Antibody tests for COVID remain popular in Russia

When Russians talk about the coronavirus over dinner or in hair salons, the conversation often turns to "antitela," the Russian word for antibodies the proteins the body produces to fight infection. Even President Vladimir Putin referred to them this week in a conversation with his Turkish counterpart Recep Tayyip Erdogan, bragging about why he avoided infection even though dozens of people around him caught the virus, including someone who  spent a whole day in Putin's company.

"I have high titers," Putin said, referring to the measurement used to describe the concentration of antibodies in the blood.

When Erdogan challenged him that the number he gave was low, the Russian insisted, "No, it's a high level. There are different counting methods."

But Western health experts say the antibody tests so popular in Russia are unreliable, either for diagnosing COVID-19 or assessing immunity to it. The antibodies that these tests look for can only serve as evidence of a past infection, and scientists say it's still unclear what level of antibodies indicates protection from the virus and for how long. The US Center for Disease Control and Prevention says such tests should not be used to establish an active COVID-19 infection because it can take 1-3 weeks for the body to make antibodies.

Health experts say tests that look for the virus's genetic material, called PCR tests, or ones that look for virus proteins, called antigen tests, should be used to determine if someone is infected. In Russia, it's common to get an antibody test and share the results.

The tests are cheap, widely available and actively marketed by private clinics nationwide, and their use appears to be a factor in the country's low vaccination rate, even as daily deaths and infections are rising again. In Moscow and the surrounding region, millions of antibody tests have been done at state-run clinics that offered them for free.

Across the country, dozens of chains of private labs and clinics also offer a wide variety of antibody tests for COVID-19, as well as tests for other medical conditions. Antibody tests for COVID-19 were first widely publicised in Moscow in May 2020, shortly after Russia lifted its only nationwide lockdown, although many restrictions remained in place.

Mayor Sergei Sobyanin announced an ambitious program to test tens of thousands of residents for antibodies. Many residents in Moscow greeted this enthusiastically. Some believed antibodies represented immunity from the virus and saw a positive test as a way out of restrictions. The test looked at two different types of antibodies: Ones that appear in the system soon after infection, and ones that take weeks to develop. But some of those who tested positive for the former were also given a positive COVID-19 diagnosis and ordered to quarantine.

More interest in antibody testing came this summer when Russia had a surge of infections. The demand for tests spiked so sharply that labs were overwhelmed and some ran out of supplies. That's when dozens of regions made vaccinations mandatory for certain groups of people and restricted access to certain public spaces, allowing only those who were vaccinated, had had the virus, or had tested negative recently. Managers of private labs, however, believe the increase in interest for antibody testing was connected to vaccination mandates.

"Many considered antibodies as an alternative for vaccination. We had enormous demand on June 17 and 18 when the demand increased tenfold compared to a previous period," Sergey Ambrosov, Operation Director at LabQuest laboratory, a large chain of testing facilities, told The Associated Press in an interview.

Russian health officials currently recommend getting vaccinated without testing for antibodies, irrelevant of how high one's antibody levels are. But it wasn't always the case: The first version of the Health Ministry's vaccination guidelines, released in February, stated that those who previously had COVID-19 or had a positive antibody test shouldn't get vaccinated. Both the World Health Organization and the CDC recommend vaccination regardless of previous infection.

Guidance in Russia has varied, with authorities initially saying that those testing positive for the antibodies weren't eligible for the shot, but then urging everyone to get vaccinated regardless of their antibody levels. Still, some Russians believed a positive antibody test was a reason to put off vaccination. Maria Bloquert recovered from the coronavirus in May, and a test she took shortly after revealed a high antibody count. She has put off her vaccination, but wants to get it eventually, once her antibody levels start to wane.

"I ask doctors at every opportunity whether I should get vaccinated, and they all say I shouldn't because I'm protected and need to wait," the 37-year-old Moscow resident told AP.

High-profile officials, like Kremlin spokesperson Dmitry Peskov and Valentina Matviyenko, speaker of the upper house of parliament, have been quoted as saying they didn't need to get vaccinated due to having high levels of antibodies, but then eventually decided to get their shots. Contradictory guidelines may have contributed to Russia's low vaccination rate, said Dr. Anastasia Vasilyeva, leader of the Alliance of Doctors union.

Even though Russia boasted of creating the world's first vaccine, Sputnik V, only 32.5% of its 146 million people have received at least one shot, and only 28% are fully vaccinated. Critics have blamed a botched vaccine rollout and the mixed messages the authorities sent out about the outbreak.