As of this morning, worldwide there have been 373,986,843 reported cases of COVID-- 2,658,162 yesterday alone! There are have 5,675,429 reported deaths, a serious under-estimate. 7,687 people died yesterday. As of yesterday, the U.S. has had the most cases-- 75,481,122 and the most deaths-- 906,861. But, possibly because we're relatively well boosted, possibly because lots of people who get it don't even report they have it here, the U.S. is no longer #1 in new cases. These were the counties with the most new cases reported yesterday:
Two dozen countries, some with small populations-- like Denmark, Austria, Israel, Czechia and Portugal-- had over 30,000 new reported cases yesterday. In terms of critical cases, serious enough to worry about deaths, the U.S. is still #1-- about 24,000 people seriously ill, around a thousand of whom die everyday. Yesterday 4 states had over 100 deaths: Texas, Arizona, New York and Pennsylvania.
But what about the people who get mild cases and then get over it and say it was like a sniffle or, at worst, something like the flu? As I'm writing this I'm talking to a friend with COVID who says he's "mostly" better but "hasn't been able" to get a test. He's out and about-- just with a lingering cough-- and not even knowing if he's positive or negative. And driving for Uber.
You know what I've been wondering about since the first time I ever heard the term about a year ago? Long COVID. You too? A few months ago Pathogens published a study Marc Desforges, Deepi Gurdasani, Adam Hamdy and Anthony Leonardi, Uncertainty around the Long-Term Implications of COVID-19. They compared the Zero COVID policies being pursed by China, New Zealand, Vietnam, South Korea, etc with the way the U.S. and Europe handle it (mitigation strategies "that aim primarily to prevent health systems from being overwhelmed. These mitigation strategies are managed through social measures and public health surveillance systems. Alongside, they have focused on the development of therapeutics for managing acute infections, and vaccine development as a longer-term strategy for controlling the pandemic").
A month later co-authors Gurdasani, an epidemiologist and outspoken advocate for Zero COVID, and Leonardi (a T-cell immunologist), summarized the uncertainties surrounding the long-term implications of living with COVID-19, highlighting the dangers associated with viral evolution and the immune dysregulation that SARS-CoV-2 infections can cause in the human body. They provide insight into the concerns being raised by reinfection and the concept of herd immunity threshold. Additionally, they note the complexity of and long-term complications associated with Long COVID."
Right from the start, their warning sounded ominous: "Although COVID-19 has been described as a respiratory syndrome, evidence supports the involvement of multiple organ systems, with fibrosis, and inflammation in the lung, heart, kidneys, central nervous system (CNS), liver, adrenal glands, bone marrow, lymph nodes, and gastrointestinal tract. SARS-CoV-2 infection has also been associated with serious thrombotic complications, including strokes, pulmonary embolism, and cardiac injury." Leonardi opposes unsafe school openings, warning of "lowered productive lifespan in kids, and it’s more of an attenuation in kids than adults. So, it’s a bad idea. We’re setting kids up to have chronic illness." Conservative do not like hearing this kind of thing, not even a little. Leonardi:
They’re very angry because they want to have us admit that T-cell immunity is going to confer “natural immunity” and “natural protection.” You might have seen Dr. Monica Gandhi constantly refer to this. And then a lot of Republicans are also going on about T-cell immunity and stuff.
My research was in T-cell memory. I found how to control T-cell memory when I worked at the NIH (National Institutes of Health) and in a T-cell immunotherapy lab. I knew back in May  when I saw the first publication in The Lancet about this virus. I was in London at the time, and there was a virologist and an oncologist that I knew. Unfortunately, he’s very conservative. He’s part of the UKIP (UK Independence Party) in the UK. I spoke with him about my concerns about this virus. The immune system doesn’t look like it’s doing very well at all. I basically understood that the vaccines would be better than infection in conferring immunity.
And obviously that went against what all the corporate interests wanted, like the AIER (American Institute for Economic Research). They want the economy completely open, and they want consumption to be full. They’re trying to convince everybody that you didn’t necessarily need the vaccines for safety and that immunity will be long lived, but it just wasn’t the case.
...I got into COVID-19 just by being concerned from an immunological standpoint, because I saw the first publication out of The Lancet in January 2020, where the patients demonstrated profound lymphopenia [a reduced level of the white blood cells that help fight infections]. That was very significant, and the people were very ill and it looked to me like there was some sort of a sepsis [infection in blood and tissue that can lead to organ failure, shock and even death] going on and these usually happen in super antigenic infections [super antigens, molecules that trigger an immune response, resulting in excessive activation of the immune system as seen with our body’s response to COVID-19]. Reading the paper set off alarm bells in my mind. I thought I knew what I was looking at, from an immunity standpoint that our natural immunity would be harmed and distorted by this pathogen.
...I would define durable competent immunity as immunity that prevents you from getting sick from a virus the second time you catch it. It’s like your one-off infections, where you get it once and then you’re good for the rest of the time. For instance, things that don’t normally re-infect you, like the chicken pox. It may remain latent inside you, but your immune memory controls it. You don’t get sick again unless you get a bout of shingles. That would be a durable competent immunity.
