Does a positive antibody test mean a person is immune and safe from spreading the virus?
by Robert Kobre, Chairman, Global Lyme Alliance
The Global Lyme Alliance (“GLA”) has acquired an expertise in antibodies and immunity as a result of our significant efforts over many years to find an accurate diagnostic test for Lyme disease and a cure. We have studied antibodies to (i) determine immunity, (ii) understand their role in fighting disease and (iii) improve upon today’s unreliable, yet widely used antibody Lyme tests. This has led to GLA’s immense knowledge regarding antibody behavior, immunity and testing. So, America, welcome to our neighborhood!
Frequently, one hears, “I’m happy I tested positive for coronavirus antibodies because now I’m immune.” This is a common assumption that having antibodies against the novel coronavirus (SARS-CoV-2) means protection against COVID-19, and therefore social distancing and similar safeguards can be relaxed. After all, don’t antibodies neutralize the virus and prevent another infection? For many viruses and bacteria this scenario is true. For the virus that causes COVID-19, this may be the case, or the antibodies may act more like they do in Lyme disease. Those who contract Lyme disease do not develop immunity and therefore can repeatedly contract the disease.
There is a myriad of reasons why a person who tests positive for antibodies to SARS-CoV-2 should still practice guidelines to ensure their own safety and that of others. First, antibodies do not stay in your bloodstream indefinitely. Upon infection, some antibodies may only last weeks or a few months. Second, not all antibodies can kill the virus or bacteria. Our immune systems are like a military defense system that is on duty 24/7 against microbial attack. Within weeks of a new intruder being detected, specially designed antibodies are unleashed in the body to hunt down the intruding virus and neutralize it. However, they are not always successful. Third, once the infection is contained, the antibodies are no longer needed and often disappear. If this occurs, don’t despair, because memory cells often develop in the bone marrow that can rapidly produce and re-release antibodies if the virus attacks again. The memory cells are much like anti-virus software that can identify a known virus and intercept it, thereby creating immunity to that invader.
These important memory cells are not always produced, however. For example, a GLA funded study showed that in Lyme disease, the bacteria can shut off the ability to develop memory cells, which then leaves the victim open to repeated infections with no protection. Medical researchers do not know if this is also the case with the novel coronavirus. If it is, then we are certainly not immune to reinfection. In fact, instances of re-exposure and reinfection have recently been reported.
Lyme disease antibody testing has been notoriously inaccurate and unreliable. These tests often fail to pick up Lyme antibodies in the blood and falsely provide a Lyme negative result. GLA has been backing studies to find a better antibody test. For COVID-19, antibody tests were developed quickly and fast tracked by the FDA. While the companies providing the tests have self-reported impressive sensitivity (does the test find the antibody) and specificity (the test finding antibodies specific to SARS-CoV-2 or ones that attach to other invaders too), most have not yet been independently verified. Additionally, tests for antibodies that neutralize the virus have not been made commercially available.
So, the issues are as follows: the antibodies likely don’t stay in your body for long, you may or may not have memory cells to stop a reinfection, the antibodies you do have may or may not be neutralizing, and the antibody tests are useful, but their reliability is not yet confirmed. Lyme disease patients are all too familiar with these unknowns. Until these questions are answered by scientists, please continue to wear masks, social distance and use caution even if you are not symptomatic and your COVID-19 antibody test is positive.
We feel it is important for the public to be aware that there are still critical unknowns as to whether a positive antibody test means a person is immune and safe from spreading the virus. Good science unfortunately takes time and validation. This is extremely frustrating, but it is a reality. Finding these answers is not easy. For 40 years, the biomedical research community has only made incremental progress in answering such questions for Lyme disease. However, Lyme disease research is woefully underfunded by federal and state authorities when compared to the tremendous public health impact of tick-borne diseases in the United States.
GLA is confident that with the billions being spent on COVID-19 research, the answers will come faster and the discoveries made will provide new pathways to cures and tests for this and other devastating diseases that threaten our way of life.
GLA Chairman Letter #1:What Can We Learn from Our Response to COVID-19?
GLA Chairman Letter #2:COVID-19: Is a Vaccine the Answer?
Blog: Personal Patient Experience with COVID-19 and Lyme Disease
GLA Point Of View: Parallel Pandemics: COVID-19 and Lyme Disease
Letter: GLA CEO Addresses COVID-19 and GLA Community