Long-Term Planning: Day By Day And The Future Of COVID Testing

Long-term planning in a normal business environment is defined over years. Long-term planning for this COVID-19 coronavirus is now defined in days as the information and strategy is changing from day to day. It is really hard trying to plan our lives based on information that changes this quickly. It is also frustrating to hear different opinions from many information sources.

My opinion is formed by two credible sources of information. I think Dr. Anthony Fauci has done an outstanding job in providing practical advice from the ever-changing scientific data about the virus. Our own Governor Larry Hogan has provided steady and logical leadership in managing how the state responds to the COVID-19 virus.

I was surprised and disappointed when demonstrations occurred in Annapolis a few weeks ago against the governor's directive to limit our social interactions. We are all under significant economic pressures and many of us have had high anxiety while being confined to our homes for the past month. According to the most recent statistics, the death rate of the virus in our state is still on the rise. Given this statistic, I know my long-term planning can still only be day by day.

We are all trying to imagine when and how this time of essential-only businesses, social distancing and mask-wearing will end. A medication to treat this nasty virus and a vaccine to prevent it will do the trick. We just aren't there yet. In the meantime, we will have to forgo any plans for the next few months because, as Dr. Fauci said, this virus has a timeframe of its own.

One of the means of opening the economy and freeing our social souls is by testing. Many countries that have already experienced the brunt and peak of the COVID virus are showing us the way. Initial testing done by nasal swabs is for the acute phase, which is for the diagnosis of the viral infection when the patient has symptoms. Testing in the chronic phase for antibodies, or the immunity response after the infection of the virus, is done by a blood draw. The nasal and now oral swabs needed for the actual test of the infection have been scarce and at times, frankly, unavailable. This new blood test, which will help guide us to reopen society, is the antibody test that measures a person's immune response to the virus.

An antibody test shows whether someone has been exposed to or potentially had the coronavirus and has developed the antibodies to fight the infection. It does not guarantee immunity, but medical experts say a positive antibody test indicates that a patient may have some level of protection against reinfection.

This antibody test is NOT intended as an initial diagnostic test for patients who are exhibiting symptoms consistent with COVID-19 virus. Antibody testing should be used only for patients who in the past were diagnosed with COVID-19 or had symptoms consistent with COVID-19. These symptoms could have been a fever, cough, shortness of breath, chills, repeated shaking with chills, muscle pain, headache, sore throat and a new loss of taste or smell. These antibody tests may also be used in instances when an individual thinks they might have had the COVID-19 symptoms in the past and needs confirmation. In either case, this blood test is only for people who are currently well for at least seven days.

World health officials warn, however, that scientists still don’t know whether coronavirus antibodies give a person immunity or reduce the risk of reinfection. The presence of IgM or IgG antibodies indicates that the patient has mounted an immune response to the virus. Although the immune response may protect against reinfection, this has yet to be established. It is also not known how long antibodies to the virus will protect someone, if at all. Scientists are still conducting research to answer these questions. Therefore, patients with positive IgM or IgG antibody results should continue to take steps to protect themselves and others.

I have no knowledge that the state of Maryland has procured these antibody tests. They have purchased 500,000 diagnostic tests using the nasal swabs (not the antibody tests) from South Korea. Maryland has not yet disclosed its testing strategy. We at the Arnold site of Maryland Primary Care Physicians have been testing people from the start of this crisis with the diagnostic nasal swabs, and now we are currently testing for the antibodies as well. If you think that you meet any of the criteria stated above, please call your health care provider to see if you can receive this test.