Study suggests novel reason for wide range in COVID illness: people never exposed to virus have some antibodies
When researchers in British Columbia tested for antibodies in a small sample of Vancouver residents earlier this year, they found that less than one per cent had definitely been exposed to COVID-19. That was little surprise, especially at a time when the virus was not spreading widely in the city. But when the scientists delved further, their conclusions were striking. Large proportions of people who seemingly had never come in contact with the coronavirus, they said, had antibodies that reacted to parts of the bug — that recognized some of the “antigens” in SARS-CoV-2 that switch on a body’s immune system. If proven valid, the discovery could be a key clue to unraveling one of COVID-19’s remaining mysteries — why infection has little or no effect on some people and yet is devastating to others. It could also have implications for the effectiveness and safety of vaccines, said Dr. Pascal Lavoie, the B.C. Children’s Hospital scientist who headed the study. “If what we’re seeing is true, and I believe it is … this could be a major finding,” he said. “It would be crucial to understanding why the virus makes some people sick. … It could (also) guide where you target your vaccination efforts.” Whether having antibodies to individual SARS-CoV-2 antigens gives people some immunity, or actually undermines their defences against the COVID-19 virus, remains to be seen, said Lavoie. Such antibodies can sometimes actually help a virus attach to a healthy cell, he said. He also stressed that the paper, posted on a “preprint” website like many COVID-19 studies, has yet to be peer reviewed and has its limitations. 'Cancellation pushback': If authorities keep ruling out the holidays, people will stop listening COVID-19 immunity wanes within weeks, U.K. study finds. Results suggest vaccine needed twice a year Russian professor twice infects himself with COVID-19, says herd immunity won't save us Indeed, outside experts cautioned Thursday it’s unclear whether the “unusual” findings represent background noise that comes with the testing or true reactivity to the virus. Lavoie said new data he has just received addresses that concern and appears to make the findings “much stronger.” He plans to submit the study to a peer-reviewed journal soon. The research needs to undergo that kind of independent assessment to properly gauge whether the findings are valid, said Dr. Mel Krajden, public health lab director at the B.C. Centre for Disease Control. Even if they are legitimate, he said, it would be “speculative” to suggest that antibodies in unexposed subjects explain the wide range of illness caused by the coronavirus. Age is the clearest predictor now of how sick COVID-19 will make people, noted Krajden. Lavoie and colleagues asked for volunteers to submit to “seroprevalance” testing — designed to tell if someone has been exposed to a virus — in May and June. They enrolled 276 people, mostly health-care workers. Of those, only three, or .6 per cent, had antibodies that indicated they had been exposed to the full SARS-CoV-2 virus. But the “remarkable” finding, the paper said, related to the presence in unexposed people of antibodies to specific antigens in the virus — an antigen being a foreign body that spurs the immune system into action. About 82 per cent had reactivity to the virus’s famous spike protein, 47 per cent to another of its antigens and seven per cent to a third, the researchers concluded. Where those antibodies came from is unclear. It might be they’re a result of contracting seasonal coronaviruses, the kind that cause colds, said Lavoie. But it’s also possible something else entirely produced the antibodies, from bacteria to food, he said. If the findings are confirmed as accurate, the next step would be to study the links between antibody levels and the severity of illness in people infected by SARS-CoV-2, said Lavoie. Dr. Catherine Hankins, a McGill University population health professor and co-chair of Canada’s COVID-19 Immunity Task Force, said she wouldn’t read too much into the paper because it’s unclear whether the antibody findings are background noise or true reactivity. Plus, the sample size is tiny compared to some seroprevalence studies that have tested thousands of people. But she said the question of how antibodies to other viruses might affect a person’s response to COVID-19 — something called cross-reactivity — is an important one. It’s still murky, for instance, why young children are relatively unaffected by the virus, while elderly people are far more likely to suffer severe cases. “Is that in any way related to how many times you’ve had a seasonal coronavirus in the past?” said Hankins. “Or have you recently had one because you’re a kid? … Is it the recent activity that protects? We don’t know yet, and these are the questions we want to answer.” • Email: tblackwell@postmedia.com | Twitter: tomblackwellNP
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'Cancellation pushback': If authorities keep ruling out the holidays, people will stop listening
Psychologist Baruch Fischhoff is considered a giant in the field of risk communication and decision-making. When asked for his quick analysis of Prime Minister Justin Trudeau’s somewhat un-prime-ministerial assessment this week that the COVID-19 pandemic “really sucks,” and that unless people are “really, really careful” usual holiday gatherings might be off the table, Fischhoff offered that, for people predisposed to the PM, “it probably speaks to their heart that he’s really worried and he’s willing to kind of let his professional guard down.” Too often COVID risk communications have been chaotic, don’t recognize the diversity of situations people are in, and are too focused on rules, Fischoff said — “’thou shalt X’ without giving people a mental model of why that is true. “And the mental model that people need here is not all that complicated — it’s something about how much disease is out there, how is it transmitted in different kinds of settings, how well different practises protect you, how likely are you able to actually implement practises when you’re having a good time.” The current COVID outlook doesn’t promise a huge number of good times ahead. “It’s going to be a tough winter,” Trudeau warned this week. “This winter