COVID-19 'long-hauler' calls for greater availability of antibody tests in B.C. to determine spread of virus

In November 2019 Vancouverite Basil Cohen was sicker than he had ever been before. 

For six days Cohen, 49, had a high fever that would not break. He lost his sense of smell and taste — not that he was eating much anyway. He developed a nagging dry cough that lasted for weeks. 

"I felt like I had molten glass down my throat," Cohen said. 

When he finally was able to see his physician in January 2020, the doctor told him there was a weird virus going around. Later that month, health officials confirmed the first case of COVID-19 in British Columbia.

Like many people who suspect they contracted the virus early in the pandemic, Cohen wants COVID-19 antibody tests, which look for proteins developed in response to an infection, to be more accessible and widely used in B.C. 

Cohen wasn't tested for COVID-19 early in the pandemic because tests weren't readily available in B.C. until long after he had first fallen ill. 

After months of talking to his GP about it, Cohen finally got an antibody test done a few weeks ago, shortly after LifeLabs began offering them in B.C. and Ontario. It came back positive. 

"I think it's better for people to know whether they've got antibodies and know whether they've had it or not," Cohen said. 

No evidence for earlier transmission: B.C. CDC

The B.C. Centre for Disease Control says antibody tests, also known as serology tests, aren't available for routine clinical use.

The centre also says although it can't fully rule out that there may have been undetected cases of COVID-19 before January, "overall, we do not have evidence for that in B.C."

The tests are being used to survey how far the virus has spread in the general population, the centre says. The fourth in that series of community tests should be available in the next few weeks. 

According to the LifeLabs website, the antibody test costs $75, which B.C.'s Medical Services Plan does not cover. But anyone who wants one first has to convince a health provider to issue a requisition form for it.

Vindicated

LifeLabs says antibodies can be found up to four months after exposure — not longer. But Cohen is certain his positive result is from that sick spell more than a year ago.

He says the timing of his illness  — before it was officially detected in B.C.  — made it hard to convince his doctor to issue a requisition form. 

"That's partly why I've been frustrated. Because I've been told over and over, 'It's impossible, it's impossible, you just had the flu,' " he said.

"That wasn't flu. I've had the flu before. And I said that was completely different." 

Cohen says he had many of the defining symptoms of COVID-19, and he believes it explains the lingering effects of the virus that he still experiences today — most nights he wakes up soaked in sweat, he frequently gets leg cramps and his lung capacity feels compromised. 

Especially as a so-called COVID-19 "long-hauler," the positive test result makes Cohen feel vindicated. 

He says even friends and family have trouble believing his illness and lingering symptoms were COVID-19. 

Broader use

Shawn Li, Canada research chair in proteomics and functional genomics and a professor at Western University in London, Ont., has been developing a test that could detect COVID-19 antibodies in as little as five minutes. 

Li says the test most provinces are using to detect the virus is an important first step, but there is only a small window during which it can be effectively administered. 

"With antibody tests, you can catch a much, much wider population," he said.

Li expects his test to soon be available for commercial use. He says it combines the effectiveness of a blood test with the rapidity of a more simple swab test. He hopes it will eventually be available as a home test. 

There is too little evidence about antibodies and antibody tests to effectively determine health policy, Li says.

He thinks there is still a lot more health officials need to know before ruling it out as one of several tools that could help scientists learn more about the virus and how to curb its spread.