Before Juhi Singh, 46, who owns a high-end wellness Center on the Upper East Side, having flown to the Amalfi Coast last month, she packed her swimsuits and left her 10-year-old son with his grandmother.
Her personal driver also took her to Health Sollis, a Manhattan medical concierge, to measure its antibodies against the coronavirus. She received the Johnson & Johnson vaccine in February and wanted to see if her immunity was still strong before joining friends at a five-star resort overlooking the Tyrrhenian Sea.
âI wouldn’t go on a trip without my antibodies,â Ms. Singh said. âIt’s nerve-racking, but my numbers are good.
An email arrived 24 hours later with its results: 14.8 arbitrary units per milliliter. Although medical experts warn that an antibody count can’t tell if someone is protected from the virus, patients have read the numbers anyway. âMine has gone down a bit, but I know my vaccine is still working and I’m still protected,â Ms. Singh said.
Antibody tests on a monthly or regular basis have become common practice among some members of the nervous upper class. âA lot of my patients and some of my friends count their antibodies,â Ms. Singh said. âThis is the Upper East Side, the Hamptons circles. It’s like a dinner conversation at this point. It’s almost like counting calories.
Medical concierge services, including Sollis, have started offering antibody testing as a benefit to clients. âI check them daily for people,â said Dr. Scott Braunstein, medical director of the Sollis office in Los Angeles.
My Conciergerie MD, a high-end healthcare firm in Beverly Hills, Calif., has set up a drive-thru where clients, including celebrities and Hollywood executives, can get tested without getting out of their G- Wagons and Teslas. “We do it with a finger prick,” said Dr David Nazarian, who heads the practice. âLet’s just say that with Delta, the test sites are busy right now. “
Corn Arthur Caplan, professor of bioethics at the Grossman School of Medicine at New York University, is concerned about the overuse of antibody tests. “Doctors who promote it are not promoting good science,” said Dr. Caplan. “I think they are putting their patient at risk because there are no agreed antibody levels.”
Some people test their antibodies because they are immunocompromised or live with people at high risk. (Ms. Singh is babysitter for her 91-year-old grandmother.) Others do this for peace of mind before taking an international flight or attending a gala.
Others just want to be armed with more information about their health condition, which has become normalized in the age of health monitoring apps. âOur patients are very analytical,â said Dr. Alan Viglione, who directs Montecito Concierge Medicine, a private health care provider in Montecito, California. âWe have a lot of patients who want to know their numbers. It has become a new trend to know what your antibodies are.
Patients who have low antibody counts may decide to change their behaviors or “lifestyle choices,” said Dr Braunstein. âThey might decide to skip this marriage. They could take extra precautions.
Some may opt for a booster injection. Although the Food and Drug Administration has only approved booster shots for people who are immunocompromised, there is evidence that more than a million Americans have already received unauthorized third doses.
A medical concierge service even encouraged high-risk patients to check their antibody levels before receiving a booster, which no public health agency recommended.
To test or not to test
Getting an antibody test (also known as a serological test) is a relatively easy procedure. Blood, taken through a finger prick or through a vein, is tested for antibody proteins created by the immune system to fight infection or after vaccination. Antibody tests do not check for the virus itself and cannot be used to diagnose if someone has Covid.
âIt’s a simple blood test, and we see the results the next day because there are a number of big labs across the country that do it,â Dr. Braunstein said. âIt’s not too expensive. Most insurance will cover it, but if they don’t, it will cost around $ 100 to $ 200. “
But the results offer limited information. Current tests only look for antibodies to SARS-CoV-2, the virus that causes Covid-19, and not for T cells, which play an important role in the body’s immune response.
It is also not known what the number of antibodies means. For starters, different tests measure the strength of antibodies differently. One person tested by Sollis, for example, may get a count of 20 or more, while another lab may give a result of 270 or more. (A person without antibodies would test negative.)
A higher number does not necessarily confer great immunity. “We don’t have exact data on what a 4 means versus a 15,” said Dr Braunstein. “You can’t specifically say you’re a 9, and I’m an 8, so you’re more protected than me.”
Indeed, the FDA does not recommend that people use antibody tests to assess immunity and, in fact, warns of its potential risk. People who receive a high number of antibodies may take fewer precautions, such as wearing a mask, which could lead to infection or spread. (Dr Braunstein said that âall of our patients are made aware of this recommendation and urged to follow all safety measures recommended by the CDC, regardless of the test result.â)
âIt can give you a false sense of security,â said Dr. Caplan, who heads NYU’s division of medical ethics. “They might say, ‘I had my antibody test, so I’m not going to wear a mask or go to this concert, because I know I’m immune,’ which they actually don’t know . “
Dr Caplan is also concerned that people will use their antibody counts as an excuse to skip a booster shot when the time comes. âEven if you have antibodies, it doesn’t mean you have enough to fight off new variants,â he said.
“Why shouldn’t I do it?” “
Yet antibody counting has become a practice among the wealthy who view their health as a full-time endeavor, where no medical test is too trivial and no medical resources are too expensive.
âPeople read articles, go online, do research and want to take tests,â said Dr. Caplan. “But it’s up to the doctor to filter this out and calm me down so that I don’t spend money on unnecessary or harmful things.”
Medical concierge services, he argues, often do the opposite – that is, they respond to the wishes of their patients. âThe problem is, when you’re a janitorial firm, you have to honor what they want because they pay you money to do what they want,â Dr. Caplan said.
Poor people, he said, often avoid medical exams because they fear losing their health insurance or their jobs if they get a bad result. “If it turns out that you have low antibody levels, you might suddenly think, ‘I can’t tell anyone about it because my boss won’t let me in to work,'” said Dr. Caplan. âThe penalties for learning about poor health are not issues the rich face. “
This is certainly the case with wealthy people who count their antibodies.
“With this Delta variant, I want to know where I am,” said Terry cohen, 62, a real estate agent in the Hamptons who works with high-end properties. âI want to understand what’s going on in my body.
Ms Cohen, who lives in Sagaponack, NY, received two doses of the AstraZeneca vaccine while in Anguilla last winter. She felt protected until the Delta variant hit the ground running in July. She also wondered why people her age in Israel were getting booster shots if the vaccines were still working, and why she heard about so many groundbreaking cases in her social circle.
News about the protection offered by vaccines also continued to change. âEverything that is said on the following Monday needs to be updated,â she said.
So she started checking her antibodies about once a month. ” Why not ? Ms. Cohen said. âWe have the ability to verify them, and it’s good data for me to know about them. I had a lot of it last time around and it makes me feel better, at least for now, knowing that I am protected.
As fears mount, concierge doctors are suggesting other ways to assess immunity.
Sollis now offers a commercially available test for $ 200 that checks for T cells. “The test is much more difficult because there are only a few labs in the country that do it,” Dr Braunstein said. âThere is a seven day delay with the results, but we think it’s worth it. “
âI’ve had a couple of clients who have requested T cell tests,â added Dr. Viglione of Montecito. âFor now, only specialist labs will do this, but in a month or so I think it will be much more common. It’s a tendency to have a lot of personal data.