The Rich and Well-Connected Get First Dibs on Antibody Tests
By: Emily Mullin
Tags: Money, Technology, Testing, Health, Coronavirus

The Rich and Well-Connected Get First Dibs on Antibody Tests

But there’s no guarantee they’ll be accurate

A private luxury boat drives near Fisher Island, Florida. Photo: Editorial RF/Getty Images

During a recent biotech roundtable hosted by industry group SynBioBeta, Apple co-founder Steve Wozniak suddenly appeared in the Zoom meeting, taking all the panelists by surprise.

“I’ve always wanted to be a Zoom bomber,” he joked. The event was about antibodies, which are at the center of research and testing efforts to combat the novel coronavirus. Wozniak revealed that he and his wife Janet underwent testing for antibodies after traveling through China and Southeast Asia earlier this year.

Wozniak tweeted on March 2 that Janet was getting checked out for a bad cough after returning from China. He added that they might both be “patient zero” in the United States, causing a mild panic on Twitter. But, as he said during the roundtable, their antibody test results came back negative.

While the vast majority of people in the United States are waiting for antibody tests to become available, some wealthy and well-connected individuals and communities are already getting access to them, even though the vast majority haven’t been vetted by the Food and Drug Administration and are not guaranteed to be accurate. The great hope is that antibody tests could reveal who’s immune to the virus, allowing those people to safely reenter society.

Good Morning America host George Stephanopoulos said in an April 21 tweet that he tested positive for the coronavirus antibodies. The week before, he announced that he tested positive for the virus, despite never having any symptoms. Other celebrities, professional athletes, and politicians have gotten diagnostic tests even as those tests have been in short supply. Antibody testing is the latest way that the pandemic is underscoring the class divide between the rich and famous and everyone else.

On Florida’s Fisher Island, one of the country’s richest zip codes, everyone can get an antibody test. The private island, which boasts an average annual household income of $2.2 million, purchased 1,800 antibody tests from the University of Miami Health System for its residents and workers, according to the Miami Herald. About 800 families live on the island, and 400 employees work there.

Like the residents of Fisher Island, people in other wealthy areas are driving efforts to bring testing to their communities. In Telluride, Colorado, and surrounding San Miguel County, married couple Mei Mei Hu and Lou Reese, who live in the area part-time and are executives at biotech company United Biomedical, provided free tests to all of the county’s 8,000 residents. But the company has experienced delays with processing the tests.

In the reclusive Bay Area village of Bolinas, known as a weekend retreat for the tech elite, biotech executive Jyri Engeström and venture capitalist Cyrus Harmon used their connections to provide free antibody testing for all 1,680 residents and get researchers at the University of California, San Francisco to set up a study in their town. UCSF is also launching a similar effort in San Francisco’s Mission District, a largely Latino neighborhood.

While prosperous communities are taking testing into their own hands, some local public health departments and universities are beginning so-called “serological surveys” to test residents for antibodies. The National Institutes of Health is also beginning one of these surveys, with plans to include 10,000 people. But with so many people interested in signing up, these studies can’t take everyone who wants a test.

Antibody tests are designed to reveal whether someone was previously exposed to the virus, rather than diagnose a current infection. Widespread antibody testing could be the key to learning the true infection rate of Covid-19 and has been proposed as a way to identify those who may have immunity and may safely return to work or school. But in the United States, these tests are still being developed and validated to make sure the results are accurate.

The tests work by looking for the presence of antibodies to the novel coronavirus in a blood sample. The immune system makes antibodies when it’s exposed to a new pathogen, and these antibodies can provide protection if a person encounters that pathogen again.

The hope is, if a person has specific antibodies to SARS-CoV-2, the virus that causes Covid-19, they could be immune from getting sick or passing the virus on to others. But scientists don’t yet know for sure which, if any, antibodies provide immunity to the virus or how long that immunity might last. The World Health Organization cautions that there is not enough evidence to show that antibodies prove immunity.

The Wozniaks’ tests, done by a lab at Vanderbilt University in Nashville, revealed that they did in fact have coronavirus antibodies but not those specific to SARS-CoV-2, the virus causing the current pandemic. That means they’ve been exposed to other coronaviruses at some point in their life, which isn’t surprising since the common cold is a type of coronavirus. The result highlights a challenge in testing: An antibody test needs to pick up the right antibodies for the right coronavirus — specifically, SARS-CoV-2 — to give an accurate result.

Public health experts are worried that antibody tests that are becoming available from abroad may also give inaccurate results. They are particularly concerned about “false positives” — when someone tests positive for the coronavirus antibodies but doesn’t actually have them. The worry is that people could receive a false-positive result and go out in public because they think they are immune when they aren’t. They could then get infected or spread the virus to others.

Despite the concerns about their reliability, these tests are available — and accessible to those who can afford them or are well-connected enough to get them. Relaxed FDA regulations have allowed tests from Chinese and Korean manufactures that haven’t been reviewed or authorized by the FDA to flood the market. More than 100 such antibody tests are now available. Some high-end concierge medicine services and wellness centers offering to test for the coronavirus appear to be using them.

Sollis Health, a concierge medical service in New York, is providing Covid-19 house calls to members for antibody testing. Membership costs $5,000 a year and house calls are an additional $1,000. On the group’s website, it says “most antibody tests are not currently authorized by the FDA” and that antibody testing “does not have our official recommendation.”

ConciergeMD of Los Angeles is offering at-home antibody testing to members for $299, even though no home antibody test has not been authorized by the FDA. A West Hollywood luxury wellness lounge called NextHealth, where clients can get intravenous vitamin therapy and cryotherapy, is advertising in-person antibody blood testing for $249 on its Instagram account.

The FDA has granted emergency use authorizations to just a handful of antibody tests, including those from Mount Sinai Health System, Cellex, ChemBio Diagnostics, and Ortho Clinical Diagnostics. The Mount Sinai test is only being conducted at the New York health system. As for the other tests, it’s not clear how the companies plan to roll them out. In the meantime, the FDA and the Centers for Disease Control are now working to validate other tests.

Critics, like Adam Harris in The Atlantic, have pointed out that the wealthy can leverage their influence during the pandemic to get access to tests and other medical equipment that most Americans don’t have. Arguably, the wealthy need antibody tests less than many other people in society do, since they’re able to stay home while frontline workers can’t. If antibody tests do end up being a true indicator of immunity, they’ll need to be distributed to the people who need them most.

But though the elite may be able to access these tests before everyone else, without hard evidence that the results prove immunity, they might not be better off than the rest of us — at least not yet.