Lasting Impact Of Covid
by Elisa Black, University of Adelaide
A world leading research collaboration between SAHMRI, the University of Adelaide, Flinders University, the Women’s and Children’s Hospital and the Royal Adelaide Hospital has delivered crucial insight into the lasting immune system dysregulation caused by COVID-19.
The study showed that people’s immune systems were significantly altered six months after their COVID-19 infection with the immune cells and gene expression experienced during this post-infection period holding clues to the intriguing “Long COVID’ symptoms affecting some patients.
The study was funded by The Hospital Research Foundation, Flinders Foundation and Women’s and Children’s Hospital Foundation and jointly led by the Director of SAHMRI’s Computational & Systems Biology Program and Professor of the College of Medicine & Public Health at Flinders University, Professor David Lynn Professor Simon Barry, Head of Molecular Immunology Group at the University of Adelaide’s Robinson Research Institute and Dr. Branka Grubor-Bauk, Head of Viral Immunology Group, THRF Mid-Career Fellow at the University of Adelaide and Basil Hetzel Institute for Translational Health Research.
It involved an in-depth assessment of a South Australian patient cohort, termed “COVID-19 SA,” set up by Dr. Grubor-Bauk, Professor Michael Beard and Professor Barry from the University of Adelaide in collaboration with A/Prof David Shaw and Dr. Benjamin Reddi from the Royal Adelaide Hospital.
At First Glance This Decline Appears To Be Occurring In Tandem With The Rollout Of Covid Shots January 1 2021 Only 05% Of The Us Population Had Received A Covid Shot By Mid
At first glance, this decline appears to be occurring in tandem with the rollout of COVID shots. January 1, 2021, only 0.5% of the U.S. population had received a COVID shot. By mid-April, an estimated 31% had received one or more shots, and as of July 13, 48.3% were fully vaccinated.
However, as noted in a July 12, 2021, STAT News article,cases had started their downward trend before COVID shots were widely used. Following patterns from previous pandemics, the precipitous decline in new cases of Covid-19 started well before a meaningful number of people had been vaccinated, Robert M. Kaplan, Professor Emeritus at the UCLA Fielding School of Public Health, writes. He continues:
Nearly 50 years ago, medical sociologists John and Sonja McKinlay examined death rates from 10 serious diseases: tuberculosis, scarlet fever, influenzae, pneumonia, diphtheria, whooping cough, measles, smallpox, typhoid, and polio. In each case, the new therapy or vaccine credited with overcoming it was introduced well after the disease was in decline.
More recently, historian Thomas McKeown noted that deaths from bronchitis, pneumonia, and influenza had begun rapidly falling 35 years before the introduction of new medicines that were credited with their conquest. These historical analyses are relevant to the current pandemic.
What Immunity Did Having Covid
A health care worker fills a syringe with the COVID-19 vaccine.
This is one of a series of articles in which reporters from WHYYs Health Desk Help Desk answer questions about vaccines and COVID-19 submitted by you, our audience.
After getting a fever, Margaret Grafenstine tested positive for the coronavirus in November, then developed a cough, a sore throat, and a slight numbness in her hands.
Grafenstine, 58, who lives in Trevose, Bucks County, said it took about two weeks for her to feel like herself again.
A test later confirmed Grafenstine had a robust antibody response to the infection and she even donated convalescent plasma. Now, shes trying to decide whether to get vaccinated.
If a person has already tested positive for COVID, why are the antibodies in that persons system from actually having the virus not good enough? she asked WHYYs Health Desk Help Desk. I just dont understand why its necessary I have a bit of a fear with the vaccine, just as I do with the virus, truthfully.
Many other WHYY listeners and readers including people who have never had COVID-19 submitted questions asking whether people who have had infections develop a robust enough immune response to avoid getting vaccinated.
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How Does Getting One Variant Protect Me From Another
When your immune system responds to one virus, it provides some degree of protection against similar viruses, Maragakis said. But the more different the viruses are, the more likely your immune system might not be able to recognize them, she said, and thats why health experts are concerned about variants.
Studies show that the currently available COVID vaccines are effective against the current COVID variants.
A study published in July in the New England Journal of Medicine found that two doses of the Pfizer vaccine was 88% effective at preventing symptomatic disease from the delta variant, compared to about 95% for the original virus strain. Data from Israel estimated lower effectiveness against symptomatic disease, but said that the protection against severe illness remains high.
The concern, though, is that the more the virus is allowed to circulate, the more variants may emerge and we may see a time that a variant escapes the currently available vaccine. And at that point, we would have to modify the vaccines and re-vaccinate people against the new variant, Maragakis said.
Researchers can study the effectiveness of a previous infection against variants by taking antibodies from people who have had COVID-19 and testing their ability to neutralize the different variants in the laboratory.
