COVID19 update, July 16, 2020: vitamin D redux; airborne transmission; impact of work-from-home on London; new revelations on T-cell response and persistent immunity

Today, a bit of a bumper crop of COVID19 news.

(1a) Dr. Seheult about, once again, vitamin D. 

At least in Israel, HMOs have woken up to the deleterious effects of vitamin D deficiency: when I checked in with my dietician (over the phone) for a routine follow-up, I told her about the vitamin D and Zn supplements I’d been taking since the beginning go the outbreak, and she mentioned that her HMO (Maccabi) issued guidelines to recommend vitamin D supplements to the entire population. 

Another aspect of Israel’s COVID19 response was revealed to me when a friend (a literary translator) developed flu-like symptoms and tested positive. (She is self-isolating at home with her husband.) The next day, she received a parcel from her HMO with a fingertip pO2 meter (i.e., a blood oxygen saturation meter), accompanied with instructions to check several times a day, and to call immediately if her pO2 dropped significantly. This acts as an inexpensive but reliable early warning system for deteriorating condition.

(1b) Dr. Mike Hansen discusses airborne transmission and masks

Relatedly, a study about the effect of universal masking policies at Brigham and Women’s Hospital was just published in JAMA . In a word, the masks are valuable in a healthcare setting. This does not necessarily mean the study militates in favor of universal mask mandates among the general population. (In fact, for aerosol transmission, surgical masks are likely not very useful.) 

(2) Is “the 30-year old who attended a COVID party and died”  a ‘fake but accurate’ story?

(H/t: Jeff Duntemann). It seems that the NYTimes has dropped all pretense of reporting the news and is now only reporting “truth” (Pravda, in the original Russian). Bari Weiss’s resignation letter speaks volumes.

(3) One man’s meat is another man’s poison: Norwegian undertakers want state aid as they have too little work

And an essay in the Daily Telegraph uses the hyperbolic term, “extinction-level event”, for what the shift from commuting to home-working is doing to central London. I would not blame this on COVID-19 though: that shift was waiting to happen (especially in one of the most expensive real estate markets in the world) and COVID merely the trigger.

(4) Some years after a sting operation revealed the operation of scientific paper ghostwriting operations in China, new revelations  (See also here.)


But Israeli expert Ehud Kliner is blaming the second wave in the country on… reopening the schools.

(6) Media should do a major mea culpa on hydroxychloroquine, as a new study adds fuel to the fire.

(7) Daily Telegraph exclusive: Good news about the Oxford/AstraZeneca vaccine trial.

(8) Last but definitely not least for today, Derek Lowe discusses new papers on antibodies, T-cell response, and COVID-19.

Turning to patients who had caught SARS back in 2003 and recovered, it is already known (and worried about) that their antibody responses faded within two or three years. But this paper shows that these patients still have (17 years later!) a robust T-cell response to the original SARS coronavirus’s N protein, which extends an earlier report of such responses going out to 11 years. This new work finds that these cross-react with the new SARS CoV-2 N protein as well. This makes one think, as many have been wondering, that T-cell driven immunity is perhaps the way to reconcile the apparent paradox between (1) antibody responses that seem to be dropping week by week in convalescent patients but (2) few (if any) reliable reports of actual re-infection. That would be good news indeed.

And turning to patients who have never been exposed to either SARS or the latest SARS CoV-2, this new work confirms that there are people who nonetheless have T cells that are reactive to protein antigens from the new virus. As in the earlier paper, these cells have a different pattern of reactivity compared to people who have recovered from the current pandemic (which also serves to confirm that they truly have not been infected this time around). Recognition of the nsp7 and nsp13 proteins is prominent, as well as the N protein. And when they looked at that nsp7 response, it turns out that the T cells are recognizing particular protein regions that have low homology to those found in the “common cold” coronaviruses – but do have very high homology to various animal coronaviruses.

Very interesting indeed! That would argue that there has been past zoonotic coronavirus transmission in humans, unknown viruses that apparently did not lead to serious disease, which have provided some people with a level of T-cell based protection to the current pandemic. This could potentially help to resolve another gap in our knowledge, as mentioned in that recent post: when antibody surveys come back saying that (say) 95% of a given population does not appear to have been exposed to the current virus, does that mean that all 95% of them are vulnerable – or not? I’ll reiterate the point of that post here: antibody profiling (while very important) is not the whole story, and we need to know what we’re missing.

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