A doctor’s diary from a pandemic: All about antibodies
Lately, many of us are thinking quite a bit about antibodies. When’s the antibody test going to be ready? Can I get a test? Do I have antibodies? Will we be able to give antibodies from one person to another as a treatment? Are antibodies our ticket to resuming our normal lives?
What is an antibody, anyway?
In medicine, we talk about antibodies all the time, though I am far from an expert on the subject. I remember learning about them in Immunology lectures from medical school, at least when I wasn’t talking in class. I remember them as Y-shaped thingies in our blood. Yes, “Y-shaped thingies” is the correct medical term. They look like this:
At least they look that way in the textbook.
Photo: CC BY-SA 2.5, https://commons.wikimedia.org/w/index.php?curid=916435
Antibodies are the soldiers that live in our blood that fight foreign invaders to our bodies. The really cool thing is that once our bodies have encountered an invader like a virus or a bacteria, our bodies manufacture these antibodies in huge quantities. Those antibodies live in us long into the future so that when our bodies encounter that pathogenic invader at some future point, our bodies recognize it and are able to fight it off much more readily. This is the role of antibodies. When you think of it you may marvel at the elegance of a system that can learn from the past so as to be able to be prepared for future.
But that is exactly what antibodies do. Learn from the past. We as people could learn from our own immune systems about learning from the past!
The big questions in the COVID-19 pandemic may be answered with research into antibodies. So that is why I rolled up my sleeve in the picture above to see if my blood has any antibodies to SARS-CoV-2 (the real name of the COVID-19 virus). I was participating in a research project being conducted at Hennepin Healthcare where I work. The Centers for Disease Control (CDC) is conducting this study at 16 hospital sites around the country to help us understand how the human body is responding to this virus. The study is looking at healthcare workers (nurses, doctors, respiratory therapists, among others) who have been working with patients infected with COVID-19. I guess I qualify. The idea is to see how many of us are developing antibodies.
A quick shout out to Dr. Matt Prekker of Hennepin Healthcare. Not only is he leading the research on this antibody study in healthcare workers, he also is a board-certified doctor in 4 specialties at once: Critical Care, Internal Medicine, Pulmonary Medicine, and Emergency Medicine. Not only that, he is the guy drawing my blood in the picture above and he’s a great guy. He and his team of researchers are worthy of a “thank you” from all of us.
This is really important research. We used to call this virus the “novel coronavirus” because it is indeed novel – new – to the world. Due to that one fact, there was nobody on the entire planet who had any antibodies in their system. That’s also why it is so deadly because nobody has the foot soldiers – the antibodies – yet in place in their blood.
Once we learn more about the human body response to the virus, we should be able answer many of the questions for which our knowledge is currently lacking:
- Does getting COVID-19 protect you from future infections? We just don’t know but it will depend on the antibody response and how durable that response is over time.
- Do people develop antibodies even if they didn’t have symptoms?
- How quickly does the immune response develop?
- Importantly, can we use the antibodies from one person to treat another person who is really sick?
Vaccine research is based on immune response as well. Vaccines work by exposing your body to a teeny amount of the virus and allowing your own body to develop its regiment of antibodies. So these areas of research overlap.
I’ve heard it said that science will help get us out of this pandemic. Today I got a first-hand look at how that may look and it gives me renewed hope.
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David
A doctor’s diary from a pandemic: Giving thanks
At my hospital and clinic system, Hennepin Healthcare, we have a method of communication called the Tiered Huddle system. It’s an innovative and really effective way for communication between people in the organization so that problems can be addressed in real time. These huddles happen every day in small work groups and at senior leadership. One feature, every day, is the “kudo” section in which anybody can recognize the contributions of another. It is a way to give thanks.
In the course of my day I see so many people doing so many things to be thankful for so I’d thought I would do a blog-based kudo session. Here are a few of my colleagues who give me great optimism, even though my hair looks like that picture above!
Nurses
I have often said and I truly believe that nurses are the heart of everything we do. So recently I asked one of our hospital nurses how she was doing. She was covered in PPE (scrubs, gown, face mask, plastic face shield, hair cap). You could barely identify who it was with only her eyes showing. In response, she went on to gesture with her hands at the other nurses around the unit. She said with such a great group of nursing colleagues, she was doing “great!” To nurses: thank you for showing that even in the scariest times, a team of supportive colleagues and a positive outlook makes all the difference.
Food service workers
The cafeteria at Hennepin Healthcare is the liveliest place in the hospital. You can always count on the good nature of the staff there. Often you’ll see people singing along to the music that is always playing prominently on the speakers. And the chefs routinely serve up food that is worthy of a great restaurant. But during COVID, things are a bit more limited, for obvious reasons. But our cafeteria staff still manage to provide food options for us in a safe manner (I do miss the salad bar and Chef Donald fixing me up a plate of cajun shrimp!). They still have the music playing and still come to work with their cheerful faces. Only now those faces are wearing masks. To our food service workers: thank you for providing one place in the hospital still available to healthcare workers that is free of worry and full of joy.
