By Sheila Page, DO
Following the initial 15 days to “flatten the curve”, as COVID 19 was progressively sweeping the nation, the restrictions on most of the American public were not lifted as expected. People desperately wanted to be able to save their businesses from ruin, allow their children to play sports again, and walk freely outdoors. They were teased with the idea that persons who recovered from COVID 19 infections would be able to test for antibodies and go back to work and be released from quarantine.1
This hope was quickly squelched by reports that seemed to show that the antibodies (IgG antibodies) did not persist, meaning the government-dictated mitigations would continue. 2,3
The prevailing message has been and continues to be that there is no treatment and no rescue from this virus other than absolute obedience to a set of perpetually changing rules. Various mitigation measures have been mandated to “flatten the curve”, a goal that has been changed to “slow the spread” of the virus. Other than hospitalization for severe disease, few solutions have been offered. Healthy asymptomatic people are quarantined for nebulous reasons that defy rational thought, but work well to scapegoat and shame non-compliant persons.
What is the truth?
Is it possible that solutions have been hidden in plain sight?
Science is the study of observable truth. Beginning with basic science, an understanding of pathogens and disease creates a foundation of truth on which we can build solutions.
What is herd immunity and why is it important?
Herd immunity is the natural resistance to the spread of a communicable disease in a community that occurs when a threshold of immune persons has been reached. The disease dies out because it has nowhere to go as the virus encounters a wall of immunity. Evidence shows that in the case of COVID 19, infection in only 10-20% of a population results in herd immunity, because the very important T-Cell immunity is already present in about 50% of the population.4
What is T-cell immunity? Why do young people do so much better with the COVID 19 infection than older adults?
T Cells identify and kill infected cells, and B cells produce antibodies.1 These are the cells that will attack the virus if the previously infected person encounters it again. The virus dies and is not transmitted by the immune person to others. T Cell immunity, which remains protective for years,5 is stronger in the youth, and they have cross-over immunity because of previous exposure to milder coronavirus infections (e.g. common cold). Cross-over immunity means that even if you have never been exposed to COVID-19, your T Cells may be effective against the virus anyway because of the similarities between the various strains of coronaviruses. This has been shown to be true for COVID-19. 6 However, as we age, we begin to lose T Cells, and are more susceptible to infection, which would explain one reason why the older members of the community are more susceptible to the illness.7
The Good News about T Cell Immunity
Studies focused on waning IgG antibody immunity to COVID 19 disregarded the fact that T Cell immunity has long term memory and is the primary protection against viruses. “A study published …in the journal Cell suggests that everyone who gets COVID-19 — even people with mild or asymptomatic cases — develops T cells that can hunt down the coronavirus if they get exposed again later.”8 We know that a substantial percentage, 50% or more, of the population has already developed immunity to COVID-19, either from recent infection or from previous common cold viruses. We can also be reassured that the youth in this country are very resistant to COVID-19 infection. They naturally present a wall of immunity to the virus, which helps prevent its spread to the rest of the population.
Understanding immunity is the first part of the solution. We cannot escape the reality of infectious diseases if we want to live and work in community with each other. We need to shift our focus away from social isolation of whole populations of healthy people. When we protect the vulnerable and treat the sick, especially in the early stage of infection, we have the potential to conquer disease. We can build hope on truth and understanding.
** A special acknowledgment is due Dr. James Todaro, who took time to explain these concepts in a public forum and gathered the references to support it. He can be found on Twitter @JamesTodaroMD.