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Wash. Post: Forty percent of people with coronavirus infections have no symptoms. Nature study, NIH blog re T cells and COVID-19 immunity

Mary

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Really interesting: https://www.msn.com/en-us/health/me...he-pandemic/ar-BB17JpdS?ocid=msedgdhp#image=2

A Boston homeless shelter had 147 infected residents, but 88 percent had no symptoms even though they shared their living space. A Tyson Foods poultry plant in Springdale, Ark., had 481 infections, and 95 percent were asymptomatic. Prisons in Arkansas, North Carolina, Ohio and Virginia counted 3,277 infected people, but 96 percent were asymptomatic.

During its seven-month global rampage, the coronavirus has claimed more than 700,000 lives. But Gandhi began to think the bigger mystery might be why it has left so many more practically unscathed.

What was it about these asymptomatic people, who lived or worked so closely to others who fell severely ill, she wondered, that protected them? Did the “dose” of their viral exposure make a difference? Was it genetics? Or might some people already have partial resistance to the virus, contrary to our initial understanding?

One of the first peer-reviewed studies on the coronavirus and T cells was published in mid-May in the journal Cell by Alessandro Sette, Shane Crotty and others at the La Jolla Institute for Immunology near San Diego.

The group was researching blood from people who were recovering from coronavirus infections and wanted to compare that to samples from uninfected controls who were donors to a blood bank from 2015 to 2018. The researchers were floored to find that in 40 to 60 percent of the old samples, the T cells seemed to recognize SARS-CoV-2.

ETA: I added links to an NIH blog post apparently about this phenomenon as well as a study published in Nature.
 
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Gingergrrl

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@Mary Thanks for posting this article and it was really interesting! I have a few questions for all the more sciency people re: the article:

- What is the difference between “Memory T Cells” that the article talks about and “Memory B Cells” (which I had thought were responsible for creating antibodies & autoantibodies)?

- Is there a test (that currently exists) for someone to check if they already have antibodies to other coronaviruses?

Thanks in advance for any info!
 

andyguitar

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- Is there a test (that currently exists) for someone to check if they already have antibodies to other coronaviruses?
There must be, because early on in the pandemic I remember reading something which I think came from some German research. It was about how exposure to other corona viruses could be protecting some from getting covid and/or be the reason why many only get slight or no symptoms despite being in at risk groups! @pamojja do you remember this?
 

pamojja

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All antibody studies summarized on this page: https://swprs.org/studies-on-covid-19-lethality/

A worthwhile interview of 1 hour and 24 minutes long:

The Fat Emperor:

Ep91 Emeritus Professor of Immunology – Reveals Crucial Viral Immunity Reality

Now THIS is a special one – a full debrief on everything important in this Covid19 issue – with one of the world’s top immunologists explaining the real situation, including “Herd Immunity” realities, and much, much more.

Dr. Stadler’s credentials in brief here – top of the heap, and named “The Vaccine Pope” by his colleagues: https://expertinova..../cv-bedastadler

We discuss and reveal every important aspect of this pandemic, in terms of what is scientifically correct.

A warning though, this immunology expert has no idea of ME/CFS.
 

pamojja

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Dr. Malcom Kendricks:

How bad is COVID really? (A Swedish doctor’s perspective)

207 Replies

7th August 2020

A doctor working in Sweden as an emergency care physician contacted me to discuss all things COVID-19. He has also written a blog, which can be seen here.

I asked if I could reproduce it on my blog as I felt it was a fascinating persepctive on what was happening in Sweden. It is also incredibly well written, in English, for someone who is Swedish. Most humbled. I hope you enjoy it.


Ok, I want to preface this article by stating that it is entirely anecdotal and based on my experience working as a doctor in the emergency room of one of the big hospitals in Stockholm, Sweden, and of living as a citizen in Sweden.

As many people know, Sweden is perhaps the country that has taken the most relaxed attitude of any towards the COVID pandemic. Unlike other countries, Sweden never went in to complete lockdown. Non-essential businesses have remained open, people have continues to go to cafés and restaurants, children have remained in school, and very few people have bothered with face masks in public.

COVID hit Stockholm like a storm in mid-March. One day I was seeing people with appendicitis and kidney stones, the usual things you see in the emergency room. The next day all those patients were gone and the only thing coming in to the hospital was COVID. Practically everyone who was tested had COVID, regardless of what the presenting symptom was. People came in with a nose bleed and they had COVID. They came in with stomach pain and they had COVID.

