[MCOH-EH] Antibody Testing Logistics

[Shea, Joann]

We are not using the IgG results to make any workplace decision nor do we tell the healthcare worker to presume they have immunity or any duration of immunity until more information on the validity of serology testing is available.

Validation is still being done by our lab ( using serology from our +COVID HCW and patients).  We use a qualitative test.

That being said, we have drawn around 1300 IgG with 5 positive. (0.4% prevalence).    The 5 positive had no symptoms but had risks such as working in our ED COVID unit, doing autopsies on COVID + patients and travel to New York in early March.

At this time, we realize the serology is primarily for data collection and validation, with the hope of also gaining some knowledge of our workforce prevalence.

We offer it in the Team Member Health clinic by appointment and have over 3500 team members, residents and medical staff signed up.  Our ID physicians are working on some research projects with our lab based on our serology testing.

We plan to continue to offer IgG testing for at least the next 2-3 months.   JoAnn

JoAnn Shea, APRN, MS, COHN-S
Director, Team Member Health and Wellness
Tampa General Hospital
Office: 813-844-7692
Cell:      813-789-3441
jshea at tgh.org
[imageTGH]<https://health.usnews.com/best-hospitals/area/fl/tampa-general-hospital-6391060>

From: MCOH-EH <mcoh-eh-bounces at mylist.net> On Behalf OfLeibu, Rachel
Sent: Friday, May 8, 2020 11:45 AM
To: MCOH-EH <mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] Antibody Testing Logistics

Duly noted and I agree with all that you have written.  Unfortunately there will there will be large scale testing done despite this and am looking for logistical suggestions which may be covered by today's webinar.

Rachel Leibu,MD, MBA, MS, FACOEM
Medical Director Occupational Medicine Services
Atlantic Health System
973-829-4277

From: MCOH-EH <mcoh-eh-bounces+rachel.leibu=atlantichealth.org at mylist.net<mailto:mcoh-eh-bounces+rachel.leibu=atlantichealth.org at mylist.net>>On Behalf Of Swift, Melanie D., M.D., M.P.H. via MCOH-EH
Sent: Friday, May 8, 2020 11:32 AM
To: MCOH-EH <mcoh-eh at mylist.net<mailto:mcoh-eh at mylist.net>>
Cc: Swift, Melanie D., M.D., M.P.H. <Swift.Melanie at mayo.edu<mailto:Swift.Melanie at mayo.edu>>
Subject: Re: [MCOH-EH] Antibody Testing Logistics


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I think we are itching to have our own IgG checked! That said, as a group of occupational health professionals working within medical centers, it's especially important for all to know that professional and scientific organizations including the American Society for Microbiology, Infectious Diseases Society of America, American Clinical Laboratory Association, the CDC as well as the World Health Organization have all issued concordant recommendations regarding the use of serology. Serologic tests may indicate prior infection and may be useful for epidemiologic research. However at this time serology cannot be used to determine protective immunity, and should not be used to make workplace decisions such as work assignment or PPE. Testing employees for antibodies is not recommended as a routine practice, and the EEOC has stated they should not be mandated by employers as they cannot assess direct threat.

Please note the ACOEM Webinar today on COVID-19 Serology and RTW: http://acoem.org/COVID-19-Resource-Center/COVID-19-Webinars<https://urldefense.proofpoint.com/v2/url?u=https-3A__nam02.safelinks.protection.outlook.com_-3Furl-3Dhttp-253A-252F-252Facoem.org-252FCOVID-2D19-2DResource-2DCenter-252FCOVID-2D19-2DWebinars-26data-3D02-257C01-257Crachel.leibu-2540atlantichealth.org-257C2c497590e03d484ee9df08d7f3650edd-257Cf6f442bea6a04cbebc321f76a10f316b-257C1-257C0-257C637245487688916780-26sdata-3DxmIBxlDlO3YytcZjJKfYbW-252FULlpt6aEO4dnBonzAEWo-253D-26reserved-3D0&d=DwMFAg&c=WxSiHUljzaZa6AO7gfNF1nsjLMo-cFTcJAt_xkKy0sg&r=i5vd-CpfKk0L54XwZivpPw&m=3FOGsGuX4fXu9soUCmjvP0yJwlse8xUTZaBN1MtflcE&s=xSjxw_YjdpByQaMEyDecPQS6-t1BXlDX3mbiFOy-VWk&e=>

