What It’s Like to Get a COVID-19 Antibody Test in NYC

Anna Amelianchik

Antibody testing for COVID-19 is now widely available in New York City. Unlike the polymerase chain reaction test used to detect coronavirus from the infamous nasal and throat swab, the antibody test does not determine whether you currently have the disease. Instead, it can detect antibodies against COVID-19 present in blood and determine whether you had COVID-19 in the past. The body produces antibodies to facilitate the destruction of invading pathogens, such as SARS-CoV-2, by immune cells. Antibody tests are designed to detect two specific types of antibodies, IgG and/or IgM. Patients with COVID-19 develop IgM antibodies shortly after the virus attacks. IgM antibodies are then replaced with IgG antibodies which become detectable in the blood of COVID-19 patients approximately ten days after they become symptomatic. While all patients recovering from COVID-19 develop antibodies against SARS-CoV-2, scientists and health authorities are debating whether the presence of antibodies protects people from reinfection. In addition, antibody levels may wane over time effectively erasing any acquired immunity. For instance, a 2006 study showed that antibodies against SARS-CoV, a coronavirus closely related to the virus that ravaged the world in the past months, lasted for several months to two years, although all study participants had low antibody levels after about fifteen months. While the longitudinal profile of antibodies against SARS-CoV-2 is still unclear, a predictive modeling study showed that, in the absence of recurrent vaccination, short-term immunity (~ten months) against SARS-CoV-2 would lead to annual outbreaks of the novel coronavirus, while long-term immunity (~two years) would cause biennial outbreaks. However, it is critically important to conduct antibody tests to better understand the impact of the novel coronavirus on communities that are heavily affected by it. 

Over a two-week period in May, the NYC Department of Health conducted a citywide antibody survey and tested approximately 70,000 NYC residents for the presence of antibodies against SARS-CoV-2. Launched in partnership with BioReference Laboratories, the study was designed to help health authorities better understand the spread of COVID-19, how the body responds to the virus that causes it, how often the virus causes an infection with symptoms, the frequency of specific symptoms, and risk factors for this disease. “For New York, a city that has been seriously impacted by the COVID-19 pandemic, this type of information will be of great value in helping healthcare professionals to analyze the presence and progression of the disease in order to identify at risk populations for possible early intervention,” said Jon R. Cohen, M.D., the Executive Chairman of BioReference Laboratories, in a press release posted on the BioReference website on May 7. The antibody test was offered to NYC residents for free with testing sites available in all five boroughs. Several members of our editorial board participated in this antibody survey at the testing site closest to The Rockefeller University campus in Long Island City, Queens. Located inside a repurposed warehouse, the testing site prioritized the safety of study participants with temperature scans at the entrance and free personal protective equipment (PPE). Several blood draw stations were spaced out to allow for a distance of at least six feet between them. Colorful tape on the floor indicated the direction of foot traffic and prevented crowding. The nurses, in full PPE, drew blood through vein puncture and collected one tube of blood per participant. For those who filled out the screening survey online, the entire process could take less than ten minutes. To determine the presence of antibodies in blood samples, BioReference used the Roche Elecsys test with 99.8% specificity and 100% sensitivity. The results of the test were available online on the BioReference portal 24-48 hours after the test was administered. As of this writing, the NYC Department of Health paused the recruitment of new participants for this survey. However, you can still access antibody testing in NYC, often with $0 co-pay for those with private health insurance, Medicaid, or Medicare. Some testing sites might also provide free antibody tests for those without health insurance. For example, Mount Sinai is looking for volunteers to donate convalescent plasma used to treat patients with COVID-19. They are screening the members of the public who have previously had the symptoms of COVID-19 and waiving fees for antibody tests. To participate, fill out this survey. For the full list of testing sites available near you, visit the New York State Department of Health website.

