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Can the innate immune system defeat a pathogen by itself? Fast enough that we don't develop antibodies, etc.?

Can the innate immune system defeat a pathogen by itself? Fast enough that we don't develop antibodies, etc.?


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Would we have any way of knowing if our innate immune system destroyed a pathogen without involving the adaptive?

Could a symptomless person who tests positive for COVID-19 with the RNA test, e.g., later test 'negative' for exposure on the antibody test?


Generally antibodies are formed, but it is possible that innate immune system has cleared out the pathogen. But antibodies will be formed even after that, as adaptive immune system has received the stimulating signals from helper T cells, which are matured during the innate immune responses triggered by an infection. This signal triggers B cells to produce antibodies. Antibody production is activated because of signals from innate immune system.

So, even if infection is cleared by innate immune system, still antibodies will be synthesized.

Reference:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3399021/

https://medicalxpress.com/news/2020-05-dont-antibodies-immunity.html


If the innate system is very fast at clearing the pathogen out, the memory B cells, responsible for antibodies production won't be numerous enough to provide with a good immunity.

Reference: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4159104/


Can the innate immune system defeat a pathogen by itself? Fast enough that we don't develop antibodies, etc.? - Biology

“Spanish Influenza – what it is and how it should be treated,” read the reassuringly factual headline to an advert for Vick’s VapoRub back in 1918. The text beneath included nuggets of wisdom such as “stay quiet” and “take a laxative”. Oh, and to apply their ointment liberally, of course.

The 1918 flu pandemic was the most lethal in recorded history, infecting up to 500 million people (a quarter of the world’s population at the time) and killing tens of millions worldwide.

But with crisis comes opportunity, and the – sometimes literal – snake oil salesmen were out in force. Vick’s VapoRub had stiff competition from a panoply of crackpot remedies, including Miller’s Antiseptic Snake Oil, Dr Bell’s Pine Tar Honey, Schenck’s Mandrake Pills, Dr Jones’s Liniment, Hill’s Cascara Quinine Bromide, and A. Wulfing & Co’s famous mint lozenges. Their adverts made regular appearances in the newspapers, where they starred alongside increasingly alarming headlines.

Fast-forward to 2020, and not much has changed. Though the Covid-19 pandemic is separated from the Spanish flu by over a century of scientific discoveries, there are still plenty of questionable medicinal concoctions and folk remedies floating around. This time, the theme is “boosting” the immune system.

Of the rumours currently circulating on social media, one of the more bizarre is the idea that you can raise your white blood cell count by masturbating more. And as always, nutritional advice abounds. This time, we’re being encouraged to seek out foods rich in antioxidants and vitamin C (back in 1918, the public were told to eat more onions), while pseudoscientists are peddling trendy products such as kombucha and probiotics.

According to one source, cayenne pepper and green tea can provide better protection against Covid-19 than face masks – a bold and highly dubious claim, considering that some face masks reduce your risk of contracting respiratory viruses by a factor of five. (Read more about what evidence exists for the idea that spices can affect your health, and how hot drinks will not protect you from Covid-19).

There’s no such thing as boosted immunity

Unfortunately, the idea that pills, trendy superfoods or wellness habits can provide a shortcut to a healthy immune system is a myth. In fact, the concept of “boosting” your immune system doesn’t hold any scientific meaning whatsoever.

“There are three different components to immunity,” says Akiko Iwasaki, an immunologist at Yale University. “There’s things like skin, the airways and the mucus membranes that are there to begin with, and they provide a barrier to infection. But once the virus gets past these defences, then you have to induce the ‘innate’ immune response.” This consists of chemicals and cells which can rapidly raise the alert and begin fighting off any intruder.


COVID-19: The immune system can fight back

Melbourne researchers have mapped immune responses from one of Australia's first novel coronavirus (COVID-19) patients, showing the body's ability to fight the virus and recover from the infection.

Researchers at the Peter Doherty Institute for Infection and Immunity (Doherty Institute) -- a joint venture between the University of Melbourne and the Royal Melbourne hospital -- were able to test blood samples at four different time points in an otherwise healthy woman in her 40s, who presented with COVID-19 and had mild-to-moderate symptoms requiring hospital admission.

Published today in Nature Medicine is a detailed report of how the patient's immune system responded to the virus. One of the authors on the paper, research fellow Dr Oanh Nguyen said this was the first time that broad immune responses to COVID-19 have been reported.

"We looked at the whole breadth of the immune response in this patient using the knowledge we have built over many years of looking at immune responses in patients hospitalised with influenza," Dr Nguyen said.

"Three days after the patient was admitted, we saw large populations of several immune cells, which are often a tell-tale sign of recovery during seasonal influenza infection, so we predicted that the patient would recover in three days, which is what happened."

The research team was able to do this research so rapidly thanks to SETREP-ID (Sentinel Travellers and Research Preparedness for Emerging Infectious Disease), led by Royal Melbourne Hospital Infectious Diseases Physician Dr Irani Thevarajan at the Doherty Institute.

SETREP-ID is a platform that enables a broad range of biological sampling to take place in returned travellers in the event of a new and unexpected infectious disease outbreak, which is exactly how COVID-19 started in Australia.

"When COVID-19 emerged, we already had ethics and protocols in place so we could rapidly start looking at the virus and immune system in great detail," Dr Thevarajan said.

"Already established at a number of Melbourne hospitals, we now plan to roll out SETREP-ID as a national study."

Working together with University of Melbourne Professor Katherine Kedzierska, a laboratory head at the Doherty Institute and a world-leading influenza immunology researcher, the team were able to dissect the immune response leading to successful recovery from COVID-19, which might be the secret to finding an effective vaccine.

"We showed that even though COVID-19 is caused by a new virus, in an otherwise healthy person, a robust immune response across different cell types was associated with clinical recovery, similar to what we see in influenza," Professor Kedzierska said.

"This is an incredible step forward in understanding what drives recovery of COVID-19. People can use our methods to understand the immune responses in larger COVID-19 cohorts, and also understand what's lacking in those who have fatal outcomes."

Dr Thevarajan said that current estimates show more than 80 per cent of COVID-19 cases are mild-to-moderate, and understanding the immune response in these mild cases is very important research.

"We hope to now expand our work nationally and internationally to understand why some people die from COVID-19, and build further knowledge to assist in the rapid response of COVID-19 and future emerging viruses," she said.


