Rockefeller U.

Paul Goldfinger, MD    Editor  Blogfinger.net

“Hope for a future without fear of COVID-19 comes down to circulating antibodies and memory B cells. Unlike circulating antibodies, which peak soon after vaccination or infection only to fade a few months later, memory B cells can stick around to prevent severe disease for decades. And they evolve over time, learning to produce successively more potent “memory antibodies” that are better at neutralizing the virus and more capable of adapting to variants.”   Rockefeller University,  NYC  10/8/21.

So today we learn about a new COVID topic, and that is “memory B cells” which can last much longer than circulating antibodies.  We won’t attempt to acquaint you with the complicated research that goes along with new interest in such B cells.  But at least you can enlarge your COVID vocabulary and consider learning more about memory B cells.

Today, patients with COVID-19 may have antibodies from 3 different sources, and they are not all the same in terms of immunity protection:

Vaccines will cause you to make antibodies which can wane in numbers and effectiveness over time—perhaps the significant falloff occurs over 5-6 months after vaccination.

Then there are the “natural” antibodies which develop due to a COVID infection.  These antibodies may be superior in some ways to those which occur after vaccination, and the combination of the two kinds  (hybrids) may be better than either alone.

But don’t wish you had natural immunity because that means that you have current or past infection with COVID-19, and that is certainly something to fear.

The final sort of antibody is that which is injected by intravenous infusion early in the course of COVID acute infection.  The most common one contains two kinds of antibodies.  It has proven to reduce mortality and morbidity early in the acute disease.  We don’t know how long those circulating antibodies last.

I had COVID recently so I probably have all three types of antibodies.  That should produce a significant wall of protection against a future  repeat infection—which is possible for vaccinated survivors of COVID-19 infection.

How those 3 kinds of antibodies interact to protect and how long they last is currently being studied.

As a practical matter, if you survive an attack of COVID-19, there is no current indication for antibody testing.

A related question is what to do if you become infected. After you are treated with antibody infusion such as Regeneron, there are some other therapies which your doctor can consider, depending on your clinical course,  but only infusions have received FDA emergency approval.

If you get a mild infection and can stay home, you can isolate for 10 days.  Go to NJ Covid web sites or the Monmouth County Dept. of Health for specific information. And stay in touch with your doctor.  If he consulted with an ID specialist, you could call that doctor for technical information.

If you successfully complete the 10 days, you may resume your life and you are consider non-infectious.  Of course you need to practice the usual precautions such as masks, distancing and hand washing.

But it is OK to invite family over including children according to an Infectious disease doctor we spoke to and according to the Monmouth County Board of Health.   You can call the Monmouth Country Board of Health in Freehold for personalized questions  if you need to.