The Covid-19 pandemic is serious, scary, real, and kills. And there is a fair amount we don’t know about it.
There I said it. You don’t have to worry about me thinking Covid-19 isn’t serious. That happens to me a lot. Someone says “OMG, the COVID-19 is just like a grizzly bear eating your face off!” and I point out that a virus and a face-eating grizzly bear present distinctly different problems. Then the person gets all pissy and mad because I did not share their specific horror. Generally, I prefer it if people do not shove their fears in my face at the expense of reason. We have real fears, we don’t need to add on the ones that are bogus, unsupported, panicked, or untethered from reality.
You might say, jeezh, Greg, what harm does it do if people don’t understand every little thing about COVID-19 and, in their conceptualizing this disease, stray away from actual science and reality and stuff? Most of the time it probably does’t matter. But people make decisions on the basis of what they think they know. If you think the SARS-CoV2 virus doesn’t really live on surfaces, you won’t be careful about door knobs and push plates in heavily used public places, and you may thus contribute to the spread of this disease. If you think COVID-19 can be spread by eating food from a can, you might waste your energy, my energy, everybody’s energy, by campaigning against canned food. And so on.
So what kinds of things are people getting wrong? Here’s a sampling.
COVID-19 is caused by a virus. Most life lessons about pathogens are not transferable across types of pathogens. A coronavirus can’t be compared usefully to malaria or sleeping sickness because those are single celled eukaryotes. COVID-19 can’t be compared to bacterial infections. All these different kinds of pathogens have different effects, do different things, act in different ways, and need to be dealt with using specific actions (or avoiding specific actions).
COVID-19 is caused by a particular type of virus. There are many kinds of viruses, and the different kinds have distinctly different biologies. Comparing the behavior of SARS-CoV2, the virus that causes COVID-19, to the influenza virus, is like comparing the behavior of eels to eagles. How they reproduce inside a cell, how they avoid a body’s immune response, how much they mutate, and how a vaccine might work for each type of virus, are really very different, in fact, astonishingly different. Comparisons are not helpful at all.
Immunity is a tricky concept to understand. I wrote about it here. I think immunity (to a pathogen) is often viewed as an absolute, and as a somewhat magical thing. If I’m immune to a particular pathogen, that pathogen can not infect me, right? If I’m walking down the street, and a pathogen is coming the other way and I’m immune to it, it crosses the street to not get anywhere near me, right?
No. If I’m what we call “immune” to a pathogen, that means that the pathogen still goes inside me. It starts to do whatever that pathogen normally does in a human body. It is, in fact, infecting me. Then, because I’m “immune” a particular part of my immune system quickly responds to that pathogen’s presence, because I’ve acquired an immunity to it either by prior infection or by vaccination. Other parts of my immune system also work against a pathogen whether I was previously vaccinated or exposed or not.
The acquired immunity that comes with vaccination or prior exposure causes my body to respond more quickly. The best kind of immunity is where my body responds well within the time period where the pathogen hasn’t made me sick yet, attacks the pathogen, and kicks the crap out of it before it can do anything. I don’t get “sick” from the pathogen not because it did not infect me — it did infect me — but because the illness that pathogen typically causes never got of the ground. The natural biological course of the pathogen did not advance sufficiently to either make me feel bad or to be passed on to another person. Or, in a less ideal immunity, common with many pathogens, I do actually get somewhat sick, and maybe I can even pass the disease on, but acquired immunity makes me much less sick and much less contagious.
And as noted, a person who is “not immune” is typically a little immune anyway. That is because the immune system has several parts that try to stop a pathogen, and because the above mentioned acquired immunity is still an immunity before it is trained up in your body. It just takes longer.
The difference between a typical “non-immune” person and a typical “immune” person, as the term is usually applied, is this and only this: For the immune person, the adaptive immune system (only one part of the immune system) acts faster because it is trained by prior infection or a vaccine (which simulates a prior infection) so the body is prepared.
Indeed, a normal immune response to a pathogen is often to get sick and seem not very immune at all. Little kids get colds all the time, and they can last a long time. It seems like from a certain young age until a few years later, still at a young age, a kid is sick all the time. Adults go around bragging about how they haven’t lost a day of work in 20 years. (Not all adults, but some.) This is largely because kids don’t have a very strong immunity to the handful of different viruses that give us regular colds. But over time, a human will typically develop a stronger and stronger immunity. All these humans are immune to those viruses to some degree, just not perfectly and totally immune.