Also the ACOEM COVID-19 Forum has addressed this in part in the response about HCW RTW: http://acoem.org/COVID-19-Resource-Center/COVID-19-Q-A-Forum/For-healthcare-workers,-should-RTW-recommendations-after-COVID-19-diagnosis-include-other-objective<https://urldefense.proofpoint.com/v2/url?u=https-3A__nam02.safelinks.protection.outlook.com_-3Furl-3Dhttp-253A-252F-252Facoem.org-252FCOVID-2D19-2DResource-2DCenter-252FCOVID-2D19-2DQ-2DA-2DForum-252FFor-2Dhealthcare-2Dworkers-252C-2Dshould-2DRTW-2Drecommendations-2Dafter-2DCOVID-2D19-2Ddiagnosis-2Dinclude-2Dother-2Dobjective-26data-3D02-257C01-257Crachel.leibu-2540atlantichealth.org-257C2c497590e03d484ee9df08d7f3650edd-257Cf6f442bea6a04cbebc321f76a10f316b-257C1-257C0-257C637245487688916780-26sdata-3DcBHftzH7F6cqAXWlwy7V-252FQ1jHZ8B4lSh-252Fy1ED2zOdmQ-253D-26reserved-3D0&d=DwMFAg&c=WxSiHUljzaZa6AO7gfNF1nsjLMo-cFTcJAt_xkKy0sg&r=i5vd-CpfKk0L54XwZivpPw&m=3FOGsGuX4fXu9soUCmjvP0yJwlse8xUTZaBN1MtflcE&s=-jG2iLmxy0xsNTAnFvLrlv6NlTkK5xbnx5lWaiv1CRY&e=> to say:
Serologic tests for SARS-CoV-2 IgG are designed to identify individuals with a prior infection.  This may be useful in epidemiologic research and seroprevalence studies.  However further studies are needed in order to determine whether a positive IgG test for SARS-CoV-2 is indicative of the presence of neutralizing antibodies. At this point we cannot make any assumptions about the protectiveness and duration of any immunity that may be present or determine whether a particular quantitative antibody level is desirable.

There is another Q/A to be released today focusing completely on the issue of serology testing. (Not to "scoop" it but I have inside knowledge that it will not endorse the practice!)


Melanie

Melanie Swift, MD, MPH
Medical Director, Mayo Clinic Physician Health Center<https://urldefense.proofpoint.com/v2/url?u=https-3A__nam02.safelinks.protection.outlook.com_-3Furl-3Dhttps-253A-252F-252Fwww.mayoclinic.org-252Fdepartments-2Dcenters-252Fpreventive-2Doccupational-2Daerospace-2Dmedicine-252Fphysician-2Dhealth-2Dcenter-252Freferrals-26data-3D02-257C01-257Crachel.leibu-2540atlantichealth.org-257C2c497590e03d484ee9df08d7f3650edd-257Cf6f442bea6a04cbebc321f76a10f316b-257C1-257C0-257C637245487688926770-26sdata-3DCOsKiC4tGz7I-252B-252FVnJrftq1j3dEGjh2nyd5D6MStZV4c-253D-26reserved-3D0&d=DwMFAg&c=WxSiHUljzaZa6AO7gfNF1nsjLMo-cFTcJAt_xkKy0sg&r=i5vd-CpfKk0L54XwZivpPw&m=3FOGsGuX4fXu9soUCmjvP0yJwlse8xUTZaBN1MtflcE&s=UQaGjcIdYPpz9Iy-lu8cxd49vEVs7bFzocNplNfEuMQ&e=>
Associate Medical Director, Occupational Health Service
Senior Associate Consultant
Assistant Professor of Medicine
Division of Preventive, Occupational, and Aerospace Medicine
Phone 507.284.2560
_______________________________
Mayo Clinic
200 First Street SW
Rochester, MN 55905
www.mayoclinic.org<https://urldefense.proofpoint.com/v2/url?u=https-3A__nam02.safelinks.protection.outlook.com_-3Furl-3Dhttp-253A-252F-252Fwww.mayoclinic.org-252F-26data-3D02-257C01-257Crachel.leibu-2540atlantichealth.org-257C2c497590e03d484ee9df08d7f3650edd-257Cf6f442bea6a04cbebc321f76a10f316b-257C1-257C0-257C637245487688926770-26sdata-3DAaSpk3pVEkyfb4nhpHfy7nbvlFI2o8Zicu011r-252BZTZI-253D-26reserved-3D0&d=DwMFAg&c=WxSiHUljzaZa6AO7gfNF1nsjLMo-cFTcJAt_xkKy0sg&r=i5vd-CpfKk0L54XwZivpPw&m=3FOGsGuX4fXu9soUCmjvP0yJwlse8xUTZaBN1MtflcE&s=Rd0E4BM2YXuquPC8lWZTemwXXR21iIsTM0evtBdZkNE&e=>

From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net]On Behalf Of Leibu, Rachel
Sent: Friday, May 8, 2020 9:51 AM
To: MCOH-EH
Subject: [MCOH-EH] Antibody Testing Logistics

Hi Everyone,

I hope you are all weathering the COVID Pandemic as best as you can.  I was curious to know what others are doing in regards to COVID-19 Antibody testing at your facilities.

Are you offering antibody "clinics", roving antibody testing, lab testing, a hybrid of the three?

Rachel Leibu,MD, MBA, MS, FACOEM
Medical Director Occupational Medicine Services
Atlantic Health System
973-829-4277

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