Antibody Test in Israel

Antibody tests, planned to begin this week, said to face significant delay
Health Ministry and HMOs don’t know when serological testing will begin to better monitor COVID-19 infection rates — and prepare for a potential second wave
By TOI staff 21 May 2020, 9:36 am 2

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A health worker draws blood from a patient for a COVID-19 antibody test at the Volusia County Fairgrounds in DeLand, Florida, on May 5, 2020. (AP Photo/John Raoux)
A health worker draws blood from a patient for a COVID-19 antibody test at the Volusia County Fairgrounds in DeLand, Florida, on May 5, 2020. (AP Photo/John Raoux)

Despite plans to start widespread coronavirus antibody testing in Israel by this week, the Health Ministry still doesn’t know when it will begin amid a significant delay, a report said Thursday.

The serological tests don’t check for the virus itself but for antibodies, substances the body makes to fight an infection. They can be used to better understand the spread of the disease, as well as determine the population’s readiness for a possible second wave of COVID-19.

Then-Health Ministry director general Moshe Bar Siman-Tov told The New York Times two weeks ago that 100,000 serological test kits, obtained from firms in the United States and Italy for almost $40 million, were being prepared for use by health clinics across the country within a couple of weeks.

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Despite that timetable, the Health Ministry was this week still mapping out the operation and the respective roles of various professional bodies, according to a report by the Yedioth Ahronoth daily, which cited an internal correspondence.

Neither ministry officials nor health clinics could say when the antibody tests would begin, the report said.

“This is a complex, difficult business,” a senior Health Ministry official was quoted as saying. “There are many details to agree upon. We don’t know when we’ll really start doing the tests.”

Some of the details yet to be agreed upon, according to the paper, were the sample size within the population, work guidelines for labs and recruitment protocols of those being tested. There is no agreement yet on whether to begin the tests by focusing on known centers of infections or to conduct the tests on a national representative sample.
An ultra-Orthodox Jewish boy receives a COVID-19 test in Bnei Brak, March 31, 2020. (AP/Ariel Schalit)

That was true also for the planned pilot focused on the ultra-Orthodox Tel Aviv suburb of Bnei Brak, which had been Israel’s worst COVID-19 hotspot.

A senior official in one of the country’s health maintenance organizations (HMOs) said it wasn’t clear when the pilot would start, and sources at Tel Aviv University, which is also taking part in the project, similarly said there had been a delay. The Bnei Brak Municipality claimed the pilot would likely begin in a week.

According to a draft of the proposal published last week by the Ynet news site, the pilot plan in Bnei Brak has received the go-ahead from influential leader Rabbi Chaim Kanievsky. HMOs will participate in the project, as will the Gertner Research Institute, which carried out the epidemiological study in Bnei Brak that was used to determine whether daycares, kindergartens and schools could reopen.

Dr. Boaz Lev, head of the coronavirus treatment team at the Health Ministry, which is in charge of the pilot, told Ynet that the plan was to carry out 3,000 tests per day to create a “situation map” of how many citizens have encountered the coronavirus.

“The serological tests don’t really show what is going on right now,” he said. “The tests [instead] show how many people have already encountered the virus and developed antibodies. If I got sick two or three months ago and developed antibodies, we can see that.”
A patient infected with coronavirus is seen during morning prayer in Mayanei Hayeshua Medical Center, Bnei Brak, Israel, April 27, 2020 (Nati Shohat/Flash90)

The serological pilot program will focus on three groups: families where there was a verified patient, symptom-free families living in a building where a verified patient lives, and a random selection of families and individuals in the city.

At the beginning of April, Bnei Brak was the first city placed under a strict lockdown, with residents only allowed to leave municipal boundaries to work in key industries or to receive medical care.

According to the report, it has not yet been decided if the testing will take place at the HMOs or in the homes of those chosen as part of the sample.

The government hopes that by conducting such widespread testing, it will be able to determine if Israel is approaching herd immunity or if it is unprepared for a resurgence of the virus.
Health Ministry Director General Moshe Bar Siman-Tov is seen at a drive-through site for coronavirus testing samples collection, in Tel Aviv, on March 20, 2020. (Gili Yaari/Flash90)

Bar Siman-Tov had said that if only a small percentage of Israelis were found to have COVID-19 antibodies, that could indicate the country’s health system may become swamped during a future outbreak.

Health experts around the world have regarded antibody tests as an acceptable means of determining lockdown policies and useful for monitoring purposes, even though the World Health Organization (WHO) hasn’t yet declared that antibodies necessarily mean their carrier has immunity from reinfection.

Despite many reports of reinfections — including at least two cases in Israel — and the WHO saying last month that there was no evidence that people who have recovered from COVID-19 and have antibodies are protected against a second infection, most experts say those reports are likely due to problems with coronavirus tests, as opposed to a lack of immunity from reinfection.

Some experts around the world, including a senior official at the World Health Organization, have argued that reports of reinfected patients have been false positives, with the tests picking up on dead virus fragments.

Agencies contributed to this report.