In this week’s Covid-19 update, Al Brooks examines immune training and measures the effectiveness of the U.S. response vs the rest of the developed world.

One fascinating feature of the pandemic is the difference in the severity of the disease among infected people.

There is early research that indicates that if a person received vaccines against any virus before the pandemic, their immune systems might be primed to respond faster to a Covid-19 infection. This is referred to as immune training, where previous vaccinations against other viruses might reduce the severity of Covid-19 symptoms.

Immune training for Covid-19

Dr. Andrew Bradley from the Mayo clinic said, “When we looked in the setting of Covid disease, we found that people who had prior vaccinations with a variety of vaccines, for pneumococcus, influenza, hepatitis and other , appeared to have a lower risk of getting Covid disease.” 

Doctors have noticed this concept of “immune training” with other diseases. For example, people who get vaccinated for tuberculosis have a reduced chance of getting malaria. TB is caused by a bacteria and malaria is caused by a parasite. The organisms are unrelated.

There is no evidence that this will happen with Covid-19, but we are still very early in learning about Covid-19 and its response to immune training. Scientists want to consider all concepts from vaccine science and infectious disease treatment and prevention.

A bigger initial “viral load” increases severity of disease

When you are initially infected with a virus, the number of virus particles is not enough to cause symptoms. The virus particles have to enter cells, take over the cell replication mechanisms, reproduce themselves, kill the cells and move on to infect other cells.

This process gets repeated many times before there is enough cell damage for you to notice. Once there is some critical mass of virus particles, it will be causing enough cell damage for you to feel bad and conclude that you are sick.

It also takes time for your immune system to figure out how to make antibodies and T cells that will remove the virus from your body and let your body heal. If the immune process starts in someone who has very few virus particles, it will be closer to completion by the time the person has enough virus particles to cause symptoms. He is more likely to have enough early immunity working to make his symptoms less severe, and his illness end faster, than someone who initially inhaled a huge number of virus particles.

This is where masks come in. If a very sick person coughs in your face, some big droplets containing a huge number of virus particles might enter your mouth, nose or eyes. But if you are wearing a mask, those big particles won’t make it in to infect you. Tiny droplets might, but they will have far few virus particles. Theoretically, if you get sick, you have a better chance of having milder symptoms and getting better faster.

Social distancing works

Dr. Mark Siedner and others at Massachusetts General Hospital, the University of Pennsylvania and the University of London are reporting in a soon to be released paper that social distancing has been effective in slowing the spread of Covid-19 in the United States. The researchers looked at a three-week period in March when most states mandated social distancing.

Social Distance Works

They concluded that this reduced the number of new cases by 600,000. If the death rate was 1%, this would have saved 3,000 lives during those three weeks. One has to wonder how many lives would have been saved if this was mandated at the national level, as it was in the majority of developed countries, all of which have had far fewer deaths per capita than the United States.

Herd immunity from recovering or vaccination

The average U.S. Covid-19 victim infects 1.5 to 2 more people. Herd immunity requires about 70% of Americans to be immune, either after recovering from Covid-19 (though this does not provide blanket immunity) or from a vaccine.

We will have far fewer deaths if it comes mostly from people getting vaccinated. With only about half the country currently wanting to get vaccinated, a lot of the herd immunity will come from infected Americans.

But suppose the vaccine is not as effective as we hope. Or that it takes a year to get 50% of the country vaccinated. Then we could easily see a third of the country catch Covid-19.

The problem with that is that the death rate is at least 0.5 to 1%. One percent of 120 million infected people will result in more than one million dead Americans. By the time the pandemic ends, there will be between 500,000 and 1 million American victims of the virus. If we handled this as well as the average developed country, probably 80% of those lives would have been saved.

How many vulnerable Americans?

Many people overseas are experiencing schadenfreude over fat, rich, selfish, arrogant Americans getting their comeuppance. As I explained last week, obesity only accounts for a small part of our greatly increased number of deaths. The lack of national political leadership is by far our greatest problem.

Obesity is important, but there are many other factors as well that increase a person’s risk of getting very ill or dying from Covid-19. Simply being over age 60 is enough. All told, 30% of Americans are particularly vulnerable to becoming very sick if they come down with Covid-19.

Thirty percent means that all of us know many people who have a high risk of a serious form of Covid-19. If the pandemic has not touched your circle yet, it will.

Tomorrow we will discuss, infection rates in younger people, Covid and food as Bill Gates view on Covid preparedness.

Al Brooks’ earlier special reports on the Covid-19 pandemic:

Covid-19 Update: Operation Warp Speed

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