A waste of money: why COVID-19 antibody tests don't make sense
Делать тесты на антитела к COVID-19 не имеет смысла, уверяют эксперты. Их результаты крайне ненадежны и не позволяют делать убедительные выводы — особенно относительно уровня иммунной защиты человека. Подробнее об этом рассказало издание with the BBC.
Фактически — это пустая трата денег, хотя и не она главная причина.
The danger is that such a test can give a person the illusion of protection, as a result of which many allow themselves to violate restrictive measures and put themselves and others at risk.
The fact is that the accuracy of such testing leaves much to be desired, and scientific studies consistently and quite convincingly show that the concentration of antibodies to COVID-19 in the blood of those who have been ill and vaccinated has a very indirect relationship to the level of protection against COVID-19.
«Наличие антител — это лишь половина картины, — утверждает молекулярный биолог Константин Андреев, сотрудник Медицинского института Северо-Западного университета США. — Есть еще клеточный иммунный ответ, который сохраняется дольше, и тест на антитела его не увидит».
In other words, you may have low levels of antibodies, but at the same time a good defense against the virus due to cellular immunity, the expert explains. And maybe vice versa. For example, the first injection of a vaccine can provoke a sharp surge in the level of antibodies, but the immune system will be weak and will only get stronger when other protective mechanisms come into play.
«Тест на антитела в США практически никто не делает, — говорит Андреев. — Страховка его не покрывает — в отличие от тестирования на сам вирус или прививки».
No insurance company, he said, "will pay for something that doesn't make sense." An antibody test is more important to scientists working on research than it is to a specific person.
For example, this is how the proportion of asymptomatic COVID-19 patients in the Italian city of Vo Euganeo was established in the spring of last year: they checked all its residents for the presence of specific antibodies and realized which of them had already met the virus and who had not. The antibody test also played a huge role in the story of the Diamond Princess cruise ship: this is how scientists learned that COVID-19 had suffered a lot on board the ship without any symptoms without even noticing the disease.
On the subject: WHO says COVID-19 pandemic will last longer than anticipated due to wrong country policies
If judged from the point of view of one person, then the value of the results of such an analysis seems very doubtful. An antibody test is not suitable for diagnosing an infection, treating it or preventing it.
Doctors recommend periodically checking the level of antibodies. And if he began to fall, be vaccinated again, but the scientist urges not to listen to such advice.
«Это полная чушь. Понятно, что кому-то хочется, чтобы все мы тестировались и прививались каждые полгода, а лучше ежемесячно. Но нет таких данных. Это просто бизнес», — уверяет эксперт.
At one's own risk
In many countries of the world, individual antibody tests are not encouraged: the authorities are actively convincing people of the uselessness of such tests and refuses to spend money on them.
В частности, на сайте Центров по контролю и профилактике заболеваний (CDC) указано, что для диагностики инфекции эти тесты не подходят, ведь чтобы выработать антитела, организму необходимо после заражения почти 3 недели. Поэтому отрицательный тест совсем не обязательно означает, что человек здоров, — а положительный, в свою очередь, отнюдь не гарантирует, что он болен.
Antibody tests are also not suitable for determining the level of immune defense. If, for some reason, you still decide to do such a test, the CDC strongly discourages making decisions based on the results obtained.
Separately, they warn against conclusions about the need for vaccination or re-vaccination after an illness.
Other disadvantages of this method are cited as an additional argument against individual testing. For example, some tests can only detect antibodies left over from an infection but not after vaccination, which only adds confusion and increases the risk of misinterpretation of results.
There is also a possibility that the test will erroneously give a positive result due to the so-called cross-reaction, mistaking for immunity to COVID-19 slightly similar antibodies left after a common cold.
Taking into account all these factors, it becomes obvious that the question of determining the level of immune protection using such a test is not even worth it. Determining the concentration of antibodies in the blood using special equipment is quite simple. It is much more difficult to draw at least some meaningful conclusions from the figures obtained.
Guessing on the coffee grounds
The fact that the virus continues to mutate only adds to the uncertainty.
Scientists cannot yet confirm that the antibodies produced by the body in response to infection or vaccinations against COVID-19 will be as effective against new variants of the virus, or how long it will last.
Sooner or later (with a high probability) the virus will evolve and learn to bypass our immune defenses. Some studies suggest that this process has already begun.
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Recently, the journal Science published an article, the authors of which were convinced that the blood plasma of patients who recovered from COVID-19 copes with new variants of the virus much worse.
It becomes even more difficult to predict the degree of immune defense based on the level of antibodies alone, and an individual test more and more resembles a fortune-telling on coffee grounds.
«Если в сыворотке крови можно обнаружить специфические антитела к COVID-19, это указывает на то, что человек уже переболел, или вакцинировался. Однако о защитной природе иммунного ответа это говорит очень мало, — пишут авторы статьи. — Нейтрализующие антитела, способные распознать шиповидный белок, дают в этом смысле больше информации. Но, чтобы их измерить, необходимо построить клеточно-вирусные системы. А этот процесс — дорогой, требует много времени, недостаточно гибкий и имеет риски заражения».
Cheap and angry
According to the professor of the Russian Higher School of Economics, epidemiologist Vasily Vlasov, to carry out full-fledged research that can determine the various components of the immune response and give a more accurate forecast, specially equipped laboratories with a high level of biochemical protection are needed.
Determining the concentration of antibodies in blood plasma, of course, is much easier and cheaper, experts agree. But why? After all, there are three types of antibodies, and only one of them needs to be counted.
«Потенциал иммунной защиты можно определить только по уровню нейтрализующих антител, — объясняет профессор Школы биологических наук в Лозанне и автор статьи в Science Дидье Троно. — А обычный серологический тест даже не способен различить, нейтрализующие они или нет. Он фиксирует все антитела не перебирая».
When asked whether it is possible to draw any conclusions on the basis of such an analysis, Professor Trona throws up his hands: "The result of such a test only testifies to the fact of a disease or vaccination suffered in the past."
«Хотя, если титры антител очень высокие… тогда вероятно, что и нейтрализующие активность там будут на хорошем уровне», — предполагает эксперт.
Впрочем, пока это только теория. Какой уровень антител нужен для эффективной защиты от вируса, ученые до сих пор не знают. Более того — они даже не уверены, что на этот вопрос можно ответить в принципе.
Even now, we still know quite a bit about the new virus, and recommendations are changing so quickly that many people around the world are simply tired of the uncertainty, according to Visha Viswanath, professor at the Harvard University School of Public Health. Yes, an antibody test is not able to determine the level of immune defense. But he can add confidence to someone and create an illusion of control in a person, and in times of a global crisis, this is also not bad.
«Люди пытаются тем или иным способом справиться с огромным потоком информации, в частности принимают меры разного уровня осмысления, чтобы просто почувствовать, что делают хоть что-то, чтобы избежать заражения, — объясняет профессор Висванат. — В такие моменты на официальные рекомендации просто не обращаешь внимания».
«Сегодня единственное, что с научной точки зрения вообще имеет смысл делать, — это пойти и быстрее привиться от вируса», — резюмирует эксперт.
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