Covid's Cumulative Effect

Spoiler: It's harm

One of the key questions of SARS Cov 2 was whether it would be dangerous on reinfection or just like any other common cold. Given that we had no information on the matter, nor the ability to speculate from SARS because there were no SARS reinfections, we had to settle with the opinions of some experts. So they gave their opinions.

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Ralph Baric, the famous Coronavirologist, claimed after a first infection, subsequent reinfections would be just like any other cold, and that the severity of the illness was due to the immune system never having seen a similar virus. He gave a talk about it here. He says valid things, like how the virus has a tendency to cause serious disease as a function of age, but does not touch upon the mechanisms. I, like other immunologists at the same time, claimed that the severe response was a function of a lack of Naive T cells. He also says incorrect things, like children will be infected while it’s mild, then “immune for life”. That is what I have been warning against for years, that the T cell memory gained from infection in the youth is moot due to evolution and attenuated T cell responses.

In fact, I have argued that the T cell response drives severe illness and organ damage. This inconvenient opinion has resulted in my castigation and mockery online, but now all these conjectures have proven true. Blocking T cell activation with Abatacept in severe disease saved 30-40% of patients. There is no herd immunity, and kids and adults alike are getting infected over and over again and are suffering organ damage. How is this organ damage manifesting? In severe outcomes, like organ failure and chronic disease.

The best publication to understand the cumulative harm done to organs on reinfection is covered in this article for laypeople. SARS Cov 2 uses Ace2 as one way to infect cells, and ACE2 is expressed all over the body in many organs. It also stimulates T cells very strongly, and these T cells will do their job, which is kill cells. This results in organ damage and repair, and when you repair this damage the tissues can become fibrotic, like a wound or scar on the skin.

So what does this mean? It means one bout of Covid is bad for you, but so is the second and the third bout as well. One should try to avoid reinfections, if possible.

Stay safe out there,

AJ