Preamble

This guideline primarily focuses on the diagnosis and treatment of cutaneous manifestations of Lyme borreliosis. It is the first part of the scheduled interdisciplinary guideline: “Lyme Borreliosis – Diagnosis and Treatment, No. 013-080, Development Stage S3”.

This part has already received consensus from 22 medical societies and 2 patient organisations. The German Cochrane Centre, Freiburg (Cochrane Germany) is currently conducting systematic review and assessment of the literature to develop this guideline to stage 3.

The interdisciplinary guideline group is currently preparing part 2 “Neuroborreliosis” which will be followed by part 3 “Lyme Arthritis, Lyme Carditis and Other Rare Manifestations”.

Synonyms

Cutaneous borreliosis, cutaneous manifestations of Lyme borreliosis, skin borreliosis, cutaneous Lyme borreliosis, cutaneous Lyme disease

Search terms

Borrelia burgdorferi infection, hard-bodied tick borreliosis, Lyme disease, cutaneous Lyme borreliosis, erythema migrans disease, erythema migrans, erythema chronicum migrans, lymphadenosis cutis benigna, borrelial lymphocytoma, multiple erythemata migrantia, multiple erythema migrans, acrodermatitis chronica atrophicans.


Will Law Schools Require Students to be Vaccinated?

Last week, Rutgers University announced that returning students must be vaccinated against COVID-19. The policy states that "Students may request an exemption from the vaccination requirement for medical or religious reasons." The scope of those exemptions, however, is unclear.

As we speak, law schools are no doubt holding discussions about whether they can impose vaccine mandates. State schools will have less latitude than private schools, in light of the Free Exercise clause, as well as state RFRAs. But I suspect schools, in general, will decide to impose some form of a vaccine mandate.

Imagine if every student in a 1L section is vaccinated. The school could eliminate the need for six (or three) feet of distancing. Students could once again sit in close proximity to their classmates. Masks would not be required. Professors could walk around the room without fear of infection. And instruction could return to what it was in 2019.

But what about students who refuse to be vaccinated? They may be stuck on Zoom. Perhaps those dynamics will provide a cudgel for students to get the jab over the next few months.

I recently received my first dose. I had a bit of fatigue, but no adverse symptoms. My arm was sore, but I quickly forgot about it. In class, I encouraged my students to get vaccinated, and explained (per school policy) any absence related to the shot would be excused. I hope other professors can likewise encourage their students. In Texas, all adults are eligible for the shot. And more and more states are moving in that direction.

Josh Blackman is a constitutional law professor at the South Texas College of Law Houston, an adjunct scholar at the Cato Institute, and the President of the Harlan Institute. Follow him @JoshMBlackman.

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If you’re vaccinated , i.e. can’t get he disease, why do you care about the presence of un-vaccinated people.

Like information, the relevant vaccines are not 100 percent effective.

They’re effective enough to lower the risk of Covid into the range of normal risks people routinely ignore. What do you want, perfection?

Millions of people got vaccinated in a state, 100 got COVID, far fewer than the 5% risk rate in trials, like 0.01%. Of those, 8 got hospitalized. None died.

Brett,
We don’t need perfection. We need data.
They are not only less than 100% effective, but clusters of vaccinated persons have shown positive PCR tests for short periods. In the EU a recent cluster of 18 persons showed infection for 1 or 2 days. Of these 4 were sent to hospital but did not develop life-threatening problems, 12 had mild symptoms, and 2 were asymptomatic. Data about their viral load were not given But viral loads range from 100,000 per ml to 1 trillion per ml of saliva or mucosal secretion.
Whether these case represents a common response to the original strain or the reaction to a new strain and whether the vaccine is just increasing the percentage of asymptomatic cases is unknown.
In any case the efficacy beyond 12 months is completely unknown.

“but clusters of vaccinated persons have shown positive PCR tests for short periods.”

This is perfectly normal. Vaccines, or normal immune response, don’t make a virus bounce off you like there’s a glass wall around you. You get infected, just like anybody else, then your immune system responds so fast the infection never gets bad enough to really notice.

If you’ve got a group of vaccinated people who are exposed to a REALLY high viral load, so many cells are initially infected that the virus has a bit of a head start on the immune system, and can produce a perceptible illness.

You would see this with ANY illness people get vaccinated against. It’s just that you don’t normally hear about it because doctors don’t routinely use ultra-sensitive tests on people who aren’t seriously ill, to prove that they’re catching something they’d been vaccinated against.

“This is perfectly normal.” That is another statement of yours based on lack of actual knowledge. Moreover, SARS-CoV-2 is the first infection win which MRNA vaccines have been used.
You seem to specialize in misleading generalities driven by your politics.

It is perfectly normal for people who have “immunity” to a disease, whether derived from an actual infection, or vaccination, to get asymptomatic reinfections. That’s basic to how the immune system functions. You’d understand that if you knew how the immune system works. It’s not a magic force field, on reexposure you DO get infected.

Read the part about adaptive immunity. Even people who are ‘immune’ to a pathogen still get infected if exposed to it again. It just tends to get stomped before you notice.

But PCR tests are VERY sensitive, they can detect even such trivial infections that are meaningless so far as your health is concerned.

Brett,
I don’t need your condescending remarks as I work with physicians who are virologists and immunologists, who are concerned about the present post-vaccine reactions.

Go ahead and live in a fool’s paradise, based on your freshman knowledge of biology.

“Data about their viral load were not given But viral loads range from 100,000 per ml to 1 trillion per ml of saliva or mucosal secretion.”

Data is not the plural of anecdote. “a recent cluster of 18 persons” is not data.

I don’t think you and Don Nico are disagreeing. He’s saying we need data and that there’s some anecdata that would suggest that “conventional wisdom” on the topic is not necessarily a good default without actually getting the data.

They might be minor disagreements, but in the absence of data there has to be some heuristic that guides policy. If conventional wisdom anecdote says X and some tiny subset new anecdote says not-X, something has to give. (Or, alternatively, it’s too soon to tell, there is insufficient support for X or not-X, in which case the default should be much closer to do nothing than do something.)

Data = Massive number of anecdotes run through a mathematical blender.

Matt as you have now revealed your complete ignorance about observational science, you can be safely ignored.

No, 18 in a filed medical report by trained personnel is data. It is just not much.
You seem not to understand observational science.

What seems to be lacking is a rational assessment of the risk.

The risk of getting hit by lightning is probably greater than the risk of catching covid after vaccination or prior covid infection.

People wearing a mask after vaccination isnt based on a rational assessment of the risk. Its based on “fear”- a fear that consumes the person.

