Dr. Michele Carbone of the University of Hawaii Cancer Center and Department of Pathology, and an international team of colleagues recently wrote an article – sort of a state-of-the-research summary – for the Journal of Thoracic Oncology that is reliable, easy to read. understand information about COVID-19 that is both important and difficult to figure out in the circus sphere of our news media.
Here are some of the highlights:
First the correct terminology: the name of the new coronavirus is “SARS-CoV-2” and it causes a disease called “COVID-19” in about 30 percent of people who are infected.
Masks and social distance help prevent infection, but the only way to make sure you don’t get the virus is to stay home and have no visitors. It’s that simple.
But for that we would have to sacrifice our normal living routines, such as spending time with friends and family, going to restaurants and shopping malls, doing our jobs in a social setting with colleagues – the things that define our lives.
Is it worth it? How to manage the risk?
Infections occur almost exclusively in closed environments
The virus floats in the air as an aerosol. Open the windows and the risk of infection drops drastically, according to Carbone and his colleagues.
The busier the environment, the greater the risk of infection – for example, the risk is very high in a crowded bus with air-conditioning and closed windows. However, the busy environment of a modern aircraft is relatively safer, they say – because the air in the cabin is filtered and it is completely exchanged with outside air every 2 to 3 minutes.
Because we gather indoors with closed windows during cold winter months, the risk of infection is higher and more likely.
Unintended consequences
We are currently shifting our attention and resources to try to control SARS-CoV-2 infections, which in turn reduces efforts to prevent and treat cancer and other critical illnesses. This can take many lives.
Carbone and his colleagues note that the National Cancer Institute (NCI) estimated that this could be responsible for about 10,000 additional deaths from colon and breast cancer, because early cancer screening for those diseases has been largely suspended.
In addition, NCI’s estimate did not take into account other cancer types, and it was assumed that everything would return to normal by January 2021 – which did not happen. The actual number of collateral deaths can be much higher.
Misleading statistics
According to Carbone and his colleagues, about 70 percent of SARS-CoV-2 infections are asymptomatic – but testing is largely focused on people with symptoms; therefore we underestimate the extent of the infections.
We also overestimate deaths from COVID-19, they say. Anyone who dies and has tested positive for COVID-19 is counted as a victim of the virus. We do not determine whether the virus was the leading cause of death.
Three out of four critically ill patients are men, and most deaths occur in older people with pre-existing conditions. Deaths from COVID-19 in individuals younger than 40 with no pre-existing conditions are very rare.
Vaccines
Three vaccines have recently become available.
Astra-Zeneca produced the “Oxford” vaccine, which is currently only distributed in the UK.
Pfizer and Moderna have each produced an RNA vaccine. These vaccines are available in the US and Europe. RNA vaccines use new technology not previously applied to mass vaccinations.
Antibodies are the proteins produced by the immune system that protect us from infection. About 95 percent of the vaccinated subjects have developed IgG antibodies that should protect them against the virus.
But these vaccines have mostly been tested on healthy adults under the age of 60. The few elderly people who received the vaccines produced fewer IgG antibodies.
The vaccines have not been tested on children.
These vaccines will not stop the spread of COVID-19
IgG antibodies circulate in our blood and protect us against systemic infection, that is, viruses that spread in our body and make us sick.
Another type of antibody, called “IgA,” protects the mucosal surfaces of the body, such as the nose, pharynx and intestines.
To date, no clinical studies have been conducted with vaccines that produce IgA antibodies. The vaccines being tested only produce IgG antibodies.
This means that the SARS-CoV-2 virus can still infect the mucosal surfaces of vaccinated individuals.
This should not be a problem for vaccinated people. The IgG antibodies from their vaccinations are supposed to keep the virus from spreading in their body, but virus that grows on the mucosal surfaces in their body can spread to other people.
However, people who are infected produce both IgA and IgG antibodies, so once they recover from the infection, they are “safe.” Re-infections are extremely rare.
When more than 60 percent of the population has antibodies that protect them against the virus, the spread of the virus will decrease because the virus cannot easily find sensitive targets. This is called “herd immunity.”
No one knows how long the herd’s immunity will last, but for SARS, which is caused by a closely related virus, it takes several years.
Children
The main – or only – reason for vaccinating children is to protect adults, Carbone and colleagues said. Children – other than those with some serious illnesses or genetic conditions – generally don’t get sick with COVID-19.
COVID-19 vaccinations cause pain, fever, and headache that last for several days in most adult recipients. We don’t know what the side effects would be in children.
If they know these things, will people vaccinate their children?
When will it end?
The fact that the vaccines currently being tested don’t produce IgA antibodies wouldn’t be a big deal if everyone got vaccinated, but it probably won’t.
Therefore, these vaccines alone will not get rid of the virus in the near future.
SARS-CoV-2 spreads quickly. Ten to twenty percent of the tests worldwide turn out to be positive.
According to Carbone and his colleagues, a combination of vaccinations and infections should therefore yield herd immunity soon, possibly in June, when COVID-19 will wane and – hopefully – disappear almost soon after.
Meanwhile, more effective treatments are being developed; therefore, the death rate from COVID-19 should decline in the coming months.
Nolan Rappaport was highlighted to the House Judiciary Committee as an executive’s expert on immigration law for three years. He then served as an immigration adviser to the Subcommittee on Immigration, Border Security and Claims for four years. Before joining the Judiciary Committee, he wrote decisions for the Board of Immigration Appeals for 20 years. Follow his blog Bee https://nolanrappaport.blogspot.com.