CDC Says Possibly ‘Less Than Half’ Of Positive Antibody Tests Are Correct

TOPLINE

In updated guidance posted on its website over the weekend, the U.S. Centers for Disease Control and Prevention acknowledged an inability to accurately determine if individuals had been infected with Covid-19 via antibody tests; if the test is used in a population where prevalence is low, it’s possible that “less than half of those testing positive will truly have antibodies.”

KEY FACTS

There are two kinds of Covid-19 tests: molecular diagnostic tests, which can identify people with active infections, even when they have no symptoms, and antibody, or serology, tests, which indicate that a person was infected at some point in the past.

According to Christopher Farnsworth, an instructor of pathology and immunology at Washington University School of Medicine, “antibody testing is really helpful in monitoring how widely a virus has spread within a community. Such testing could help determine how many people have recovered from the virus, even if they never had symptoms.”

Thus, antibody tests could potentially play a very important role if and when schools should reopen, or when professional sports will return.

However, the CDC has acknowledged that antibody testing can frequently be inaccurate, especially in populations where there is a low prevalence of the coronavirus. 

In fact, under certain scenarios, “less than half of those testing positive will truly have antibodies,” the agency says.

This is particularly dangerous because it could lead to individuals believing they have been infected with the coronavirus, and acting as if they have immunity, when that is not the case.

As a result, the CDC advises that antibody test results should not be used to make decisions related to schools, dormitories, or correctional facilities, and that testing shouldn’t be used to determine immune status in individuals.

BIG NUMBER:

98,717: That’s the number of Americans that have died from coronavirus as of Tuesday afternoon, according to Johns Hopkins University data. 

Critical Quote:

“The viral testing is to understand how many people are getting infected, while antibody testing is like looking in the rearview mirror. The two tests are totally different signals,” Ashish Jha, professor of Global Health at Harvard, told The Atlantic last week. 

Key Background:

A positive test indicates an individual has produced antibodies in response to a previous infection. Still, it does not definitively tell us whether those antibodies will protect that person from getting re-infected. Fortunately, according to the CDC, recurrence of Covid-19 illness appears to be very uncommon, suggesting that the presence of antibodies “could confer at least short-term immunity to infection with SARS-CoV-2.”

Further Reading:

Interim Guidelines for COVID-19 Antibody Testing (CDC)

Antibody tests might be wrong half the time, CDC advises (CDC)

Experts urge caution in interpreting COVID-19 antibody tests (Washington University School of Medicine in St. Louis)

Rollout of antibody tests met with confusion, little oversight (CNN) 

‘How Could the CDC Make That Mistake?’ (The Atlantic) 

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