COVID-19 Antibody Testing Experience with Quest

Every time I venture out where I encounter other people, I ask myself if it was worth it.  I don’t do it often, but I decided to do it to get a blood test for antibodies to COVID-19.

Why did I bother?  I’m hoping and wonder like everyone else if that cold that I had in the last few months could have been a mild case of coronavirus.  And if it was, I personally believe that antibodies will provide protection against getting re-infected.  It hasn’t been proven yet, but based on what I know about other illnesses and other coronavirus infections, it seems likely that antibodies will provide protection from future infections and also that antibodies will last for a significant length of time (at least one year).

It does worry me that the WHO has made a point of saying that antibodies may not provide protection.  Do they know something or are they just being extra cautious?  If anyone is going to be returning to work, I think we should start with people with antibodies until we have some evidence that antibodies do NOT provide immunity.  That makes more sense to me than having a blanket re-opening of places without regard to antibody status.  Perhaps I’m unreasonably optimistic and this is all just wishful thinking, and I hope by the slight chance that I have antibodies it would mean that I have won the golden ticket.  First thing I would do is find out if I can donate plasma, even if I’m on Humira.  Which does also raise the question of whether I would even produce adequate antibodies, but I’m not going to put much thought into that possibility at this point.

So I’ve been debating antibody testing for over a month.  I considered ordering some of the point of care finger prick tests, but just when I was about to do it, other companies announced much higher blood tests.  The last thing I would want was to spend the money and effort to do a test and then wonder if the results are a false negative or a false positive.

So I started with asking my doctor about testing last month and was told that the tests haven’t been well validated yet, etc.  I asked again this past week and was told that the tests still haven’t had external validation and to check again in a month.

I reviewed the data available so far on the Roche antibody test and the Abbott antibody test and they both seem to have extremely high specificity (necessary when there is a low prevalence of disease) and a very high sensitivity.

Add to all of this and insurance companies are covering these tests at 100%, so you can get them for free, with a doctor’s order.

Quest has offered their own patient directed test.  For around $129 you can get an antibody test.  I considered it, but then I saw that there were other options.  Labcorp has an option were for $10 they have a doctor order the test for you and then my insurance would cover the test.  Labcorp seems to use the Abbott test and the Roche test, both excellent tests.  I wonder if I should have gone that route.

But I also came across a site, Plushcare, which says that most insurance companies cover their $99 doctor fee and then they will write an order for the COVID antibody testing.  Based on the website, it said that they use either Labcorp or Quest.

I checked with my insurance, and confirmed that the telehealth visit with Plushcare was covered 100%.  I spoke to a very nice doctor based in California by videoconference through an app on my phone.  After we went over why I think I may have antibodies, he asked me a few other questions, and then said he would send the order electronically to Quest and I should have the results in about 48 hours.  He said Quest is using the Abbott antibody test and I asked if he was sure and he said he was.  Based on Quest’s website, they don’t only use Abbott, or at least didn’t always.  They initially used EuroImmun and may still use it.  I’m not sure why as EuroImmun test seems to have only 90% sensitivity compared to Abbott’s of nearly 100% sensitivity.

I went ahead and made my appointment at a local Quest lab.  I assume it would be very empty with scheduled appointments but it wasn’t quite that empty.  I showed up 5 minutes before my appointment, wearing my KN95 mask.  There was no way to open the door without touching the handle, but I figured I just won’t touch anything or myself.  When I walked in, there was a set of 3 people standing together (parents and a teen child) and another person standing on the other side of the room, apparently also waiting for labs to get done.  I went to the sign in kiosk and realized I had to take out my phone to scan the QR symbol.  I figured I would just sanitize my phone after the session.  The kiosk tells me there is an estimated 12 minute wait and I can either wait outside or inside.  If I wait outside, I will receive a text message when my appointment is ready.  I decide to wait outside and I get back in my car realizing that I have now touched my car with my non-sanitized hands that have touched the door, the kiosk, my phone, and then the door again.  I’ve also walked past several people and I’m starting to question my choice of bothering to get tested.

I sit in my car for a bit over 20 minutes and decide to check my quest app to see if there is any more information about my appointment.  The app tells me that it can not locate my appointment.  Crap.  I decide to go inside and I wonder if maybe they called me and I missed my turn, etc.  I go to the counter and realize there is no person working the counter.  I go back to the kiosk and sign in again and it again says the wait time will be 12 minutes and I can either wait inside or outside.  This time I say wait inside.  There is now only one other person waiting so I go to the other side of the room and I again question the wisdom in doing this.  I did then notice a monitor showing the people waiting and I see my name is second on the list with the first person have a 3 minute wait, me having a 7 minute wait, and a 3rd name listed as a walk-in (who must have been waiting outside in his/her car as no one else was inside).  I at least was relieved that I didn’t miss my appointment, but I did wonder if perhaps they called me and skipped me instead of texting me.

They call the person ahead of me and they are talking to him through the window.  He says that he ordered his test online.  She asked if he paid for it already and he said not yet.  She said that they can not draw his blood until he pays.  They said he can go online, pay, and then schedule another appointment.  He asked if he could do it right now and they said that he could.  Meanwhile, they then called me and I was glad I didn’t have to wait any longer around potential COVID-19 infected air.

I went back and sat in the blood draw chair (thinking the probably don’t wipe it down between patients, but perhaps they do).  I told her I wanted to make sure it was the Abbott test and she said Quests uses their own test.  I asked if she was sure about that as I was told it would be the Abbott test. She said she is sure.  I assume she is wrong, but now I’ll  have to wait for the results to see if it says which testing platform they used.  I have seen results of antibody tests that were done at other labs and it did specify that the test was run on the Abbott platform.

So now I’m waiting the 48 or so hours until I get my negative result, wondering how much risk I put myself in by going to get the test done.  I figure there is probably about a 5% prevalence of COVID in our community (maybe even less than that), so perhaps I have a 5% chance of having been exposed.  Rationally, I believe that my risk of exposure is even less than that as I am pretty careful about social distancing, wearing a good KN95 mask, and avoiding breathing around other people.  I had my “sickness” in mid-February which was before there were any reported cases in Illinois as far as I can remember.

Worst case scenario, I will get the expected negative test result, but it will have been run on one of the other platforms Quest has used, which may not be as sensitive (higher false negative rates) and I will wonder if I should bother getting retested with the Roche or Abbott test.

Best case scenario is I have antibodies and hopefully then so do the rest of my family.

The likely scenario is that I will test negative and it will be the Abbott platform. I’ll post my update when I get the negative result.

Uodate: about 13 hours after the test I got my email saying the result was ready to be viewed. It is negative (as expected) but the result does not even say which platform they used to run the test. I’ll see if I can find out, but I doubt I can find a human at Quest who can answer that.

 

Update: I called Quest and after multiple lengthy voice prompts and about 20 minutes of hold time I spoke to a representative. She said they are only using the Abbott platform at this time. Hopefully that is correct information, both for me and for other people who are getting tested at Quest. I was already confident my negative test was accurate, but this provides even more assurance.

The key now is to stay negative until a safe vaccine or treatment is available. Interestingly, today, I saw an article about researchers at Georgia Tech exploring the use of antibody positive individuals as the first people to return to essential work sites. Someone there is thinking along the same lines as me.

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