A Head Full of Coronavirus Research, Part 31

Mr. Slavitt is on Twitter touting his Strib profile but saying his favorite part was the “troll blogger” who called his views “literally insane.”  I appreciate the free commercial but wish he would use my name so people could find me and get the science and data I provide as opposed to political commentary.  I have no desire to engage in a back and forth of words, particularly since it is so one-sided.  Andy’s other recent tweet that attracted attention was saying that Kentucky and Tennessee were on the watch list, but Kentucky’s governor was taking steps to keep things under control, while Tennessee’s, horror of horrors, won’t even consider a mask mandate.  This follows his typical pattern; Kentucky’s governor is a Democrat and Tennessee’s a Republican, but no, Andy isn’t political at all.  I would invite you all to hop over to the Covid Tracking Project or other sites and take a look at the two states, based on Mr. Slavitt’s comments, and see whether on a per capita basis there is a significant difference.  One thing that is very clear, is that Tennessee is doing a whole lot more testing than Kentucky, which as I recall, Andy thinks is a good thing.

I did say that Andy’s call for a second massive national lockdown, where interstate travel would be banned and people basically confined to their homes, was literally insane and it is.  The WHO apparently agrees with me, as they have now called for an end to the use of lockdowns, saying the harms from those actions are far worse than those from the epidemic.  I struggle to find something accurate in any of his predictions or recommendations.  For example, Mr. Slavitt was instrumental in getting a mask mandate in Minnesota.  That has had absolutely no effect, in fact cases have risen substantially since its enactment.  On the other hand I am pretty proud of my record, which exists because I actually read as much relevant science as I can and I look at and analyze the data.  I admit that I don’t call up politicians and talk to them regularly like Andy, but then I have never found politicians to be a particularly accurate or deep source of information.

Very early on, I said this epidemic was bifurcated by age and front-loaded and that needed to be taken into account in developing public policy in response.  I said the Minnesota model would be wildly inaccurate and it was.  I said the lockdowns et al, would be enormously damaging, far more so than the epidemic, especially to minorities and the poor, and they have been, to the point that other than a few unconfirmed acting CMS Administrators, no one supports them.  I pointed out that prior adaptive immune response needed to be considered.  And so on.  It isn’t me being so great, it is doing what anyone can do–read the research and look at the data.

And one final note; Mr. Slavitt told the reporter that I was just a retired blogger, which I guess is better than being a troll blogger.  So everyone knows, I have never retired and probably never will.  I actively invest in health care companies and sit on boards and I am deeply involved in a startup that I co-founded that manages cell and gene therapies for payers.  That experience, over 40 years worth, is an asset that gives me a background in research, analytics, epidemiology and immunology, all of which turns out to be kind of useful in thinking about this epidemic.  Enough of the battle of, or rather with, half-wits, and on to the research.

I meant to mention this paper some time ago and it got buried.  A summary of CV-19 disease in the Journal of the American Medical Association provides an excellent review on key issues such as transmission, nature of the disease, and treatment options.    (JAMA Article)

The CDC has done another study attempting to disentangle transmission by age group.  (CDC Study)    The agency looked at 767 hot spot counties in June and July, both 45 days before and after they became hotspots.  According to the CDC’s analysis increases in test positivity among those 24 and younger occurred first, followed by increasing positivity among those older than 24.  But the difference is very small; for those 24 and under positivity began rising 31 days before hotspot identification, for 25 to 44 year-olds, it rose beginning 28 days before hot spot identification, for 45 to 64 year olds, 23 days, and for 65 plus, 20 days.  The attempted implication is that young people spread it to old ones, but based on number of contacts alone, you would expect spread first in the younger group and last in the older.  The absolute rates of positivity were also not dramatically different.  And based on how long positivity stayed high, it was apparent that CV-19 circulated quickly among the youngest group and positivity declined rapidly as well, whereas the older groups had sustained periods of higher positivity, again consistent with contact patterns.  This is more nonsense about young people transmitting to old; if you want to demonstrate that, do contact tracing and show us the results.

Two more studies bear on the issue of possible cross-reactive adaptive immune responses.  The first looked at whether these responses were correlated with disease severity.  (SSRN Study)   The research was done in China and the authors examined 344 patients looking for immune reactions to both CV-19’s and seasonal coronavirus’ spike proteins and for cross-reactivity in regard to one of the seasonal.  Interestingly, during the course of the disease, antibody activity increased against both CV-19 and one of the seasonal coronaviruses, but not the others.  Two-way cross-reactivity was detected between these strains.  Non-CV-19 infected persons, however, did not appear to display a cross-reaction to CV-19.  Antibodies to the one seasonal CV were higher in people with severe CV-19 disease than those with mild disease.  But these antibodies did not appear to be neutralizing in regard to CV-19.  The authors conclude that the presence of higher levels of the seasonal coronavirus may be a risk factor for more severe disease, likely due to contribution to a systemic inflammatory response.

The second study comes from New York and also looked at whether antibodies from recent seasonal coronavirus infection had a neutralizing effect on CV-19.  (Medrxiv Paper)   They used blood samples collected from 37 people who had a confirmed seasonal coronavirus infection before the epidemic.  They then tested to see if those blood samples contained antibodies which were cross-reactive to CV-19.  They did not find any.  so in contrast to the previous study, they believe that an antibody response to prior exposure to seasonal coronaviruses has no effect, good or bad, on CV-19 disease severity.