With COVID-19, we hear stories of “reinfection” and this has led many people to believe that humans do not develop an immunity. The numbers of possible re-infections is very very small compared to the number of people infected, and it is highly likely that those instances are bad reports, or individuals who never really got rid of the disease to begin with. Of the remaining, much smaller number of individuals, re-infections may have happened because that person’s immune system just didn’t produce a strong immunity in that person. A very small number of possible re-infections is expected for any disease and isn’t alarming.
Usually, an exposure to a pathogen that we can develop an immunity to results in an immunity that lasts for a while. Usually, years.Sometimes enough years that it seems like a life long immunity, or close to it. In other cases, you get a modest immunity that gets better with more exposure. Remember, SARS-CoV2 is a particular virus, and should not be compared willy nilly to other viruses. HIV gets around the human immune system, but it is a very different virus. Not a valid comparison at all.
Sometimes our immunity does not help us much with a later infection, or so it seems. You get a Yellow Fever shot and later they tell you you need another one. Or, the flu shot from last year isn’t helpful this year. This might be a linguistic matter. We call the pathogen by a certain name, but underlying that name is a wide range of different species or strains of that pathogen. We use the word “flu” for “influenza” but there are many different major types of influenza. If influenza was a “canid” then there would be foxes, wolves, coyotes, and domestic dogs. All in the same family but not really the same.
Alternatively, later infection could be the result of a particular strain mutating enough to side step our immunity, somewhat. Or, it could be that our immunity wore off.
A common misconception about mutations is that they make a pathogen worse. Well, they can, but they usually don’t. We hear “COVID has had 29 mutations! Aieeeee!!!” I assure you that SARS-CoV2 has had many many more mutations than that. If you get COVID-19, the SARS-CoV2 inside you probably mutates hundreds or thousands of times as it replicates using your cellular machinery, as viruses do. But, the vast majority of mutations cause a viral strain to become broken, or to not change at all. A small number may make the virus a little better at what it does, or a little less good at what it does. From our point of view as the host of the virus, a small number of mutations might make it harder to pass it on, or easier to pass it on, or liable to make a person a little more sick or a little less sick. That any one of these mutations occurs in your body does not mean that that mutation will now be part of the general population of SARS-CoV2 viruses. The vast majority of mutations that both happen in an infected individual and that do not produce a dead-end variant will not be passed on to the next person. You will just sneeze them out and they will be killed by ultraviolet light, hand sanitizer, or the main thing that kills most individual virus particles: Time.
We hear a lot now about rare and scary things. Twenty-three year olds dropping dead of a stroke, or other odd blood clotting things, and so on. Those may be real or they may not be real. If tens of millions of people get a disease, there will be situations where a cluster of individuals were going to also have some other thing happen to them medically, and they happen to have this thing occur while they have COVID-19. Coincidence. Or, a disease like this might really have some other effect that is very rare, but that thing is, well, very rare. After the discovery of some possible odd effects on blood clotting, people started to say things like “it kills young people in this strange way and we didn’t know it until now! Aieeeee!!!!” but at the same time, the death-over-age statistics did not change. We did not find 300,000 dead 23 year olds. The strange new thing remained rare, and enigmatic. Important, interesting, something we must find out about. But still very rare.
I’ll end here with a dirty little secret of the immune system: Of all the different biological systems that make up the typical animal (including humans) it is with the immune system that the gap between all that can be known and what we confidently know is largest and deepest. We know a lot, but we also don’t know a lot. And, it is so damn complicated that it is impossible to expect the average non-expert to not make the sorts of mistakes mentioned above. I can add this: I’m heavily revising what I cover in my course on the immune system, to help future generations of pandemic victims have an easier time parsing what is happening around them. Assuming I can get back into a classroom with them!
Have you read the breakthrough novel of the year? When you are done with that, try:
or Paperback
*Please note:
Links to books and other items on this page and elsewhere on Greg Ladens' blog may send you to Amazon, where I am a registered affiliate. As an Amazon Associate I earn from qualifying purchases, which helps to fund this site.
Greg:
Thank you for the good information!
Watching Governor Waltz’s daily briefing (in Minnesota).
It is now official state policy to slowly build herd immunity.
I think this is a good decision.
As usual, I appreciate your posts filling in the gaps in many people’s knowledge of important (or even just interesting) topics.
Re: “in a less ideal immunity, common with many pathogens, I do actually get somewhat sick, and maybe I can even pass the disease on, but acquired immunity makes me much less sick and much less contagious.”
