Butterfield: If the test was conducted properly, it answered the question it asked. And it may have asked the total antibodies: Has your body seen this virus and had an antibody response of any kind? Or it could have specifically asked: If you saw the virus, did you come up with that really effective antibody response? Most of the tests I’m aware of ask the total-antibody question.
Hamblin: What’s your sense right now about how likely it is that those would be neutralizing antibodies?
Butterfield: The data I’m aware of thus far says that if you have positive total antibodies, that some of those antibodies really will be the good, neutralizing, effective antibodies. Then the question is: How much? Are there enough of them? And are they going to hang around long enough to protect you? And that’s the next part of the mystery we have to solve.
Wells: When do we think we could say, Okay, having antibodies at this level actually means you’re immune?
Butterfield: Well, hospitals and universities and different companies are testing [for antibodies] all the time. And if our hope is that antibodies could protect you for a year, kind of like an influenza vaccine is thought to protect you for that year’s flu, then we’re a year from starting to collect the data to having so much exposure opportunity that we think we have an answer.
Wells: I’ve been reading about the idea that you lose these antibodies over time. What does that mean?
Butterfield: The data showed that there is a decline in what was measured over time. And that’s normal, to an extent. The immune system regulates itself. In an infection, you’ve got those early responders—the villagers with pitchforks trying to stop something initially. Then the Navy SEALs came in after a week and they really specifically targeted exactly what the problem was.
And then the problem goes away, the infection goes away. The villagers already went back to their lives when the Navy SEALs showed up. And now the Navy SEALs go back to headquarters and wait for the next problem, and the village goes back to normal life. You might leave a couple Navy SEALs there just in case.
Wells: What is the mystery of coronavirus to you, as someone who thinks about this all the time?
Butterfield: The thing I worry about the most are long-term effects of the virus, which we’re just starting to see. I was hoping, like all of us were hoping, that it was going to be a bit more analogous to an upper-respiratory tract infection, where it would stay in one place, do one thing, and be cleared. And that’s not how this is going. This is affecting a lot of different organ systems and it’s leaving people with residual effects even after they’ve gotten rid of all signs of the virus.
Hamblin: So, in the metaphor, when you deploy the military into a small village to defend it, the deployment itself can create issues. It might be overall good. You want the Navy SEALs in there. But it’s obviously a very difficult thing to do.