We Thought We Had COVID-19 In January, But What Do Our Antibodies Say?
You probably know someone who thinks they had COVID-19 back in January. I happen to know someone like that pretty well.
My husband Seth was really sick in mid-January. I recently asked him what he remembered.
"It came on very suddenly, I woke up one morning, started getting ready for work, never made it to work," he said. "I was coughing so long and to such a degree that I had to force myself to stop coughing to gasp for breath."
He also had the chills so bad that he was sleeping in multiple layers of clothes under several blankets. Though he never took his temperature, despite strong suggestions from his wife.
After three weeks of this, I finally convinced him to go to urgent care. He got an inhaler and some antibiotics.
Then, about a month later, the coronavirus showed up in the U.S. It didn’t take long for Seth to connect the dots.
"I would kind of wonder if this sudden, unusual illness could be attributed to that disease," he said.
I thought it was a possibility because Seth's symptoms so closely matched the COVID-19 symptoms. And a week after he got sick, I was knocked out for two days with complete exhaustion and body aches.
Of course, I wanted it to be true — if we really had already survived coronavirus, while we'd still be cautious, it would feel like a huge worry had been lifted for ourselves and our almost 3-year-old son.
Then I heard about this study happening at the La Jolla Institute for Immunology. Researchers there are searching the world for antibodies from people who’ve survived COVID-19. The institute usually just runs antibody tests on people who had already tested positive for COVID-19, but they agreed to test Seth and me for this story.
When we showed up a nurse took blood samples from both of us, put them in a centrifuge and passed them off to Dr. Jen Dan, an infectious disease researcher. She began what's called an ELISA, a way of testing the blood samples to see whether they contained specific antibodies.
Dan would compare our blood to other samples from both people who’ve survived COVID-19 and people who hadn't been infected. If we had the same antibodies as the survivors, then we also very likely had the disease.
The test would take 24 hours to complete, so we'd have to wait another day to know whether our suspicions were founded.
Right now, antibody tests are pretty easy to find. You can buy them over the counter or on the internet, and many blood banks have started to offer them for free. But epidemiologists are heaping lots of caution on both the tests and their results. Some aren’t approved by the U.S. Food and Drug Administration and they can be wrong, even giving false positives.
Plus, even if you had antibodies, you don't know for sure whether you're immune, said Dr. Erica Ollmann Saphire, the director of a global antibody consortium at La Jolla Institute for Immunology.
"We think that most people that have been infected will have made an antibody response, but there may have been some that didn't," she said. "What we most need to know is whether the antibody response is protective, whether having those antibodies will mean that you won't get sick again."
The evidence suggests people with antibodies likely have immunity, but they don't know how much or how long it lasts, Saphire said. The research she's leading is working to find the very best antibodies from COVID-survivors, which will be used to treat COVID and hopefully prevent it in the first place.
With those best-of-the-best antibodies, Saphire hopes to make drugs that can treat COVID and help people from catching it in the first place.
The next day, Seth and I came back to the institute and watched Dan, the infectious disease researcher, finish the test. During the last step, she added a colorless solution to reveal the presence of antibodies. If there were antibodies, the mixture would turn blue.
The top two rows on her plate had the samples from the known coronavirus survivors, and those little wells of liquid quickly turned blue. Underneath those were Seth and my samples. I kept peering over them, hoping for two blues.
Dan had a great poker face, and not just because she was wearing a mask. She took the samples away to analyze them on her computer.
After what seemed to us like a long time, she came back and went over the results with Dr. Shane Crotty, an infectious disease expert at the institute. Crotty pulled up them on his computer. Suddenly, he seemed like a doctor who was very good at giving bad news.
"These are the positives," he said, pointing at several dots on a graph. "Today, here are the negatives that she ran, and here's Seth and here's Claire."
Our marks sat on the graph below all the other negatives. We were super negative. Meaning we definitely had not had COVID-19.
"We're below negative, not even negative," I said with a laugh.
"Yeah, you are," Crotty said.
But, our results make sense, he said.
"This certainly fits with the timeline in California, that there weren't any confirmed cases in California at the time you were sick," he said. "And even right now when people get (antibody) tests, you can see the numbers that are reported are 10% positive, which means nine out of 10 people who thought they were infected are frequently turning out that, no it wasn't."
So, the upshot from our little adventure is that despite what your friend, your neighbor or your husband might be telling you — and what you might be telling yourself — it’s highly unlikely that anyone in San Diego had COVID-19 before February.