=
When I get my flu shots, I have been told that I may still get the flu but that it will likely be a milder case than it would have been without the shot, or words to that effect. Many people probably had the same or similar experience and so should be aware of possibly partial immunity.
= =
Re: “rare and scary things:
=
As someone who has had more than one low-percentage-chance reaction to medications, I tend to be, I believe, more concerned when I read or hear of “rare” cases of reactions to medication and infection than those who have never experienced such reactions.
I too have had a number of “rare” drug side effects. Ciprofloxacin makes my tendons soft and easily snapped, Prilosec makes my heart pound and race, and yes, there are more. So I take rare conditions seriously – I know that when the risk is small but the consequences are drastic, you have to take that risk seriously.
RickA, will you stfu about the myth of’ herd immunity’? Last week the WHO said there is no evidence whatsoever that people who have been infected by Covid-19 are immune to further infections from the virus; alternatively, viral mutation may mean whatever immunity there is might only last a matter of months. A major problem is that we know virtually nothing about the virus and are learning on the go. Furthermore, even if there is temporary immunity against short-term reinfection, we don’t know how much of the population has to be infected to confer herd-level immunity. Some epidemiologists suggest as much as 75% of the population. Perhaps more. Totally unrealistic.
You really are a clueless idiot. In ten years of blogging you rank near the top in terms of stubborn, rank stupidity. Well done.
Tryvor:
I think that with the current actual flu SHOT, you don’t get any flu like symptoms or side effects. That can only happen with a live vaccine, which I think only occurs in the nasal version, which, I think, is no longer used in the US <--- all this subject to change and I'm not perfectly up to date. Yes, I'm trying to be careful and use words like "typical" to a) avoid the concept of normal vs. not normal while b) reminding that these are generalizations that do not apply to every case!
JeffH, I pretty much disagree with that. While we do not KNOW what the immunity profile with this virus is, it is highly unlikely that people who get it won’t develop an immunity, and it is very likely that THAT immunity will stick long enough that we don’t have to worry about that issue at this time.
As noted in the post, mutations are a thing, but not to the level peopel generally think they are. While we know little for sure about this virus, we know a lot about viruses in general and about this kind of virus generally.
But yes, herd immunity would kick in really well in the 70s, and we currently have two schools of thought on the estimates. The short version is less than 5% (most likely) and the long version is maybe close to 20% (hopeful but unlikely). We’ll get herd immunity eventually, but probably with a vaccine!
Greg, Dr. Gary Payinda wrote a great piece in the New Zealand Herald a few days ago: “Covid-19: time to put herd immunity out to pasture”. He says essentially what I did above. With SARS Covid-1, immunity lasted no more than 1-2 years. Given the similarity of COVID-19 to SARS, it is crazy to put our faith in herd immunity when we know so little about this virus, despite what you say. The WHO last week advised against issuing immunity passports. The reason for social distancing and hygiene is to flatten the curve and not to overwhelm the health system. Boris Johnson was initially aboard the herd immunity bandwagon until he realized he would be conducting a social experiment that might lead to the death of a million or more British citizens. He swiftly and wisely abandoned the approach but too late to prevent the death toll in the UK heading for 50,000 or more.
Herd immunity is the wrong approach. If we knew it would work, it would still be wrong because millions would die in the first wave to achieve it. But since we are not remotely confident that immunity is long lasting with Covid-19, then it is insanity to pursue it. If indeed the Governor of Minnesota has adopted the herd immunity approach as RickA states, then he is imho unfit for office and should immediately be fired.
JeffH, both you and the doctor, and various commenters on line, are confused by something that is in fact fairly confusing. Antibody titers for coronavirus infections do in fact go down very quickly, and antibodies are undetectable months after the end of infection, or really, weeks.
However, this is normal and expected. If antibodies were still present years after, it would mean something has gone wrong, or the infection is in some way chronic. The body stops creating antibodies, but the adaptive immunity, as discussed in the post above, continues.
This is a little like saying that a fire department is incapable of putting out a second fire because the hoses stopped spewing water after the first one.
But the point of my post was really to caution against the exact conversation we are having here. We are talking at cross purposes.
There is no reason to believe that COVID-19 related immunity is short lived.
If it is short lived, like two or three years, there is nothing wrong with that, as long as we have a vaccine. Re-read the above post. Immunity is not what you and the good doctor seem to think it is. We may well end up with an annual COVID vaccine just like we have an annual flu vaccine, but maybe fore somewhat different reasons (again, because of the differences referred to above).
