ANTIBODY QUANTITATIVE TESTING- ORANGE COUNTY URGENT CARE COVID BLOG

In a world that keeps on pushin’ me around  
I’ll stand my ground 
And I won’t back down. 
 
Tom Petty 
 
Let’s present the actual real-life case of a PDQ married couple I will call Donald and Daisy.  (It’s real except their names of course.) 
They are both in their 60’s. 
Both were vaccinated in Feb/March (the brand isn’t important). Being fully vaccinated, they assumed they were safe to travel to the Caribbean in late September. 
They needed to show proof of vaccination, which of course they had. 
 
They were gone two weeks, returning early October.  
On their second day at home they both began coughing. Coming to our drive through curbside testing, they both tested positive for Covid in Mid-October. Daisy was moderately sick for two weeks.  Donald developed Covid pneumonia and was hospitalized and is still on home oxygen.  But both survived, thank God. 
 
Daisy’s antibody level on diagnosis? 269. 
And Donald’s?  27. 
 
What happened? Easy. The antibodies produced by the vaccine faded. Went away. Disappeared.   
In Donald’s case, it was as if he wasn’t vaccinated at all.  
 
Donald had “Mouse Called ” PDQ in mid-September asking if it was ok to travel. We advised to have an antibody count. They declined due to a busy schedule. Had they checked the levels BEFORE the trip they could have had boosters or perhaps postponed the trip. 
 
We continue to advocate for regular antibody level testing. When we began offering this in early summer, it was purely data gathering. But now, after several thousand tests, we can tell you our findings, and make reasonable assumptions. 
 
A disclaimer–we will be simply giving you data from our own PDQ patients. We will not draw scientific conclusions. We won’t claim proof or speculate on data from other groups. 
 
For example, if I tell you the street corner by my house has intersecting traffic stopping when the signal light is red, every day I drive by it, I’m just giving you factual data. I am NOT concluding red lights prevent accidents. That’s for the statisticians and scientists to do their thing.  
 
Yet, it IS a reasonable assumption. But it’s not valid proof. All I can say with certainty is all traffic stops at the red light by my house.  
 
So, Mr. Petty I am taking your advice.  
 
I’ll stand my ground. 
 
At PDQ we have been advocating to check antibody levels monthly, since that appears to be an accurate way of telling if you are protected. 
 
Antibodies work.  
 
No matter how you get them- vaccine or natural. Whether Moderna is better than J&J or a vaccine is better than natural isn’t the point. It doesn’t matter. What DOES matter is how high your antibody count is. At least that’s a reasonable assumption based on our numbers. 
 
Over 400, good shape. 
Under 300, beware—mask, avoid large gatherings, and get vaccinated and/or get a booster. 
300-400 appears to be the dreaded gray zone. 
 
More data to chew on; if the antibody count is over 400, we have had ONE symptomatic  Covid infection. Mind you, some patients do not allow us to check their antibody level when they are first diagnosed, but that is what our data is telling us. 
 
What about an antibody level under 300? Dozens of new cases. In fact, ALL but one of our new Covid cases who had been vaccinated had levels under 300. 
 
Again, I caution that this is just PDQ data. It has not been analyzed by a Chi square, confidence interval, or signed off by Dr. Fauci. 
 
And there IS good data from our medical researchers showing a definite link to high antibody levels and Covid protection.  
 
However, a recent JAMA article called antibody testing a “flawed science.”  They acknowledged high levels appeared to be protective, but the exact thresholds were still in question. We agree. That is why we give our data here, without making a conclusion. 
 
About six months ago I made a prediction- we will reach herd immunity by Halloween. I rarely make predictions, since I feel NO ONE can look into the future. Yet in this case I had a good feeling. 
 
Since both PDQ and California are experiencing a surge in new cases, it’s easy to say—I was wrong. But was I?  
I’d say yes and no. 
 
Explanation- People think herd immunity is having Covid go away. 
Not at all. 
 
Herd immunity occurs when a significant portion of a population is immune to an infectious disease, thereby limiting disease spread. For those who are not immune, they are indirectly protected because the ongoing disease spread is small.  
With herd immunity, masks, social distancing and even showing proof of vaccines should all go back to normal- whatever that was. 
 
In California, our numbers tell us 2/3 of adults are vaccinated. And another 20% have had Covid but not yet vaccinated. That’s 86% protected, and we are thus at herd immunity.  So I was right, and you can pay me your losing bets when next see me. 
 
But wait. Cases are RISING. Especially in states with the HIGHEST vaccination rate. Pretzel logic, right? (That’s for you, Steely Dan fans.) 
 
To explain we need to get three things straight. 
 
1. Vaccines work (by producing antibodies.) 
At PDQ, 60% of our recent new Covid cases were in vaccinated people. That’s right. Over half. So, do vaccines work or not? 
 
Answer: Vaccines do not prevent Covid infections. Look at Donald and Daisy -they were two of many vaccine failures.  Neither does having previous Covid infections.  
 
ANTIBODIES work. 
 
Now in fairness, the vaccines do trigger the antibodies. And a Covid infection also triggers antibodies. So how does that explain the lack of herd immunity? 
 
