October 15, 2020

Reinfecting herd mentality

More reports are arriving about documented reinfection with SARS-CoV2. We just had one here in Seattle and possibly a second. A resident of the nursing home at the center of the first outbreak became ill with Covid-19 very early in March, spending 40 days in the hospital, but recovered. More recently, he became ill again and tested positive for SARS-CoV-2. Fortunately, he did not get very ill the second time and recovered more quickly.

Lucky for him and us, he lives in a town with a research institute, Institute for Systems Biology, that keeps track of the genetic fingerprints of the viruses. They have created a “biobank” to hold onto blood from infected patients to use in further research as needed. Collaborating with the hospital the patient was in and other institutions around the world, the institute analyzed both viruses. Their genetic material RNA was compared to each other and with other strains around the world. This analysis of the viral RNA shows that there were two different strains that infected him 140 days apart. The first was genetically closer to the original virus from Wuhan, China, which was the cause of the initial outbreak in the Seattle area. The second virus was a variant that arrived from Europe and infected the east coast first before spreading west.

They also looked at the antibodies of the patient. This shows he did not make as many of the neutralizing antibodies that fight the virus for the first infection, but has made more for the second infection. What is clear is that we still have so much to learn about SARS-CoV-2 and Covid 19. What is not clear is why he didn’t make enough antibodies the first time. Re-infection is still rare and probably depends on multiple things, including if a patient is treated with immune suppressing meds that may blunt the body’s ability to make the antibodies. Most people do develop antibodies that seem to work, but some people don’t. It is looking like it is related, in some cases, to the severity of the disease and, in others, the treatment. As an example, if I had a recent case of Covid-19 and was treated with a monoclonal antibody and a steroid that suppresses my immune system, I would be more vigilant about preventing re-infection. I couldn’t trust if I made antibodies through testing because I would still have some of the treating antibodies in my system that can turn to the test positive.

The institute is collaborating internationally to continue this important research to help us get effective vaccines and understand how this happens in a few, but not all. The thought now is that the patient didn’t make enough protective antibodies from the first infection, rather than having the virus sneak past in the second infection. What this means, we are not sure. Scientists are still optimistic we will get a vaccine that can boost the immunity to SARS-CoV-2 and looking at areas that may need more attention. This info can be helpful for that goal.

All this adds to the alarm about “herd immunity”. Once again, some of our leaders are pushing a disproven and dangerous theory that having younger people try to get infected and spread it to others will get us to the ethereal “herd immunity”. It reminds me of the way certain politicians have chosen dissenting scientists to help deny the facts of global warming, despite the overwhelming numbers of respected scientists endorsing that climate change is real. We must not be fooled into a herd mentality.

Wash your hands, cover your nose, keep safe six, and don’t be fooled.

And finally, my caveat is that this is my experience and my opinions, which are subject to change as more information is available, and not related to the organization I work for. Thanks for reading.

https://www.seattletimes.com/seattle-news/health/seattle-area-man-is-the-third-person-in-the-u-s-confirmed-to-have-been-infected-twice-with-coronavirus/

https://www.seattletimes.com/seattle-news/seattle-researchers-building-biobank-of-patients-blood-to-unlock-the-mysteries-of-the-new-coronavirus/

https://isbscience.org/partnerships/

https://www.medrxiv.org/content/10.1101/2020.09.22.20192443v1.full.pdf re-infection

https://www.mdlinx.com/news/study-confirms-first-us-case-of-covid-19-reinfection-indicating-exposure-may-not-translate-to-total/2CS91MliO0z49Sx9INz90c

https://www.medpagetoday.com/infectiousdisease/covid19/89077

https://www.washingtonpost.com/graphics/2020/health/coronavirus-genetic-code/

https://www.medpagetoday.com/infectiousdisease/covid19/89127 herd immunity bad

https://www.seattletimes.com/nation-world/nation/proposal-to-hasten-herd-immunity-grabs-white-house-attention-appalls-top-scientists/

https://www.medpagetoday.com/infectiousdisease/covid19/89082