[Editor’s note: This article has drawn global attention and stirred debate. The author has written a followup, providing additional context and addressing critics.]
“If you look for truth, you may find comfort in the end; if you look for comfort you will not get either comfort or truth only soft soap and wishful thinking to begin, and in the end, despair.” — C.S. Lewis
While Omicron’s subvariants find new ways to evade vaccines and destabilize immune systems, another pandemic has overwhelmed officials who are supposed to be in charge of public health.
Let’s call it a plague of willful incompetence or an outbreak of epidemiological stupidity. Or maybe José Saramago’s novel has come to life and targeted public officials with a scourge of blindness.
In response officials have largely abandoned any coherent response, including masking, testing, tracing and even basic data collection.
Yes, the people have been abandoned.
So don’t expect “normal” to return to your hospital, your airport, your nation, your community or your life anytime soon.
Although many public health officials still dismiss COVID infections as inevitable and even beneficial, a growing body of science shows this fashionable dogma is dangerously wrongheaded, if not an outright form of malpractice.
Reinfections, and 2022 is surely the year of reinfections, just increase the damage from COVID, which can be profound: immune dysregulation, blood clots, nerve cell death, inflammation, lung damage, kidney failure and brain damage.
New science shows that Omicron and its variants are getting better at evading immune defences induced by vaccines or by natural infection. BA5, for example, is more transmissible than any previous variant.
As a consequence it is now possible to be reinfected with one of Omicron’s variants within three weeks.**
The data also shows that each reinfection confers so little immunity — because the immune system is unable to remember it — that we must seek every other protection available.* A summer infection, for example, will not protect you against a fall infection. But each and every infection will damage your immune system regardless of how mild the symptoms.
Let’s start with a startling U.S. Veterans Affairs study involving five million people.
It looked at the health outcomes after a first, second and third infection in both the vaccinated and unvaccinated. A second infection, for instance, doubled the risk for death, blood clots and lung damage. It also increased the risk of hospitalization by three times. Every COVID infection increased the risk for bad outcomes in a graded fashion.
The unvaccinated fared worse than the vaccinated. “Reducing overall burden of death and disease due to SARS-CoV-2 will require strategies for reinfection prevention,” noted the study.
There is more bad news. Past infection by older variants dampen rather than strengthen immune protection even among those with three vaccinations. “That previous SARS-CoV-2 infection history can imprint such a profound, negative impact on subsequent protective immunity is an unexpected consequence of COVID-19,” noted the researchers in Science.
The high global prevalence of Omicron subvariant infections and reinfections “likely reflects considerable subversion of immune recognition” in the population, the study concluded.
COVID is paving the way for other diseases
So the virus is getting better at thwarting vaccines and evading immunity. Although vaccine protection against hospitalization and death remains strong, it is being steadily eroded by Omicron’s subvariants. Meanwhile protection against severe disease has declined as the effectiveness of our vaccines progressively wanes.
Immunologist Anthony Leonardi, a specialist in T cells, which play a complex role in immune function, predicted such a development nearly two years ago. That’s when he speculated that COVID was destabilizing the immune system by subverting T-cell function.
And that is exactly what many researchers are now finding.
Leonardi bluntly describes the current state of things on Twitter: “There is a cumulative damage from SARS-CoV-2 reinfections, and reinfections are not mild, the virus is intrinsically virulent. Immune memory does not turn a SARS into something like a flu. It remains severe.”
So if each COVID infection depletes T cells and destabilizes immune function and the damage is cumulative, then policies that allow the virus to run riot through the population will not only cause immense suffering but erode public health along with trust in government. The word diabolical comes to mind. The British immunologist Danny Altmann compares the situation to "being trapped on a rollercoaster in a horror film.”
Previous COVID infections probably also play a major role in deadly hepatitis infections in hundreds of children. A Chinese study recently spelled out the likely mechanism: "Similar to patients with HIV-1, the children previously infected by SARS-CoV-2 may have a repetitive immune activation caused by the comparatively long-term existence of SARS-CoV-2 in the gastrointestinal tract… children may be prone to infections by other viruses, which would contribute to the development of acute hepatitis."
But COVID has become such a formidable biological force on the planet that is also affecting the ecology of other viruses and other species. What role immune-destabilizing COVID infections are now playing in the rapid advance of monkeypox or the deadly meningitis outbreak in Florida is not really understood.
But many experts suspect that COVID infections, along with declining smallpox immunity, are playing a subversive role. Immune systems bashed by COVID open doors for other infectious diseases.
Every COVID infection now leaves a non-linear legacy of troubling human health outcomes in unforeseen ways. A Danish study, for example, found that people infected with COVID “were at an increased risk of Alzheimer's disease, Parkinson's disease and ischemic stroke." The risk wasn’t trivial: the infected were 3.5 times more likely to be diagnosed with Alzheimer's and 2.5 times more likely to be diagnosed with Parkinson’s.
‘A nightmare scenario’
So letting the virus run unchecked is pretty much a strategy for creating a tsunami of neurological impairment and chronic illness in the general population. It is also a nihilistic prescription for sowing chaos in western societies already dancing a tango with political collapse.
Letting the virus rip also supports a nightmare scenario where initial infections disarm and sabotage immune systems leaving them more vulnerable to future infections and new pathogens such as monkeypox.
A pandemic that progressively weakens its host population with each successive wave is ultimately more dangerous than one that dispatches 10 per cent of the population and then vanishes.
Thanks to bad public policy, the frightening reality of a forever pandemic is becoming more probable day by day.
