Aug 22nd 2020, 23:41:47
I don't think you can blame the people of America for the death tolls. Personally, I'm not much for that type of shaming. At least not yet. First of your leaders have given a lot of sprawling advice. Trump for instance unveiled a spectacularily well thought out plan(https://www.whitehouse.gov/openingamerica/) to reopen your economy and then he went on to publically shame the governors that followed that plan and hailed the ones that opened up faster than his plan suggested.
Mixed messaging from states, municipies and federal level has caused a lot of issues as well. Even if there wouldnt be direct conflicts between mayors and governors or governors and the president it would still be a problem to have many voices that keep saying different things.
These issues are not unique to USA tho, and I think theres a lot more to the great variation in deaths per capita than the response:
Look at qatar with 193 deaths and 116765 total cases, according to worldometer. Thats 0.165% case fatality rate. The infection fatality rate is higher than that in most western countries.
Further, antibody cohorts from man sub-saharan countries show IFRs which even if adjusted for demographics is about one order of magnitude lower than european and american numbers:
https://www.medrxiv.org/...07.27.20162693v1.full.pdf
https://www.medrxiv.org/...07.30.20164970v2.full.pdf
https://clubofmozambique.com/...avirus-antibodies-167192/
Theres clearly more to the death tolls than just blaming people or blaming leaders for everything. I think that is just our hubris to suggest everything is about that. Several factors vary between countries other than their demographics or overall health levels. Some have suggested genetics play a part but people of african decent dying in Europe and USA and NOT dying in Africa speaks loudly against that.
What is comming up lately is the T-cell mediated immunity which we know varied a lot from country to country, and we know it matters. Over the next few months that is what Im most keen to get more information on.
Here is a few teasers about T-cell mediated immunity:
-SARS-CoV1 T-cell activity persists for decades.(which makes it very likely that SARS-CoV2 T-cell activity does as well)
-Acute phase SARS-CoV-2-specific T cells display high cytotoxic activity
-T-cell activity correlated with various clinical markers of disease severity
-SARS-CoV-2-specific T cells were detectable in antibody-seronegative family members of people who had tested positive and individuals with a history of asymptomatic or mild COVID-19(What does this mean? it can either mean that SARS-CoV-2-specific T cells protected them from infection, or that they got the virus and didnt get symptoms or antibodies, either of which is absolutely amazing news; in the first case it means far more people are immune than the 5-25% of people who have already had the virus or it can mean that all those people with T-cell activity from before are immune to severe covid19 and death from it, which means that no matter what, the virus will run out of people it can be fatal to way faster than we have anticipated)
https://doi.org/10.1016/j.cell.2020.08.017
----
-UNEXPOSED INDIVIDUALS HAVE SARS-CoV-2-specific T cells!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
- Seriously, they do! Blood donated several years before this pandemic was tested for T-cell activity and it was found in this cohort. This has been done by at least a dozen groups of scientists all over the world, each finding T-cell activity in blood that comes from donors that could never have been in contact with SARS-CoV2. This means that a large portion of the population of the world, and possibly you but quite surely some of the people you hold dear, will have a protection from this virus even before fighting the infection. If it means they are immune or if it means they will be take it like a common cold and have no risk of getting hospitalized we don't know yet. But regardless, it is VERY GOOD news.
https://doi.org/10.1016/j.cell.2020.05.015
This is clearly a vast area we need more information about, the first started comming in May, and now new papers are published every day on the subject. And its pretty much all good news, both for vaccine mediated and disease mediated herd immunity, as 20-60% of all those cohorts studied(very varied) are already protected somehow, probably due to cross-immunity from another coronavirusinfection they've had.
This heterogenity in T cell activity needs to be understood before we can blame the american/swedish/Italian people or leaders for high death tolls and likewise we need to hold off on hailing New Zealand, Taiwan, Japan and South Korea for their success, which could easily be largely due to "luck" with low or high levels of pre-pandemic T Cell activity, for all we know so far.
Mixed messaging from states, municipies and federal level has caused a lot of issues as well. Even if there wouldnt be direct conflicts between mayors and governors or governors and the president it would still be a problem to have many voices that keep saying different things.
These issues are not unique to USA tho, and I think theres a lot more to the great variation in deaths per capita than the response:
Look at qatar with 193 deaths and 116765 total cases, according to worldometer. Thats 0.165% case fatality rate. The infection fatality rate is higher than that in most western countries.
Further, antibody cohorts from man sub-saharan countries show IFRs which even if adjusted for demographics is about one order of magnitude lower than european and american numbers:
https://www.medrxiv.org/...07.27.20162693v1.full.pdf
https://www.medrxiv.org/...07.30.20164970v2.full.pdf
https://clubofmozambique.com/...avirus-antibodies-167192/
Theres clearly more to the death tolls than just blaming people or blaming leaders for everything. I think that is just our hubris to suggest everything is about that. Several factors vary between countries other than their demographics or overall health levels. Some have suggested genetics play a part but people of african decent dying in Europe and USA and NOT dying in Africa speaks loudly against that.
What is comming up lately is the T-cell mediated immunity which we know varied a lot from country to country, and we know it matters. Over the next few months that is what Im most keen to get more information on.
Here is a few teasers about T-cell mediated immunity:
-SARS-CoV1 T-cell activity persists for decades.(which makes it very likely that SARS-CoV2 T-cell activity does as well)
-Acute phase SARS-CoV-2-specific T cells display high cytotoxic activity
-T-cell activity correlated with various clinical markers of disease severity
-SARS-CoV-2-specific T cells were detectable in antibody-seronegative family members of people who had tested positive and individuals with a history of asymptomatic or mild COVID-19(What does this mean? it can either mean that SARS-CoV-2-specific T cells protected them from infection, or that they got the virus and didnt get symptoms or antibodies, either of which is absolutely amazing news; in the first case it means far more people are immune than the 5-25% of people who have already had the virus or it can mean that all those people with T-cell activity from before are immune to severe covid19 and death from it, which means that no matter what, the virus will run out of people it can be fatal to way faster than we have anticipated)
https://doi.org/10.1016/j.cell.2020.08.017
----
-UNEXPOSED INDIVIDUALS HAVE SARS-CoV-2-specific T cells!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
- Seriously, they do! Blood donated several years before this pandemic was tested for T-cell activity and it was found in this cohort. This has been done by at least a dozen groups of scientists all over the world, each finding T-cell activity in blood that comes from donors that could never have been in contact with SARS-CoV2. This means that a large portion of the population of the world, and possibly you but quite surely some of the people you hold dear, will have a protection from this virus even before fighting the infection. If it means they are immune or if it means they will be take it like a common cold and have no risk of getting hospitalized we don't know yet. But regardless, it is VERY GOOD news.
https://doi.org/10.1016/j.cell.2020.05.015
This is clearly a vast area we need more information about, the first started comming in May, and now new papers are published every day on the subject. And its pretty much all good news, both for vaccine mediated and disease mediated herd immunity, as 20-60% of all those cohorts studied(very varied) are already protected somehow, probably due to cross-immunity from another coronavirusinfection they've had.
This heterogenity in T cell activity needs to be understood before we can blame the american/swedish/Italian people or leaders for high death tolls and likewise we need to hold off on hailing New Zealand, Taiwan, Japan and South Korea for their success, which could easily be largely due to "luck" with low or high levels of pre-pandemic T Cell activity, for all we know so far.