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Antibody Testing Is Important in COVID-19 Response, But More Data Is Needed to Expand Its Role

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Silver Spring, MD, May 7, 2020 — With increasing interest in expanded serological testing as part of the nation’s COVID-19 testing strategy, the Association of Public Health Laboratories (APHL) and the Council of State and Territorial Epidemiologists (CSTE) today issued a joint statement outlining potential public health applications for antibody testing, while identifying caveats that limit its current use.

According to “Public Health Considerations: Serologic Testing for COVID-19,” serologic testing is helpful in estimating the prevalence of past viral infection or the cumulative incidence of infection in the US population. It can also improve understanding of disease transmission patterns and the proportion of people previously infected, among various populations. In order for these methods to be used effectively, however, public health researchers and scientists need more data on the performance characteristics of these tests and the human immune response to COVID-19, such as the persistence and protection offered by antibodies.

“Serological testing is an important part of a testing strategy in response to COVID-19, but there is simply a lot that we still don’t know,” said Scott Becker, MS, chief executive officer of APHL. “Until we have more evidence, serological tests alone should not be used to make decisions such as when staff can return to work, the need for personal protective equipment or the need to discontinue social distancing measures.”

“We don’t have all the information we need yet about COVID-19 serologic testing,” added Janet Hamilton, MPH, executive director of CSTE. “As we learn more, the information will improve our understanding of disease transmission patterns, and data from serologic surveys can be used to understand the proportion of persons previously infected among various populations.”

With the limitations in mind, the statement identifies several potential public health applications, including:

  • Determining how widespread COVID-19 infection has been in a community or population to both understand the scale of the current pandemic and in preparation for future vaccine development and deployment;
  • Identifying people with an antibody response to serve as convalescent plasma donors; and
  • Determining if a person had an immune response to SARS-CoV-2, irrespective of whether they had symptoms or not, yet more data is needed.

The statement also provides an overview of serologic methods, considerations for selecting assays for seroprevalence surveys and for test result interpretation, and outstanding research needs.

For more, contact Michelle Forman at 240-485-2793 or

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The Association of Public Health Laboratories (APHL) works to strengthen laboratory systems serving the public’s health in the U.S. and globally. APHL’s member laboratories protect the public’s health by monitoring and detecting infectious and foodborne diseases, environmental contaminants, terrorist agents, genetic disorders in newborns and other diverse health threats. Learn more at

Founded in 1951, the Council of State and Territorial Epidemiologists (CSTE) represents the interests of State Epidemiologists from all 50 U.S. states and territories, comprising the Council. CSTE is also the professional home to nearly 2000 practicing applied epidemiologists working at the state, local, tribal and territorial levels. For more information, visit

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