Sunday, January 21, 2024

Grand Theft Immunity

T. Ryan Gregory asks us to consider the possibility that repeated infection is rolling the dice that leads to Long Covid, which causes immune damage:

"If we're insisting on using the rhetoric of fiscal metaphors, "immunity theft" can be small and brief (petty immunity theft) all the way to severe and long-term (grand immunity theft). It all adds to negative effects on public health. Even if Covid infection caused grand immunity theft "only" in patients with Long Covid and only caused petty immunity theft for a short period in others, that is still a LOT more susceptibility to other infections overall. And that's the best case.

A much worse case is that damage of repeated infections is cumulative, or risk of severe effects is higher (or just even equal) with each infection. We don't know, because this is a new virus. But there are very good reasons to take this risk seriously. Let's be clear. "It's only a temporary reduction of immune function, which other viruses do too" and "It's only a serious issue in people with Long Covid" are terrible arguments for doing nothing. 

And as to the "other viruses do it too":
1. Covid isn't seasonal, so it adds the effect year-round, including with bad timing in the lead up to other respiratory illness season.
2. People don't get those other viruses up to several times per year. For flu, it's more like once every 10 years. Average of 8% (range 3-11%) of the population infected with influenza each year = any particular person infected on average once every ~12 years. If it’s 11%, that's once every 9 years. 
3. Other viruses don't circulate in anything like the numbers that Covid does.
4. Even if it only does what other viruses do, adding another one to the mix is bad. 

We could also use some humility regarding what we don't know about viruses. Measles has been with us for at least 1,000 years and the virus was identified in 1954. We just learned what it does to the immune system a few years ago. And all of the above relates only to reduction in immune function after Covid infection. There is also the impact of co-infections with Covid and something else (flu, RSV, etc) occurring at the same time being worse. 

It also matters where and in whom Covid infections occur. Hospital-acquired (nosocomial) infections have a significantly higher rate of severe outcomes, given the factors above and the fact that adding Covid to anything else does not improve the situation. Finally, there's the issue of everyone paying the price for sub-critical but sustained pressure on healthcare systems, from more crowded emergency rooms, more beds occupied, more demand for ambulances and longer offload times, and/or more healthcare worker illnesses."

And some re-worked lyrics from Tern who also made the graphic at the top (from a TV show if you're a Boomer, from The Blues Brothers if you're Gen X). 

"Rolling rolling rolling,
though your veins are swollen,
keep those 'fections rolling," he cried.
"Don't wear a mask to stop 'em,
just cough and share and swap 'em,
soon all your organs with be fried.

My heart's calculatin'
a coronary is waitin'
is waitin' at the end of my ride."



***

COVID BASICS: (1-3 from Dr. Joe Vipond): 
"1. Covid is predominantly airborne. [It can cross a room in minutes and linger for hours.]
2. Over 50% of transmission is from asymptomatic people. [They feel perfectly healthy!!]
3. Long Covid is real and impacts a substantial number of people. We've NEVER EVER EVER had these three things told to us by the system. Not once. Not by our leaders." And also...
4. Vaccines help reduce severity of cases, but can't eliminate transmission (yet), and they wane in effectiveness within months because Covid mutates so fast (because of all the spread!) 
5. N95s trap Covid using inertial impaction, diffusion, interception, and electrostatic attraction. They really work!!
6. Covid's the #3 killer in Canada, and we don't know how many people it has disabled. Avoid being one of them. There is no effective treatment for Long Covid, only prevention. Be wise with N95s! 

Well-fitting N95s reduce transmission by about 95% - even higher if everyone wears them; cleaning the air helps by about 30%, and vaccines reduces hospitalization by 60%. Put together, we could ALL be 99.999% protected from this mess and more! We don't have to get sick every winter; it's a choice. 

3 comments:

Taylor said...

Most people don’t argue at extremes but instead fight over subtleties in the middle that lead to very different actions.

I, for one, am grateful for science (technology) and do not minimize our mortality and risks in life—but there is a point where some of our modern approaches to health and crises can cross into hubris.

Not a perfect analogy, but as with forest fires, we’re often better off letting nature be nature. Overzealous attempt to thwart nature lead to worse outcomes in some other manner (e.g., even worse fires in following years)

Lockdowns and masks—our myopic focus on one problem—win only a Pyrrhic victory.

I take a more stoic perspective on health and life than the ardent ‘slave morality’ expressed by today’s wise.
Our time here is short and not guaranteed. What matters is how we spend the time that we have.

Marie Snyder said...

I take it you mean you spend your time contemplating death (memento mori), as Seneca warns in The Shortness of Life, "It takes a whole lifetime to learn how to die." And I imagine you don't waste time with any passion-fueled distractions from this pursuit or any idle preoccupations. However, it's possible to do all that while wearing an N95. (Lockdowns were four years ago - nobody's calling for them anymore). None of the stoics would have us bring harm to others with careless acts, foolishly weighing hedonistic desires against life itself. The stoic mindset acts with the virtues of justice, wisdom, fortitude, and temperance, which, it could be argued, demands acting for the common welfare of all. Don't fear death, but don't hasten it along before it needs to come, or invite a life of sickness if you have the knowledge and ability to avoid it. "Retire to those pursuits that are calmer, safer, and more important," i.e. contemplating philosophy!

Taylor said...

If only we lived in a world where cardinal virtues were inscribed in culture. But even then, people would argue over application. One person’s courage is another person’s folly. One person’s temperance is another person’s anhedonia.

I don’t disparage someone for wanting to stay safe, but I disagree with the premise of harm. Biological truth peddles in probabilities. The caution of N95s today is illogical, to me.

Though I take a polar opposite stance, I enjoy your writing. You are clear in your position, and above all else, consistent in your views. ‘COVID delenda est’
I agree with your intimations elsewhere that the greatest frustrations have been with the people that once gladly followed all the mitigations and then at some point gave up or lost the plot. Whether worn down or misguided, I despise the apparent mindlessness of the masses.