Then, after a few months, all the COVID patients disappeared. It is now four months since the start of the pandemic, and I haven’t seen a single COVID patient in over a month. When I do test someone because they have a cough or a fever, the test invariably comes back negative.

At the peak three months back, a hundred people were dying a day of COVID in Sweden, a country with a population of ten million. We are now down to around five people dying per day in the whole country, and that number continues to drop. Since people generally die around three weeks after infection, that means virtually no-one is getting infected any more.

If we assume around 0.5 percent of those infected die (which I think is very generous, more on that later), then that means that three weeks back 1,000 people were getting infected per day in the whole country, which works out to a daily risk per person of getting infected of 1 in 10,000, which is miniscule. And remember, the risk of dying is at the very most 1 in 200 if you actually do get infected. And that was three weeks ago. Basically,COVID is in all practical senses over and done with in Sweden.

After four months. In total COVID has killed under 6,000 people in a country of ten million. A country with an annual death rate of around 100,000 people. Considering that 70% of those who have died of COVID are over 80 years old, quite a few of those 6,000 would have died this year anyway. That makes covid a mere blip in terms of its effect on mortality.

That is why it is nonsensical to compare covid to other major pandemics, like the 1918 pandemic that killed tens of millions of people. COVID will never even come close to those numbers. And yet many countries have shut down their entire economies, stopped children going to school, and made large portions of their population unemployed in order to deal with this disease.

The media have been proclaiming that only a small percentage of the population have antibodies, and therefore it is impossible that herd immunity has developed. Well, if herd immunity hasn’t developed, where are all the sick people? Why has the rate of infection dropped so precipitously? Considering that most people in Sweden are leading their lives normally now, not socially distancing, not wearing masks, there should still be high rates of infection.

The reason we test for antibodies is because it is easy and cheap. Antibodies are in fact not the body’s main defence against virus infections. T-cells are. But T-cells are harder to measure than antibodies, so we don’t really do it clinically. It is quite possible to have T-cells that are specific for covid and thereby make you immune to the disease, without having any antibodies.

Rest at site..
 

valentinelynx

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Sweden's population is likely much healthier than the US population, with a better health system. We already know that people who are obese, have diabetes or hypertension are more susceptible to the virus. Those conditions are rampant in the US. It'll be awhile before COVID-19 is finished with the US.
 

pattismith

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Sweden's population is likely much healthier than the US population, with a better health system. We already know that people who are obese, have diabetes or hypertension are more susceptible to the virus. Those conditions are rampant in the US. It'll be awhile before COVID-19 is finished with the US.

"A Boston homeless shelter had 147 infected residents, but 88 percent had no symptoms even though they shared their living space.
A Tyson Foods poultry plant in Springdale, Ark., had 481 infections, and 95 percent were asymptomatic. Prisons in Arkansas, North Carolina, Ohio and Virginia counted 3,277 infected people, but 96 percent were asymptomatic. "


@valentinelynx

There is something strange, i can't understand why 96 % of people were asymptomatic in prisons in Arkansas.

Prisons are closed places where we assume viruses are easy to spread. Could it be that people in Arkansas prisons are less obese, less ill, or younger than the general population?

I find it's not easy to compare the statistic!
 

Mary

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Could it be that people in Arkansas prisons are less obese, less ill, or younger than the general population?
Arkansas is one of the poorest states in the U.S., and it ranks 49th (almost dead last) in health care. Generally obesity and poor health are associated with poverty. I think the only thing in the prisoners' favor would be their age!
 

Gingergrrl

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- What is the difference between “Memory T Cells” that the article talks about and “Memory B Cells” (which I had thought were responsible for creating antibodies & autoantibodies)?

- Is there a test (that currently exists) for someone to check if they already have antibodies to other coronaviruses?

Apologies for quoting myself but I was wondering if anyone knows the answers to either of my questions from yesterday? I know people have widely differing views on COVID and I don't want to debate anything vs. am asking these questions from a medical/science perspective.

For the first three months of the COVID quarantine I was not supposed to leave my home for any reason b/c I was immuno-compromised and had zero B-cells due to my prior treatment. My understanding was that it is the B-cells that create antibodies to viruses and other pathogens (in addition to auto-antibodies) and it is the Memory B-cells that allow you to maintain immunity to prior vaccines (even if your other B-cells are at zero).

But this article was talking about "Memory T-cells" (not B-cells) and I was trying to figure out what this means?!! I know that you must have adequate T-cells in order to have a functioning immune system and fight a virus like COVID, but I thought it was the B-cells that created the antibodies. Does anyone know?

