CORONAVIRUS SECOND WAVE | OVERREACTION OR WORST-CASE SCENARIO BIAS?

CORONAVIRUS SECOND WAVE | OVERREACTION OR WORST-CASE SCENARIO BIAS?

In spite of the scare of coronavirus second wave infections, we have seen the ease of lockdown across different countries. This, as expected, has been cheered by citizens. Schools are open in Serbia and Germany; restaurants and bars are open for business in Italy; Spanish football clubs began training in groups of 10 players; leagues are soon to resume.

We may enjoy this development but health officials are quick to warn of a second, likely more devastating wave of the outbreak.

coronavirus second wave
Dr. Mike Ryan

At a media briefing, Dr. Mike Ryan, executive director of the World Health Organisation’s Health Emergencies Program, warned that the virus might remain a constant presence. In his words, “This virus just may become another endemic virus in our communities and this virus may never go away. HIV hasn’t gone away”.

According to reports, about 5.1 million of the estimated 7.8 million people in the universe have been infected. This means herd immunity is far from realization. For COVID-19, herd immunity would mean over 80% of the population must have antibodies in order to provide any sort of protection for the remaining 20%. 

What’s a Coronavirus second wave all about?

The universal standard of what a second wave of the pandemic would look like — at a global, national or regional level – is non-existent. So far, the only numeric index relied upon remains the 50 cases per 100,000 people.

WHO spokesperson, Christian Lindmeier said, “the second wave” is not a fixed technical term. “The term only refers to renewed outbreaks after an initial reduction in cases. Hence, the same applies to a ‘third’ wave.’’

coronavirus second wave

A quick recall to December 2019 when the infection probably started with just one person and 5 months later, we have 5 million people already infected. Despite the established protocols and the approval of Remdesivir for treatment, a coronavirus second wave is inevitable, especially, if the causative organism could not be eradicated with preventive measures such as hygiene or without herd immunity being achieved. 

If you survive a Coronavirus infection can you be re-infected?

YES! …and NO!

So yes, coronavirus can attack your body over and over again.  While there are variations, chances are, your immune system knows how to counter the attack of a recurring pathogen. Thus far, scientists maintain that ‘SARS-CoV-2 probably induces immunity like other coronaviruses’ [2].

Nicolas Vabret, an assistant professor of medicine at the Mount Sinai Icahn School of Medicine who specializes in virology and immunology reiterated “we do not have any reason to assume that the immune response would be significantly different” from what’s seen with other coronaviruses.

Related…

If this is true, your body will probably retain a memory of the virus for at least a few months or years and should be protected from reinfection, at least in the short-term.

However, much is unknown in the long term. COVID-19 aside being new and poorly understood, may behave much like HIV. This means that, yes, antibodies are produced, but totally useless to confer meaningful immunity due to the rapid mutation.

Another peculiar pattern would be that SARS-CoV-2, unlike other coronaviruses, has seamlessly remained virulent across regions with different temperature ranges.

A report published a few weeks ago in The Journal of the American Medical Association (JAMA) supports the idea that people may test positive for the virus long after they seem to have recovered. In four medical professionals in Wuhan, China a test that detects the viral genetic material remained positive five to 13 days after they were asymptomatic. This does not necessarily mean that they were still able to infect others.

Recently, the Japanese government in Osaka reported how a woman had tested positive for the coronavirus for a second time. This happened weeks after recovering from the infection and being discharged from the hospital. While there is a possibility that testing flaws may be the culprit, again it could be a strong indication that continuous reinfections is a possibility – similar to that of the malaria parasite.

Will the coronavirus second wave be the same disease?

With COVID-19, it appears that the recovered person can develop other symptoms, including insomnia and neurological problems.

This strengthens a worrisome possibility that the novel coronavirus disease possesses the property of a biphasic infection. This means that the infection continues but causes a different set of symptoms from that observed in the initial attack. During the Ebola outbreak for instance, infections persisted for months after recovery thereby further prolonging the epidemic.

Related…

Structurally, a more subtle reason why there is reinfection could be mutations (the virus changes its structure). When it involves viruses especially RNA like the SARS-CoV-2, the mutation is a normal thing. Unlike other organisms whose genes are written in double-stranded DNA, the coronavirus genes thrive on a single-stranded RNA.

Mutations are merely deviations that happen when the virus replicates inside cells resulting in failure to copy all its genetic code thereby leaving some fragments.

Owing to these mutations, Scientists have analyzed about 13,000 samples in Britain since mid-March and found that a new strand appears roughly twice a month.  The frequency of mutations is relevant due to the fact that the faster a virus mutates, the quicker it changes behavior, and the trickier it becomes. This is what happens with HIV. Another seasonal influenza mutates rapidly so much so that we need a different vaccine each year.

BOTTOM LINE

The supposed reinfection seems related to the fact that upon discharge, recovered patients still harbor low levels of the virus but failed to be detected during testing. A later test could merely be a reaction of the PCR test swab to antibodies and not antigens ( a toxin or other foreign substance which induces an immune response in the body, especially the production of antibodies.)

Going forward, how long immunity with SARS-CoV-2 would last will be a great determinant when designing a vaccine for the new coronavirus, especially if the virus becomes a seasonal menace.

Though the second wave of infection is imminent, it would most likely be in low slung numbers and not large enough to be a priority at this point in the outbreak. This however, doesn’t mean we should neglect the warnings, become sloppy and give in to normalcy bias.

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