Optimizing Your Health: The Latest Medical News & Opinion from Dr. Rand McClain

Getting Tested for the Corona Virus Now Could Allow You to Get Back to a Normal Life

Dear Patients,

As we approach what some are calling April 47th of the COVID-19 (“COrona Virus Disease-2019”) “lock-down”, some of the focus has shifted from infection prevention and the care of those currently infected with the COVID-19 to proactive measures to getting back to some sort of normalcy before we have access to a vaccine.
 
Germany and Britain have begun testing its citizens to determine who can return to work and resume relatively normal activities. Citizens who test “positive”, and therefore have immunity against SARS-CoV-2 are issued an “Immunity Passport” allowing them freedom from stay-at-home and social distancing restrictions and directives. Dr. Deborah Birx, the coordinator of the White House coronavirus task force, has called such tests "critical", and, immunologist Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, stated that this testing is “going to be important when you think about getting people back into the workplace".
 
Most of the testing about which we hear is what is referred to as molecular testing in which reverse transcription polymerase chain reaction (“RT-PCR”) technology is used to test for the presence of SARS-CoV-2 (the name of the actual virus that causes the disease, COVID-19). But, we know that approximately 81% of those infected with SARS-CoV-2 suffer mild to moderate symptoms, and, Dr. Anthony Fauci recently stated that as many as 50% of those infected are unaware that they have been. And, we know that once infected, based upon what we know so far about this virus and other viruses, it is very unlikely for anyone infected to be re-infected within the coming months and possibly years. That’s pretty important in determining one’s risk of becoming infected and transmission of infection in the coming months – for each individual as well as the community.
 
So, how do we know if we are one of the unwittingly infected who is now immune (and can be “free at last”!)? A serology test that measures antibodies to SARS-CoV-2.
 
The body’s immune system develops antibodies called immunoglobulins that mark the virions (viral particles) for destruction. The body’s immune system first makes immunoglobulins, called immunoglobulin M (aka “IgM”), for the immediate (first several days) threat, and then immunoglobulin G (aka “IgG”) for the long-term threat, acting as sort of an immune memory that speeds recognition and pre-emptive response if the virus is ever encountered again. So, if when we draw blood, look for antibodies in the serum, and find IgM or IgG, we know that the body has been infected - possibly currently (IgM presence) or recently (IgG presence) - and has obviously created these antibodies that will confer this future immunity. Relief. And, freedom…
 
If anyone believes he or she has recently (within the last 2 weeks) been exposed to SARS-CoV-2, then it is appropriate to use RT-PCR testing for virions AND serological testing for antibodies. But, if in hindsight, you think that that sore throat and sniffles in January (there are recent reports that suggest it was possible that SARS-CoV-2 infections were present as early as November 2019) might have been a mild case of COVID-19 (and, like all of us in our office, we hope that’s what we had), then antibody (IgM/IgG) testing is appropriate and a consideration.
 
Great! How do I get tested? Hold on…One of the biggest issues now is lack of availability of validated testing and the overabundance of non-validated testing flooding the market. The FDA has issued Emergency Use Authorization (“EUA”) for certain testing methods, equipment and laboratories, and published a list of those recognized under Section IV.C and D. What we are using and recommending now at Regenerative and Sports Medicine is laboratory testing (as opposed to “at-home testing kits”) through a Nationally recognized laboratory that uses Diazyme Laboratories, Inc. testing equipment (see: “Q: What serology tests are being offered under the policy outlined in Section IV.D of the Policy for Diagnostic Tests for Coronavirus Disease-2019?” at https://www.fda.gov/medical-devices/emergency-situations-medical-devices/faqs-diagnostic-testing-sars-cov-2 ). These tests provide the highest accuracy – technically referred to as “sensitivity” and “specificity” – available.
 
If you live locally, you are welcome to come to Regenerative and Sports Medicine offices for testing. Otherwise, we can send the testing supplies to your Primary Care Physician (or any doctor you prefer) who can perform the necessary blood draw in his or her office. Results are provided within 24 hours of the Laboratory’s receipt of the specimen. Please email us at contactus@psrmed.com if you would like more information about testing or to request either the antibody or RT-PCR tests.
 
Best in health,
Dr. Rand McClain

Dr. Rand McClain
 

P.S.

If you are a Los Angelian and believe you might be currently infected with SARS-CoV-2, and have symptoms such as shortness of breath, fever and cough, the City of Los Angeles, in partnership with the County of Los Angeles and CORE (Community Organized Relief Effort), are offering molecular (RT-PCR) testing for SARS-CoV-2 free of charge. Please see: https://lacovidprod.service-now.com/rrs and schedule an appointment directly with them. Note that we do not have the resources to treat anyone with active SARS-CoV-2 infection at our Regenerative and Sports Medicine offices.

Contact Regenerative & Sports Medicine at 310-452-3206

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