According to BBC News, Alan Mack and his daughter Rebecca Mack were both diagnosed with COVID-19 in April 2020. Rebecca, a nurse in the children’s cancer unit at Royal Victoria Infirmary in Newcastle, England died of the virus soon after diagnosis. Her father also contracted the virus severely, but was able to recover. In hopes that other families wouldn’t be subject to the same pain they faced, Mr. Mack has given his blood plasma to research eight times already. He has also been told that he can keep doing so while he has the antibodies to combat the virus. With over 40.3 million cases, 1.12 million deaths worldwide, and still no method of prevention, we are living in a world taken over by COVID-19. However, there seems to be a light at the end of the tunnel and that starts with individuals like Mr. Mack, participating in testing for COVID-19 Antibodies.
What are Antibodies?
Antibodies are like the body’s military unit. They are proteins that bind to foreign antigens to initiate an immune response. Despite being only a cog in the complex immune system, antibodies allow the body to know what substances may have malicious intent against the body. Antigens, which can be thought of as the opposing side (if sticking with the combat analogy), stimulate the body to release antibodies.
To be more technical, antibodies are able to bind to these structures due to their unique ‘Y’ shape. Antibodies are produced by a type of white blood cell (B cells). When antigens bind to the surface of these cells they initiate a process that divides and matures B cells into clones. Mature B cells then produce many antibodies into the bloodstream to attack the bacteria/alien substances that initially triggered the response.
Recent preliminary studies on antibody treatment have found that monoclonal antibodies, or versions of proteins that the immune system naturally makes, can be used to provide “short-term protection from SARS-CoV-2” according to the National Institutes of Health. In fact President Trump’s recent COVID-19 treatment was a mixture of two monoclonal antibodies.
Immunity?
Though research is still in the preliminary stages, scientists are rushing to see how antibodies from coronavirus patients can be used against the virus. The question is: can the mature B cells that hold information about COVID-19 produce antibodies to attack the virus if given to others? Right now the answer is fuzzy. Recently, a study by researchers released in September 2020 at the David Geffen School of Medicine in the University of California found that someone who has COVID-19 antibodies should not be provided with lasting immunity. If antibodies cannot give the person they originate from viral immunity, the chance they can be repurposed by scientists seems minimal.
Another, fairly recent preliminary report released October 14 (and has not been peer-reviewed) shows evidence that a inhaled antibody treatment was effective on hamsters. Obviously this evidence is in its early stages, but if an inhaled treatment proves effective in humans we could be steps closer to achieving a reliable drug against the virus.
Antibody therapies, for the last 30 years, have been used to treat a plethora of conditions ranging from cancers to infections: the keyword being ‘treat’. As mentioned before, it is unknown if and how scientists will implement antibodies to treat COVID-19, and in no way can they be seen as a ‘cure’.
Why Aren’t Antibody Tests the Most Reliable?
Due to the falsity of the antibody test results, individuals have begun to question the validity of the virus. One FaceBook user from England posted her positive COVID-19 test and negative antibody test side-by-side, accusing the virus of being ‘man-made’ as an explanation. This post was shared over 2,000 times around the world. Though the virus has been proved to be natural, this is the precise reasoning as to why the FDA has not approved antibody tests yet, but President Trump won’t stop in his crusade to create antibody tests, even if that means using scientists outside the government. Trump is known for his over-exaggeration techniques, frequently involving the use of 5th-grade level adjectives. However, he called the antibody treatment he promoted without scientific evidence, the ‘cure’ for COVID-19.
The companies Trump has been working with are drug manufacturers Regeneron and Eli Lilly. Both of these companies are awaiting approval of the FDA to move forward, but it seems that the FDA hasn’t affirmed any sort of antibody testing yet. Even if they do gain approval, there’s a low chance that these tests will be available to all. Many other company heads have also attested that the country may not be ready to create antibody tests.
As previously mentioned, the FDA has not approved most antibody tests as of the last update in September. Likewise, the CDC currently does not recommend any testing for COVID-19 antibodies either. These tests don’t accurately portray results all the time, they have been known to frequently show false positives and negatives. A Reuters article states, “According to an NHS leaflet discussing the antibody test, it is ‘not guaranteed to identify everyone who has had the virus’”. Infected people can have negative antibody tests. Some reasons as to why this may be the case are that antibodies can be developed any time from one to three weeks after contraction. Unlike some diseases, COVID-19 is known to have different strains, in turn producing different antibodies.
Though the FDA has objected to most antibody testing, they authorized the use of point-of-care antibody tests for COVID-19. These tests can be administered in a provider’s office, hospital, or urgent care center. This test is a finger prick blood test that takes only 15 minutes.
Trump’s Antibody Trial
President Donald Trump’s contraction of COVID-19 has made the news worldwide, but what’s even more shocking is how he was able to recover. For his treatment, Trump received a dose of an experimental antibody developed by the drug company Regeneron. There are no officially approved COVID-19 treatments, but Regeneron and Eli Lilly are the two companies furthest along in their research with the antibodies. The president was granted use for the antibody trial through compassionate use- when that is the only available option. The dose used on president Trump was the higher of the two doses Regeneron is currently testing on their patients. Regeneron even has a deal with the Department of Defense for the first 300,000 doses of the treatment once available. However, as of now, there is limited product available for use.
The antibodies created by both Regeneron and Eli Lilly have shown promising results in hospitals. They have proved to shorten the amount of time patients spend in the hospital, and lower the level of the virus inside the body, in some cases. They are now finding that this effect is only true when this treatment is given soon after infection.
Antibody Trials vs Vaccines
Since the early stages of COVID-19, discussion on when a vaccine will be released to the public has been widespread. It seems impossible that the way society formerly ran will ever return. But the recent advancements/research on antibodies greatly varies from vaccines. While antibodies bind to the virus and then attempt to kill it, a vaccine is a version of the virus that is non-infectious and will help the immune system recognize it if it ever comes in contact with the infectious form. Another difference deals with the goals of these treatments. While antibodies look to treat those with COVID-19, a vaccine is a preventative measure that trains the immune system’s ability to protect from future infection.
Despite the clear difference between the two measures, both are needed in order to suppress the virus’s impact. According to the Vanderbilt Institute for Infection, Immunology and Inflammation, with the vaccine to provide immunity to the general population, and antibodies to provide immediate treatment to infected persons, these tools will ensure greater protection to the public from COVID-19.