Herd immunity is very much a real thing and it is very much what we are trying to achieve. It is, in fact, our number one, and really only goal.
How do we get there? Not by letting everyone become infected. (This is the part where you have to listen carefully about what I am saying, and note that if I don’t say something, then I didn’t say it!). Sure, that might in theory work, but it is a gruesome way to do it, and is imperfect.
Herd immunity is achieved by having a vaccine. A vaccination program is herd immunity.
Meanwhile, the numbers being thrown around, 60%, 70%, etc. don’t mean much. If the disease is largely irradiated we can probably live with 60% if we also have systems to tamp down the smaller outbreaks that would then occur. If we end up with herd immunity of close to 100%, that would be great.
I refer you to my comments about mutations as well.
The emergency room doctor you refer to (not an epiemiologist) says that using “herd immunity” to avoid a lockdown is wrong. He is correct to say this.
Greg, as you say there’s nothing wrong with titres declining over a couple of years. The issue is whether they decline so much that there’s little effective specific immunity after 12-24 months, or if there’s still sufficient immunity to prevent serious symptoms and to keep the successful shedding of virus sufficiently low that the basic reproductive rate is near or below 1.
In a viral disease model where there’s high contagiousness and appreciable mortality, such differences in the duration of effective immunity can make a significant difference.
I should also mention that your call for Governor Walz to resign because you think he is doing it wrong is not well supported given that Minnesota’s main advisor on epidemiology is considered to be in the top very small handful of experts in the world, and that immunology at Minnesota (UMN Immunology department) is considered to be one of the key centers for research. There is not one elected official in the US who stands above Walz in his commitment to using the best science.
I say this in the hope that you consider the possibility that what you see as a discord between what you fervently believe about the virus, various strategies, and the Minnesota response, may include a misinterpretation or two. In other words, you might have, quite understandably I’m sure, have a few bits wrong if you think Walz and his team need to step down because they have it so wrong! 🙂
“When I get my flu shots, I have been told that I may still get the flu but that it will likely be a milder case than it would have been without the shot, or words to that effect. Many people probably had the same or similar experience and so should be aware of possibly partial immunity.”
There are two sides to this. One is that your body *kinda* recognizes it and is able to adapt in a few days – the darn thing mutated again or you got an older variation not included in the shot because it wasn’t expected to make the rounds anymore.
The other is that case of being “reinfected”. And this is where the antibody/immune tweet that WHO made was so annoying.
We don’t carry active antibodies of everything in our system at all times. A few might hang around, likely because they haven’t found anything before the kidneys have filtered them out or they broke down on their own through simple entropy. So there is that window where you get reinfected, and your body has to have its cells kick into high gear and start regenerating the antibodies once it recognizes the particular threat again. This process takes time, and in that interim, you can start to feel other symptoms as other parts of your immune system also kick in (sinus drainage, fever, appetite loss). But your system does usually kick in, and gets rid of it in a much shorter time span.
In this, the big unanswered question is, while waiting for your body to remember this thing and kill it again, this “reinfection” that they’re talking about, are you *shedding*. Are you reproducing it enough to the point that non-immune people around you can catch it? With flu, it is usually not long enough to be dangerous. With others, the answer is usually not at all.
With Covid19…we just don’t know. The fact of asymptomatic transmission makes this a real beast of uncertainty.
A third situation with the flu is the problem child – the real mutation nobody expected.
There was, from my reading (WebMD has an article that even cites Fauci), an influenza b strain that this year’s shot just totally missed. It hit really hard across the country, especially the South, and for many, showed very similar symptoms to Covid19 except the smell and taste loss (something we didn’t realize until the anecdotes starting coming in from our very social-media saavy nation.
A lot of those who got Covid19 tested and came up negative were found to have this instead, and I know of one case where this happened in the very same household as a Covid19 patient – she had Covid19, but her husband only had this flu-b strain. Even after general recovery, they still had to isolate from each other for a couple of weeks to not give what they had to the other. 😀
Hmm…that bit of our “internet-saavy” nation.
How much is lost in translation. We discovered much of its odder symptoms because on our social media, we were talking about it. But not every country lives in twitter and facebook, and while everybody speaks and reads English (egotists that we Americans are), not everybody will see something in another language and instantly feel like sharing it with a translation.
So these other things we found in late March – the loss of taste and smell, the blood clotting and how that could be a killer for younger people more than the lung damage. How much of that was known to the Chinese, the Koreans, passed to the CDC, but never made it to the rest of us until us Americans actually caught it and started talking about it amongst ourselves?