Consider why you have to put that word in there.

you missed the important point about a rational assessment of the risk.

“The risk of getting hit by lightning is probably greater than the risk of catching covid after vaccination or prior covid infection.”

That assertion seems silly. What level of vaccine effectiveness would support that assertion? What levels of vaccine effectiveness have been reported?

Moderna says 95% effective for a disease that is 99+% survivable.

As well, if you do get it after the vaccine, it’s almost guaranteed to be a mild case, unless you’re severely immune compromised.

Wreck,
The disease is NOT 󈭓+% survivable.”
Case fatality rate vary from country to country and are in the range of 2% – 3% and rising in several industrialized nations.

That’s not taking into account the large fraction of people who get asymptomatic cases. Only the people who get medical attention.

Again Brett. You’re not telling the whole truth. Your comment does not explaing increases in the CFR in the past 5 months. It also does not account for the fact that almost all the reported instances of asymptomatic cases are only presymptomatic. Nor does it account that we now have considerable data about exposure and previous infection doe to both PCR and serological tests.

Yea its the whole truth. The CDC used to publish such stats but no longer does because people may get the wrong idea.

Wreck,
You need not rely on the CDC. Consult the available material from the numerous public health agencies in the industrialize world and you will find the the fraction of actually asymptomatic cases is quite low.
You can trump-bludgeon the CDC but that all amounts to lying.

Your large fraction is certainly not a preponderance of cases.
Most of what you thin are asymptomatic are actually presymptomatic

You have to deduct the 25% mortality of moribund nursing home patients. Your 2% rate is fraudulent. It is like the flu, puffed up to promote tech billionaire enrichment. There were excess deaths in 2020. Half came from people locked down from early diagnosis and care of cancer and heart disease. The lawyer scumbag Dem Govs killed thousands of American, by the lockdown, not by the virus. Then these scumbags allowed infected, asymptomatic young people to travel to provide intimate care to eradicate thousands of nursing home patients, saving Medicaid $billions.

The world economic downturn killed millions of poor people by starvation.

No bigger mass murderers than the lawyer scumbag Dem Govs. Bigger and faster than all mass murdering 20th Century tyrants.

David the rates I quoted are from the past 5 months, long after the care home tragedies.
You’re talking about matters that you know nothing about.

Real world: tightest lockdowns, highest death numbers, big tech billionaire enrichment. Stop defending the indefensible, mass murder by the lawyer scumbag to enrich tech billionaires.

You can’t make a rational response so you revert to your usual “lawyers are the toilers in the fields of Satan” arguments.
Worthless blather.

You’re talking about matters that you know nothing about.

That’s kind of definitionally true with Behar.

In addition to Nico’s point, Moderna’s single data point is not determinative.

1) Buildings are stupid, travel is stupid. End them, discount tuition by closing physical infrastructure overhead. This idea promotes the interests of the tech billionaires, but no one cares

2) Vaccines are effective, but have no long term data about cancer or unpredictable effects. Of course the disease is far more risky than the vaccine for the elderly. It is not using any part of the virus

3) young people in 1L who get infected are likely to have no symptoms or very mild symptoms unless immunocompromised. Cannot argue if they think, long term effects should be better known. So choice, not coercion is medically appropriate.

As to exams, any lawyer analyzing 50 issues in 2 hours, from memory, is committing malpractice. Exams should get real world, be open book, open Westlaw, open consulting of specialists. Time should be 24 hours.

IRAC is from Scholasticism. Best briefs were by St. Thomas. IRAC is prohibited in our secular nation.

More anti-lawyer blah, blah. Your brain is stuck in a rut.

Try a rebuttal instead of a personal insult for a change of pace, as an intellectual exercise.

I spole of all self stated goals of all law subjects being in utter failure. I recommend all law students attend a half day of Traffic Court, run in accordance to the Rules of Criminal Procedure. They will see nothing covered in law school. And, nothing they see will have been covered in law school. Law school is in failure. It sucks like every aspect of the lawyer profession, the most toxic occupation in our nation, 10 times more toxic than organized crime.

Blackman and Volokh teach 1L. They need to repent.

Try examining the insults to see if there are any accurate complaints. Hint: yes.

Like the entire covid event, terms are used and never defined

What is effective?
All of the vaccines for the rona, are 100% effective at keeping people out of hospitals and alive. But that is not the goal. If that were the goal. 100% of the vulnerable would be vaccinated by now. But. govt in its wisdom have not prioritized the vulnerable.

Because there are people who can’t get vaccinations and are thereby left vulnerable.

If you think you’re already smarter than all the so-called authorities anyway, why do you care about going to classes at all, much less in person?

“If you’re vaccinated , i.e. can’t get he disease, why do you care about the presence of un-vaccinated people.”

YOU can’t get the disease, but THEY still can. Why would any Conservative give a damn what happens to any other person?

THEY should take appropriate steps. If THEY are vulnerable THEY have already been Vaccinated.

There are three things being overlooked here.

First, the latest I’ve heard is that the distance/mask mandates will remain even when everyone is vaccinated. I don’t know how much of this is science and how much is fascism, but I’m hearing it.

Second, and more importantly, law school is a buyer’s market and has been so for over a decade now. Enrollment plummeted and numbers haven’t returned — and law schools are now also looking at declining demographics as the Millennials age out.

Correct me if I am wrong, but don’t most entering law students have an acceptance at more than one law school? Well, those not wanting to be vaccinated may well make a decision between two law schools on this basis — and with all the effort in “enrollment management” (i.e. finding warm bodies to fill seats), I can’t see paying students being turned away for lack of a vaccination.

And third, there are a lot of people with natural immunity — and there are some medical questions about the safety of vaccinating them.

“First, the latest I’ve heard is that the distance/mask mandates will remain even when everyone is vaccinated. I don’t know how much of this is science and how much is fascism, but I’m hearing it.”

That’s almost entirely fascism. They’re using this pandemic to switch to an “absolute safety” standard, unlike any other disease has ever been subject to. Expect that, even if it goes away, they’ll try to impose mask mandates every flu season.

They simply want to stop making cost/benefit judgements on medical precautions anymore.

“That’s almost entirely fascism. ”
Brett you don’t KNOW that. It is your political opinion.

I’ll grant a large fraction of political motivation to such statements. But given what the society does not know through experimental verification about the efficacy as a function of time. A mask mandate may be a prudent measure.

“A mask mandate may be a prudent measure.”