I was also wondering if there is a current test (that already exists in medicine) in which someone can be tested to see if they have immunity to other Coronaviruses? I would imagine that few people have immunity to the original SARS or MERS but that some might have immunity to other Coronaviruses? Is this something that can be tested for (at a specialty lab or Mayo or anywhere?) or does this not exist?

Thanks again for any replies :)
 

pamojja

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@Gingergrrl know almost nothing about, but remember in the interview I posted above it was said, that B-cells are produced along T-cells in an innate immune response. The article had this piece:

But T-cells are harder to measure than antibodies, so we don’t really do it clinically.

So there should be test available used for research.
 
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Pyrrhus

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- What is the difference between “Memory T Cells” that the article talks about and “Memory B Cells” (which I had thought were responsible for creating antibodies & autoantibodies)?

- Is there a test (that currently exists) for someone to check if they already have antibodies to other coronaviruses?

Memory B cells are B cells that have come into prior contact with an antigen/pathogen/infected cell.
When a Memory B cell again comes into contact with that antigen/pathogen/infected cell, it immediately starts turning out copies of itself to act as Plasma B cells, which are the cells that release antibodies that bind to the antigen/pathogen/infected cell. Then, other cells come along and destroy the antibody-coated antigen/pathogen/infected cell.

Similarly, Memory T cells are T cells that have come into prior contact with an antigen/pathogen/infected cell. When a Memory T cell again comes into contact with that antigen/pathogen/infected cell, it immediately starts turning out copies of itself to act as Effector T cells, which are the T cells that work to destroy the antigen/pathogen/infected cell. Some destroy the antigen/pathogen/infected cell directly, while other T cells secrete cytokines to "call for backup".

I was also wondering if there is a current test (that already exists in medicine) in which someone can be tested to see if they have immunity to other Coronaviruses? I would imagine that few people have immunity to the original SARS or MERS but that some might have immunity to other Coronaviruses? Is this something that can be tested for (at a specialty lab or Mayo or anywhere?) or does this not exist?

I sincerely doubt that such a test exists. And if it did, we don't yet know what it might mean for the novel coronavirus. Remember that roughly 40% of the common cold is caused by coronaviruses, so most people have antibodies to at least some coronaviruses.
 
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Gingergrrl

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@Gingergrrl know almost nothing about, but remember in the interview I posted above it was said, that B-cells are produced along T-cells in an innate immune response. The article had this piece:
So there should be test available used for research.

Thank you and I think my two questions might have been confusing! There are definitely tests to measure B cells, T cells, and NK cells (the absolute number, the percentage, and the functioning) b/c I have had those tests a bunch of times throughout my treatment. I was trying to figure out if there was a test to see if someone has antibodies or immunity to prior Coronaviruses (and it sounds like from @Pyrrhus (below) that there isn't :(

Memory B cells are B cells that have come into prior contact with an antigen/pathogen/infected cell. When a Memory B cell again comes into contact with that antigen/ pathogen/ infected cell, it immediately starts turning out copies of itself to act as Plasma B cells, which are the cells that release antibodies that bind to the antigen/pathogen/infected cell. Then, other cells come along and destroy the antibody-coated antigen/pathogen/infected cell.

This part all makes sense to me (although I could not have explained it as well as you just did)!

Similarly, Memory T cells are T cells that have come into prior contact with an antigen/pathogen/infected cell. When a Memory T cell again comes into contact with that antigen/pathogen/infected cell, it immediately starts turning out copies of itself to act as Effector T cells, which are the T cells that work to destroy the antigen/pathogen/infected cell. Some destroy the antigen/ pathogen/ infected cell directly, while other T cells secrete cytokines to "call for backup".

This is the part that I did not know about (that there were also Memory T-cells besides Memory B-cells). I'm not sure from what you described if the Memory T-cells also create the antibodies or if that part is strictly done by the B-cells?

I sincerely doubt that such a test exists. And if it did, we don't yet know what it might mean for the novel coronavirus. Remember that roughly 40% of the common cold is caused by coronaviruses, so most people have antibodies to at least some coronaviruses.

Thank you and this is exactly what I was wondering. It seemed like the research was theorizing that maybe some people who tested positive for COVID but were asymptomatic was because they already had antibodies or immunity from a prior Coronavirus. I know it is just a theory (but it seems like an excellent theory to test) so I wondered if there was actually a way to do this?
 

pamojja

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It seemed like the research was theorizing that maybe some people who tested positive for COVID but were asymptomatic was because they already had antibodies or immunity from a prior Coronavirus.

