For life to return to anything approaching normal, we’ll need widespread testing for the coronavirus. We have to know not only who has it but also who has had it and is now likely to be immune.
Answering the first half of that equation — who has the virus — is one of the original failings in dealing with this pandemic in the United States, a problem that’s only slowly being fixed. Without nearly enough COVID-19 tests to go around, it’s still impossible to say how many cases exist and pinpoint where they are, aside from those who end up in the hospital. That’s a major reason for the near-blanket lockdown here.
But we still have a chance to get the second half right. With judicious use of blood tests that could become available this spring, it’s possible to determine who has already been exposed to the virus and doesn’t have to fear returning to work or school or caring for people who are sick.
Given the biomedical firepower in this region, Massachusetts should lead the way in rolling out blood tests at a massive scale. While scientists here and elsewhere are racing to perfect these new tests, Governor Charlie Baker’s administration needs to be planning now for a fast deployment of thousands or even millions of them.
Researchers in Germany, where coronavirus death rates are surprisingly low, have such ambitions in mind as they develop a viable test. They intend to test 100,000 people for antibodies in their blood that would indicate a past infection with the coronavirus that causes COVID-19. The researchers suggest that people who have those antibodies could get certificates that would exempt them from restrictions on public life. At the very least, government officials will be able to rely on the data as evidence for loosening social distancing restrictions. Something similar, albeit on a much smaller scale, is happening in Telluride, Colo., and its surrounding county thanks to local biotech executives who donated test kits.
Diagnosing live cases of COVID-19 typically requires a swab from your nose or throat. That swab is then analyzed for genetic material belonging to the coronavirus. However, that method doesn’t determine if someone already has had the virus and recovered — an experience that sometimes produces no symptoms or mild ones. Nasal swab tests also sometimes fail to detect active cases because infected patients eventually stop shedding the virus in their noses.
Blood tests for viral antibodies generally can be administered with a pinprick on your finger. Usually within minutes, they can detect the existence of antibodies that the immune system produces to respond to a virus.
But creating such a test for a new disease like COVID-19 is tricky. Scientists need time to confirm that they can reliably detect antibodies that are specific for COVID-19 and not for other viruses. Follow-up research is also necessary to determine the antibody level in the bloodstream that is necessary to confer immunity and just how long the immunity lasts.
One of the labs doing such work is led by Galit Alter of the Ragon Institute of Massachusetts General Hospital, Harvard, and MIT. Alter is collaborating with MGH researchers who have been hustling to validate commercially made antibody tests and ones developed in-house, and she hopes local institutions can begin offering blood tests within a week or two.
What would it take to increase the chances that happens and can be scaled up? “We just need resources and access,” Alter says. “We can only move as fast as our money and time can stretch out.” But while her group has gotten some crucial philanthropic support, “we just haven’t heard anything from government about this, nor have we received any support.”
The governor’s office, or the command center set up by Baker, could help such efforts. If Baker elevated the subject of immunity tests into his regular briefings, he might inspire more philanthropic contributions and other collaborations. He could prepare the public for the prospect of widespread blood testing. He also might prepare his own administration for that, because it’s not clear that it has plans to obtain or facilitate antibody tests at a mass scale. Would existing testing locations be up to handle that, or would new ones be needed? How will public health officials document and follow up on positive immunity tests? How might such data inform Baker’s future decisions on loosening — or reinstating — social distancing?
Baker has been understandably frustrated by the federal government’s shambolic response to the pandemic, which has undermined the state’s ability to obtain ventilators for hospitals and protective equipment for doctors and nurses. He is trying to ensure the state is prepared for the expected surge in coronavirus cases beginning next week.
But managing a crisis demands thinking ahead and planning for several steps at a time. There’s still time to devise a system for antibody testing that makes Massachusetts a model for the rest of the nation, and that helps everyone return to our regular lives as soon as it’s safe.
Editorials represent the views of the Boston Globe Editorial Board. Follow us on Twitter at @GlobeOpinion.