Not according to the CDC statement on masks and the ‘real’ flu:
Background Masks are not usually recommended in non-healthcare settings however, this guidance provides other strategies for limiting the spread of influenza viruses in the community.
Unvaccinated Asymptomatic Persons, Including Those at High Risk for Influenza Complications
No recommendation can be made at this time for mask use in the community by asymptomatic persons, including those at high risk for complications, to prevent exposure to influenza viruses.

First, we are not talking about flu. Corona virus is not flu.
Second, CDC is still recommending masks for corona viruses.
Granted, the way many people use masks they are pretty ineffective.

They’re recommending them because the standards have changed. We got caught up in a kind of medical moral panic, and nobody can back down now without being accused of not treating Covid seriously.

Again, just political speculation on your part.
When the US has a rate of contagion 10x greater than anywhere else on the planet more than Pollyanna wishful thinking is called for.

If your complaint is that Ole White Joe does not tell people to stop touching and raining and lowering their masks, touching mucosal surfaces, etc. then I’ll agree with that. A mask poorly used is not helpful. But the enforcement of distancing requirement is the signle strongest measure against contagion.

“When the US has a rate of contagion 10x greater than anywhere else on the planet more than Pollyanna wishful thinking is called for.”

Fine, then. Wake us when that actually happens.

Finally, you have told us the while truth.
You can type while you are asleep.

You are undoubtedly referring to cases not normalized by population. We look bad on that because we’re the third most populous country in the world. The most populous, China, issues fraudulent numbers, and the second, India, isn’t doing enough testing to produce plausible case numbers.

“Antibody tests suggest that India may be undercounting infections by a factor 50 to 100, Laxminarayan said — meaning that although the country’s official total is 4.4 million cases, the “true” number could be upwards of 100 million.”

Brett,
Two of the physicians in our goup are virologists from (and in India).
Your speculation about under-reporting is a gross speculation and may be a simple lie.

Don, you sure do appeal to your Really Smart Friends a lot.

Let’s turn to actual numbers. India has conducted about 243MM total tests in a population of about 1390MM. Even under the unrealistic assumption the 243MM includes no dupes, that’s only 17% of the population.

There’s simply no basis for anyone, Really Smart or otherwise, to say that all infections — or even close to all infections — are being detected.

Brian,
They are not just really smart friends. In this case, they are people that I am working with on the topics of SARS-CoV-2 infections.

If you look at per capita numbers, instead, you will see we are well down the list.

I mean, if you look at per capita numbers, you will see that we are not well down the list. We’re one of the worst countries.

Brett,
“If you look at per capita numbers, instead, you will see we are well down the list.”
You lie.
If look on a per capita basis the US is 14th out of more than 200 nations.
Hardly well down the list and discounting San Marino and Gibraltar the US is 12th in deaths per capita.

I guess you learned about honesty from the Orange Clown

Note how Mr. 󈫺x greater contagion rate” scurried away when faced with hard numbers and is now trying to distract by screeching that subjective language is somehow a “lie.” Shameless.

“When the US has a rate of contagion 10x greater than anywhere else on the planet more than Pollyanna wishful thinking is called for.”

A lie. Its high but on par with Israel and less than several European countries. In the end, all of Europe except the UK will be worse.

Its lying countries [China], islands, and poor countries with no testing that we are 10X worse than.

Brett, I know the rates per person almost by heart. The US is doing as badly as Germany, Italy and France. Okay. We have nothing to be proud of.
Again, you adore anything that reflect badly on your politics of “Trump did nothing bed concerning covid.” Actually he squandered the golden opportunity to win by a landslide by letting real doctors do their job and just showing compassion and good sense.

He also can’t levitate. Asking him to do something he had no ability to do is just an expectation waiting to be disappointed.

If you are saying that Trump disappointed Brett, that is obvious.

” I don’t know how much of this is science and how much is fascism, but I’m hearing it.”

Spend less time listening to fascists, and that problem will go away by itself.

Would they be on Zoom for their own benefit or others? If their own, why couldn’t they wear N95 masks? Others who were vaccinated shouldn’t care.

It’s bare, naked, fascism.
They want to control people, nothing less.

Horse hockey. Your opinion based on knowing nothing

When your main arguments against a policy are speculation about the future and speculative telepathy, you don’t really have a good argument at all.

The old folks who teach have their shots. By next semester enough young people will have their shots that we won’t have epidemic outbreaks any more. But people like making rules for other people.

How do some of these ‘you not boss of me’ malcontents handle stop signs, red lights, lane markers, and ‘do not park in intersection’ mandates?

Those under the age of 10 or so should get some slack in this regard.

You’re actually equating traffic laws to getting a vaccination?

I was referring to reflexively anti-social misfits.

Hi, Artie. A town in Germany removed all those and eliminated accidents. Traffic rules are irrational, rent seeking, revenue generating lawyer fraud.

Vaccine only is effective for 3-6 months. What are they going to do, mandate an ongoing regime of shots?

OK, that’s a fantasy. They’re saying it’s only been proven to work for 3-6 months, but they’re only saying that because that’s all the clinical experience they have with it. There’s no evidence it actually stops working remotely that fast.

Considering the virus has mutated to various strains already, and the flu vaccine only is partially effective with whatever strains they think will be prevalent and has to be changed every year, and essentially COVID is a coronavirus (what we used to call the common cold), what say you?

So far, none of the variants that have turned up are entirely able to bypass the vaccine Effectiveness is reduced, but still high. This is rather different from influenza, where if they pick the wrong strains, the vaccine is largely worthless. Influenza is a lot more variable than Covid.

That said, it would not hugely surprise me if they had to update the vaccine at least once, fortunately quite easy to do with mRNA vaccines. Hopefully they won’t drag their heels approving the new version.

Covid IS a coronavirus. There are several hundred different viruses that cause “the common cold”, it’s sort of an evolutionary sweet spot viruses evolve towards, just virulent enough to propagate, without incapacitating the host enough to cause them to isolate. I’d expect Covid 19 to also eventually evolve into another cold virus, given enough time. Being extremely virulent is a bad ‘lifestyle’ for a virus, it’s maladaptive. That’s why you usually see extreme virulence only in viruses that have just jumped species, and aren’t yet adapted to live in a host without killing it.

Only four of those “common cold” viruses are coronaviruses. Most are not. Notably, though, exposure to any of those coronavirus common colds apparently gives you significant immunity to Covid, enough to get you a mild case.

