article by Vardas and colleagues, “Antibody testing – the missing weapon in the fight against Covid-19 in South Africa”, which provided excellent background into the two types of tests that could be used in identifying someone infected by the coronavirus SARS-CoV-2, and some of the history behind South Africa’s testing strategy.
The polymerase chain reaction is positive in the days immediately leading up to the appearance of symptoms and for about the first week of the illness, during which time the amount of virus detectable in the airways falls off. Therefore, the polymerase chain reaction test is helpful for doctors to confirm their clinical suspicion that the person in front of them manifesting symptoms suggestive of Covid-19 has the infection.
In contrast to the usefulness of the polymerase chain reaction test to diagnose acute Covid-19, our immune response takes longer to kick in once we’ve been infected by the virus. Antibodies are slow to develop and be detected in blood; international and local experience with serology tests for SARS-CoV-2 has confirmed that antibodies are not reliably picked up by currently available tests in the first two weeks of symptoms.
So, is there a place for serology testing in South Africa’s response to the epidemic? The answer is a likely yes, but only in the surveillance arena, enabling large-scale mapping of infections to show the rate of previous infection with the virus, and in the research arena.
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