2020-05-31

COVID-19: A Scientist's View


Here is a very good article, not political, but helpful.
If  you read only one thing about COVID-19 today, read this from David C. Hess (Harvard/Princeton Alumnus, current Associate Professor/Director of Biotechnology at Santa Clara University). He's someone who should know a thing or two about this pandemic - Just the science, no political agenda. No B.S.

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Many of our local and state governments are pushing towards forms of reopening. For the past 12 years my lab has studied the evolution and spread of infectious diseases, I research this stuff and I teach this stuff, I am an expert, this is not uninformed opinion. We are no where near ready for a safe reopening, but there does not seem to be any stopping it.
Thankfully, some regions are being responsible, but many are not. I predict that by the end of June at least 5 more metro areas in the US will be as bad as NYC at its peak.
Hopefully then we learn our lesson and understand that we are dealing with a once in 100 year event that will take incredible resolve and resources to safely navigate.
What will follow is a series of 4 myths each dispelling the what the proposed safety of this reopening is based upon:
1. contact tracing
2. antibody testing
3. herd immunity
4. treatments.

Myth 1. Contact Tracing.

Contact tracing is great, I have collaborated with public health workers that do this for a living, it is a powerful public health tool.
First off, this virus can spread in the asymptomatic phase and you can't start contact tracing until some presents with the disease, so its usefulness is blunted from the beginning.
Second, our public health system did not have enough trained persons to do all the contract tracing work for other diseases before corona virus-- where are we getting the actual people trained to do contract tracing from, are we going to use out of work baristas or blackjack dealers to do the work that requires a Masters in Public Health to do and to be good at takes years of field training? We don't have the people to do contact tracing for a disease that spreads as fast as this corona virus.

Myth 2. Antibody testing.

So the idea is we just give people an antibody test and if they are positive then they are immune and safe to be moving about. Sounds great, right? Except we don't have a good idea of what these tests mean with regards to immunity.
First problem, false positives, many of these tests cross react with antibodies raised by your body against non-COVID19 coronaviruses that you have been exposed to in your life.
You do not want a false positive, that means I tell you that you are immune but you are not actually immune. Second problem, without a vaccinated control group that we know is immune we don't know where to set the threshold of the test to claim immunity and this varies for every disease.
We have no idea what a positive on these tests actually means in terms of immunity. Don't believe me that a positive antibody test doesn't equal immunity to the disease-- then you might want to read up on the most common way we test for HIV-- hint it’s an antibody test and spoiler alert if you have antibodies for HIV it does not mean you are immune to HIV, it means you're F#@KED.

Myth 3. Herd Immunity.

Viruses have been evolving solutions to our immune system for hundreds of millions of years. If Herd Immunity worked as simply as it is presented on social media then no one would have the common flu. Haven't we all had the flu at some point? Well, if everyone has had the flu then how do we still get the flu?
Viruses evolve.
Every person that gets infected is an experiment for the virus, it makes billions of copies of itself and everyone has a chance to be a new mutant that will evade any herd immunity that has been acquired and will start spreading freely again.
If we let this virus just burn through our country or the world, everything we know about viral evolution tells us that it will evolve variants that can reinfect those that are currently immune.
This is one of the reasons that keeping the global case count low until a vaccine is developed is crucial.
We have one shot at eradication-- if we suppress the global case count and then get a vaccine and deploy it before a major variant arises then we can kick this thing out of humans and back into bats for another 10,000 years-- but once a few major variants develop then it is likely a new permanent human disease and a very different and worse problem for the world.

Myth 4. Treatments.

So surely science will save us, this is a big deal, let's do a Manhattan-type project and come up with a cure. Uh, okay, I think you have been watching too many movies. Viruses are not alive and that makes them very hard to kill.
I am not trying to be funny. The simplest bacteria that we have discovered has to do nearly 200 biochemical and biophysical reactions to stay alive. Many of those reactions can be targeted specifically (without hurting our cells) with drugs to kill the bacteria and that is why we have so many effective antibiotics.
Do you know how many biochemical and biophysical reactions a virus needs to do as it floats around in the environment? Zero, Zilch, Nada. That is why it is not alive, it is inert. Killing a virus is like killing a rock, how do you kill a rock? That is why soap is so effective, it is a detergent and soap literally tears the genome of the virus apart from the viral coat that protects the genome, you are physically destroying it.
Do you really think there is no money or desire in curing things like herpes or the common flu?
Our best success against viruses is HIV and that took nearly a decade and consists of 3 drugs that you take the rest of your life to control the virus. Understand that drugs to treat this disease will only reduce the symptoms, they may save lives (which is great) but people will still be in hospitals and on ventilators, the likelihood of a magic cure very remote.
Cures for most viruses don't exist, you are thinking of vaccines which you take before you get sick to prevent you from getting sick, we are really good at making those and we will, it just takes time and we need to get there. I hope this information helps, I wish all of you health and safety during this difficult time. I hope to be proven wrong about most or all of this, I will take scorn and ridicule in exchange for saving tens of thousands with acknowledging reality.

It has been pointed out to me that my posts are depressing and may seem like I am saying there is no hope. Fair point, that is not my intent.
We can beat this, but it will take time (9-18 months) and during that time our lives will look very different than they did in 2019. Once we realize this, we can make the right decisions, get help to those that need it most and endure.
I have hope, I just wish we didn't have to learn the hard way how bad this disease can be.
Update:
Thank you everyone to your feedback and responses to my posts the other day, I wasn't sure how they would be received. I do want to clarify what I mean by Myths, for example contact tracing-- it is not that contact tracing isn't good in theory or won't be part of the solution, we just aren't ready to have it deployed on a massive scale to create a safe reopening environment.
These 'myths' will likely be part of a long term solution, but the Myth is that they are ready to go now or May 1st or June 1st. These terms have been thrown around social media as if they are light switches you flip on and then everything is safe.
I just wanted to provide a deeper scientific context to the challenges of rolling these interventions out. I hope the information helped as we all try and make the best and safest decisions for ourselves and our families.
Best,
David

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