Scientists aren't waiting around for governments to launch antibody testing

Canadian scientists counting on antibody testing to learn more about COVID-19 and how to fight the respiratory illness aren't waiting for the government to act — increasingly, they're forging ahead themselves.

Three months after the pandemic reached Canada, basic yet essential questions remain unanswered, such as whether humans can develop immunity, and how widely the virus has spread.

"We need to get good evidence," said Dr. Prabhat Jha, an epidemiologist at the Centre for Global Health Research at St. Michael's Hospital in Toronto. "Given it's an emergency, we're pushing as hard and quickly as we can."

Jha is running the largest national COVID-19-related antibody study in Canada. His lab has partnered with polling firm Angus Reid to survey more than 10,000 people for potential COVID-19 symptoms they had in March, April and May.

Participants take their own blood samples with a pin prick and send them in to Jha's lab, where researchers test for the presence of antibodies to SARS-CoV-2, the virus that causes COVID-19, and measure the levels of those infection-fighting proteins.

There's a good rule in pandemics… do the science, worry about money later.​​​​- Dr. Prabhat Jha, epidemiologist

His lab has already sent out 3,500 test kits, and plans to send thousands more in the coming weeks. 

Jha hopes to have all the samples back in early July, and have results by late July or August — all before the study has received federal funding for COVID-19 research. 

"You know, there's a good rule in pandemics, which is: do the science, worry about money later," Jha said.

Ideally, Jha would like to measure antibody levels about one month after infection, when their levels are typically higher, then continue to test volunteers regularly to see how those levels change. He'd also like to be able to find out how much protection the antibodies offer by monitoring participants for reinfection during a potential second wave of COVID-19. 

"That's why we went in a hurry and used our own resources to fund the study, because waiting would mean a less definitive answer," Jha said.

On May 12, just as it approved the first antibody testing device in the country, Health Canada said the COVID-19 Immunity Task Force would test at least one million people for antibodies over the next two years.

It remains unclear when those tests begin or who will be able to access them.

In a statement on Friday, a spokesperson for Health Canada said the federal government has supported other levels of government to do antibody testing by approving medical devices to conduct the tests.

"While the Public Health Agency of Canada (PHAC) and Health Canada have not yet developed specific guidelines or directives to guide antibody testing in provinces, territories or municipalities, PHAC's National Microbiology Laboratory, together with laboratory partners within the Canadian Public Health Laboratory Network, have evaluated the safety and effectiveness of antibody tests to determine which ones can enter the market," said the spokesperson. 

Immunity tracking in progress

Another researcher racing ahead is Dr. Kumanan Wilson, a physician scientist at The Ottawa Hospital and the creator of CANImmunize, an app that provides vaccine reminders and reliable vaccine information to Canadians.

Wilson is working on an update to the app that will help users track their immunity to COVID-19 once a potential vaccine is available, or in the event science can prove infected people can form natural immunity. 

Canada is taking a conservative approach to a lot of our testing, a lot of technologies.- Dr. Kumanan Wilson, The Ottawa Hospital

"Normally we would do all of this work serially. We would wait for the science to mature," Wilson said. "Because of the urgency of having solutions now, we think it'd be worthwhile looking at these in parallel."

Wilson believes governments should be preparing to roll out some kind of immunity passport system even before the antibody research is complete.

"Canada is taking a conservative approach to a lot of our testing, a lot of technologies," he said. 

The proposal to give people with immunity to SARS-CoV-2 different privileges is controversial, mainly due to fears it could create conflict between the new classes.

But Wilson doubts Canada will be able to administer enough serological tests to cover everyone who wants one, limiting that risk of conflict. Rather, he sees the test results being applied to specific workplaces where physical distancing is difficult, such as factories or long-term care facilities.

Under that scenario, individuals with "immunity badges" would be allowed to intermingle with colleagues who are still considered to be at risk of infection, creating "a form of immunological distancing."

"That could be really crucial to keeping the population safe and the economy open," Wilson said. 

Jha is careful to note his study will not provide any sort of certificate of immunity for participants. For the volunteers, knowing their antibody status is more about allaying their curiosity about whether a previous cold or fever was in fact COVID-19, Jha said.

Antibody testing coming soon, Ontario says

Ottawa Public Health has not begun testing for antibodies. A spokesperson said the agency is still waiting on guidelines from the federal government and province.

The Ontario Ministry of Health said antibody testing will be available in "the near future."

"Decisions are still being made on exactly how it will be accessed and for whom it would be used," wrote a government spokesperson in an email.

The ministry would not say whether or not it is considering the use of immunity passports. 

"Further research will help us fully understand the relationship between positive antibody tests, what that means in terms of immunity and protection against re-infection. Pending further research, we know the use of these tests could be very useful as we move forward in our fight against COVID-19," the spokesperson said.