Exposure to Covid in one variant also apparently gives you substantial immunity to other variants, of the same sort. So, once everyone has been vaccinated or exposed, Covid is likely to cease to be a serious illness, even as it does mutate. It will become the sort of thing you catch as a child, suffer very little more than a runny nose, and never worry about again.

Brett,
You are whistling in the dark, saying many things about this family of virus that are merely your optimistic suppositions.

I spent four years in college studying human biology, and read medical research for fun.

See this, for instance. If you catch a cold while coming down with Covid, it’s protective.

I spent four years in college studying human biology, and read medical research for fun.

Maybe you are some kind of savant in biology. But the thing is, your conceptual foundation is screwed up. don’t seem to know the first thing about scientific proof, and assert certainty where there is none.

Maybe you’re right. But we won’t and can’t know for at least 3 or 4 years.

Wow! Brett. Bully for you.
I have been doing research on SARS-CoV-2 for the past year and meet monthly with an international panel of experts about the topic.

Wow, and you still didn’t know that ‘immunity’ doesn’t mean you don’t get trivial infections detectable by PCR if re-exposed? That’s amazing.

You are truly ignorant Brett.
No one said that you cannot be reinfected by SARS-CoV-2 and carry that infection for a long time. The only claim is that the vaccine is for an indefinite time effective in preventing that infection from turning into covid-19 and its associated pneumonia.

And no one said that the infections are trivial. Some will get reinfected and will die. But to you that is probably trivial unless the reinvected one is Trump.

Or, how about this? Previous infections with milder strains of coronavirus reduces severity of subsequent Covid 19 infections.

Single papers are not scientific proof, *especially* in the medical disciplines.

The longitudinal studies won’t come out for some time yet. And even then, they’ll need to be repeated – did you see the ridiculous data they used for the London HQC longitudinal study?

How about it Brett?
That is a speculation to explain low contagion in south east Asia.

There may be some speculation, but that article is about actual research findings.

BTW,
Your citation is to a popularized article about medical speculations, not about any extensive study, either physiological or epidemiological.

If you can’t make a lasting vaccine for colds, or the flu, then in a short period of time, the COVID19 vaccine will be useless. Or, as you say, they updated the thing and suddenly they tell everyone they have to get a new round of shots.

Oh, and had to change the definition of “vaccine” post hoc to make those mRNA treatments a “vaccine”.

You CAN make long lasting vaccines for colds. It’s just kind of futile, because there are several hundred different “colds” “The common cold” is just how we refer to a whole group of viruses that cause roughly similar symptoms.

The number of different vaccines it would require is impractical, especially given that “the common cold” isn’t that serious.

“You CAN make long lasting vaccines for colds. ”
Please present medical evidence for that fact.

“Oh, and had to change the definition of “vaccine” post hoc to make those mRNA treatments a “vaccine”.”

Nobody is changing anything. mRNA vaccines have been around for decades.

You say effectiveness is reduced but is still high.
Probably true but quantitatively poorly evaluated.

Then you continue with your personal peculation.

Exactly, there is no clinical data. So how do you attribute all caution to fascism.
Do you KNOW that the people for whom it is less effective are not exactly the super-spreaders? NOPE.
There is still a lot to learn.
The only thing that we know is that the vaccinated are willing to take more of a chance to go about their business as before.

“So how do you attribute all caution to fascism.”

The fascism stuff is annoying, but if “there is no clinical data” there’s no basis for caution, either. There is clinical data (to say nothing of centuries of experience in epidemiology), and the caution/policy should follow the data, not the worst imagination of people. Cost-benefit doesn’t run one direction just because you can imagine horrible things might happen.

NT,
The problem that there is considerable data about the levels of contagion and the rising level of case fatality ratio. The centuries of epidemiology is irrelevant with respect to SARS-CoV-2 or the extremely large range of titers (that I cited above) of the disease or about the efficacy of mRNA vaccines.
31 million cases of covid-19 in the US is hardly in the imagination of people nor are nearly 560,000 dead in the US alone.
The cost of wearing a mask is minimal as one opens the economy. I think that you are dismissing the negative which has shown its face for the past 17 months, to the benefit of a hoped for future.

“The problem that there is considerable data about the levels of contagion and the rising level of case fatality ratio.”

This is inconsistent with the data I’ve seen. And the case fatality ratio ignores non-reported cases. The infection fatality ratio is the measure of a disease’s lethality. But I’m happy to look at whatever data you have.

Here’s the data I’m looking at. It does not show a rising CFR. It shows a flat or decreasing CFR. Pick any two spots on the chart (“Cumulative confirmed COVID-19 deaths and cases, World”) and see for yourself. If increased testing decreases the CFR, that should tell you that the IFR is probably lower than the CFR from pre-testing days. (There are other things that will bring a CFR down, regardless of the initial IFR. And the IFR changes over time as well, for all diseases.) Even easier: scroll down to “Case fatality rate of the ongoing COVID-19 pandemic” by country. The trend line is way down.

If you are looking, look again evaluate correlations on a per person basis and correlated with testing on a per person basis.

Could you explain? I don’t know what you mean. How would I go about evaluating correlations on a per person basis correlated with testing on a per person basis?

“on a per person basis”
you might like the Latin better “per capita”

This is getting tiresome. Can you just tell me what you fucking mean? This started because you said “case fatality ratio”. That has a set meaning. It is the ratio between cases of COVID on the one hand and fatalities from COVID on the other. Then you said this jumbled mess:

“evaluate correlations on a [per capita] basis and correlated with testing on a [per capita] basis”.

I don’t know what this fucking means, I don’t speak you. Evaluate which correlations?

If you mean cases of COVID are rising per capita, that’s true any time cases increase and the population remains stable. If you mean fatalities of COVID are rising per capita, that’s true any time fatalities increase and the population remains stable. Are you just trying to say that COVID cases continue to increase?

Stop hiding the ball and just tell me what you meant by “rising level of case fatality ratio”. Why is it when I say shit with a link, your response is for me to look again, but when I ask you to explain what you mean, you respond in code? Are you fucking with me or are you serious about having a conversation? If the former, just say so and we can both move on. JFC.

“other things that will bring a CFR down”

That does explain reductions in the first six months, but not the most recent six months. Moreover, there are no data reported on the time variation of the level of truly asymptomatic cases on a country by country basis. Hence, you comment about discounting the asymptomatic numbers is not relevant to the secular trends in the data.

Epidemiology is more complex than looking at one website.

