Not an ‘Immunity Passport’, But Ignorance Isn’t Bliss

Before we can resume business trips, we will need to make sure that employees are safe while travelling.

Nothing beats the power of face-to-face negotiations and informal conversations, which can prove crucial when closing a deal or launching an important project.

That is why many companies will be eager to resume business trips – at the very least the essential ones – once travel restrictions are lifted. First though, they will need to find a way to ensure their employees’ safety while travelling.

One way to do so is to have employees take the all too controversial antibody test, also known as the serology or serological test.

Antibody testing 101

Where the widely administered swab test which we’ve all become familiar with detects if a person is, at that given moment, infected by SARS-CoV-2, the antibody test seeks to determine if that person has already had COVID-19 in the past and has since recovered. About 6 to 10 days after being exposed to the novel coronavirus, the human body begins to develop antibodies that react specifically to it – first immunoglobulin m (IgM), a short-lived antibody which disappears after a couple of weeks, then immunoglobin g (IgG).

The latter stays in a person’s blood in the longer term and can defend the body against a subsequent infection by the virus. It is therefore possible to know via a simple blood test whether a person has gained immunity to COVID-19. There is also a lot of debate surrounding the efficiency of the serological tests. One article I read summarized it nicely, “Think of it like trying to identify different types of fruit.

It’s easy to distinguish between an apple and an orange. But determining whether we have an orange or a mandarin is much harder. Our test has to be sensitive to more than just color, shape, and texture of the fruit’s skin. We would need to look for a characteristic unique to the orange, such as the roundness of the orange, or how easy it is to peel the skin off.”

As of the date of publishing this article, there are many companies that provide the COVID-19 antibody test, yet only very few have attained gov’t authority and backing around the globe due to discrepancies and lack of accuracy. The tests that have been developed to this day many times deliver false negatives (people incorrectly considered not immune) and even false positives (people incorrectly considered immune) results.

As efforts are undertaken to make them more accurate, there have been positive developments in recent days – such as Abbot and Roche securing the approval for the use of their (lab-based) serology tests exhibiting very high accuracy.

Another popular question nowadays, how long the immunity will last for, is still uncertain. Other known coronaviruses cause an immunity lasting from a few months to a few years. Similarly, the immune responses vary between patients, with some only developing low levels of antibodies.

This could be linked to how sick patients were from COVID-19, with patients exhibiting stronger symptoms developing higher levels of immunity – but this is still unclear. Moreover, whether people with IgG antibodies are still contagious is also unknown.

Here too, however, there are grounds for optimism, as it is generally believed that SARS-CoV-2 should behave rather similarly to its close cousin SARS-CoV-1 (the virus that causes SARS, with whom it shares about 76% of its genome), whose immunity is known to be efficient and long-lasting (about three years).

Whereas this test is, for now, performed only in laboratory environments, many companies are racing to produce accurate home test kits (consisting of simple finger-pricking test with wait times as short as 10 to 15 minutes to obtain results). Once these kits obtain approval and finally hit the market, expect them to be cheap (British company SureScreen’s tests reportedly cost as little as £6) and widely available (imagine being able to order your kit from Amazon…).

A word of advice

Tests only provide a snapshot of a person’s immunity at a given time – they cannot detect whether someone is sick at the time of taking the test, nor can they predict whether that person is likely to become infected later on. In other words, they are not an ‘immunity passport’.

Despite the uncertainties, ignorance isn’t bliss, and for now, testing for antibodies remains our best bet to securing travel. It can provide an additional layer of safety both for companies sending out their staff on essential business trips as well as for the employees who undertake them. That is an advantage that cannot be easily discarded.

Clearly, some caution should be exercised when it comes to antibody testing, though in my opinion, the benefits of getting tested far outweigh not getting tested before travel.

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Jenny Cohen Drefler

Jenny Cohen Derfler

Air Dr CEO & Co-Founder

Jenny is the CEO and one of the Co-Founders at Air Doctor. She spent more than 20 years at Intel, most recently as general manager of its manufacturing facility in Israel and before that in various engineering and manufacturing roles in Silicon Valley. Air Doctor is her second startup having previously founded electric vehicle company ElectRoad.