Mind and Body

For people with antibodies, the question of what comes next looms large

"Other people are more excited for me than I am myself."

“Do you have the antibodies? Do you want to be with me?”

Strumming an acoustic guitar, Chilling Adventures of Sabrina star Kiernan Shipka sings that refrain to the camera, a soulful take on the idea that y-shaped proteins can latch onto Covid-19 and stop it from reinfecting cells. The song is her contribution to a celebrity "satirical rock opera" based on, you got it, antibodies. It may seem like a joke, but the proposition is all-too-real. Reputationally, antibodies signal who is safe to be around — and who is not.

However, scientists and people who test positive for coronavirus antibodies urge people to remember that antibodies can’t guarantee immunity from Covid-19. Meanwhile, having antibodies can trigger complex feelings.

“It definitely felt like a win,” says Jordan Leinen, 30, a producer in New York City who tested positive for antibodies. She says the relief fades when confronted with the reality of what having antibodies actually means.

“Other people are more excited for me than I am myself," she tells Inverse. "It’s like, 'oh my god you do, I’m so jealous,' but I think ultimately we have to accept some personal responsibility and acknowledge that we don’t know so much about them."

Bonnie Spring, the director of Northwestern University's Institute for Public Health and Medicine Center for Behavior and Health, tells Inverse that antibodies may feel like a win because they culturally represent something we don't know if they actually can do: protect ourselves from a disease we can't see and currently can't cure.

"It would be nice if having antibodies guaranteed protection, so we didn’t have to worry," Spring says. "The reality is that the enemy is actually an amorphous, faceless, still mysterious disease. Antibodies have come to represent protection and safety."

Testing positive means grappling with what we hoped antibodies might mean, versus what we know they can actually do. Those who have tested positive are adamant that behavior shouldn't change because of an antibody test. That doesn't mean that having antibodies doesn't affect one psychologically anyways.

An artists' rendering of the coronavirus and antibodies, proteins produced by the immune system that can recognize it and declaw it. STEVEN MCDOWELL/SCIENCE PHOTO LIBRARY

The psychological power of antibodies – Since the pandemic began, antibodies have represented hopes for treatment and a ticket to normalcy in lieu of a cure.

In March, scientists began testing the idea that antibodies might actually help treat Covid-19 patients. Donors who had tested positive for coronavirus lined up to give their blood. One such donor, a Julliard student named Tim Wilis, told Inverse that having antibodies put him in a position to fight coronavirus, not worry about it.

“I realized I'm just the kind of person who can feel helpless and hopeless in a situation like this," Wilis told Inverse. "It gives me my power back to help other people, which this pandemic really stole from me."

Around the same time, Germany and England were floating ideas that we could use antibodies to create “immunity passports” which allow reentry into society for those with antibodies. Research never actually supported the concept of immunity passports. The psychology of them was striking nonetheless.

"It would be nice if having antibodies guaranteed protection."

In a preprint (not peer-reviewed) paper uploaded in May, scientists found that the language of “immunity passports” affected how people perceived their risk of getting coronavirus. When the term "immunity" was used to describe antibody tests, 19.1 percent of people "erroneously perceived they would have no risk of catching coronavirus in the future given an antibody-positive test result."

When only the word "antibody" was used to describe a test, 9.8 percent still thought the same. (It's worth noting that, for now, reinfections appear to be due to the virus resurfacing, not catching Covid-19 again.)

What it's actually like to have antibodies — Those who actually have coronavirus antibodies like Patrick Southern, 36, want to make it exceedingly clear that they’re not letting their positive antibody results get to their head.

In March, Southern was living with his pregnant wife in Brooklyn when he tested positive for Covid-19. Soon after, she also tested positive upon arriving at the hospital for the birth of their son.

That was the beginning of a saga in which she didn’t see her son for 11 days after he was born, even when he had to undergo surgery due to a rare complication. Southern says that, despite their family's post-coronavirus antibodies, they’re still not taking any chances.

“If you have antibodies it tells you absolutely nothing,” he tells Inverse.

Still, he admits that having antibodies has made him reevaluate his approach to living amid the pandemic.

“I'd be lying if I said that finding out I had antibodies didn't make me think okay, well, then my chances of getting it at the grocery store are probably a lot less than they would have been," Southern says. "I think there's a kind of folk understanding at play, that in the immediate future, you are safer with antibodies, even if we don't have clear data that that tells us that.”

The promise of antibodies – Ultimately, Leinen and Southern are living proof that getting a positive antibody test can both offer a small feeling of relief (however fleeting or not grounded in the best immunology) and still not change how you act.

“It is nice, but I don’t really feel like it is anything special," Leinen says. "I’ve been tested twice and they still remain. Which is positive, I feel good about that."

When friends seem excited for her or wish that they themselves had the antibodies, she says that she doesn’t share that view.

“When it’s you yourself who has them, it’s not as exciting,” she explains.

Instead, both protect themselves using the tools that are available to everyone – masks, social distancing, avoiding crowds – precautions that are available whether or not there are y-shaped proteins floating around in the body.

These actions fit with the current science: According to a correspondence published in the New England Journal of Medicine on July 21, antibodies may starkly decline after mild patients recover. (That’s not out of the ordinary for disease recovery. It also doesn’t necessarily suggest immunity also declines because the immune system isn't entirely reliant on antibodies to make a comeback.)

Meanwhile, early-stage research suggests that not everyone develops the same degree of antibodies. A preprint study on 37 asymptomatic patients released in June suggests that antibodies may wane faster in those who are symptomatic. Forty percent of asymptomatic patients tested negative for one type of antibody during the early recovery phase, whereas only 12.9 percent of symptomatic patients tested negative during that time.

Crucially, these findings don’t mean that antibodies can't confer protection at all — especially in the short term. Instead, they indicate that we can’t rely on them alone to beat coronavirus just yet. Experts predict that cellular and antibody immunity are equally important.

This situation is made more complicated by the fact that commercial antibody tests can deliver false positives, false negatives, and detect a subtype of antibody that doesn't actually confer immunity.

In turn, the public health messaging around antibodies has shifted from what antibodies could potentially offer to what they can’t: freedom from worrying about the coronavirus.

Maybe that’s not what we were hoping for in March we first began to watch the science of antibodies develop, Spring says, but it's what we got. It's better to be cautious, put a mask on, and distance, then go all-in on uncertain antibody science.

“Given how little effort these actions require, why wouldn’t you take them?” Spring says.

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