That's the explanation in the video, and for the situation in Sweden. Antibodies alone are too low to explain the obviously very high immunity to this corona virus.
 

Pyrrhus

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I'm not sure from what you described if the Memory T-cells also create the antibodies or if that part is strictly done by the B-cells?

Antibodies are strictly done by B cells. But it takes both B cells and T cells to make up adaptive (memory-based) immunity. So, even if you don't have any Memory B cells or antibodies that recognize a virus, you may have Memory T cells that will recognize the virus.
 

Mary

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I was also wondering if there is a current test (that already exists in medicine) in which someone can be tested to see if they have immunity to other Coronaviruses? I would imagine that few people have immunity to the original SARS or MERS but that some might have immunity to other Coronaviruses? Is this something that can be tested for (at a specialty lab or Mayo or anywhere?) or does this not exist?
@Gingergrrl - this thread talks about a potential new test for determining if someone who was previously infected with COVID-19 currently has immunity to COVID-19: New test to detect neutralizing antibodies to COVID-19 - may reflect immunity

This test though only seems to apply to people who have had COVID-19 already, to determine if they have immunity against re-infection:
Neutralizing antibodies make up less than 1% of the total antibodies measured by current commercial tests, and Wang says they’re being missed. That means we could be underestimating just how many people are already protected against reinfection with the virus.

Neutralizing antibodies are not sufficient in all cases. But based on the body’s response to other viruses, neutralizing antibodies are a good indicator of protective immunity in most patients who have recovered from a disease.
 

Gingergrrl

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This test though only seems to apply to people who have had COVID-19 already, to determine if they have immunity against re-infection:

Thanks and that is really interesting, too! I realize that no one knows yet who is going to end up with immunity in addition to many of the tests are poor (with both false negatives and false positives). Not to mention how challenging it is to even get a PCR test let alone an antibody test.

I am super curious though, from the article that you posted in this thread, it said that:

The group was researching blood from people who were recovering from coronavirus infections and wanted to compare that to samples from uninfected controls who were donors to a blood bank from 2015 to 2018. The researchers were floored to find that in 40 to 60 percent of the old samples, the T cells seemed to recognize SARS-CoV-2.

This means that (at least in the research) they had some way to test the old blood samples from 2015 to 2018 to see if they recognized the COVID antibodies. Although it just says "recognize SARS CoV-2" and doesn't use the word antibody but I am assuming that this is what they did. I am just confused HOW they did it and if this can be done outside of research (but I am assuming that it cannot be).

At first I thought, well, maybe some of the people that they tested had prior COVID but were asymptomatic but this isn't possible since the blood samples were from 2015 to 2018. Therefore it must mean that they had some other type of Coronavirus.
 

Mary

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This means that (at least in the research) they had some way to test the old blood samples from 2015 to 2018 to see if they recognized the COVID antibodies. Although it just says "recognize SARS CoV-2" and doesn't use the word antibody but I am assuming that this is what they did. I am just confused HOW they did it and if this can be done outside of research (but I am assuming that it cannot be).

At first I thought, well, maybe some of the people that they tested had prior COVID but were asymptomatic but this isn't possible since the blood samples were from 2015 to 2018. Therefore it must mean that they had some other type of Coronavirus.
Here are a couple of excerpts from the article which might answer some of your questions:
One mind-blowing hypothesis — bolstered by a flurry of recent studies — is that a segment of the world’s population may have partial protection thanks to “memory” T cells, the part of our immune system trained to recognize specific invaders. This could originate from cross protection derived from standard childhood vaccinations. Or, as a paper published Tuesday in Science suggested, it could trace back to previous encounters with other coronaviruses, such as those that cause the common cold.

Recent studies have suggested that antibodies from the coronavirus seem to stick around for only two to three months in some people. While work on T cells and the coronavirus is only getting started — testing T cells is much more laborious than antibody testing — previous research has shown that, in general, T cells tend to last years longer.

One of the first peer-reviewed studies on the coronavirus and T cells was published in mid-May in the journal Cell by Alessandro Sette, Shane Crotty and others at the La Jolla Institute for Immunology near San Diego.

The group was researching blood from people who were recovering from coronavirus infections and wanted to compare that to samples from uninfected controls who were donors to a blood bank from 2015 to 2018. The researchers were floored to find that in 40 to 60 percent of the old samples, the T cells seemed to recognize SARS-CoV-2.
So the studies done showing immunity in blood from 2015 -2018 was done with T cells. The article says that work with T cells is "much more laborious than antibody testing" so presumably this kind of testing would not be commercially available right now, but who knows, maybe down the line?