Again, Greg, with herd immunity we are shooting in the dark. So who wants to end lockdowns, social distancing and become infected? Do you? Which sector of the public do we send to the front lines to become infected to attain this highly unclear figure of 60 to 70%? The chief British epidemiologist who initially advised Boris Johnson on a herd immunity approach was ultimately overruled as the body count began to rise and the health system began to buckle. Even Sweden now, which despite right wing rhetoric in the USA suggests adopted a herd immunity approach (but still forcefully encouraged social distancing) is beginning to close bars and restaurants as the toll rises. Your Governor’s medical adviser is putting his neck on the line if he is pushing for a herd immunity strategy. Again, the majority of epidemiologists as well as the WHO oppose it. Moreover, I read last week about a young woman who was infected with Covid-19 in California in March and who developed various symptoms but recovered. A subsequent blood sample revealed that she probably did not possess sufficient antibodies to resist a second infection. Medical professionals were flabbergasted, especially as the woman experienced quite nasty symptoms during her infection. What this suggests is that we are dealing with something in Covid-19 that can produce many surprises. Blindly pushIng for a strategy to ensure that at least 60% of the population become infected in the first wave is totally illogical.
There is also no guarantee whatsoever that there ever will be a vaccine against Covid-19. We need to face up to that. No vaccine was ever developed for SARS, which is in many respects very similar to Covid-19. It is extremely difficult to develop vaccines against some viral groups like coronaviruses. We hope that one can be developed, but in the meantime we need to do whatever we can to suppress the spread of the virus. Clearly, measures taken in South Korea, Viet Nam, Taiwan, and later in Germany, Switzerland, Austria and some other countries is working. Mass testing and social distancing.
Again, JeffH, we get herd immunity with a widespread vaccination program. If needed, this might be an annual vaccine that is adjusted for new strains. This is not shooting in the dark!
We do not need to be responsible for people using words wrong.
On the vaccine, yes we can’t read the future, but there have been vaccines previously developed in animal models, and I think read for humans, just not fully tested and never deployed. People who work on these things think a vaccine can be developed.
Some important criticisms of herd immunity with respect to Covid-19:
https://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=12325791
https://nationalpost.com/opinion/matt-gurney-why-the-covid-19-herd-immunity-theory-is-dangerously-flawed
https://www.lbc.co.uk/radio/presenters/maajid-nawaz/coronavirus-immunologist-exposes-flaws-of-uk-herd/
https://www.theguardian.com/commentisfree/2020/apr/17/herd-immunity-is-a-fatal-strategy-we-should-avoid-at-all-costs
For me, herd immunity will only work if we get a vaccine soon. To let the virus go through the majority of the population in the absence of a vaccine is ludicrous. This will lead to tens of millions of deaths across the world, and over a million in the US alone. Is this the way to go? Definitely not – unless we get a vaccine and get it soon.
Jeffh:
What is the alternative to building up herd immunity?
What if there is no vaccine soon? Or in 18 months? Or ever?
We already know we cannot stay locked down until we get a vaccine – because many Governors are already opening their states back up, in small incremental steps. Minnesota is doing this.
So more people will get exposed to COVID-19. More people will get sick and some will die and most will get better. You get that – right?
So what exactly are you complaining about? What is it you want the Governors to do?
The way I see it – absent a vaccine, we can either build up herd immunity in a managed fashion or an unmanaged fashion. I don’t see a third choice. Neither does the Governor of Minnesota.
The way you complain about COVID-19 is kind of pointless. You might as well complain about the sun rising every morning.
You have to learn to deal with reality and not how you wish the world to be.
Where do you get this notion that it is possible to ‘build up herd immunity in a managed fashion’?
Why do you think the UK government U-turned from that ‘idea’ so violently that they have never since stopped trying to pretend that it wasn’t government policy at all?
It is common sense. You manage it by selectively allowing people out of stay-at-home quarantine, while keeping risk groups at home and isolated.
Off the top of my head, one idea is to ask for volunteers to be exposed to sick patients to get the illness on purpose. For example, you could get volunteers 40 and under – expose them and within a month they would probably be back at work and immune.
The goal being to get as many people sick as possible, without overwhelming the hospitals.
You might try to get your workers at old folks homes immune as a first order of business (since 90% of the people dying are from old folks homes). Perhaps you would then try to get your hospital workers immune next. Then first responders, and so on.