Think of guns. To quote an old political argument…Guns don’t kill people. Actually people don’t kill people either.  
BULLETS kill people.  
Saying I am going to protect my house by buying a gun means nothing if you don’t have bullets.  
To illustrate- Just ask Alec Baldwin. The gun didn’t kill Halyna Hutchins. A bullet did. 
 
Now work with me on this analogy. What if bullets actually let’s say, melted after a while? Or turned into blanks? Some in three months, others in a year. You would not be able to defend yourself until you checked for this and then got MORE BULLETS!  Not more guns! 
 
So, in my weird analogy, the bullets are the ANTIBODIES. No bullets, no protection. Vaccine or not. Previous infection or not. 
 
2. The CDC says that those with natural antibodies are five times more likely to be hospitalized with a second Covid infection than those that are vaccinated. Yet at PDQ, you want to guess how many new infections were in patients with natural antibodies over 400? 
 
One. 1. Uno. 
 
And that patient had no symptoms. She had a PCR in hopes of attending a friend’s wedding.  
 
What about “natural antibodies”? Our data show with a low viral load (mild case) natural antibodies last three-six months. But a high viral load (as in hospitalized and ICU patients)? OVER a year.  
 
PDQ data would suggest you are much better off -i.e. have more antibodies- having been in the hospital in January than having the vaccine in January. 
So why is our experience so much different than the CDC’s? 
 
Well, many more people have had mild cases of Covid, i.e. low viral load. And this is word for word from the study: 
 
“The study only examined adults who had tested positive more than three months ago.” In other words, they stacked the deck against natural antibodies by picking patients whose antibody counts would be lower. No such restriction was placed on the vaccinated group, however. They also excluded the J&J vaccine! 
 
Could it be the CDC and others want to downplay the efficacy of natural antibodies so that more people will vaccinate?  (I am asking for a friend.)  
 
Now let’s address #3. 
 
“I have an immune system, thus do not need a vaccine,” or in the case of Aaron Rodgers, “I bolstered my immune system using a technique championed by that famous immunologist Shailene Woodley.” 
 
The problem with that is that all your immune system does is produce antibodies AFTER the alarm goes off to your ADT alarm system.   
  
Once your body sends out the troops, Covid may have already made it into your lungs (speaking from personal experience). Having a “good “immune system doesn’t mean you have anti-Covid antibodies already in the house waiting to attack the Covid perpetrators as soon as they enter your nose.  
 
But wait—-is there any way we CAN have the troops already there–waiting to neutralize (kill) the infamous spike protein without needing to first send an alert to your immune system? 
Yes!!! 
Can we Have antibodies ALREADY in our system -Designed to kill Covid right off! That’d be so cool if we can arrange that! 
But how? OMG, I know! Take a vaccine -it produces anti-Covid antibodies!   Or actually recover from Covid and let those antibodies you sent out hang around and protect you from a second Covid infection. 
 
This is immunology 101. Taught accurately in every high school, college, and medical school in the country for decades. But for some reason, between politics, and stupidity, antibodies are not recognized as what is needed for herd immunity. Or to get into a venue for that matter. 
 
In some diseases, antibodies (either vaccine or natural) last a long time…maybe even a lifetime such as Measles and Chicken Pox. 
In other cases, maybe five-ten years, such as Tetanus. And in other viruses only one year—like the annual flu vaccine we take.  
 
Here is what we have found at Caduceus.  
 
Vaccine antibodies last 3-10 months. 
Moderna- 6-10. 
Pfizer- 4-9. 
J&J- 3-6. 
Then they are gone. As in- you have NO antibodies once they disappear. 
 
This is how previously vaccinated people are getting Covid now. If they were vaccinated in early 2021, there is a good chance their antibody count is low or zero. 
Here’s the irony. To get into a concert tonight at the Performing Arts Center, I must show my proof of vaccination. But if I was vaccinated in the spring, there is a good chance I’m NOT immune. Yet I am welcomed into the venue. 
But if I bring my trusty antibody count I do every month showing tons of good anti Covid antibodies (from BOTH my infection plus my vaccine), I would be banished to return home. Although I am VERY protected.  
 
For this I blame our leaders and giant organizations such as the CDC and WHO for not doing the simple research that will prove this.  
 
To summarize:  
1. Antibodies work. Whether from vaccines or natural immunity. 
 
2. Having no or low antibodies puts you at high risk of contracting Covid. No matter if you have been vaccinated or had a previous Covid infection. 
 
3. We advise all PDQ patients to check their antibody counts every four-six weeks, regardless of vaccination status or past Covid infection, at least until we do reach herd immunity. 
 
I advise to not get hung up on whether you need a booster. Or if you had J&J in March. Or if you have natural immunity from your Covid infection in 2020. Or if it’s safe to travel if you’ve had the vaccine. 
 
Just check your antibodies.  
 
If your count is under 300, we advise full vaccination, including receiving boosters as needed. 
 
PDQ can draw your antibody level anywhere they draw blood. Most insurance covers this; if not the cost is reasonable. No visit is needed if you are a registered patient. To discuss the findings with a doctor, a video visit can be easily arranged from the comfort of your home or office. 
 
We won’t back down. 


Gregg DeNicola MD
Caduceus Medical Group, PDQ Urgent Care & More, PDQ Telehealth