Lace Up for Immune Health

Anna Amelianchik

Exercise is critically important for physical and mental health because it helps stave off diseases related to obesity and reduces the symptoms of anxiety and depression. However, there is reason to believe that exercise might also protect against infectious diseases. In fact, a 2010 study showed that near-daily aerobic activity and the perception of being physically fit significantly reduced the frequency and severity of respiratory infections in both men and women during a twelve-week study period. Although we don’t know whether physical activity can help protect us against SARS-CoV-2 specifically, studies in exercise immunology, a relatively new but increasingly important area of scientific research, show that exercise may give your immune system a significant boost.

Short bouts (under sixty minutes) of moderate and vigorous exercise, such as walking, running, or cycling, may enhance the activity of innate immune cells, such as macrophages and natural killer cells. Macrophages help the body fight infection by engulfing and destroying invading pathogens (e.g., viruses and bacteria). Macrophages also secrete molecules that promote the activation of natural killer cells which can detect and kill infected cells to stop the infection from spreading.

In addition, aerobic exercise can help orchestrate the adaptive immune response by mobilizing two main types of lymphocytes: T-cells and B-cells. T-cells kill infected cells and use messenger molecules, known as cytokines, to increase the overall activation of the immune system. T-cells can also directly activate B-cells, which help us fight off bacteria and viruses by producing antibodies that “tag” invaders and help other immune cells eliminate them. In the short run, exercise may enhance immunosurveillance by recirculating immune cells found within various tissues and organs in the body, such as the lymph nodes and spleen, back into the bloodstream. In the long run, regular exercise may help ward off infection by redistributing immune cells to the organs favored by viruses and bacteria, such as mucosal membranes and the lungs.

Early-stage research shows that exercise may also promote defense against infectious diseases by increasing the production of antioxidants. Our bodies produce an antioxidant molecule known as extracellular superoxide dismutase (EcSOD), which breaks down free radicals that damage cell membranes, proteins, and DNA. Elevated EcSOD in blood and vital organs, including the lungs, may protect against acute respiratory distress syndrome (ARDS), a common and often lethal complication of COVID-19.

Finally, exercise may boost your immune system indirectly, by reducing stress and improving sleep. In fact, aerobic exercise reduces the levels of stress hormones, such as adrenaline and cortisol, which can interfere with our immune system’s ability to fight infection. Regular exercise can also help normalize disrupted sleep, which is crucial for the proper function of immune cells.

If you reside in New York City, you might not be able to get back to your gym or your favorite fitness class for a while, but there are several excellent alternatives that can help you stay fit and boost your immune defenses while social distancing:

Walk, run, or cycle responsibly. If you are an avid runner, continue to enjoy this solitary form of exercise, but take precautions, such as wearing a face covering and staying at least six feet away from other people in parks and on sidewalks. If wearing a surgical mask or a thick cloth mask while running is uncomfortable, consider investing in moisture-wicking multifunctional headwear. If you are new to running, make sure to start easy (several apps, including Nike Run Club and 5K Runner: Couch to 5K might help) and choose the right pair of running shoes to avoid injuries. Finally, if running is too hard on your joints, a brisk walk or a bike ride will offer similar benefits as long as you practice social distancing.

Replace a stair stepping machine with actual stairs. If your building or street has a mostly-empty staircase, fire up your legs and glutes by walking or jogging up and down the stairs,giving yourself a thirty second break between circuits. Mix it up by doing additional exercises such as calf raises, squats, or seesaw lunges at the top of each flight.

Do bodyweight exercises at home. With a little bit of space and some imagination, you can reach your fitness goals even during a pandemic. Follow workout classes on YouTube or Instagram Live, take advantage of Nike’s promotion that allows you to access Nike Training Club Premium for free, or start a fun exercise challenge with your friends. Rockefeller’s own Tim Blanchard offers strength/cardio classes via Zoom (you can also access Tim’s classes on YouTube). If mountain climbers and burpees aren’t your thing, you can get your heart rate up by joining TikTok dance challenges. Who knows, you might even become the right kind of viral!