Dr. Michele Carbone, from the University of Hawaii Cancer Center and the Department of Pathology, and an international team of colleagues recently wrote an article – a kind of summary of the research status – for the “Journal of Thoracic Oncology” that provides reliable information And easy to understand about COVID-19 that are important and not easily determined in the circus atmosphere of our news media.
Here are some highlights:
First, the correct terminology: the name of the new coronavirus is “SARS-CoV-2” and it causes a disease called “COVID-19” in approximately 30 percent of infected people.
Masks and social distance help prevent infection, but the only way to be sure that you won’t get the virus is to stay home and not receive visitors. It’s that simple.
But that would require us to sacrifice our normal life routines, like spending time with friends and family, going to restaurants and shopping centers, doing our work in a social environment with colleagues – the things that define our lives.
Worth it? How to manage risk?
Infections occur almost exclusively in closed environments
The virus floats in the air like an aerosol. Open the windows and the risk of infection drops dramatically, according to Carbone and his colleagues.
The more crowded 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 crowded environment of a modern plane is comparatively safer, they say – because the air in the cabin is filtered and is replaced by the outside air every 2 to 3 minutes.
As we gather inside the house with the windows closed during the cold winter months, the risk of infection is higher and more likely then.
Unintended consequences
We are currently diverting our attention and resources to try to contain SARS-CoV-2 infections, which in turn is reducing efforts to prevent and treat cancer and other critical illnesses. This can cost many lives.
Carbone and his colleagues note that the National Cancer Institute (NCI) estimated that this could be responsible for approximately 10,000 additional deaths from colon and breast cancer because early cancer screening for these diseases has been largely suspended.
Furthermore, the NCI estimate did not consider other types of cancer and assumed that everything would return to normal in January 2021 – which it did not. The actual number of collateral deaths can be much higher.
Misleading statistics
According to Carbone and colleagues, approximately 70 percent of SARS-CoV-2 infections are asymptomatic – but the tests are primarily aimed at people who have symptoms; consequently, we are underestimating the magnitude of infections.
We are also overestimating the deaths caused by COVID-19, they say. Anyone who dies with a positive test for COVID-19 is considered a victim of the virus. We have not determined whether the virus was the leading cause of death.
Three out of four critically ill patients are men, and most deaths occur in older individuals with pre-existing illnesses. Deaths from COVID-19 in people under 40 without pre-existing diseases are very rare.
Vaccines
Recently, three vaccines have been made available.
Astra-Zeneca produced the “Oxford” vaccine, which is currently distributed only in the United Kingdom.
Pfizer and Moderna each produced an RNA vaccine. These vaccines are available in the USA and Europe. RNA vaccines use a new technology that has not been applied to mass vaccinations previously.
Antibodies are proteins produced by the immune system that protect us from infections. Approximately 95 percent of vaccinated individuals developed IgG antibodies that were supposed to protect them from the virus.
But these vaccines have been tested mainly on healthy adults under the age of 60. The few older individuals who received the vaccines produced less IgG antibodies.
Vaccines have not been tested in children.
These vaccines will not prevent the spread of COVID-19
IgG antibodies circulate in our blood and protect us from a systemic infection, that is, from viruses that spread inside our body and make us sick.
A different type of antibody, called “IgA”, protects the mucous surfaces of the body, such as the nose, pharynx and intestine.
To date, no clinical trial is being conducted with vaccines that produce IgA antibodies. The tested vaccines produce only IgG antibodies.
This means that the SARS-CoV-2 virus can still infect the mucous surfaces of vaccinated individuals.
This should not be a problem for vaccinated people. The IgG antibodies in your vaccines should prevent the virus from spreading inside your bodies, but viruses that grow on the mucous surfaces of your bodies can spread to other people.
However, infected people produce IgA and IgG antibodies, so once they have recovered from the infection, they are “safe”. Re-infections are extremely rare.
When more than 60 percent of the population has antibodies that protect them from the virus, viral spread will slow because the virus will not be able to find susceptible targets easily. This is called “herd immunity”.
No one knows how long the herd immunity will last, but for SARS, which is caused by an closely related virus, it lasts for several years.
Children
The main – or only – reason for vaccinating children is to protect adults, according to Carbone and his colleagues. Children – except those with some serious illnesses or genetic conditions – are generally not sick with COVID-19.
COVID-19 vaccinations cause pain, fever and headaches that last for a few days in most adult recipients. We don’t know what the side effects would be in children.
Will people vaccinate their children knowing these things?
When will it end?
The fact that the vaccines currently being tested will not produce IgA antibodies would not be a major problem if everyone were vaccinated, but this is unlikely to happen.
Therefore, these vaccines alone will not eliminate the virus in the immediate future.
SARS-CoV-2 is spreading rapidly. Ten to 20 percent of tests worldwide are positive.
Therefore, according to Carbone and his colleagues, a combination of vaccinations and infections is expected to produce collective immunity soon, possibly in June, when COVID-19 will decline and – hopefully – almost disappear shortly thereafter.
In the meantime, more effective treatments are being developed; thus, the COVID-19 mortality rate is expected to decrease in the coming months.
Nolan Rappaport he was assigned to the House Judiciary Committee as an expert on immigration laws for the executive branch for three years. He subsequently served as an immigration attorney for the Subcommittee on Immigration, Border Security and Claims for four years. Before working on the Judiciary Committee, he wrote decisions for the Immigration Appeals Council for 20 years. Follow his blog in https://nolanrappaport.blogspot.com.