Chaplains, social workers and those who comfort
This is a frightening time for many. Not only for healthcare workers but for patients. It is a sad reality that all hospitals need to limit visitors to the hospital during this pandemic. We have done so as well and it is one of the issues we have struggled with the most.
How do you care for a dying person when their family members can’t be at the bedside? And how do you care for those family members? And how do you care for healthcare workers who themselves are frightened and exhausted?
At our hospital, I have seen our group of spiritual leaders and social workers and palliative care workers and patient representatives and ethics professionals all step up with guidance, support, resources to help, and a loving presence. Our chaplains routinely use technology to help families be with their loved ones, at least as best they can when they can’t be physically present. They put on weekly virtual seminars in which healthcare workers can hear the stories of their colleagues, voice their own emotions, and support one another. I’m really proud to work at a place that focuses on “Trauma Informed Care” and to the idea that we are never alone. To our chaplains and others who support patients and families and staff: thank you.
I’ll do more thank you comments in future posts. Lots of people to thank . . . security officers, interpreters, environmental service workers . . . the list goes on.
Hope you are all well! Subscribe to this blog by e-mail if you wish, and follow me on Twitter @DrDavidHilden.
A doctor’s diary from a pandemic: Finding comfort
Meet Zoe, our 15 1/2 year old dog. Just look at that face! Zoe has no idea about coronavirus and social distancing is just not a thing for her. Her concerns today are the same as they were a couple months ago before the big pandemic hit: food, sleeping, and the occasional walk outside even though she limps now and can barely walk 50 feet. And if we’re having popcorn – her favorite – life is simply grand for this old pupper.
Don’t you wish you had the zen like live-in-the-moment life of a dog?
Our lives, alas, are a bit more complicated. Here at the hospital of Hennepin Healthcare, the halls where patient care is not done are as quiet at 12 noon as they usually are at 2:00 am. On the patient care units, the nurses and doctors and food service people and all the staff are busy doing what they do best – caring for people. Only now they are all gowned up and wearing face shields and masks. Lack of facial expressions between patients and nurses and doctors means eye contact is critical and surprisingly effective.
But all this leaves me to wonder about where we find comfort in our lives. For me, art has always been one of those areas of comfort. Whether it be live theater, orchestral or rock concerts, gallery shows or movies at a theater . . . these are things I miss.
Some ideas of stuff to do
So here’s what I’m doing to get a bit of comfort even while working in a hospital and doing my best at social distancing. And yes, I’ve resorted to putting up pictures of my dog. It’s come to that.
Minnesota Orchestra At Home. This is an awesome series of world-class musicians playing in their own homes. Check out Principal Cellist Tony Ross with his mother-in-law on the piano. They play Solveig’s Song by Grieg and it is beautiful, complete with his dog faithfully keeping everything on the up and up. Or Fei Xie and Christopher Marshall doing a bassoon duet. Even Maestro Vanska breaks out the clarinet with Concertmaster Erin Keefe playing a piece of his own composition. This Little Light of Mine by a brass quintet! There are many more and I recommend them to you for a quick bit of music and fun. Click the link above to see the musician videos.
Streaming on TV. OK, like nearly everybody, I’m watching stuff on the tube. My only problem is that I don’t really have any “shows” since Julie and I finished watching every episode of The Great British Baking Show before the pandemic hit. That show was our favorite (“it’s all in the bake” you know). But I still have episodes of Mrs. Maisel and The Crown to watch. And the new PBS Masterpiece mini-series World on Fire looks really good, at least based on Episode 1. And what to make of the Tiger King series. Oh dear. I watched the first episode and I’m just not sure I have the inner fortitude to watch another. Sort of like watching a train wreck in real time on that one.
How about books? I’m currently about 300 pages into David Blight’s Frederick Douglass. This is a hefty read but I am learning so much about the 19th century’s most famous orator. Here is something I didn’t know . . . it is largely thought that more people heard Frederick Douglass speak than any other person of the entire 19th century. And he was probably the most photographed person of that century as well. I found that super cool.
I’m also trying to remember to just be still every day. Not always successfully.
So we carry on with whatever comforts we can find. I hope you are finding some ways to find comfort amid the isolation if you are at home, and some comfort amid the chaos if you are working in healthcare/grocery stores/public safety/trucking/shipping companies . . . or any of the others out there keeping us going in important jobs.
Or you could always just chill out like Zoe the urban animal. Not a care in the world for that beast.
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