The Immune Response To Coronavirus
When a virus attacks its first cell in the body, that cell has two jobs to do before it dies, said Benjamin tenOever, a professor of biology at the Mount Sinai Icahn School of Medicine. The infected cell needs to issue a call for reinforcements, sending out a cascade of chemical signals that will activate an army of immune cells to come battle the invading virus. And it needs to issue a warning to other cells around it to fortify themselves, something it does by releasing proteins called interferons. When interferons land on neighboring cells, they trigger those cells to enter defensive mode. The cells slow down their metabolism, stop the transport of proteins and other molecules around their interiors, and slow down transcription, the process by which genetic instructions become proteins and other molecules.
In a studyaccepted to the journal Cell, tenOever and his colleagues found that SARS-CoV-2 appears to block this interferon signal, meaning it messes with the cell’s second job. So the first job the call for immune system reinforcement works just fine, but the cells in the lungs don’t enter defensive mode and so remain vulnerable to viral infection.
“It just keeps replicating in your lungs, and replicating in your lungs and all the while you keep calling in for more reinforcements,” tenOever told Live Science.
“At that point, it’s not about what the virus has done,” he said. “At that point, it’s about controlling the severe inflammation.”
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What Happens After You Recover From Coronavirus 5 Questions Answered
Even with the current inflated mortality rates, most people will recover from coronavirus.
Studies differ on how long recovered patients will remain infectious.
There have been isolated cases of reinfection, but questions linger.
The vast majority of people who catch COVID-19 will make a complete recovery. But this brings new uncertainties about how quickly we can expect to regain health and what our ongoing social responsibilities might be.
Talk of recovery might seem premature for Europe and the US, who are entering the virus peak phase, but the first wave of convalescents is coming through. Chris Gough, an anaesthetist from Oxford, UK, was one of these thousands, tweeting about emerging from this frightening experience: Day 6: Feeling a little better. Or, thought I was, but then fell asleep on the sofa for an hour. Still no desire to leave the house. Hoping tomorrow will bring much more energy.
On the other side of the curve, China where on 20 March there were no new cases reported can show the way towards beyond the coronavirus. Here are five key recovery questions:
What Are The Health Risks Of Getting The Vaccine After An Infection
There have been some exceedingly rare adverse events, including blood clots and myocarditis. But for most of those cases, the patients recovered quickly and showed no evidence of long-term consequences.
Wherry said most of the people who had the rare blood clots and allergic reactions did not previously have COVID-19.
So the risk seems to be at least a little bit lower why that is, Im not sure. It may just be statistics, that we dont have as many previous COVID people getting vaccinated, he said.
If you get the vaccine too close to a COVID-19 infection, an inflammatory response might be provoked that would make you feel pretty sick again. Thats considered a side effect not an adverse event, Wherry said. Though people with no previous COVID infections typically get stronger side effects after the second dose of a vaccine, people who have had previous infections often get side effects after the first dose.
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Who Gets Antibodies After A Covid Infection
Looking more closely at the data, we saw that people who had a greater number of symptoms while they were ill with COVID – particularly the âclassic threeâ symptoms of cough, fever and loss of smell – were more likely to have gained antibodies against the virus.
In contrast, people with one or more health issues associated with an underlying condition were less likely to have antibodies after being infected, as well as people who currently smoke. However, our research can not link smoking directly to reduce immune response and it might be that there are other negative health behaviours involved here that impact the immune system.
There was no link between age, sex/gender or social deprivation with the likelihood of having antibodies afterwards.
What About T And B Cell Responses
T and B cells have a central role in fighting off infections and, crucially, in establishing long term immunity. Some T and B cells act as memory cells, persisting for years or decades, primed and ready to reignite a broader immune response should their target pathogen arrive in the body again. Its these cells that make truly long term immunity possible.
A study published in February in Science assessed the proliferation of antibodies as well as T and B cells in 188 people who had had covid-19.7 Although antibody titres fell, memory T and B cells were present up to eight months after infection. Another study in a comparably sized cohort reported similar results in a preprint posted to MedRxiv on 27 April.8
Monica Gandhi, an infectious disease doctor and professor of medicine at the University of California San Francisco, says we have evidence that T and B cells can confer lifelong protection against certain diseases similar to covid-19. A well known Nature paper from 2008 found that 32 people born in 1915 or earlier still retained some level of immunity against the 1918 flu strain, 90 years hence.9 That is really profound, she says.
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Who Is At Risk Of Covid
By now, we know that anyone can get COVID-19 the vaccinated and unvaccinated, those who have had it already and those who havent. In the same vein, anyone can get COVID-19 again.
Its important to note that were still learning a lot about reinfections and whos at risk for those reinfections, Dr. Esper says. But doctors do know that some people are at higher risk of reinfection for COVID-19 than others.
