back to now . . . Anxious minutes pass as the email with my results spends time in quarantine. It is released into my care and I open it.

It’s negative. At least now I know. And at least I didn’t pass it on.

Glen Murphy

The symptoms of Covid-19 began to appear for me around March 8th. At the time, I assumed it was just aches, pains and tiredness from a busy weekend and that it couldn’t actually be the still fairly unknown coronavirus that has since flipped the world on its head.

Little over a week later, I had been tested and diagnosed with the virus and could only lie in bed shivering and pumping sweat for days.

This was still in the early stages of the pandemic, especially in Ireland. On the date of my test – an ominous Friday, March 13th – there were 90 reported cases and one death in the Republic. I remember squinting at the daily news updates on my phone in my pitch-black bedroom with watery, aching eyes for only a minute or two at a time.

While my experience of the virus was very difficult, I never felt my life was in danger – unlike my mam, Jackie. She was hospitalised for five days after most likely contracting it from me the same weekend I started to show symptoms. She developed pneumonia in both lungs but her condition began to quickly improve when she was put on the malaria medication Hydroxychloroquine. I was back to normal by the start of April but it took mam almost 2½ months before she felt right again.

For this exercise, like my colleague Conor Pope, I go to the Travel Health Clinic in Dublin to find out if I had developed antibodies after recovering. Given how much was and still is unknown about the disease, one question I was repeatedly asked in the weeks after recovery was, “are you immune now?” It was a question I couldn’t answer.

Dr Astrid Weidenhammer took a small blood sample – I’m no fan of injections or needles, but she made me feel quite at ease – and the result came back positive.

This means that my body has developed a natural response. How long these coronavirus antibodies last and how effective they are at preventing reinfection remain to be seen. According to the clinic, based on existing knowledge of other coronaviruses, it is likely a positive test indicates that an individual will not be reinfected for possibly up to a year.

This was quite reassuring to read in the email. My biggest fear at the start of the pandemic was not really contracting the disease, but more that I might pass it on to someone who would be significantly more vulnerable, such as a grandparent.

Despite pre-lockdown life feeling like a lifetime ago, it is still early days in the study of this virus and there are no guarantees as to naturally developed immunities. The World Health Organisation said as recently as June that just because antibodies have been developed by an individual, it does not mean that that individual is protected from reinfection, for either the short or long term.

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