A new report from Johns Hopkins Bloomberg School of Public Health offers up a national strategy for expanding coronavirus antibody testing across the United States, and recommends that the US Centers for Disease Control and Prevention lead a “consistent, standardized effort” to perform such testing nationwide.
Antibody tests, also called serologic tests or serosurveys, look for evidence of an immune response to coronavirus infection and then use that evidence to determine if you have been infected with the virus in the past, even if you never developed symptoms or had an official diagnosis. A serosurvey then can show what proportion of the population has been previously infected.
The new report, published online Thursday and authored by eight experts affiliated with Johns Hopkins University, describes the value of serosurveys and provides recommendations for the US government and states on how to effectively perform these tests amid the Covid-19 crisis.
“The US government should take this opportunity to lead these serosurveys to ensure that resources are used efficiently, and the data collected can be used to improve the public health of Americans in the future,” the researchers wrote in the report.
The report acknowledged that “budget must be carefully considered” when designing serosurveys, which can be expensive — possibly costing up to millions of dollars, depending on the size, cost of tests and storing samples, among other factors. Serosurveys for the common flu can cost about $3.53 million for one project, for example, and surveillance studies for HIV can cost about $708,000 for one project, according to the report.
The report also noted that once serosurveys are conducted, the US government should create a central repository or database for the new data being collected to reside — and the CDC could lead the way in designing the serosurveys and their protocols.
“A central repository, similar to that found in ClinicalTrials.gov, would be a valuable resource to include all serosurveys, including their methodology, timelines, and purpose. A systematic method of entering data on serosurveys would then allow studies to be easily compared and could also allow individuals to access serosurveys in their area,” the researchers wrote in the report. “Right now, states are designing and initiating their own studies, but having a consistent protocol for carrying out serosurveys would make findings more valuable.”
The report added that employers and universities using antibody tests “should be strongly encouraged to register their studies” in that central repository.
The report also emphasized that validating serological tests remains critical for ensuring that tests are indeed producing accurate results. In early May, the US Food and Drug Administration announced that the National Cancer Institute would be helping to validate antibody tests on the market — yet no results from those validation studies so far have been made public, according to the Johns Hopkins report. The report says, “The FDA, NIH, CDC, and NCI should release the results of their antibody test validation study.”
Overall, the researchers wrote that “serosurveys can generate valuable data on the true prevalence of SARS-CoV-2 infection that can better inform public health decisions at a population level.”