A primer on COVID-19 tests and vaccines

The Enterprise — Michael Koff

“I don’t think there is anything to be afraid about,” said Nosa Aigbe Lebarty, M.D. of the COVID-19 vaccine.

ALBANY COUNTY — The county continued to break COVID-19 records on Friday with 104 residents hospitalized and 21 of them in intensive-care units.

“We know that COVID-19 is not something to play with; it’s not something to joke around with,” said Nosa Aigbe Lebarty, one of two doctors who opened CentralMed Urgent Care at 1662 Central Avenue in Colonie on Aug. 23, in the midst of the pandemic.

Lebarty, who was born and raised in Nigeria and has his medical degree from Poznan University School of Medical Sciences in Poland, is also the founder and president of Project Health Africa, which provides health-care supplies to Africa.

Albany County Executive Daniel McCoy asked Lebarty to speak at his Friday morning press conference about testing for COVID-19.

In the course of a 10-hour day, Lebarty said, his urgent-care center administers 80 to 100 COVID-19 tests, which includes rapid tests, PCR tests, and antibody tests.

“There’s a lot of demand for it,” he said of testing.

An antibody test, as the name implies, looks for antibodies that the body’s immune system has made to the virus.

Because antibodies take time to develop, such a test cannot be used to diagnose COVID-19. Rather, an antibody test will tell if a person has had the virus.

Blood is taken for an antibody test, usually from a finger stick.

“At this time researchers do not know if the presence of antibodies means that you are immune to COVID-19 in the future,” according to the Food and Drug Administration.

There are two types of diagnostic tests for COVID-19: molecular tests, such as PCR tests, that detect the virus’s genetic material, and antigen tests that detect specific proteins from the virus.

Both are usually taken from nasal swabs. Saliva can also be used for certain PCR tests.

A PCR test, which detects genetic material of the virus using a lab technique called polymerase chain reaction, is typically highly accurate and does not need to be repeated, according to the FDA, while antigen tests — in which results in some cases are available within 15 to 30 minutes — are more likely to miss an active COVID-19 infection. Negative results may need to be confirmed with a molecular test.

“The gold standard is PCR,” said Lebarty. But he also said that the rapid antigen tests done at his urgent-care center “tend to mirror PCR almost 100 percent.”

“We still have to conform with state guidelines,” he said, so that, if a patient with COVID-19 symptoms gets a negative reading on a rapid antigen test, that has to be followed with a molecular PCR test.

On Saturday, Albany County Health Commissioner Elizabeth Whalen said her department does not recommend that employers ask for a negative test before infected workers return to their duties because people often test positive on a PCR test once they have recovered.

“The test is reactive to a genetic component and does not tell us if this is alive or dead,” she said.

Whalen referenced studies that have shown people who have had COVID-19 are infectious for generally about nine to 10 days. “This is the period of isolation we recommend,” said Whalen.

One exception, she said, is for nursing-home workers who must follow a different protocol.

Lebarty said it was his observation, not based on scientific experiment, that more and more people are testing positive in their second week after exposure to COVID-19 than in the beginning.

Although the Centers for Disease Control and Prevention have changed their guidelines for a shorter quarantine or isolation period, New York State has stuck with the original 14 days.

Lebarty said, although it is “inconvenient for folks,” people should follow the 14-day rule in light of so many tests coming back positive in the second week after exposure.

“We have a tendency to get tired with things that are so prolonged,” he said.

Lebarty also urged honesty and gave examples, among his patients, of friends who had not told friends they had been tested despite the fact they were getting together.

“It’s a snowball effect,” he said.



Nineteen-thousand New Yorkers have been vaccinated for COVID-19 so far, Governor Andrew Cuomo said at his press conference on Friday.

McCoy said he had heard from people who didn’t want to be “guinea pigs” and wouldn’t take the vaccine. The first doses — created by Pfizer and BioNTech — are being given to high-risk health-care workers and to nursing-home residents.

McCoy said probably more than 95 percent of the residents of Shaker Place, the county’s nursing home, had agreed to be vaccinated. The first doses, administered through Walgreens, are expected on Monday or Wednesday.

Workers at the nursing home won’t get vaccinated until February, McCoy said, and some of them don’t want to take the shots. He asked Lebarty if the vaccine is safe.

Lebarty said people had legitimate reasons to be cornered since the vaccines were developed at “warp speed,” the federal government’s name for the project.

Although Pfizer didn’t use federal funds, it was the first to get emergency use authorization for its vaccine from the FDA. The New York State Clinical Advisory Task Force also signed off on it.

A vaccine developed by Moderna, in Massachusetts, is expected to gain emergency use authorization from the FDA next week.

