A Head Full of Coronavirus Research, Part 47

Here is my quick observation for the day.  Many European countries are going back to lockdowns of various types as they see cases rise.  First, they are acting too soon, wait a couple of weeks, because I suspect this wave is near or at the peak, particularly in light of much higher testing, and the severity in most countries of the first wave.  But what really astounds me is that the politicians have learned nothing.  Lockdowns made no difference the first time, in fact, may have exacerbated spread in some ways.  Lockdowns are extremely costly, not just economically, but socially.  Europeans can just look north and see the example of Sweden.  The lesson there is the harder you come at the virus, the more total pain for a longer time that you are causing yourself.  You think you can squash this virus–what an obviously absurd idea.  Europe is not an island like New Zealand, and who would want to be in New Zealand, the new Hermit Kingdom.  Encourage people to use common sense precautions to control spread, encourage the obviously vulnerable to be more careful or isolate.  That is going to do as much as anything else.  Anyone who thinks a vaccine is going to magically make this go away is deluding themselves as well.  This will be an endemic virus like flu, we can and will adapt to it, there will be a price to be paid, as there is with influenza.  We can’t let life end because of a bleeping virus.  And I continue to fear that our attempts to suppress CV-19 will only lead to the development of much more lethal version.

This study is a major antibody prevalence survey that has been going on in the UK.  (Imperial Study)   The study was massive, covering over 350,000 people who self-administered a test at one of three times over the summer and early fall.  Prevalence fell from 6% to 4.8% to 4.4% over the three test times.  No participant was surveyed every time or twice, so kind of weird to imply that antibodies declined if it wasn’t the same people.  They are just inferring that from the overall positivity rates.  Positivity was highest and the decline the smallest among the youngest age group, and the opposite was true for the elderly.  There was no change among health care workers.  The authors interpret this as antibodies not providing lasting protection against reinfection.  I think that is just plain wrong, for several reasons.  One is that they are completely ignoring the T cell side of the equation and research suggests that is the more important adaptive immunity thrust against CV-19.  The second is that for people with mild and asymptomatic infections, of course antibodies are going to decline.  The body can’t waste time and effort sustaining antibodies against something that wasn’t much of a threat, and that if it reinfects the person again, would likely still be a mild or asymptomatic illness, and the person would be very unlikely to be infectious.  There is a reason why people with severe disease tend to have higher antibody levels, it was more of a threat to the person and the immune system reacts accordingly.  And the third is that I don’t trust these antibody studies in terms of the assays used.  We have seen too many studies in which an assay simply wasn’t sensitive enough to pick up antibodies, but another, more sensitive one did pick them up.  So I am not worried about what this says in terms of development of enough population immunity to slow transmission.

And right on cue, here is one of those other studies, just published, that shows persistent neutralizing antibodies for at least 6 months.  (Science Study)   The researchers followed around 120 patients for up to six months, including many patients who had mild illness.  They found persistent antibodies, only slightly declining in number, and persistent neutralization capability.  This was as true in patients with mild illness as other patients. The authors suggest that this indicates either an ability to prevent reinfection, or to minimize any ensuing disease.

The English public health service is expressing concern about use and misuse of PCR tests.  (UK Paper)   Here is my favorite quote:  “A single Ct value in the absence of clinical context cannot be relied upon for decision making about a person’s infectivity.”    The paper notes that PCR testing does not tell you about infectiousness and that there are many steps in sample collection and performance of the test that can lead to variable and inaccurate results.  They further state that low CT numbers are indicative of infectiousness whereas high ones generally are not, but there could be circumstances where the patient is infectious.

The US isn’t the only country noticing that there are a large number of excess deaths resulting from the lockdowns and terrorizing the population.  This study comes from Germany and involved emergency visits.  (Medrxiv Paper)   The authors compared 2020 to 2019, especially for visits from patients with serious chronic illness.  They found a large drop in visits, depending on the week, from 35% to 45%.  More importantly, they identified excess deaths, only 55% of which were related to CV-19.  The rest they attribute to lockdown effects.

More good news, from the UK, on what is happening to people with serious mental health problems during the epidemic.  (Medrxiv Paper)   These researchers were also looking at mortality patterns among this group of patients.  They also found excess deaths beyond those attributed to CV-19, about 35% of all excess mortality.

Here is a survey from a major health benefits consultant finding that 44% of employees have put off health care, either due to fear or money concerns.  (WTW Survey)   Most said they had or expected to experience poorer health as a result.  But lockdowns and terrorizing people are all good.

In case you think hospitals are good places to go, this will help you understand why over the last few decades every effort has been made to limit hospitalizations.  These researchers looked for pathogens co-infecting a person with CV-19.  (Medrxiv Paper)  ICU patients in the UK were the source of patients.   The authors found no co-infections picked up in the community, but a significant number of patients acquired bacteria or viruses on the ICU ward and the longer the patient was there, the more likely that they got infected by another pathogen.  Getting infections in hospitals is a long-standing problem.  Progress has been made, but it is still a problem, and it exists for CV-19 patients as well.

Just a very quick ht on a study that looked at antibody prevalence in health care workers.  (Medrxiv Paper)   The thing that caught my eye was that so few of the workers who had CV-19 symptoms were positive by PCR test.  Presuming a symptom means CV-19 is a big mistake.