The right testing
The importance of neutralising antibodies
Lower costs and convenience
A proposed user model

Abingdon Health is assessing how COVID-19 (SARS-CoV-2) antibody testing can be used to unlock economies safely and conveniently for the public. In a series of blog posts covering travel, education, and events, we demonstrate how antibody testing will be central to this. In this blog we look at COVID-19 workplace testing and occupational health.

Determining the right COVID-19 testing for workplaces

The UK Government recommended that private-sector employers offer their on-site workforce access to a minimum of two lateral flow tests every week. This helped identify staff who are carrying the virus without displaying symptoms, reducing the risk of transmission. Currently, lateral flow tests are free and can be ordered from the NHS Test and Trace website but this may end once adults are fully vaccinated1. With this and caution around easing social restrictions, mainly for large crowds,2 it is likely the Government will want the private sector to foot the bill for testing.woman walking down a normal street after COVID

The UK Health and Safety Executive Workplace Health Expert Committee Testing for SARS-CoV-2 concluded in their February 2021 review of COVID-19 workplace testing that it should only be considered in the context of a “multi-strand risk management strategy”. The type of test selected will be dependent on a range of factors which include the trade-off between speed and accuracy. The Committee raised several considerations including:

  • biosafety
  • training of test operators
  • adherence to testing
  • volume and speed of results
  • availability of tests and cost

The report also noted the prevalence of antigen and PCR testing currently in the UK testing environment.

Antigen testing at the point of care or PCR testing are very useful and can quickly identify more positive cases of COVID-19 and ensure those infected isolates as soon as possible. This reduces the spread of the virus and protects those who cannot work from home, and our vital services. However, we believe an integrated testing approach combining antigen/PCR testing alongside neutralising antibody testing will be the most effective and efficient approach.

The importance of neutralising antibodies

Evidence3,4,5,6 is building regarding the importance of neutralising antibodies in indicating immunity, and so, alongside these tests, we believe that a neutralising antibody testing system can play an effective role and deal with many of the challenges outlined by the report including ease of use, speed of result and cost.

Lower costs and convenience with antibody testing – a worked example

Pequeña muestra de sangre agregada a la prueba rápida de flujo lateral de AbC-19

If we look at a company of 200 employees, based on testing each employee twice a week at a cost of say £10 per antigen test, over a three-month period this would equate to a cost of £48,000 for the testing kits alone, without taking account of the time taken to administer the tests. Testing using PCR tests would be significantly higher.

Comparatively, using a neutralising antibody test and assuming a level of immune response, whether from vaccines or having had a COVID-19 infection, of 70% in the workforce then the costs will reduce significantly. Testing all employees using a neutralizing antibody test would cost £2,000 (200 tests at say £10 a test); with the 30% without immune response requiring continued antigen testing, which could cost £14,400 over a three-month period; so a total cost of the integrated solution being £16,400 and a saving of 70% compared to antigen-only testing.

For employees, this system is very convenient as one test provides a result for three months, avoiding the hassle of regular testing. In addition, this test result can also be used for a range of other uses, including; going to work; to a conference or to the theatre. For the employer, the cost differential is significant and there is the reduced impact on the workforce of continued testing and less time away from the office or the factory floor.

A proposed model: a simple COVID-19 testing solution for the workplace

AbC-19 rapid antibody test certificate app

Start with an antibody test – if there are positive neutralising antibodies present – then a three-month antibody certificate could be provided to be used for the employee. The tests can be administered in workplaces by occupational health workers or in other settings by qualified lay people.

Lateral flow neutralizing antibody tests are easy to administer. They consist of a blood finger prick test and take only 20 minutes to get a result. No large laboratory equipment is needed, the result can be recorded on a smart phone app and a QR code issued if required that can be used for a time limited period (e.g. three-months) for multiple purposes. It is simple, accurate, cost-effective, and connected.

If there are no neutralising antibodies present – the person would still need to perform antigen as set out in the Government guidelines.

In essence, an integrated antibody/antigen test approach is easy to administer and is cost-effective.

Watch our video to see how the antibody test approach works. Also visit our COVID-19 Antibody Certificate Solution page to learn more.

In summary

Antibody testing has a crucial role to play in ensuring employers keep their employees safe and well and in an efficient and economic way. We have made significant strides in dealing with COVID-19 through the roll-out of vaccines, lockdowns, use of protective equipment and testing regimes. Challenges remain and people want to return to the office and to do so, we need to provide cost-effective, simple solutions whilst at the same time ensuring we minimise the risk of COVID-19 infection.

The answer lies in an integrated approach, whether it’s the combination of vaccines, PPE and testing and within testing the combination of the tools that we have available; antigen, PCR and antibody testing.

References:

  1. https://www.bmj.com/content/374/bmj.n1760
  2. https://www.telegraph.co.uk/politics/2021/07/12/boris-johnson-urges-use-covid-vaccine-passports/
  3. https://www.newscientist.com/article/2237475-covid-19-news-antibody-levels-could-help-predict-vaccine-efficacy/
  4. https://pubmed.ncbi.nlm.nih.gov/33369366/
  5. https://www.medrxiv.org/content/10.1101/2021.05.07.21256847v1
  6. https://www.nejm.org/doi/full/10.1056/nejmc2103916

The article above was authored by Leigh Thomas, Senior VP, Director of Global Sales at Abingdon Health.