• drhancur

Hysteria and the Coronavirus: Part 5

As near I can tell, the public health strategy is to "slow the spread" until a vaccine arrives to save the day. They don't say it directly and the media never seems to ask any meaningful questions. The problem is that "slowing the spread" also means slowing any type of herd immunity which also means that we extend the existence of the pandemic indefinitely. While others have pinned their hopes on an effective vaccine, I have been in the Swedish-Israeli herd immunity group. What I read on a pharma website this week turns everything on its head. In an article in STAT, immunology experts, from Hong Kong University to the University of Texas, discussed different types of immunity and the likelihood of their effectiveness. The first type is called "sterilizing immunity" and is the result of being directly exposed to a virus either by infection or by vaccination. Just about all of the experts discounted this type of immunity because of the nature of the coronavirus i.e. it being a respiratory virus. If they are correct, then the public health strategy described above, and seemingly endorsed in the popular media, will fail.

The second type of immunity is called "functional immunity" and essentially states that, once infected, some sterilizing immunity occurs and reinfection will be milder and probably not fatal. Support for this position lies in the respiratory nature of the virus and our experience with other respiratory viruses. This week a case of reinfection was reported in Hong Kong which would seem to lend credence to the concept of functional immunity.

The third type of immunity is called "waning immunity" and is really a variant of functional immunity in which the immunity fades over time whether from infection or vaccination. Functional immunity would probably occur so reinfection would be shorter and milder. Waning, like functional, immunity is based upon our long history with other coronaviruses.

A final type is called "lost immunity" in which the sterilizing immunity would disappear over time and people would be subject to reinfection as if they had never been infected, including severity. Apparently, none of the experts believed this to be even possible (thankfully).

If these experts are to be believed, then there is no possible cure for COVID-19 and we are going to have to learn to live with it the same way that we do with the flu and the cold. It may have wrinkles that make it more difficult in some ways but the general situation will be the same. The mentality that exists today in which we respond to predictable and expected new cases with restriction or lock-down cannot continue anymore than it could in response to the seasonal flu. Particularly vulnerable people have to protect themselves as they would from the flu today.

In summary, the coronavirus is here to stay. It will not be eradicated, stopped or disappear if we just try harder to protect each other with testing, masks or social distance. It will likely be managed by functional immunity, aided hopefully by eventual vaccination.

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