Cuomo announced on Friday that the state’s panel, following the FDA’s advisory committee’s recommendation for emergency use authorization of Moderna’s vaccine, has reviewed and approved use of the vaccine in New York State.

“Our clinical advisory task force approved Moderna this morning,” Cuomo said at Friday’s press conference. “So we talked about the skepticism about the federal approval process which is nationwide. We said we were going to set up a New York panel to affirm the federal approval.”

New York expects to receive about 346,000 doses of the Moderna vaccine next week, pending final FDA authorization, Cuomo said. This is in addition to the 170,000 from Pfizer, which can now be stretched further.

Cuomo said that the state’s Department of Health has approved and issued guidance regarding the use of an extra one to two doses that have been discovered in Pfizer vaccine shipments. Pfizer vaccine vials were previously believed to contain five doses each, but may possibly contain six or seven doses. 

“We have distributed the Pfizer and Moderna vaccine to 292 sites across the state,” Cuomo said on Friday. “We have what we call regional hubs that are the medical facility that is working on the distribution plan for Phase 2.”

Albany Medical Center is the hub for the Capital Region.

In late January, Cuomo said, New York will begin Phase 2, vaccinating “essential workers, priority, general.” Details are on the state’s website.

Both the Pfizer and Moderna vaccines use a new technology of messenger RNA, or mRNA.

“To trigger an immune response, many vaccines put a weakened or inactivated germ into our bodies. Not mRNA vaccines,” explains the CDC. “Instead, they teach our cells how to make a protein — or even just a piece of a protein — that triggers an immune response inside our bodies. That immune response, which produces antibodies, is what protects us from getting infected if the real virus enters our bodies.”

RNA (ribonucleic acid) like DNA (deoxyribonucleic acid) is a nucleic acid. The CDC stresses that mRNA never enters the nucleus of the cell, which is where DNA genetic material is kept. Rather, the cell breaks down and gets rid of the mRNA soon after it is finished using the instructions.

The CDC describes the entire mRNA vaccination process this way: “COVID-19 mRNA vaccines give instructions for our cells to make a harmless piece of what is called the ‘spike protein.’ The spike protein is found on the surface of the virus that causes COVID-19.

“COVID-19 mRNA vaccines are given in the upper arm muscle. Once the instructions (mRNA) are inside the immune cells, the cells use them to make the protein piece. After the protein piece is made, the cell breaks down the instructions and gets rid of them.

“Next, the cell displays the protein piece on its surface. Our immune systems recognize that the protein doesn’t belong there and begin building an immune response and making antibodies, like what happens in natural infection against COVID-19.

“At the end of the process, our bodies have learned how to protect against future infection. The benefit of mRNA vaccines, like all vaccines, is those vaccinated gain this protection without ever having to risk the serious consequences of getting sick with COVID-19.”

Lebarty said, “The goal is to illicit the body response to that protein … It’s not going to change your genetic make-up.”

He concluded of the vaccine, “It is safe … I will be taking one.”


Newest numbers

“New York is still at the bottom of the national curve and that’s good news. Big question: Will we have shutdowns?” Cuomo asked at Friday’s press conference.

Later, he said, “I believe New Yorkers can slow the spread and that hospitals can manage the increase. Those are the two variables …. I believe New Yorkers are seeing the numbers and the increase from Thanksgiving, and I think they’re going to learn from it.”

Albany County has certainly seen an increase following the Thanksgiving holiday.

As of Friday morning, the county has had 8,747 confirmed cases, McCoy said.

Of the 220 new cases, 22 had close contact with someone infected with the disease, 176 did not have a clear source of infection identified at this time, and 22 are health-care workers or residents of congregate settings.

The five-day average for new daily positives increased to 195.8 from 186.4. There are now 1,637 active cases in the county, up from 1,601 on Thursday.

The number of county residents under mandatory quarantine decreased to 3,237 from 3,245. So far, 30,134 residents have completed quarantine. Of those, 7,110 of them had tested positive and recovered.

There were 14 new hospitalizations reported overnight, and there are 104 county residents currently hospitalized from the virus — a net increase of four. There are now 21 county residents in intensive-care units, up from 18 yesterday.

Albany County’s COVID-19 death toll remains at 188.

Statewide, the positivity rate, based on Thursday’s test results was 5.25 percent. The Capital Region, of which Albany County is a part, had a rate of 6.49 percent.

The Capital Region has 331 patients hospitalized with COVID-19, which represents 0.03 percent of the population, leaving 25 percent of the region’s hospital beds available. Statewide, 0.03 percent of New Yorkers are hospitalized with COVID-19 and 27 percent of hospital beds are available.

The Capital Region has 253 ICU beds and 177 of them are now occupied, which leaves 35 percent available. Statewide, 33 percent of ICU beds are available.

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