An incompetent immunity, or not durable immunity, is the kind of immunity you usually get from a coronavirus infection, such as the common cold. You can get reinfected, and it’ll be as bad as the other times. And even for older people, when older people get reinfected with influenza virus types, they might have it more severely. Just because they’ve had the vaccine or have been infected in the past, the influenza virus mutates a bit, and that’s possibly why the reinfections can be bad, but it could also just be the waning of immunity.
Cellular immunity [Immune response that does not involve antibodies. Instead, various types of white blood cells, including previously sensitized T-cells, are recruited in response to an infection. Cellular immunity is very effective against cells infected with viruses, intracellular bacteria, as well as cancer cells. It also mediates transplant rejection.], in some cases, usually it can react quick enough to prevent disease, but for some conditions it’s not quick enough to prevent illness again.
Notably, when Delta came along, which is very fast at infecting, it fuses with cells so quickly and replicates so quickly and transmits so quickly, it outpaces our natural cellular immunity because our cellular immunity takes time to ramp up.
What happens is you have an infection, and you stimulate some T-cells that recognize the infection and B-cells get stimulated and they proliferate, and they control the infection. And it takes some time for these cells to grow in numbers and phenotype to address the infection.
Then after the infection is addressed, the numbers dwindle, you get what’s called memory formation. And the numbers of the cells that dealt with the infection go down, and they go in like a quiescent state. And when the pathogen comes around again, those cells will recognize the pathogen and then grow in numbers.
The second time around all this happens faster because your body has made cellular memory. But the problem with some viruses though, like the Delta strain of the coronavirus, is that it can outpace our cellular immunity. So, that’s what I think is happening with SARS-CoV-2. So, our cellular immunity might be durable enough to let’s say prevent some severe illness and in healthy immunocompetent people. But for mild and moderate illness everybody might be rolling the dice if they don’t have antibodies that can address it.
Basically, what we’re going to need is boosting, to make sure antibody levels are high enough to deal with the pathogen if we encounter it. And then there’s the issue also of a mucosal protection, which is a hot topic right now, and the way these vaccines are made…
In part two of the interview, Leonardi said he thinks "Long COVID is going to be as diverse a problem as cancer. It’s hard to define, because, like cancers, they present as a very different spectrum of diseases depending on where they are and where they came from. Long COVID, I would say, for an easy definition, is a persistent sequela of SARS-COV-2 infection. It can be anything. We can say it’s fibrosis in the lungs or fibrosis in the heart or kidneys or brain fog or there’s a brain hypometabolism phenotype. For instance, there is hypometabolism in the brain in depression and people who’ve been infected with SARS-CoV-2 have a brain hypometabolism that persists for a while. I don’t know for how long, but they imaged it. It’s just a complete multi-system problem because of how ubiquitous ACE2 is. And not only that, but the immune system also goes haywire. Now, the immune system is responsible for going into all the tissues in the body, except for a few immune-privileged sites. But SARS-CoV-2 doesn’t respect the immune-privileged site whatsoever. It brings T-cells into the brain. So, we can see the impact of the infection across every physiological system. Because if it distorts the immune system and the immune system is responsible for patrolling the body everywhere, then there are going to be problems everywhere... [including] an irreversible neurodegenerative process [like] Lewy body dementia and Parkinson’s disease."
[COVID infections in children] really worry me. We are just assuming that infection won’t have long-term consequences in people, and especially in children. And there’s almost a systematic exposure of people and children to the virus before they’re vaccinated. I know from what I’ve read in the studies that have come out that some people are going to definitely be genetically susceptible to very bad outcomes and death. And I think it’s not right for kids to be just exposed to this without a fighting chance, without vaccination.
It’s very disturbing when I think that we’re running the risk for everybody to get something like any Lewy body disease or neurodegeneration and we’re systematically exposing generations to this. I was trying to help. My hope is that we take it seriously and we give people protection. If these children have genetic susceptibility or health concerns, or if their family has health concerns, they’re given remote options. I was thinking if I were in their position, would I want to be consigned to definite exposure to SARS-CoV-2? No, I wouldn’t! And I would want to be protected, with acknowledging that the virus is airborne. So, better ventilation in classrooms, mask wearing and vaccination of children.
There’s a terrible assumption that kids are okay with SARS-CoV-2 infection when there’s data coming out that they have lost out on a greater number of healthy years than adults. Kids have better immunological response to vaccination than adults as well. And kids are more likely to be infected than adults and kids are more likely to be reinfected than adults.
We’re messing up! We’re doing this completely wrong only because probably, my assumption is, kids have less agency. Kids don’t have the agency adults do. That’s fine that they are not like grandma or grandpa when it comes to being infected, it isn’t as dangerous. But it’s unjust to not protect them and vaccinate them. Infection in children should not be written off.
A lot of people are saying it’s endemic and everyone is going to get it. So, they relinquish responsibility of controlling its spread and making these areas safe and just consigning kids to definite inflammation and infection where they’re less likely to make immune-competent memory.