The Antibody Answer

Several pharmaceutical giants are working furiously on a number of COVID-19 vaccines.  At the same time numerous studies are underway to find safe and effective drugs for treating the virus.  The near-term answer appears to be using plasma from survivors of the virus.  Survivor plasma is rich in antibodies that can recognize the virus and launch the body’s counterattack.  Doctors have had some success with this approach and the idea is gaining widespread acceptance.  The ideal donor patient for this therapy is likely to be a patient who was among the sickest of patients.  Researchers surmise that the intensity of illness should correlate with antibody levels in the recovered patient’s plasma.  Since this form of therapy has become public knowledge, many of those who were sick with COVID-19 and recovered completely have been volunteering to be plasma donors.  At this point the primary limiting factor is the availability of antibody testing.  Knowing an individual’s antibody status is not just important in determining whether or not they are a candidate for plasma donation.  In response to a viral infection our immune system produces a short-term antibody known as IgM.  After the infection is cleared another type of “memory” antibody is produced known as IgG.  This is the antibody that doctors will be looking for to determine if someone is healthy enough to return to work.  These long-term or memory antibodies are often referred to as “convalescent antibodies.”  Antibody testing is critical for a number of reasons.  It will tell us:  1) how many people have been infected (since many people have few or no symptoms), 2) how many individuals have long-lasting antibodies and may return to work safely.  Individuals with long-lasting antibodies will likely NEVER get the infection again and need not wear personal protective equipment (PPE).    On April 13 the Food and Drug Administration (FDA) gave emergency authorization for use of a new saliva-based test for the virus.  This testing method was found to be as accurate as the conventional nasal swab and reduces risk to healthcare personnel collecting the specimen.   Either the absence of the virus or the presence of IgG antibodies could be used as criteria for restarting the economy safely.  The President wisely relinquished authority over social mandates to the individual state governors and local officials.  The President can not be aware of every region of the country.  Decisions at the local level should be left to leaders who know best the conditions in their area.  However these leaders must then accept responsibility for their decisions.

Some would argue that the coronavirus pandemic is the perfect example as to why we need a “Medicare for all” national healthcare system.   On the other hand I believe that a single-payer, government-run healthcare system would have made the situation worse.  Government bureaucracies are inefficient and costly in almost every instance.  Every state and locality is unique and densely populated areas like New York City, Los Angeles and Chicago have needs that are distinctly different from rural Iowa or Wyoming.  A federal mentality tends to do the “one size fits all” approach that often helps no one.  Look at the number of private companies moving forward with vaccines and production of ventilators and PPE.  Americans can (and want to) work together when the need arises.  One thing is certain, we can’t wait on a vaccine or the toll in terms of deaths and economic destruction may never recover.


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