We agree that epidemiology is more complex than looking at one website. Where do you suggest I look to evaluate your claim that the CFR is going up? And do you have a website that shows the IFR going up? The general trend in epidemiology is for both to go down, as treatments improve, estimates of asymptomatic cases improve, etc. It would be remarkable if COVID was somehow different. And if you think it is different, what’s your theory on causation?

But before we get there, let’s start with what you are looking at that convinces you that CFR or IFR is going up.

The thing is, NToJ, there is data – it’s just not determinative. It’s all extremely uncertain, as can be seen by results being all over the map. Add in attempts to generalize based on previous experience with other diseases, and there’s enough there to pick results to suggest just about anything you want.
Useful to policymakers when they’re deciding on the risk mix they’ll allow, but also such that people on the Internet saying ‘this is how it is and shall be’ are fixing studies to their narrative, not vice versa.

The mainstream papers printing all the bad news stories are also being dumb about the science.

“Useful to policymakers when they’re deciding on the risk mix they’ll allow, but also such that people on the Internet saying ‘this is how it is and shall be’ are fixing studies to their narrative, not vice versa.”

All true. The problem is that “policymakers” are the same species of animals as “people on the Internet”. When people become policymakers, they don’t suddenly become immune to the same cognitive biases. That also helps explain some of the variability in data data is collected by flawed humans, too. All the more reason for people to focus exclusively on data and science rather than demagogues.

I have a major problem with solutions when data is uncertain. First is the assumption that if the data is uncertain we have to do something. This is a conceit mainly of people in power, who remain there by proving they are doing something. It’s contributed to by people who sell ACTION or FEAR, like every source of news you consume (which speaks directly to your point about news stories). There may be a rational basis for action over inaction, like a black swan event, but you can’t even discuss black swan events intelligently without having priors, and you only get those with data and experience. So if data and experience is truly a wash, there’s no rational reason to prefer ACTION over INACTION. And since ACTION involves acts by idiot people, if anything we should feed the omission bias.

My main point is that if it is true that the data is not reliable, then our reaction should not be to tell stories with data. We should just do something else. Or find better data. “Wait and see” strikes me as a sensible approach under those circumstances.

Focusing exclusively on the science is not right either though. Policy is science + values.

And people around here who insist that their value of freedom means free rider-based costs are of no moment are arguing more from self-validation than dealing in reality.
I will note that it is a lot rarer to find people on the other side of that mix, and advocating for permanently social distancing with masks, media doomsaying aside.

I don’t know that I like your default of wait and see idea. Lots of countries did a waiting thing. Sweden, UK, Brazil…They still suffered economically. I don’t think it’s that simple, even in retrospect.

Though speaking of retrospect, I would not be surprised if by 2025 we get better science and it turns out we were all way too spun up. But that’s 2020 hindsight. And maybe part of that is the bias towards action, but I don’t think that’s at all clear. Trump had a bias towards maintaining the status quo in spades, and it did not seem to be really well aligned with public thinking, the rarified air in this blog aside.

I’m glad navigating the mix of divided values plus sketchy data is not my job.

“Policy is science + values.”

Right but at the end of the day the vast majority of humans have the same values, ordinarily some theme on utilitarianism. Even nihilists like bob from ohio ostensibly believes that his side winning at all costs means the world will be better. (Or, more likely, he thinks pretending to be a nihilist on the internet is harmless.)

Also I can test values. If someone purports to care about the human condition, and wants to mitigate human misery, but then spends their time precious, finite time ranting about snow blindness in cats, that person is either lying about their values or is irrational. In either event, policy should not factor in their stated values (except to the extent this person needs to be managed so that some other good can be had).

“And people around here who insist that their value of freedom means free rider-based costs are of no moment…”

Can be tested just like our hypothetical snow blindness in cats person. Or they are just bob from ohio looking for a human connection by pretending to be something they really aren’t.

“I don’t know that I like your default of wait and see idea. [Provides anecdotes of why this approach failed in the past.]”

That’s you saying you have evidence that supports not waiting and seeing. That’s perfectly consistent with what my approach is, which is only act on evidence (not fear-based intuition). I think we probably disagree about the total universe of evidence, but I’m not suggesting anything more radical that people have evidence before they move towards policy.

“Trump had a bias towards maintaining the status quo in spades…”

That is certainly not my recollection of the last administration.

Right but at the end of the day the vast majority of humans have the same values, ordinarily some theme on utilitarianism.

This is absolutely off topic, but I don’t think that’s right. Certainly utility is always in the mix, but I’d argue that America at least is really Kantian. Our fictional supervillains are the ones with the pure utilitarian arguments our heroes are the ones that won’t sacrifice individuals to gain utility. That’s the mythology we tell ourselves, and I’d say it both reflects and creates our values.

Your point about values doesn’t speak directly to what the right policy is, but I do think your point about Bob, etc. being more performative on the Internet than for real is almost certainly true.

Backwards-looking anecdotes don’t seem like useful evidence to me.

Your point about intuition is really interesting. In my biz – funding of basic research – intuition is secretly the backbone. Once you start trying to make it rational or based on metrics, you’re suddenly doing applied research with an outcome in mind. I’d argue policy is similarly an endeavor not devoid of that intuitive/nonrational aspect, though many do try and deny it.
We like to pretend data is sufficient to determine policy, because we want responsibility to somehow be rationally allocated based on some predicable system. But our systems are anything but predictable, and neither are our individual values. We strive for consistency, but I’d say most of us fail a lot. Hypocrisy is the tribute virtue pays vice and all that. But as I said, that’s also part of what we want. For better or worse, we don’t want a President-bot maximizing utility.

“Certainly utility is always in the mix, but I’d argue that America at least is really Kantian. Our fictional supervillains are the ones with the pure utilitarian arguments our heroes are the ones that won’t sacrifice individuals to gain utility.”

First, I don’t think it’s sensible to evaluate how humans actually are by how their imaginary heroes or villains are. Heroes, by definition, are supposed to inspire us to be better than our true natures. Utilitarian villains make a lot of sense to avoid mustache-twirling tropes. It’s because we identify with the utilitarian motivations of villains that makes them believable (and effective in art).

Second, it’s not always been the case. Where did the mustache twirling tropes come from? (And where do Greek and Norse gods fall on the hero/villain continuum?)

Third, the mythology is broad and varied enough that I’d have a hard time accepting any definition of American Mythology.

Fourth, it’s possible that humans are Kantian but unlikely. The feedback loop that makes humans does not reward Kantianism. Utilitarianism speaks to pleasure/pain, things we’ve evolved visceral understandings of. Humans have to be taught Kant.

