Coronavirus UK: Only 4,900 antibody tests have been carried out

They’re considered the key to letting countries out of lockdown, allowing officials to get a clearer picture of the true size of the coronavirus outbreak.

But the UK has still only carried out fewer than 5,000 antibody tests – despite mass schemes being carried out across the globe.

Italy has begun screening the blood of 20,000 people a day, while one programme in the US will involve 40,000 healthcare workers.

Germany plans to test 15,000 people and apply the findings to its whole population, and even Andorra has ordered 150,000 kits – enough to give its entire population two each.

Antibodies are proteins in the blood which reveal if someone has already fought off an infection, including the deadly coronavirus.

Health chiefs have plans to conduct the ‘biggest surveys in the world’ to discover how many of the population have some sort of immunity to the virus.

But they are miles off the 5,000 per week target – Department of Health data shows only 600 were carried out at the Porton Down laboratory yesterday. 

Officials promised Britons would be able to do antibody tests in the comfort of their own home in the near future, buying them from Amazon or Boots. 

But officials claim the tests they have looked at are not accurate enough to be used, saying they range from between 50 and 70 per cent. 

Experts stress the more people screened, the clearer the picture on the true size of the UK’s crisis, which began spreading on British soil in February.

Germany 

Last week, Germany was one of the first countries in Europe to announce plans to carry out large-scale coronavirus antibody testing.

The country launched three studies. In the first, 15,000 samples will be taken every fortnight from blood donations.

The second will look at blood samples taken from about 2,000 people in the country’s worst-hit areas.

Preliminary results from these two projects are expected to be published in May.

In the third study, 15,000 people in 150 regions across Germany will be tested for antibodies for a representative study of the broader population. The research will begin next month.

It’s not clear what antibody test will be used for each of the studies and if they are the same one. 

The preliminary findings of a smaller study in Ganglet, involving 500 people, were published on April 10. 

Researchers found 14 per cent of those tested had antibodies to the virus, although this does not prove they were immune to catching the disease again.    

Commenting on the findings, Keith Neal, an emeritus professor in the epidemiology of infectious diseases, University of Nottingham, said: ‘As they mention a 15 per cent rate of past infection will on its own slow the spread of the virus, probably by about 20 per cent.’ 

Finland   

Finland’s Institute for Health and Welfare (THL) has also announced a similar – but much smaller – antibody testing programme.

Initially 750 people of working age will be randomly invited for a test per week, according Finnish broadcaster Yle.

At first it will involve residents in the capital region, Helsinki, which has been the hardest-hit by coronavirus cases so far, and will then spread out over the spring. 

THL’s research specialist Merit Melin told Yle that it’s possible 40 to 50 per cent of those who have had a novel coronavirus infection were asymptomatic.  

Any positive sample will be checked again using a different test before an individual is confirmed to have been exposed. 

The results will be used to help the government decide what steps to take next, but it’s unclear what antibody test they are relying on.

US 

The US Centers for Disease Control (CDC) is analysing blood donations of Washington and New York City residents – two of the worst-hit regions in the States.  It started enrolling people on March 30. 

A separate survey is looking at random samples of people across the country.

A third study, run by Beaumont Health, the largest health care system in the state of Michigan, is looking at more than 40,000 health workers. 

Dr Matthew Sims, Beaumont’s director of infections disease research, told ‘Tucker Carlson Tonight’ Monday the study would determine ‘what percentage of the population is asymptomatic, what percentage got it and never knew it.

He said: ‘These are people, a lot of which are being exposed to patients who have COVID[-19]. So what we’re going to be doing is looking at a relatively high-risk population to see whether or not they’ve developed antibodies.’ 

Dr Sims said he expected the first set of results from the study ‘in about a month’, Fox News reports.

The University of Southern California (USC) and the Los Angeles County Department of Public Health are hoping to screen thousands of people in Los Angeles. 

Early findings from 900 people published by USC suggested 5.6 per cent of the population had the virus.

Researchers estimate that as many as 442,000 people throughout the county of nearly eight million adults had the virus as of April 9 – 55 times than confirmed positive cases at the time – 7,994. 

Dr Barbara Ferrer, director of the L.A. County Department of Public Health, said the findings underscored ‘the importance of expanded polymerase chain reaction (PCR) testing’ to curb the outbreak.

In early April, thousands of volunteers took part in a Stanford University antibody study which aims to discover how many in California are ‘immune’.

A research team took 2,500 tests at the three sites throughout the county – in Mountain View, Los Gatos and San Jose.

Maryland is also taking advantage of antibody testing – it bought $9million worth of antibody tests from South Korea, it was revealed yesterday.