Myths And Facts About Covid
CDC has updated its recommendations for COVID-19 vaccines with a preference for people to receive an mRNA COVID-19 vaccine . Read CDCs media statement.
Accurate vaccine information is critical and can help stop common myths and rumors. It can be difficult to know which sources of information you can trust. Learn more about finding credible vaccine information.
Below are myths and facts about COVID-19 vaccination.
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Myth: It Is Safer For My Child To Build Immunity By Getting Infected With Covid
FACT: Getting children ages 5 years and older vaccinated against COVID-19 is the best way to protect them from COVID-19.
No one should try to expose themself or others to COVID-19 on purpose. Childrens risk of COVID-19 infection is similar to adults. When children get COVID-19, they may be sick for several days and miss school and other opportunities for learning and play with others. Children who are not vaccinated and get COVID-19 may also be at risk for prolonged post-COVID-19 conditions, hospitalization, multisystem inflammatory syndrome , or death. The Pfizer-BioNTech COVID-19 vaccine is over 90% effective at preventing COVID-19 in children ages 5 through 11 years. Getting children 5 years and older vaccinated can help protect them from getting COVID-19, as well as keep them in school and group activities by helping stop the spread of COVID-19 in their community.
Children may have side effects after getting vaccinated, which are similar to those they may experience after getting routine vaccinations. These side effects are normal signs that their body is building protection. Any side effects should go away in a few days. In rare situations, COVID-19 vaccination might result in more serious side effects, such as a severe allergic reaction or myocarditis and pericarditis . Learn more about possible side effects.
If I Have Antibodies Am I Immune
This is not guaranteed and that is why the World Health Organization is nervous about countries using immunity passports as a way out of lockdown.
The idea is if you pass the antibody test then you are safe to go back to work. This would be particularly valuable for staff in care homes or hospitals who come into contact with those at risk of developing severe symptoms.
But while you will find some antibodies in nearly every patient, not all are equal. Neutralising antibodies are the ones that stick to the coronavirus and are able to stop it infecting other cells. A study of 175 recovered patients in China showed 30% had very low levels of these neutralising antibodies.
That is why the World Health Organization says “that cellular immunity may also be critical for recovery”.
Another issue is that just because you might be protected by your antibodies, it doesn’t mean you cannot still harbour the virus and pass it onto others.
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Myth: All Events Reported To The Vaccine Adverse Event Reporting System Are Caused By Vaccination
FACT: Anyone can report events to VAERS, even if it is not clear whether a vaccine caused the problem. Because of this, VAERS data alone cannot determine if the reported adverse event was caused by a COVID-19 vaccination.
Some VAERS reports may contain information that is incomplete, inaccurate, coincidental, or unverifiable. Vaccine safety experts study these adverse events and look for unusually high numbers of health problems, or a pattern of problems, after people receive a particular vaccine.
Recently, the number of deaths reported to VAERS following COVID-19 vaccination has been misinterpreted and misreported as if this number means deaths that were proven to be caused by vaccination. Reports of adverse events to VAERS following vaccination, including deaths, do not necessarily mean that a vaccine caused a health problem.
Learn more about VAERS.
Should I Just Get Omicron Over With
If youre vaccinated, an infection might not make you super sick, but dont count on it making you super immune, either.
For the past two years, Marie, a 30-something student in New York, had the right idea about COVID-19: She didnt want to get it. Then, in the middle of December, as the antibody-dodging Omicron swept through her state, the coronavirus found her all the same. But Maries three vaccines helped keep her illness short and manageable. By years end, she and several of her friends had found themselves in a roughly similar spot, doing some of the same pandemic math: vaccine + vaccine + vaccine + infection = surely a reasonable amount of safety, right?
So they threw a New Years party. At the close of December, 10 of them, all recently recovered from COVID and out of isolation, headed upstate for a maskless two-day bash. They were celebrating the start of 2022, but also the start of some kind of post-infection reprievea taste of normalcy, a chance to kick back and mingle. We figured none of us can spread it, because were all over it, Marie, whom Im identifying by only her first name to protect her and her friends privacy, told me. Maybe they even had a wee bit of extra immunityalmost as if the virus had gifted them a crude bonus boost.
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Why Does Immunity Matter
It matters for obvious personal health reasons and whether you will get Covid-19 multiple times and how often.
Immunity will also affect how deadly the virus is. If people retain some, even imperfect, protection then it will make the disease less dangerous.
Understanding immunity better could help ease lockdown if it is clear who is not at risk of catching or spreading the virus.
If it is very difficult to produce long-term immunity, then it could make a vaccine harder to develop. Or it may change how the vaccine needs to be used – will it be a once a lifetime or once a year like the flu shot.
And the duration of immunity, whether by infection or immunisation, will tell us how likely we are to be able to stop the virus spreading.
These are all big questions we still lack answers to.