Another idea – you could allow kids to go back to school. This would increase the chance that kids would get exposed to COVID-19, and once some kids get it their parents get it also. This would be a more unmanaged approach – but you get the idea.
Perhaps you could do something regional – say by city or county. I am sure other people would have better and more efficient ideas.
The goal would be to get to 66% (herd immunity assuming an R0 of 3) without getting high risk groups exposed. You would try to keep those over 60 from getting exposed (unless they volunteered – and many would), and obese people, people with diabetes and so forth.
So I see many ways to manage it – rather than allowing the infection to proceed in an unmanaged fashion.
My wife is a teacher. I think this idea is dangerous nonsense.
The same goes for everything else you say. I note that you think that its really only old people in care homes who are going to die. It isn’t.
Nor do viruses respect borders, so any arbitrary notions of ‘controlled’ infectious spread are dangerous nonsense. Oh, I said that already.
BBD says “My wife is a teacher. I think this idea is dangerous nonsense.”
Ok – I get that.
But what will your wife do when schools reopen in the fall? Assuming there is no vaccine by the fall?
You might want to give that question some serious thought – because I doubt distance learning is on the table for next school year.
It could possibly be better for your wife to get sick this summer, than later next fall during the school year – assuming she will get sick sooner or later of course.
But of course, timing when you get sick is a managed approach – which you seem to be against. So never mind.
This is not the given you seem to think it is.
I love the way you seem to think that I have given no serious thought to something that might kill my wife. As for your doubts about what is and is not on the table for next school year, where do you get this certainty?
I’m against the fantasy notion that there can be a ‘managed approach’ to allowing the disease to infect the population. Why do you think the UK government abruptly abandoned the dangerous nonsense of ‘herd immunity’ and has since tried to pretend that this was never policy in the first place?
I don’t know about other countries but most US schools are looking at two (and some three) scenarios for the fall.
– back to in seat classes as normal (least likely)
– back to in-seat classes with a heavy mix of on-line instruction due to continuing social distancing guidelines (worst case: maximum of 10 people in a room at any time is being discussed at several institutions, with limits on student housing occupancy)
– continued on-line mode
As usual rickA has no clue what he’s talking about, and expects others to take his ignorance as something that should be considered valid
RickA, well, then, go to an area with a high number of people infected by the coronavirus and get yourself infected asap. Join the herd. You are welcome to it. Me? Social distancing and hygiene. Herd immunity might build up that way slowly anyway, but if Covid-19 is anything like SARS, then immunity is transient. Heck, the flu mutates so quickly into new strains that people need to be re-immunized every two years. THERE IS NO GUARANTEE OF EXTENDED IMMUNITY WHEN YOU ARE INFECTED BY COVID-19. Do you understand that? When you say that ‘some will die’ adopting the herd immunity approach you mean millions in the US alone. Across the world, a herd immunity exposure approach would kill perhaps 50 million or more. So stop camouflaging your vile beliefs behind simple phrasing. MANY MILLIONS WILL DIE IF LOCKDOWNS AND SOCIAL DISTANCING MEASURES ARE ABANDONED.
Did you read any of my links? Or just prefer to wallow in your profound pit of ignorance and callousness? If we expose populations to Covid-19 and abandon measures to flatten the curve, then health systems are going to be overloaded beyond capacity and many, many more people will die. Hence why 99% of the world’s governments disregard herd immunity. They have some humanity. You clearly lack a shred of compassion, especially for those doctors and nurses on the front lines giving their lives to save others.
No one is asking you to volunteer to try to get immune. Of course there are no guarantees in life. But how many times did you get chicken pox? Measles? Usually once you have been exposed your immune system protects you from the exact same virus and even some closely related ones. But it does depend.
That is life.
What you cannot do is expect the entire country to stay-at-home for 18 months or longer. We cannot do that. Once you decide not to stay at home (as a state or nation), you then have to think about what to do absent a vaccine. That is what I am doing. I am thinking out loud. And I think managed herd immunity is better than unmanaged herd immunity. There is no other choice. Without a vaccine, we will slowly get to herd immunity. It is just how you get there – not whether you get there.
Please explain your plan in more detail – because I think you don’t understand the economics of having everybody stay at home indefinitely.
And you don’t seem to understand that prematurely ending the lockdown will – not might, WILL – trigger a second peak of infections. This WILL, not might, WILL trash the economy even worse than it already is being trashed.
Chasing the dollar will cost you more than you seem to recognise.