I will spot you that there is robust empirical evidence that humans do not behave like utilitarians in many control scenarios, but in my view that doesn’t prove that humans are not utilitarian. It just proves that humans are evil.

And I do want a President-bot maximizing utility.

Americans are Kantian. Humans do not ascribe to any universal philosophy.

I think the myths we tell ourselves are as close a way to assess our values as anything else.
And I don’t know of the idea of heroes as being purely aspirational. Utilitarian but aspiring to be Kantian is an odd set of values, no?

I concur that this has not always been the case values change. But what we once were was deontological over utilitarian. All that talk of honor and what not amongst the Founders.

Humans are really good at creating weird incentive systems that make them act in ways other than to maximize utility. Kant codified that system, he did not invent it.

I Robot had us ending up with utility-maximizing robots running everything. It didn’t seem bad to me either, but I think it’s telling that the Hollywood reboot had that as a sinister scenario, wherein the utilitarian robots pushed for a police state. I think you and I are the outliers amongst the populous.

This discussion, while interesting, is hopelessly imprecise. There’s a lot of overlap between what deontology permits or prohibits and what utilitarianism permits or prohibits. And there are 70 different sub-flavors within each. And it’s difficult to define American values in a country with such a diverse set of humans in it.

“I think the myths we tell ourselves are as close a way to assess our values as anything else.”

I was thinking how humans actually behave is at least as good an assessment of human values than our imaginations. I often wake up from a dream believing I just played an amazing game of professional basketball, only to slowly realize that I’m not good at basketball in the world I occupy. A young NTOJ would casually idolize Wolverine, but I no more shared his values than I did shared Michael Jordan’s.

“All that talk of honor and what not amongst the Founders.”

We are not going to resolve this debate with cherry-picking, but I can do it too. All that talk of honor turned to general Welfare when it came to the real business of organizing our actual affairs. And there’s plenty of room for honor and virtue in Rule Utilitarianism.

For I, Robot, it matters whether you’re a positive or negative utilitarian. But anyway, what made the movie version of I, Robot’s villain so sinister is not that it was a creature with values foreign to humans. The police state was scary because humans experienced it and don’t like being told what to do. The road to hell being paved with good intentions describes a lot of human experiences.


How Vaccines Work

A vaccine works by training the immune system to recognize and combat pathogens, either viruses or bacteria. To do this, certain molecules from the pathogen must be introduced into the body to trigger an immune response.

These molecules are called antigens, and they are present on all viruses and bacteria. By injecting these antigens into the body, the immune system can safely learn to recognize them as hostile invaders, produce antibodies, and remember them for the future. If the bacteria or virus reappears, the immune system will recognize the antigens immediately and attack aggressively well before the pathogen can spread and cause sickness.

The Herd Immunity Imperative

Vaccines don't just work on an individual level, they protect entire populations. Once enough people are immunized, opportunities for an outbreak of disease become so low even people who aren't immunized benefit. Essentially, a bacteria or virus simply won't have enough eligible hosts to establish a foothold and will eventually die out entirely. This phenomenon is called "herd immunity" or "community immunity," and it has allowed once-devastating diseases to be eliminated entirely, without needing to vaccinate every individual.

This is critical because there will always be a percentage of the population that cannot be vaccinated, including infants, young children, the elderly, people with severe allergies, pregnant women, or people with compromised immune systems. Thanks to herd immunity, these people are kept safe because diseases are never given a chance to spread through a population.

Public health officials and scientists continue to study herd immunity and identify key thresholds, but one telling example is the country of Gambia, where a vaccination rate of just 70% of the population was enough to eliminate Hib disease entirely.

However, if too many people forgo vaccinations, herd immunity can break down, opening up the population to the risk of outbreaks. That is why many officials and doctors consider widespread immunization a public health imperative and blame recent disease outbreaks on a lack of vaccination.

For example, in 1997, prominent medical journal The Lancet published research claiming to have found a link between the measles vaccine and autism. As a result, in following years the parents of over a million British children decided not to vaccinate their kids. The research has since been thoroughly debunked, but the number of measles cases has skyrocketed, from just several dozen a year in 1997 to over 2,000 cases in 2011. Similar outbreaks have occurred throughout the United States, involving both measles and whooping cough, with doctors and officials blaming low rates of vaccination.

Types of Vaccines

The key to vaccines is injecting the antigens into the body without causing the person to get sick at the same time. Scientists have developed several ways of doing this, and each approach makes for a different type of vaccine.

Live Attenuated Vaccines: For these types of vaccines, a weaker, asymptomatic form of the virus or bacteria is introduced into the body. Because it is weakened, the pathogen will not spread and cause sickness, but the immune system will still learn to recognize its antigens and know to fight in the future.

  • Advantages: Because these vaccines introduce actual live pathogens into the body, it is an excellent simulation for the immune system. So live attenuated vaccines can result in lifelong immunity with just one or two doses.
  • Disadvantages: Because they contain living pathogens, live attenuated vaccines are not given to people with weakened immune systems, such as people undergoing chemotherapy or HIV treatment, as there is a risk the pathogen could get stronger and cause sickness. Additionally, these vaccines must be refrigerated at all times so the weakened pathogen doesn't die.
  • Specific Vaccines:
    • Measles
    • Mumps
    • Rubella (MMR combined vaccine)
    • Varicella (chickenpox)
    • Influenza (nasal spray)
    • Rotavirus

    Inactivated Vaccines: For these vaccines, the specific virus or bacteria is killed with heat or chemicals, and its dead cells are introduced into the body. Even though the pathogen is dead, the immune system can still learn from its antigens how to fight live versions of it in the future.

    • Advantages: These vaccines can be freeze dried and easily stored because there is no risk of killing the pathogen as there is with live attenuated vaccines. They are also safer, without the risk of the virus or bacteria mutating back into its disease-causing form.
    • Disadvantages: Because the virus or bacteria is dead, it's not as accurate a simulation of the real thing as a live attenuated virus. Therefore, it often takes several doses and "booster shots" to train the body to defend itself.
    • Specific Vaccines:
      • Polio (IPV)
      • Hepatitis A
      • Rabies

      Subunit/conjugate Vaccines: For some diseases, scientists are able to isolate a specific protein or carbohydrate from the pathogen that, when injected into the body, can train the immune system to react without provoking sickness.