Long COVID, which affects nearly 300,000 Canadians, comes with a range of life-challenging symptoms and no real treatment. The symptoms include brain fog, fatigue, muscle pain, chronic inflammation, blood clots and kidney failure.
Researchers now suspect that the virus can persist for long periods of time in the body (mostly likely in the gut — months after infection people are still shedding viral RNA in their stools). This persistence seems to correlate with the worst of long COVID symptoms. Researchers don’t know if it’s a product of immune activation or the dogged presence of a replicating virus.
The British epidemiologist Deepti Gurdasani has long wondered why so many public health officials have been so blasé about exposing children to a novel virus that can result in persistent infections and chronic disease. “The more we learn about long COVID, the more it seems that SARS-CoV-2 isn't just an acute infection, but a persisting virus in a significant proportion of people. And not one that one should take lightly. It's not the flu.”
Meanwhile the variants keep on marching like some vast army of Amazonian ants hellbent on global conquest. Their current success owes much to the behaviour of public health officials and politicians who think society can live with disrupted supply chains, overwhelmed hospitals, chaotic airports and a workforce with crippled immune systems.
By abandoning the critical goal of stopping or reducing viral transmission about a year ago, authorities have given viral evolution an incredible edge.
The more opportunities the virus has to infect hosts, the more opportunities it has to mutate and produce variants. Each infected individual can produce between one billion and 100 billion infectious virions, or virus particles, during peak infection.
More than a billion global infections have produced trillions of viruses over the last two years in an overcrowded planet of eight billion people. In the absence of common-sense public health measures, COVID is now conducting an evolutionary viral rave.
The rapid appearance of more variants in ever shorter periods of time spells incalculable trouble. Many researchers now suspect some of the variants have arisen in immunocompromised patients with no real defences where mutations can evolve at hyper speed. “The possibility of SARS-CoV-2 evolving resistance to existing therapies during such infections is real,” warns Cambridge researcher Ravindra Gupta in a recent Lancet letter. “Hence, curing COVID-19 infections in immunocompromised individuals is of crucial importance as it is possible that an existing patient might harbour the next variant, a highly transmissible new variant of concern that challenges immunity and existing therapeutics.”
Facing a new, grim reality
So here is the uncomfortable reality the authorities don’t want to talk about but to which every citizen must pay attention.
The pandemic is not over, and it will not likely end for years. It spreads through the air in aerosols like a viral smoke, in distances greater than two metres. The disease (a thrombotic fever) is not mild. Just one infection can destabilize your immune system and age it by 10 years. The risk of long COVID increases with each infection. Reinfections harm the immune system and increase hospitalizations and death even among the vaccinated. (Just watch the data coming out of England and Quebec now.)
Meanwhile, the virus is now evolving at a rate faster than vaccine development (three waves this year alone). And the effectiveness of current vaccines are now waning. Mother Nature offers no guarantee that virus will evolve to a benign or endemic state this year or the next. Meanwhile human behaviour has increased biological risk instead of dampening it.
In real terms “living with the virus” means living with a normalization of death, reinfections, long COVID, disruption and exhausted health-care workers. People would never vote for a deteriorating quality of life and risk, but that’s where public policy is now taking us.
Vaccinations, of course, are critical, but they have not and cannot end the pandemic by themselves. The Australian physician David Berger wisely advises citizens to view them as “an ejector seat.” It might “prevent actual death if the aircraft is on fire and the wing has fallen off, but still no guarantee, and may still end in disability. I do not decide to do a risky manoeuvre because I have the ejector seat.”
As one critic recently noted on Twitter, the world has divided into two groups of people: “Those who already realize that SARS-CoV-2 causes neurological, vascular and immune system damage… and that damage from reinfections is cumulative. 2) Those who are about to find out.”
Or as José Saramago might have put it, “the only thing more terrifying than blindness is being the only one who can see.”
To avoid the prospect of an accelerating pandemic and its related anarchy requires flexibility, steady collective action and courageous leadership. And by that I do not mean lockdowns but strategic actions aimed at stopping or reducing transmission of the virus. Reducing transmission is the only way to slow down viral evolution.
There is no mystery to this approach. It means free N95 masks for the entire population and appropriate masks for children. It means installing proper ventilation and filtration (HEPA filters) in schools and workplaces, along with CO2 monitors. It means paid sick leave for the infected. It means transparent data collection and reporting so people can gauge the ever-changing risk in public spaces. And it means communicating the truth about this pandemic, which is by definition an evolving and novel emergency that requires our full attention.
We could have avoided this deteriorating situation, as The Tyee repeatedly advised, by eliminating COVID in our communities more than a year ago.
Elimination remains the only long-term and bottom-up strategy that makes any sense in terms of risk reduction. It is also imminently doable with adequate testing, masking, tracing, supported sick leave and targeted goals for reducing transmission.
But our public health officials gambled with the future and chose a fantasy world instead. Now COVID has become a runaway train with unknown biological consequences.
If anyone needs a reminder that direct simple actions can thwart viral aggression, consider the actions of the Japanese people. Despite having one of the world’s oldest populations, they outperformed most western countries in terms of death and disability with aplomb.
They did so, not with lockdowns, but by observing a real public health message on “the three Cs.” Avoid closed spaces with poor ventilation. Avoid crowded spaces. Avoid close contact settings with people.
And mask up.
And that’s what citizens who care about the future of our children, our health-care workers, our immunocompromised and our elderly, will do now.
* Story edited on July 8, 2022 at 12:31 p.m. to give a clearer statement about weak levels of immunity Omicron infections have been shown to provide.
** Story updated on Jan. 9, 2023 at 8:34 a.m. to reflect findings about reinfection periods found since the article's publication.
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