Larry Hogan, the state’s Republican governor, said he had obtained 500,000 tests from LabGenomics following weeks of negotiations. 

In the latest sign of frustration with the Trump administration, Mr Hogan said his team worked to find and buy the tests- a ‘worthwhile investment’ for the states economong – in the absence of the federal government providing assistance to the states. 

Italy 

The Italian region of Lombardy has said it will start performing 20,000 coronavirus immunity tests per day from today, April 21, starting with health workers.

The governor of Lombardy, Attilio Fontana, said the region had been conducting a ‘search for reliable serological tests’.

Officials claim they now have a ‘reliable’ tests which has been developed at a research hospital near Milan. It is believed to be from diagnostic firm Diasorin, but this is not confirmed.  

The provinces of Bergamo, Brescia, Cremona and Lodi are next in line for the tests after their health systems were overwhelmed by the crisis. 

Similar plans are underway elsewhere in Italy – the national government wants to conduct a sample of 150,000 random tests, Italian media says.

That process is at a less advanced stage, and the national government has not yet identified a test which it will use.

The government of the hard-hit region Lombardy, with 67,000 cases to date, says the tests will ‘certify immunity to the virus’. 

Giancarlo Maria Liumbruno, the director-general of the Italian National Blood Center, said the country has more than 1.7million blood donors they could screen to see if they’ve had COVID-19. 

South Korea

South Korea – one of the few countries to flatten its curve without social restrictions – has become a primary source of antibody tests. 

Reports say the nation has used the blood-based kits for weeks, but details of an official programme are not clear.

South Korea has been widely praised by leading scientists for its rigorous testing and contact tracing scheme – yesterday it recorded just nine new cases.

Several firms based in the country have ramped up production, including Chucheon-based Boditech Med.

The company is now manufacturing thousands of its iChroma COVID-19 antibody kits, which it claims are 96 per cent reliable, for various countries.

The Ministry of Foreign Affairs in South Korea said over 100 countries had requested cooperation to supply Korean diagnostic kits, local media report.

Local diagnostic manufacturers said they were signing several export contracts daily, because tests manufactured in South Korea appear to the most reliable. 

Boditech and three other companies – SugenTech, Humasis, and GenBody – are approved to export antigen/antibody rapid diagnostic test kits. 

The Netherlands

The Dutch have been among the first globally to give an indication of how many in the population are currently immune.

A study of blood donors found that around three per cent had developed antibodies against the new coronavirus, health authorities said on April 16.

The National Institute for Public Health and the Environment (RIVM) said it would begin testing 10,000 samples weekly on March 19 using the blood donation service Sanquin. But results are expected to go only to RIVM. 

RIVM is also carrying out a multi-year study – called the PIENTER study – which will look at how people of different age groups develop immunity.

Some 6,000 will be invited from all over the country to take part.

Andorra

Andorra has ordered enough antibody tests to screen the whole population nearly twice over, it was revealed at the beginning of April.

The tiny country with a population of 77,000 has placed an order for 150,000 of the coronavirus tests from South Korea, local media reported.

Health minister Joan Martínez Benazet says the tests are ‘absolutely reliable’ and will arrive via Spain in the next two weeks.

Once they do, Andorran health authorities plan to test the entire population to see if their body has developed immunity to COVID-19.

‘We want to test the whole population for coronavirus antibodies within a few weeks,’ the Andorran health minister said.

‘That way we’ll see how high the infection rate in the population really is and what measures we need to take so we can restart public life.’  

It’s not clear what test was bought, or when they will arrive. 

Sweden

Two researchers are spearheading a project to see how many of Stockholm’s 2.3million inhabitants have antibodies against the coronavirus.

Professor Niclas Roxhed and Professor Jochen Schwenk from KTH Royal Institute of Technology will post serological self-test kits to 1,000 random addresses. They will apply their findings to the city’s population.

The research is hoped to trigger the roll out of antibody testing on a larger scale ‘within a few months’, the professors said.   

A research team at KTH has begun developing its own serological test for COVID-19 antibodies. 

However, Sweden hasn’t announced any plans to use a surveillance scheme using antibody tests.

Professor Johan Giesecke, an epidemiologist and advisor to the Swedish Government, says he thinks up to 50 per cent of the population in Sweden and the UK have already been infected, RealClearPolitics reports. 

So what is the UK doing?

Currently Britons can only get a test if they are very sick with COVID-19 in hospital. NHS and key workers and their household members can also get swabbed if they have symptoms. 

But antibody testing is part of the fourth pillar of the Government’s testing scheme called surveillance. 

