CityWatch: New York governor looks to antibody testing as a potential means to get people back to work

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New York has developed an antibody test, the key to getting life back to normal, Gov. Andrew Cuomo said Tuesday, offering some hope despite the state’s largest single-day death toll from the coronavirus.

“How do you get people back to work as quickly as possible? It’s gonna come down to testing,” Cuomo said at his daily briefing. “You’re going to have to know who had the virus, who resolved the virus, who never had it. And that’s going to be testing.”

The number of deaths in New York state from Covid-19 totaled 731 on Monday, significantly higher than the peak of 630 recorded last week. It brings the total number of coronavirus deaths in the state to 5,489. 

There are, nonetheless, very early signs that the crisis in New York has begun to plateau (particularly decreased daily hospitalizations and new victims being intubated). And Cuomo, more every day, is taking time at his briefings to discuss restarting the economy, in which antibody testing could play a critical role, experts said.

Wadsworth Center, a state-run lab in Albany, New York’s capital, developed the new antibody-testing regimen and, once approved by the Federal Drug Administration, could be scaled out for wide use, Cuomo announced on Tuesday. 

“This tests the blood to determine whether or not you have the antibodies, which means you had the virus and resolved the virus,” Cuomo said. “You can get to work, you can go back to school, you can do whatever you want.” 

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Antibodies are the protective proteins the immune system produces in response to viral infection, and their presence in the blood indicates that a person has, or has had, the disease. The FDA has approved some antibody tests, including one last week by private company Cellex, and such tests are already in use in other countries, such as China and Singapore. 

But testing accuracy is a chief concern, especially since some antibody tests don’t distinguish whether someone’s infection is active or resolved. New York’s test only measures an antibody known as immunoglobulin G, which indicates that a person had the disease but is no longer contagious, the state’s health commissioner, Dr. Howard Zucker, said Tuesday.

“It’s important to make sure that the tests we are measuring show that individuals had the infection, that they don’t still have the infection,” Zucker said. 

The next step is to scale testing to a point where it’s useful to researchers, and possibly to people who can then go back to work. The state will be working with the FDA over the next week to get more labs approved to run its antibody test, the officials said. 

“You have 19 million people in the state of New York. Just think about how many people you would have to test and test quickly,” said Cuomo, who’s working with the governors of neighboring Connecticut and New Jersey on a plan to restart their interlinked economies.

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Epidemiologists and pathologists have touted an antibody test as critical to learning more about the disease, including the true mortality rate. There could be thousands of New Yorkers with the antibody who never knew they caught the virus, as medical experts have estimated that around 25% to 50% of cases are asymptomatic. 

“It’s crucial,” said Dr. Joshua M. Epstein, professor of epidemiology at New York University’s School of Global Public Health. “The antibody test is the key to restarting the economy without restarting the epidemic.”

New research by Epstein and his colleagues indicates that several million Americans who’ve already had the disease could return to work if such testing were widely available. 

Another factor that remains unclear is how long people’s immunity lasts. There have been some unsubstantiated reports from China of people getting sick a second time. Some, like Epstein, point to related coronaviruses, SARS and MERS, which confer long-term immunity. 

Others, like virologist Dr. Robert Gallo, are not yet convinced, especially since we don’t build lasting immunity to common colds, which are also caused by types of coronaviruses. In the 1980s, Gallo co-discovered HIV, a virus that provides no immunity. 

The antibodies “might not be protective at all,” said Gallo, co-founder and director of the Institute for Human Virology at the University of Maryland School of Medicine and co-founder of the Global Virus Network. 

But a highly accurate antibody test is no less critical, he added. For one, it would identify those who could donate plasma to help vulnerable people sick with Covid-19. Nobody knows if that treatment is effective, he said, “but it’s worth a little try until you have something easier to give people.”

Widespread testing would also help trace the epidemic, better clarify how deadly it is and provide insight into the length of immunity, Gallo said—even if it doesn’t provide an immediate jump-start to the economy. 

“I think it’s vital,” he said. 

Cuomo on Tuesday reiterated that the return to normalcy is still a ways away. 

“This is not a light switch that we can just flick on and everything goes back to normal,” he said.