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Testing for antibodies in L.A., could help restart New York

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Restarting New York's economy — as well as the rest of the nation — is going to require a number of factors coming together to ensure there is no resurgency of the coronavirus following the pandemic. One of those factors may have made a significant step forward in California. 

Last week, officials in Los Angeles County began testing the blood of 1,000 randomly selected people — including those who have demonstrated no COVID-19 symptoms — to see if any of them have , or had, the SARS-CoV-2. 

Checking to see if the virus is present is one thing. Seeing if someone had it once the virus is no longer active is another, requiring something known as serological testing. The idea behind serological testing goes with how the body naturally tries to fight off viruses and other biological invaders using a blood protein known as antibodies.

What kinds of antibodies are created depends on the disease, and researchers believe they have isolated the antibody people's bodies are creating to fight off SARS-CoV-2. The idea is that if this specific antibody is present in the bloodstream, that person has been exposed and recovered from the coronavirus — even if he or she never showed any symptoms — and thus is likely significantly immune from being re-infected in the near-term.

Such a test being available could help restart the economy, according to Gov. Andrew Cuomo. 

"The big question for everyone is when do we reopen?" Cuomo said during his Sunday daily coronavirus briefing. "People want to get on with their lives, and people want to get out of the house. We need the economy working, people need a paycheck, life has to function. The answer is that we want to reopen as soon as possible."

"The last thing we want to see is an uptick in that infection rate," the governor added, "an uptick in those numbers that we worked so hard to bring down."

How is that done? 

"We are going to need testing, more testing, faster testing than we now have," Cuomo said. 

Both Cuomo and Mayor Bill de Blasio have pushed to expand testing in both the state and city by the end of the week — if needed supplies can become available. But Cuomo insists that testing won't be at its most effective until we can test those who aren't sure if they have been exposed to the virus or not.

The Los Angeles County study, according to the Los Angeles Times, could be a major starting point to not only provide more accurate data when it comes to mortality rate of the virus, but also to see how well social distancing has been working, and even when the shutdown that has occurred in New York and many other states can actually end.

"Is it 1 percent of our population? Is it 10 percent of our population? " Dr. Paul Simon, chief science officer of the Los Angeles County public health department asked the Times. "That's the difference between 80,000 adults and 800,000 adults. We have no idea." 

Los Angeles isn't alone. Santa Clara County, just south of San Francisco, started testing the previous week, and the Center for Disease Control and Prevention has focused some initial antibody testing in "coronavirus hot spots," according to the Times

It also could help public health officials determine how deadly the virus actually is. For example, the death rate in Los Angeles County is 2.8 percent, while the seasonal flu has a death rate of 0.1 percent, according to the Times. However, those numbers are considered skewed, because only those who are severely ill or who meet certain criteria are being tested. If more people were tested — including those who may have recovered from mild symptoms, or no symptoms at all — it might provide a much more realistic mortality rate that is much lower than the current one. 

"If the mortality rate of COVID is 10 times that of the flu, then we should all be freaking out and we should be staying at home and making sure that we practice very strong physical distancing," Neeraj Sood, a professor and research vice dean at the University of Southern California's Price School of Public Policy, told the Times. "But if the true mortality rate of COVID is five times less than the flu, then we don't need to be doing that. Then it is a less deadly disease."

It's still not clear how helpful serological testing can be in the long run. The hope is that those who have developed antibodies have also developed at least short-term immunity to the virus. However, researchers are still not clear how immune people are who have been exposed to the virus already.

Cuomo did sign an executive order expanding antibody testing once it becomes more available, which he said he hopes happens sooner rather than later.

As of Sunday, New York City had more than 103,200 confirmed coronavirus cases, of the 1.85 million confirmed cases globally, according to Johns Hopkins University & Medicine. There have been just under 6,900 deaths in the city, but more than 42,700 recoveries nationwide, although it's widely believed recovery numbers remain under-reported.

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