will be difficult,” German Chancellor Angela Merkel warned Thursday as that country prepares for a month-long partial shutdown beginning Monday. “The virus is circulating at a speed that not even the most pessimistic forecasts had anticipated,” French President Emmanuel Macron said in a televised speech announcing a new national lockdown until Dec. 1. In Canada, COVID-19 is resurging outside the fortress of the Atlantic Bubble and Northern Canada. In Manitoba, Premier Brian Pallister this week upbraided those Manitobans doing “dumb things” to “grow up.” The province’s chief public health officer said some of those testing positive have had “way too many contacts,” so many they can’t remember them all. And despite pleas to limit turkey dinners to “immediate households,” Thanksgiving weekend is being tied to rising case counts in Ontario, Manitoba and Alberta. Study suggests novel reason for wide range in COVID illness: people never exposed to virus have some antibodies The COVID-19 pandemic really 'sucks' and now Christmas is in jeopardy, Trudeau warns 'Enough is enough': B.C. children's soccer club hires security after parents threaten violence over COVID-19 policies After months of well-meaning but sometimes cloying slogans, about marathons and sprints and “we’re all in this together” — COVID, as the annual report this week from Canada’s chief public health officer highlighted, is in fact disproportionately harming and killing the marginalized, racialized communities and the elderly, not the privileged and powerful. A new Ipsos poll for Global News suggests Canadians are feeling sapped; half (48 per cent) said they’re tired of COVID public health recommendations and rules. While the majority (nine in 10) are following masking rules, parents (88 per cent) were less likely than those without kids (94 per cent) to say they’re doing everything they can — “perhaps an indictment of how workable many social distancing measures are in practice for those with young families,” the pollster said in a release. Renowned epidemiologist Dr. Michael Osterholm says a trifecta of risk issues — fatigue, anger and winter weather that will drive people indoors — is creating a perfect incubator for COVID-19. Add in the holidays, with travel and family get togethers, “and we’re going to see a major increase in transmission in family settings or social settings around the holidays,” predicted Osterholm, director of the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota. Osterholm, by the way,  in a Jan. 20 statement, warned that the coronavirus would cause a global pandemic. Without vaccines, “We’re in this period where we don’t really have anything to offer people to limit transmission except their own behaviour at a time when that is a huge challenge to get the public to do it,” Osterholm said. “If you just make it all dark with no hope, that’s not helpful.” We’re somewhere between total darkness and total light, he said, borrowing time until vaccines are approved. “What we’re really trying to give people is a sense that this is your COVID year. It’s not going to be like last year. But hopefully it’s not going to be for next year if we have vaccines,” Osterholm said. To that end, people should limit holiday gatherings to their bubbles, he said. “Don’t fall for some concoction that says, ‘well, we’ll all get together in the dining room and the kitchen and the living room, and we’ll all stay 15-feet apart and, oh, by the way, there are 32 of us in that dining room, kitchen or living room.’ How are you gonna do that? That math doesn’t work out here,” Osterholm said on a CIDRAP podcast this week. Dr. Zain Chagla has called “cancellation pushback” a canary in the coalmine. “We’ve got several months/possibly years here — if the attitude is nope, people are going to stop listening,” Chagla, an infectious diseases physician at St. Joseph’s Healthcare in Hamilton tweeted after health authorities urged no trick-or-treating in Ontario hotspots. Businesses, urban planners, regional and municipal governments can help create opportunities for people to get low-risk human contact, Chagla said. “Outdoors is still OK — it has to be done safely where something like the Rose Garden doesn’t occur,” he said, referring to the White House super spread event where U.S. President Donald Trump announced Amy Coney Barrett as his nominee to the Supreme Court. At least a dozen in attendance later tested positive for COVID-19. “Maybe Christmas is not the typical indoor event where you have 12 family and a large dinner and people sleeping over,” Chagla said, “but maybe dedicated green space where kids could meet Santa, decorative lights that get people inspired, pot lucks or markets. They’re not going to be zero-risk, but you can make them low-risk.” It’s possible that people who paid little heed to advice to limit their Thanksgiving gatherings to their households “thought they were taking a reasonable risk, but didn’t understand what that meant,” said Fischhoff, of Carnegie Mellon University. Abstract concepts like exponential growth are unintuitive; they can be difficult to communicate and grasp. But it also didn’t help that there were differing definitions of “immediate household.” “We learn top-down from principles if they’re well established, and bottom-up from personal experiences,” Fischhoff said. If someone has been exposed, the ordeal of getting tested and waiting for the results becomes something visceral. “Some people would say it was not such a big deal, but others will say, ‘I don’t want to go through that again, I didn’t sleep for a week.’” Risk communications should avoid simplistic solutions; they should be respectful, informed, and people should be treated like adults, Fischhoff said. “I think people could be helped with better information and better options. That will be enough for a lot of people, given they don’t want to get sick and they don’t want to get other people sick,” he said. “They will say there is light at the end of the tunnel. ‘Eight months from now life will become more normal. I want to be there when we get to the end of the tunnel.’ “For other people, it won’t be enough, but it might once the horror stories continue to spread. I don’t know how many people are zero or one degree from a serious scare.” • Email: skirkey@postmedia.com | Twitter: sharon_kirkey
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