Technology versus nature in a race to control immunity

Positive test results are up, hospitalisations are up, and unfortunately deaths with Covid-19 are also up. It is a grim picture painted in the popular media. I can’t help but notice that a couple things seemed to have quickly gone out of fashion with them. We heard plenty about these things in the media last year – asymptomatic transmission and ‘R’ numbers. They were used to explain and curtail contacts. It’s time to revisit these concepts.

Studies claim anywhere between 45% and 80% of people with Covid will show mild or no symptoms. Most of these people won’t know they have it, or had it. Only a test result would tell them so. So if more people are testing positive daily at the moment, then its fair to say that many more again might be out there carrying the virus without knowing it. Contact tracing brings some of those into the net of rising case numbers, but with testing capacity having hit its limit many times recently, it’s unlikely we tested and identified many of those who are asymptomatic.

There’s an important point to be made here. I won’t bore you with all the maths, but using Ireland’s official figures, then we can say 3.5% of the population have tested positive for the virus since we first started PCR testing. If we include asymptomatic, untested, cases then that means anywhere between 7% to 20% of the population may have had it over the course of the last year. That is up to a fifth of the population that has built up immunity naturally to the virus. And that assumes nothing about transmission and ‘R’ numbers. As long as the R number – the number of close contacts each person has – remains high, above 1, then the virus can spread exponentially, so we’ve been told. We’ve had periods during the easing of lockdowns when the R number has increased spread, so if the majority of cases have been asymptomatic, then an even greater portion of the population at large may be immune than we think. There is a silver lining in this situation and, no, I don’t mean the vaccines. What comes with an increasing number of positives tests, and hospitalisations, and sadly even deaths, is an even greater number of people with established natural immunity to the virus.

Back last year there was a dangerous idea spread of achieving ‘herd immunity’ over time. The healthcare authorities insisted it was too dangerous a thought for us, one that we could not afford to consider. So lockdowns and restrictions, in an effort to control the virus, stifled herd immunity from building up in the population. Then the vaccines came, and it all changed. Herd immunity the natural way had been all but forgotten. (In fact, it hadn’t been forgotten, it had been dropped*.) But now, herd immunity was back on the table, and seemingly achievable only with human drugs. Over the longer term, everyone will contract this virus in some form. We can not stop that. Current measures slow the inevitable. But those measures also buy time for a vaccine to be rolled-out. The race is on to get vaccines out, just as the exponential winter transmission is in danger of letting nature do what it does every year and build immunity for the majority of us in the herd, the natural way, as it has for all of history.

It is tragic that any harmful virus leads to premature deaths or long-term health damage. The case fatality rate for Covid is (on average) about 2%, and that has fallen over the year, as hospitals have become better at treating the condition since the start of the pandemic. The link between Covid and mortality is well understood by now.

Can we say the same for vaccines? The answer: not yet.

Some of these vaccines are using new, experimental technologies (mRNA) only recently cleared for widespread use on humans in an emergency scenario. There is no human pharmaceutical drug that does not have side effects on some users (and potentially dangerous ones on a minority). There’s no sensible reason to assume this new technology will be any different in that regard, and there’s more reason to be cautious with it than rush it into all the population. Did our healthcare bodies do a comparative risk analysis of exposure to the virus versus exposure to the vaccine, to decide on this strategy (and the claim that it is safe)? Of course not, because they can’t – we do not yet have the long-term data of vaccines side effects to make that decision. And so, it is in part a gamble, and an expensive gamble at that. Let us hope the cost of the gamble is only financial. We have bet the house on artificial immunity and eschewed natural immunology as a means to reach equilibrium against the threat of this virus.

The race is on. But can we say it is a fair race, if one competitor has been sabotaged from the start? If vaccination coincides with an abatement of cases, then it can be claimed to be responsible for it, even if natural herd immunity had a part to play. It is interesting that in vaccinating the majority of the population we’ll also be vaccinating those who’ve already built up natural immunity previously. There is no plan (and no time given) to identify if someone has the antibodies already before rushing to inject them.

Perhaps there is equilibrium to be reached here, in a solution that utilises both natural spread and artificial inoculation. After all, the aim is to end unnecessary deaths by any means, right? That conversation is not even taking place. Those making the decisions in Ireland label people who sought to open up the conversations about controlled, natural spread as ‘let-it-rip merchants’. Hardly a mature nor scientific argument. It is language that seeks to dismiss any conversation before it gets started by emotively discrediting those who consider a role for natural immunity in the response to this pandemic. It is not, and should not be, an either/or situation. It is a situation where everything available to us should be considered in limiting the damage induced by this pandemic. Vaccination has unquestionably been adopted as the only remedy. All else has been taken off the table, leaving us to wonder why.

With new shiny unproven bio-technologies that are to be injected into our bodies it is right to be prudent and cautious. It is our manipulation of the smallest things in nature – the building blocks of life - that seem to have caused the greatest soul-searching calamities in human technological history. It started with splitting the atom. Let us hope and pray that our novel nRNA technology, injected into billions, will not have regrettable consequences, with socio-political ramifications. We tinker with even the smallest things and then find what we have unleashed is out of our control.

Let’s not even get started on the kind of tinkering and the true source of this one little viral molecule that has caused the premature death of millions already.