COVID – 19 – TESTING in the third year of the pandemic – what is different?

The good news is that in Upstate New York the numbers are DECREASING, fewer new daily cases, less people getting hospitalized and thankfully fewer people are dying.

The number that is INCREASING is the number of post COVID infection survivors, and studies show that 30-60% of those have consequences from having been infected. The tests used in acute infection (nasal swap, PCR, saliva) are not helpful at this point, and antibody tests start turning negative rather early in post infection period. Not helpful if you feel “off” and don’t know why.

What is making me not feel well?

How do I know if I had COVID in the past? Are my symptoms due to COVID that I had earlier or is it something else (in which case other tests need to be done and appropriate treatment initiated)? Could one have COVID with minimal symptoms and not even be aware of contracting the infection? Could symptom free infections with COVID-19 have long lasting consequences?

Do you know?

There is a test available that can answer these and other questions with a high degree of accuracy and it can be readily obtained through your doctor or by yourself on line.
Our immunity plays a most important role in how we interact with viruses and bacteria, and there are two parts to our immunity: innate and adaptive immunity and it is the latter we need in long term. You may not know if you ever had COVID and your antibody (like to spike protein) and antigen (COVID virus) tests are negative, does it mean that whatever is making me unwell is something other than post COVID? No, not necessarily.

Let me explain (or skip this part if you already know it)

Using COVID as an example, the infection starts by inhaling a bolus of virus particles (the greater the number the more dangerous it is) which first colonize our respiratory passages (nose and oropharynx) where they multiply and proceed to invade us internally. If our immunity is strong and the person is young and healthy the circulating immune cells intervene and the illness may be unnoticed or mild. If we are genetically unlucky (some people do not develop protective immune defense neither after infection or vaccination) or have pre-existing conditions the outcome may be dire, even deadly.

There are two parts to our immune system, the innate (we are born with) and the adaptive (created by encountering pathogens during our lives). There are two main types of lymphocytes, bone marrow derived B-cells which make antibodies and thymus derived T-cells known for their long memory. Both cell types get “educated” to recognize the invader virus for the future but B-cells soon forget while T-cell provide long lasting cellular immunity and react quickly and efficiently on repeat viral exposure, they are less variant specific than the antibodies and stay in circulation longer. It is those anti-COVID T-cells that can be measured to obtain the answers we need.

A positive test answers three important questions:

  1. You and the virus have met before (had infection in the past or were successfully vaccinated, or both).
  2. You have an adaptive immune response to the virus
  3. Your current symptoms could be due to “long COVID”