Wednesday 7 October 2020

Cassandra Crossings?

I can strongly empathise with the original Cassandra, who got no pleasure (or profit) from having her dire prophecies confirmed. I think it was all too easy to predict, that the re-opening of UK Universities this Autumn, had all the ingredients for jumpstarting the rate of Covid-19 transmissions across the entire country. We now have reports of major surges of positive Covid tests on many of the campuses. The University of Manchester, along with Manchester Metropolitan University and Sheffield University, have reportedly ceased virtually all of their face-to-face teaching as a consequence. Students, locked into halls of residence, are said to be muttering about being 'conned' into returning. The absolute nadir, are reports of attempts to hold illegal 'Covid Parties' by students, where the sole qualification for entry is a positive test result (this wouldn't happen in Sweden!). This is all a bit 'wild west' but surely the movers and shakers could have seen it coming? I am, consequently, reluctant to get back into the prophecy 'game' but another aspect is starting to worry me. There are an increasing number of reports of people getting a second infection by the virus (https://www.theguardian.com/world/2020/oct/06/flurry-of-coronavirus-reinfections-leaves-scientists-puzzled). Of course, firmly establishing that it is a second infection is quite difficult. It really depends on having swabs containing the same virus (established by RNA sequencing) for each of the two events. This is technically difficult and rather unusual (especially given, the sometimes superficial nature, of most testing). It could not be established by someone simply having antibodies against the virus in their blood. Having said that, there are now a number of reasonably well-validated second infections, which are causing some medical 'head scratching'. Two things worry me. One is, that some of the second infections appear to have occurred within a few months of the first infection. This suggests that getting a single effective vaccine dose will not eliminate the virus from our populations. The second is, that although the second infections were very variable in their intensity, some patients had a worse experience the second time around. This suggests that the first infection (or vaccination?) does not always protect the individual against exposure to the virus (it may even prime them to show an intense reaction). I am also, naturally, worried about reports of lasting damage to the lungs, hearts and circulatory systems of some people who contract the virus (often those having a reportedly 'mild infection'). I think it is much too early to attempt to aim for 'herd immunity', even in populations of the 'mildly affected' young. I was very taken by a quote from immunologist, Professor Danny Altmann, who wrote "The problem is whenever an immunologist says something about Covid immunity, it's right for about two weeks and then it's completely wrong". I am certain, that you could replace the word 'immunologist' by the word 'scientist'(or 'medic') and fully retain the sense of this statement.

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