When are we getting back to school?, antibodies, and immunity

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Udagama et al. 2020 ACS Nano

You know I think I've realized how much more interconnected bioengineering, biology, and I guess the stuff we are learning right now is increasingly even more connected with my daily life... especially now during this pandemic when I'm missing my other home at MIT where there used to be a sense of community when doing my psets and work and where there used to be a sense of driven collaboration... now it's hard to find a sense of fulfillment in completing a pset by myself. I guess I just enjoy talking about psets, questions, and discussing things with people more often than I realized I did. Anyways, on the topic of getting back to school— which seems to be on the top of everyone's minds right now.

 When are we going to get back to school? 

That question is actually quite related (although somewhat orthogonally?) to the topic we are learning right now— antibodies. A lot of new serological (blood) tests have come out currently looking at whether or not someone who in the past has had COVID19 has developed the antibodies (we're looking particularly at IgG, IgM, and more recently IgA) to the virus in order to fight it and also prevent reinfection. A lot of work is also being done with antibodies on the therapeutic end, where finding broadly neutralizing antibodies could also be effective in the body's fight against the virus.

However, there recently have also been questions on whether this is enough to test for immunity. To clarify, most of the testing that has currently been done in the U.S. is a form of RT-qPCR (or reverse-transcriptase qPCR) testing (something we used the last module!) and that's where the nasopharyngeal swabs (the things that get stuck right up through your nose to the back of your throat) come in. And, as many articles will tell you with the talk about reopening (which is not a good idea yet by the way) and this site (which has some interesting information), in order to ensure there is not a resurgence or reinfection we have to have a kind of system in place where the people who are immune and healthy return the workplace first (currently the numbers are not clear as to what the rate of this being is though!). It's either that, or we wait for a vaccine in the fall. So back to why this test may not be enough to ensure immunity. Antibodies are specific but because there are several other coronaviruses out there they may not be specific to SARS-CoV2. In addition, your body's immune cells— the real defense system— must also be able to retain that "memory" to fight the virus in that case as well. So now there are questions on whether or not T-cell immunity might be enough or how else we might be able to evaluate and determine immunity. An overview of testing is provided here if you are curious like I was (Udugama et al. 2020). My doc (tinyurl.com/covid19teens) also has a section with a table on different testing methods out there (including the CDC's, the Broad's, and Mammoth Bioscience's) and also some research on questions that I've had while researching this topic in my free time.

Before continuing with this article, I should add to all this in saying that I was fortunate enough to learn a lot of this information thanks to a virtual panel I planned this week with GlobeMed@MIT on infectious diseases, health equity, and planetary health with several experts looking at this question right now! 

Finally, I would like to say I've found a lot of hope but also share a lot of concern -- one of the biggest limiting factors currently, besides accuracy due to the long incubation period of SARS-CoV2, is not necessarily even the technology out there for testing. It's the investment in it for the long-term but also the accessibility of that technology across the nation (and globally). For example, Abbott Biosciences (the same company that came out with the 5-minute RT-qPCR in the case where you are positive, 13 for if you are negative) already came out with an antibody test 4 days ago!
Abbott Launches COVID-19 Antibody Test | Abbott Newsroom

But the REAL question is-- will it get to the people who need it most soon?

Anyways, I hope that we all get this antibody test or the effective vaccine comes out soon so that we can get back onto the campus that we love. Wishing you all the best and please stay safe! Some exciting random news is that Facebook now has some kind of support/hug emoji? I'm definitely going to be using that all while practicing social (or more accurately, "physical") distancing.

-- Melody



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