What scientists discover from their analysis of blood samples in England will directly inform how the Government make big choices, such as easing the lockdown. 

A much higher percentage of people testing positive for antibodies is a good sign because it suggests the virus may be much less lethal than the 13 per cent death rate currently see in Britain.

It would also suggest that thousands, potentially millions, have developed some form of immunity to the infection. 

However, there are still questions left unanswered about the level of antibodies someone has to produce to gain immunity, and for how long they are protected.

Nevertheless, screening mass populations would give a much clearer picture of how the disease has spread. 

On April 3, the PM’s spokesman said 3,500 antibody tests could be carried out per week to get an idea of how the virus was spreading. 

However, since that day, only 4,892 had been carried out – a rate of 271 a day.  

The DHSC also said the programme is expanding ‘during April so that we have the potential to test around 5,000 samples per week’.  

Infectious disease expert Professor Neal believes PHE’s progress has been delayed because they have to check their own test is accurate first – using those 5,000 samples. 

‘I imagine PHE is currently testing their test against blood samples of people who have had COVID-19 compared to those who haven’t,’ he told MailOnline. 

The programme may have stalled because the most precise serology (antibody) tests are manual and slow, Professor Neal said. 

Ideally they’d use an ‘automated’ test which is faster – and also likely to be used in Germany, Professor Neal said. 

‘Currently we don’t have a particularly accurate antibody test in the automated list,’ he added.

‘What we need to know is how many people have had it, and those who had COVID-19 symptoms two months ago – are they immune now?’ 

To answer the vital questions about the virus, Professor Neal said: ‘The more you test, the more information you get. 

‘But if you double the tests, you only get 40 per cent more information due to confidence intervals. If you double it again, it gets harder. That’s why studies don’t include everybody.’ 

He said PHE could use blood banks to collect samples – an approach being taken by Holland and the US. The only issue with this, however, is that British donors tends to be more middle class females who donate blood, which doesn’t paint an accurate picture of the UK population.

‘There is no perfect sample frame,’ Professor Neal said. ‘But that doesn’t matter, as long as you know who you have sampled.’

What about a home antibody test? 

Britons have been promised a home antibody testing kit that they could buy from Amazon or Boots, which would reveal if an individual has already had the virus. 

The home antibody testing kits are currently woefully inaccurate, however, compared with the ELISA tests used in the laboratory which are reasonably precise. 

Scientists at Oxford University – who are investigating the reliability of these rapid tests, have yet to approve any,  meaning it could now be months before they are used in the UK, if at all.   

England’s chief medical officer Professor Chris Whitty admitted on Thursday that the Government was still a long way off getting a reliable antibody test.

He argues the ‘one thing worse than no test is a bad test’.

The Medicines and Healthcare products Regulatory Agency says no test under 98 per cent accurate is safe for mass-use. 

PHE have previously refused to reveal how accurate their desired commercial antibody test will be. 

One expert, Dr David Ho at Columbia University in New York, said even a good test might only pick up 50-60 per cent of people who have antibodies. 

This is because they are less sensitive – meaning they do not pick up on clues as well as antigen tests.

Or, the test may be done too early, when there are not enough antibodies to detect, or too late, when the antibodies have dropped too low. 

Currently scientists are not 100 per cent clear on how long antibodies are in the blood. But its thought they peak around 21-28 days after recovery. 

An industry source – a distributor of antibody tests – told MailOnline the bar has been set far too high and that some of the best tests are just missing the mark by one of two per cent accuracy.

‘There is not a single ImmunoAssay test in the world right now that could meet that standard,’ the source said. ‘Not one. Despite the fact there are millions in use across the globe.’

They added that even though serological testing is not error-free, it is far quicker and cheaper than the PCR antigen tests conducted by PHE. 

What’s more, PRC testing produces negative results which don’t actually mean anything to the individual, or population data.

‘A negative PCR test only reveals if you were clear of the virus three days ago – not whether you have it today,’ the source said.

‘Serological testing could reach 100,000 NHS workers a day. Even if it was only 80 per cent accurate, that’s still 80,000 people per day who have now been correctly been assessed as negative or positive.  

‘How on earth can that be better than no test at all? There is no logic.’ 

Eleanor Riley, professor of immunology at the University of Edinburgh, also argued even if tests aren’t perfect, they would be useful.

‘Antibody tests – even if they lack some sensitivity – can be used to estimate what proportion of the population has already been exposed to the virus,’ she told The Guardian.

‘This is really helpful in telling us whether there is likely to be widespread immunity in the population and thus how likely there is to be a second wave of infections (and how big that wave might be), once the social-distancing measures are relaxed.’