BBD:
There will be a second wave of infections no matter what. The only way to avoid a second wave is to either get a vaccine (which we cannot count on), or keeping everybody isolated from each other. So the second wave is coming.
So the economy will be disrupted again, negating any economic benefit from a premature easing of restrictions.
Re: Joe Shelby: “cells . . . start regenerating the antibodies once it recognizes the particular threat again. ”
=
Is it know how cells “remember” how to “recognize the particular threat”? What actual thing is involved” Cells are amazing and fascinating but as a geologist I’m used to dealing with rocks and fossils that don’t Thave active memory.
“Is it know how cells “remember” how to “recognize the particular threat”? What actual thing is involved” Cells are amazing and fascinating but as a geologist I’m used to dealing with rocks and fossils that don’t Thave active memory.”
This is central to immunology. It is absolutely known at several levels, but there are many areas of continued research (Read the last paragraph of the post).
It is a fascinating subject.
I recommend googling t-cells and b-cells.
Tyvor, from a couple of sets each of a few hundred genes and recombinations of parts of gene sequences, the body during fœtal development builds T cell and Be cell clones whose receptors are each specific for particular/different antigens. With a lego-like rearrangement of the receptor genes/sequences, and from combinations of resulting protein monomers, in the order of 10 million different clones or more can be generated from the original few hundred genetic templates.
These clones loll about the body (it’s more complicated than that, but you get the picture) with their receptors expressed on the surface of the cells. If they encounter their particular target antigen for the first time (a random process) they are activated to reproduce, and in the case of B cell the receptor is also expressed in slightly modified form as soluble antibodies. These actived cells do their jobs mopping up the intruder, and then develop a primed pool of resting cells that will respond more quickly on subsequent re-challenge.
It’s energetically/volumetrically inefficent to have every possible clone pre-primed, hence the two-stage process. And it’s hellishly more complicated than this. But in a nutshell that’s how it works.
Re: Joe Shelby: “cells . . . start regenerating the antibodies once it recognizes the particular threat again. ”
=
Is it known how cells “remember” how to “recognize the particular threat”? What actual thing is involved” Cells are amazing and fascinating but as a geologist I’m used to dealing with rocks and fossils that don’t have active memory.
In case you missed it the first time:
https://gregladen.com/blog/2020/04/30/problems-conceptualizing-covid/#comment-873089
Tangentially related: Yesterday morning I watched a fascinating documentary on a pioneer of cancer immunotherapy: James Patrick Allison — work for which he won a Nobel Prize in 2011.
Always a maverick, Jim Allison hypothesized that the CTLA-4 receptor on human T cells was not another hook the cells used to latch onto and attack cancer, as the prevailing paradigm of the time asserted, but rather a necessary brake on immune response.
Treatments based on the conventional theory sought to enable CTLA-4 in order to add its action to the known receptor. Dr. Allison’s enzyme sought to block it — in effect releasing the emergency brake on the immune system.
He had a long struggle to get his treatment put to the test. There were several reasons, but in large part this was because, in patients who had received it, the tumors first grew larger before fading away. Reaching the “fade-away” period required years-long trials. Few drug companies wanted to pay for them. But, finally, one did — thanks to Jim Allison’s persistence.
And, hey, the guy relaxes by jamming on stage with Willie Nelson. He’s one of the livelier scientists I’ve heard about.
More information here:
https://www.bms.com/life-and-science/people/jim-allison-breakthrough.html
Re: BBD: “Chasing the dollar will cost you [RickA] more than you seem to recognise.”
It doesn’t seem to occur to any of these “open right now ” people that some of the people who go back to work and then die are not easily replaceable without extended periods (months or more at a minimum) of training. Maybe they haven’t noticed but many jobs in modern societies depend on trained and experienced people, not instantly replaceable by grabbing people off the street.
One of the several reasons why we are in this mess is that Trump and/or Trump minions decided that it was more businesslike to fire the experienced, trained people in the pandemic preparedness and response units which Obama left behind for the next administration and hire such people only when they were needed! Yeah, that worked out great.
Then there weres weeks of these kinds of comments by Trump:
Jan. 22, to reporters: “It’s one person coming in from China. We have it under control and It’s going to be just fine.”
Feb, 26 press conference: “when you have 15 people, and the 15 within a couple of days is going to be down to close to zero, that’s a pretty good job we’ve done.” (Feb. 26), as it the disease wasn’t communicable and hadn’t spread at all.
IF the disease wasn’t communicable doggone it, not “it”.
