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     2355 Canyon Blvd.   |   Suite 102   |   Boulder, CO 80302

Boulder Holistic will be offering antibody testing

Terri Fox and Amy Reidhead
Boulder Holistic will be offering antibody testing beginning this week
 
At Boulder Holistic, we believe accurate and widespread testing for the coronavirus SARS-CoV-2 is essential to stopping the spread of this virus. Testing is vital from both a public and personal health perspective. It helps to identify individuals who have already been infected and whose bodies have mounted an immune response, as well as to recognize and protect those who are still at risk for developing the disease.
 
After talking to multiple labs and doing extensive research, we have ordered specialty laboratory test kits for measuring SARS-CoV-2 antibodies that we feel good about. These are IgG/IgM tests that are 97% sensitive and 98% specific (which is great accuracy for any test). In other words, the false negative rate is 3% and the false positive rate is 2%. These numbers are based on a study of 200 COVID-19 patients in China who tested positive on nasopharyngeal PCR tests. It’s a small study, but it was the best one found thus far.

This is a blood draw test. We will reserve them for our patients on a first come, first serve basis. We also ask that only well patients, not currently experiencing symptoms, use this kind of testing. 

Because this virus is so new to all of us, there are no clear cut answers. In order to understand antibody testing, we need to dive into the science a bit, so try to stay with us on this one, it’s important!  
What is IgG and IgM antibody testing?
 
IgG is a type of immune cell called an antibody that your body produces once it has seen a new pathogen. When you develop IgG antibodies, it means your body has been exposed to or infected with this coronavirus/SARS-CoV-2 in the past. When your body produces IgM antibodies, it means that your body is fighting the virus currently (even if you are asymptomatic.) If you are IgM is positive, you are likely contagious. Once your antibodies are IgG positive and your IgM is negative, it means that you have been exposed and have recovered and are not currently fighting the virus. Therefore, it would be very unlikely for you to be contagious. 
 
That brings us to another big assumption here: that being IgG positive implies you have immunity. This assumption could have a great impact on public health decisions and how to move forward.  
 
Unfortunately, this virus is too new for us to know for sure if being IgG positive and IgM negative means you have immunity to coronavirus/SARS-CoV-2. There is one small study that looks promising for exposure and recovery conferring immunity (meaning if you’ve had the virus, you are unlikely to get it again.) This study was done on primates who were infected with coronavirus and became symptomatic for COVID-19. Scientists found that after they recovered, and were re-infected with the virus, none of the monkeys got sick the second time. This is encouraging but not conclusive, as we have not had time to do similar human studies yet. 

What else do you need to know about viral and antibody testing?

  • Typically, the time of exposure to the virus and the onset of symptoms is approximately 2-21 days, however >90% of people who develop symptoms to coronavirus will do so within 14 days of exposure
  • Viral testing: This type of testing requires swabbing the nasal or oral cavity or obtaining oral secretion to test for the presence virus by PCR. This method is best used during an active infection to identify a sick individual. We have been referring patients to have these done in urgent care and hospital settings as well as through drive up testing centers. This type of testing has been very difficult to get so far. National Jewish may be a good resource now for this type of drive-up testing. All testing requires a requisition from your healthcare provider. Click here for complete information.
  • Antibody testing: Using serum or blood testing, this type of testing may be used to identify whether a person has been exposed to the virus currently or in the past by testing for immune cells called antibodies
  • Antibody production can occur within that 2-14 day incubation window of an infection
  • Oral or Nasal swab testing is recommended during an active infection, when a patient is symptomatic
  • Antibody testing is recommended 3+ weeks after symptoms begin to ensure accuracy of this type of test results
  • Many people exposed to coronavirus are asymptomatic, and therefore can get an antibody test at any time

Available testing at LabCorp and Quest

Traditional testing companies like LabCorp and Quest are now offering antibody testing as well. LabCorp will only do SARS-CoV-2 IgG testing in their facilities; they will not draw for the IgM portion of the test. You can ask that your provider order an IgG/IgM test and your blood can be sent to LabCorp for results, but the blood itself must be drawn at a different facility (like at a doctors’ office, urgent care or hospital). It is our understanding that Quest is currently only offering SARS-CoV-2 IgG testing. LabCorp and Quest have not yet released pricing for this testing, nor do we know whether or not it will be covered by insurance. LabCorp and Quest have also not published the accuracy of their results. Both companies will bill patients and/or insurance directly.

What we think matters most

The deep concern and worry we have with IgG only antibody testing is that you may be getting an incomplete picture. Meaning, you could be an asymptomatic carrier and not know it. If you know your IgM is negative in the presence of an IgG positive result, it’s reassuring that you’ve already had coronavirus and don’t have it now, and importantly, you are very unlikely to be contagious. But if you only know your IgG result, you could still be actively contagious for up to three weeks. It feels to us that getting only an IgG is a potential public health risk. People could assume they are safe because they have already had it, however, we would not know if they are still contagious and actively shedding the virus without the IgM result.
Our recommendation
 
Whatever lab you use, please ask to get both the IgG and IgM tested. Understanding whether you’ve had the disease or currently have it is critical and we believe this could save lives and help to prevent the spread.
 
Finally, also understand none of the tests currently available are FDA approved. In this pandemic, we simply have not had the time to wait for rigorous FDA testing. These private-label testing companies are providing early testing approved under the Emergency Use Authorization (EUA).
 

If you made it this far, good work!

Please let us know how we can help. We will be providing testing 1 day/ week this week and then hopefully 2-3 days per week after that. We are happy to give our patents lab requisitions for LabCorp and Quest, or feel free to pick up the test kits to get it drawn elsewhere if that works best for you.
 
Email the office and let us know if you want to get tested and we can guide you from there.
 
Stay home, and take your Vit C, D, Zinc, Quercitin and melatonin at the very least.
 
May this information give us accurate information and help guide us to a healthier future for all.
 
We are here to help,
 
Drs. Terri Fox, Amy Reidhead, Melissa, Sara and Ame
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2355 Canyon Blvd.   |   Suite 102   |   Boulder, CO 80302

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