      • Advantages: With these vaccines, the chance of an adverse reaction in the patient is much lower, because only a part or the original pathogen is injected into the body instead of the whole thing.
      • Disadvantages: Identifying the best antigens in the pathogen for training the immune system and then separating them is not always possible. Only certain vaccines can be produced in this way.
      • Specific Vaccines:
        • Hepatitis B
        • Influenza
        • Haemophilus Influenzae Type B (Hib)
        • Pertussis (part of DTaP combined immunization)
        • Pneumococcal
        • Human Papillomavirus (HPV)
        • Meningococcal

        Toxoid Vaccines: Some bacterial diseases damage the body by secreting harmful chemicals or toxins. For these bacteria, scientists are able to "deactivate" some of the toxins using a mixture of formaldehyde and water. These dead toxins are then safely injected into the body. The immune system learns well enough from the dead toxins to fight off living toxins, should they ever make an appearance.

        Conjugate Vaccines: Some bacteria, like those of Hib disease, possess an outer coating of sugar molecules that camouflage their antigens and fool young immune systems. To get around this problem, scientists can link an antigen from another recognizable pathogen to the sugary coating of the camouflaged bacteria. As a result, the body's immune system learns to recognize the sugary camouflage itself as harmful and immediately attacks it and its carrier if it enters the body.

        DNA Vaccines: Still in experimental stages, DNA vaccines would dispense with all unnecessary parts of a bacterium or virus and instead contain just an injection of a few parts of the pathogen's DNA. These DNA strands would instruct the immune system to produce antigens for combating the pathogen all by itself. As a result, these vaccines would be very efficient immune system trainers. They are also cheap and easy to produce.

        Recombinant Vector Vaccines: These experimental vaccines are similar to DNA vaccines in that they introduce DNA from a harmful pathogen into the body, triggering the immune system to produce antigens and train itself to identify and combat the disease. The difference is that these vaccines use an attenuated, or weakened, virus or bacterium as a ride, or vector, for the DNA. In essence, scientists are able to take a harmless pathogen, dress it in the DNA of a more dangerous disease, and train the body to recognize and fight both effectively.


        Acquired immunity

        This is immune protection that the body learns after having certain diseases. The body learns to recognise each different kind of bacteria, fungus or virus it meets for the first time. So the next time the same bug invades the body it is easier for the immune system to fight it. This is why you usually only get some infectious diseases such as measles or chicken pox once.

        Vaccination works by using this type of immunity. A vaccine contains a small amount of protein from a disease. This is not harmful but it allows the immune system to recognise the disease if it meets it again. The immune response can then stop you getting the disease.

        Some vaccines use small amounts of the live bacteria or virus. These are live attenuated vaccines. It means that scientists have changed the virus or bacteria so that it stimulates the immune system to make antibodies. A live vaccine won't cause an infection.

        Other types of vaccine use killed bacteria or viruses, or parts of proteins that bacteria and viruses produce.


        Chronic inflammatory diseases

        Some conditions that do not involve autoantibodies are referred to instead as "autoinflammatory" syndromes. Immune cells in the body's first-line defense mechanism (including neutrophils, macrophages, monocytes and natural killer cells) trigger a chronic inflammation on their own, leading to the destruction of various tissues: the skin in psoriasis (which affects 3 to 5% of the European population), some joints in rheumatoid arthritis (see inset), the digestive tract in Crohn's disease, and the central nervous system – the brain, spinal cord and optic nerve – in multiple sclerosis (see inset below). Whether autoimmune in the strict sense of the term or autoinflammatory, all these conditions are the result of immune system dysfunction and develop into chronic inflammatory diseases.

        Neutrophils © Institut Pasteur


        Sympathetic Nervous System (SNS) Fight / Flight

        We are most familiar with the sympathetic branch of the autonomic nervous system, which is the branch that can make us feel like someone’s put a foot on our gas pedal. The sympathetic nervous system enables us to take action in everyday life, and also in the event of threat. When we’re in danger, it helps us fight, chase off predators, or flee a hurricane.

        In the first minutes and hours of a fight or flight response to stress, our bodies release adrenaline, increase our blood pressure and heart rate, augment our body temperature and breathing, enhance our blood sugar availability to fuel our muscles for fighting and fleeing, and increase our immune response (Dhabhar, 2018). This is all aimed at maximizing energy levels to support fight or flight.

        And it is all part of the healthy cell danger response.

        These changes optimize our ability to survive through escape mechanisms and by warding off infections, healing wounds by clotting more efficiently, and increasing our speed and strength.

        “[The CDR is a] coordinated set of cellular responses … that evolved to help the cell defend itself from microbial attack or physical harm … and at its most fundamental and most ancient role: to improve cell and host survival after viral attack (Naviaux 2014, p. 7).

        The actions of the acute fight or flight response are consistent with Naviaux’s acute cell danger response, which is the opposite of what he found in ME/CFS (paraphrased from his 2016 article on ME/CFS):

        The acute CDR is found in acute infection, during acute inflammation and in the metabolic syndrome (a cluster of conditions that include high blood pressure, high cholesterol, insulin resistance and high blood sugar levels, and increased fat around the waist area. These symptoms, also known as Syndrome X, are associated with increased risk for heart disease, stroke and diabetes).

        In this acute sympathetic nervous system response, our bodies also decrease or suppress functions that aren’t important for immediate survival, such as digestion and rest.

        If stress continues for a long time, an increased degree of fight or flight arises in which cortisol is released, the immune system is suppressed, inflammation rises and symptoms can occur.

        In health, our bodies return to baseline when the stressor goes away or the threat disappears.

        In health, at rest, and in play and safety, the sympathetic nervous system coordinates with the other branches of the autonomic nervous system to constantly tweak and maintain just the right levels of blood pressure, heart rate, oxygen consumption, mitochondrial function and other basics that support our ever changing activities of daily life.

        In some circumstances, which I’ll discuss later, the sympathetic nervous system remains turned “on” and this acute CDR contributes to disease (Naviaux, 2014).


        How to stay informed

        As the virus spreads, it's easy to get caught up in the fear and alarmism rampant across social media. There's misinformation and disinformation swirling about the effects of the disease , where it's spreading and how. Experts still caution that the virus appears to be mild, especially in comparison with infections by other viruses, such as influenza or measles, and has a markedly lower death rate than previous coronavirus outbreaks.

        Sarah Mitroff, Leslie Katz, Carrie Mihalcik, Edward Moyer, Andrew Morse, Corinne Reichert contributed to this report.