RickA, I am not saying that people must stay at home indefinitely – but I am saying that it is far too soon to return to ‘business as usual’. I do not normally think much of the National Post, a right wing media source in Canada, but the article I linked to by Matt Gurney in there makes a lot of sense. If we end lockdowns now and forget about social distancing, then lots and lots of people are going to get very sick. Not only elderly people or those with underlying medical conditions either, but otherwise healthy people under 50 – the bulk of the workforce – are going to be very ill. Many will end up in hospitals, and the system will buckle and collapse. Here in the Netherlands, which has a much better healthcare system than you do in the US, the number of intensive care units was completely filled by early April with primarily people infected with Covid-19. The system was operating at capacity and there was serious concern here that the infection would soon overwhelm the hospitals. Luckily the Dutch government instituted strict social distancing measures early enough in the pandemic, and also closed schools, universities, bars, restaurants, and banned any kind of events where more than 10 people were able to attend. The peak was reached around April 10 and there has been a steady decrease in daily infections and deaths since then. The number of IC beds occupied has dropped by around 30% since late March. These measures have suppressed the first wave. Now, we need to be prepared to do it all again if necessary later in the year if and when the second wave hits. The death toll here is officially around 5000 but likely around 8000; still, it would have been far higher had the government allowed social events to continue and had gone the herd immunity route. Indeed, no nation in the world is adopting it, and you need to ask why.
The answer is obvious. It doesn’t work for Covid-19. If it was viable, many nations would be adopting it. They aren’t because they have at least a bit of common sense. They do not want their health systems to be overwhelmed and to be the overseers of a staggering death toll.
Re: RickA: ” You manage it [herd immunity] by selectively allowing people out of stay-at-home quarantine, while keeping risk groups at home and isolated.”
=
Trump & co. is already kind of managing something like that. In the vanguard we have the “spontaneous” protestors (actually organized, financed, and sent by right-wing organizations and applauded by our fake president). Some such protests have featured crowds of these people, few wearing masks, milling around for several hours. In 10-14 days at least some of these volunteers should be on their way to immunity or death.
BBD wrote,
I have an asthmatic daughter who is a teacher also twin daughters who are at the drip face as are the twin daughters (granddaughters) of one of them. I find RickA’s take on this topic irresponsible at best.
RickA should really study ‘Deadliest Enemy: Our War Against Killer Germs’ by Michael Osterholm, Mark Olshaker and pay particular attention to the para’ that begins:
but really start reading from the previous page from “By April, the CDC and Canada’s National Microbiology Laboratory”
the above being in the chapter ‘SARS and MERS: Harbingers of Things to Come’ , which gives the lie to any claims that this came out of the blue, was unanticipated, unexpected.
Another useful section earlier in the book cited above begins:
“In some instances, the offending microbial agent is merely the trigger; the “bullet” comes from our own bodies”
It should be noted that a Coronavirus patient may appear to be only slightly affected but a week or so into the illness becomes suddenly worse as the virus has replicated enough to cause a massive response from the immune system which overwhelms the lungs with debris (it is described as a burning of the lungs) causing organ failure through lack of oxygen – then death.
I am not sure what would happen to me personally for apart from having heart failure and consequent reduction of kidney function (due to lack of oxygen during the repeat myocardial infarctions over two days) I have something called MGUS (Monoclonal gammopathy of undetermined significance) which may make by immune system depressed or erratic.
Another useful source (even though it is mainly about the 1918 influenza outbreak it has material relevant to SARS) is The Great Influenza: The Epic Story of the Deadliest Plague in History by John M. Barry
“Scientists have identified a new strain of the coronavirus that has become dominant worldwide and appears to be more contagious than the versions that spread in the early days of the COVID-19 pandemic, according to a new study led by scientists at Los Alamos National Laboratory.”
https://news.yahoo.com/mutant-coronavirus-emerged-even-more-110046843.html?soc_src=hl-viewer&soc_trk=fb
Linked to the preprint DOI here:
https://gregladen.com/blog/2020/05/04/how-the-pandemic-ends/#comment-873180
A brief history of the coronavirus family of viruses:
https://getpocket.com/explore/item/coronaviruses-a-brief-history?utm_source=pocket-newtab
Some more statistics:
https://tamino.wordpress.com/2020/06/21/covid-19-red-states-blue-states/?fbclid=IwAR3KVvtr7aS1MUtu9r0A8SGv8csQRIEvLf6SSg_pP9judQSznClRUoRf4yQ
Covid-19 in Sweden:
https://www.covid19insweden.com/en/