Dr. Debasish Sarma Roy

October 15, 2020, 18:24:33   

With so many millions of people infected with the neo virus till date, many people are waiting for the development of herd immunity eagerly, which they think as the only hope so far to end this menace. However by the nature and duration of the antibody levels in the infected persons, it is a big doubt now whether herd immunity will develop at all. Most flu like illnesses by other coronaviruses imparts only a short term antibody response, making the person susceptible to another infection soon. Governments of some countries have suggested that the detection of antibodies to the SARS-CoV-2 could serve as the basis for an "immunity passport" or "risk-free certificate" that would enable individuals to travel or to return to work assuming that they are protected against a re-infection. But experts are saying that there is currently no evidence that people who have recovered from COVID-19 and have antibodies are protected from a second infection.  At this level it is not very clear either how much immunity will be imposed by the vaccines, though so many types (by nearly 160 companies/organizations) of which are in the pipeline for production en masse. With so many reports of dwindling antibody titres in the affected population and so many different strains of the virus in circulation one is intrigued to introspect a bit. Why is this that a person may not expect to be immune to a fresh attack after may be a few weeks or few months of getting out of one?

It is known fact that RNA viruses mutate rapidly, and coronaviruses are no exception. In fact these are thought to mutate inside a patient even and take a different sequencing (basic genetic program) so that next time when it is passed on to another person from this host, it is basically a new virus. Means it has some new tricks up its sleeves, to invade more efficiently or evade the host immune system more dexterously. The virus remains a SARS-CoV-2, but its characters are changed, so that it's infectivity and it's susceptibility to get killed by drugs are also changed. Similarly our immune system cells or specific proteins produced after it once invaded our body are also fooled and fail to recognize that it has been the same culprit which once invaded us. Why it is mutating so fast? As an entity the virus does not 'want' its host get killed by it, then that would make the end of it as well. So, their ultimate intention would be to get into a symbiotic relationship with its host so that both can live. Out of context here, but generates the thought though, as if it is the very opposite nature of the country from where this particular virus has originated, the country that wants to gobble up the world politically, economically, and by many more means. Likewise another intriguing notion is this rapid mutability, haywire host immune response with cytokine storm and widespread intravascular micro- or macro-coagulation of blood are features due to its customized creation in the lab? Though seems very unlikely so far as per opinions of stalwarts in this field, but we know that this is the era of rocket science, and Elon Musk recently showed what he can do in the labs to control the animal / human brain or mind. And a recent report of community spread of Brucellosis in thousands of people in China, a security breech spill over from a research lab, also strengthen this point. So, if Mr. Tesla, a single solidly rich person can achieve that much of scientific breakthroughs (consider his electric car segment and space programmes as well among other things) within just a few revolving time of the earth around the sun, then what a super rich country with billions to spare and a megalomaniac mind to propel it and with so little accountability to its own people or the world at large can achieve with so many state of the art highly sophisticated labs and with such ahuge population falling within the top notch IQ levels in the world! (See – National IQ, International School Test Achievements, etc.)

On a more serious note, is this rapid mutation in the viral structure a result of human kinds continuous efforts to kill its progeny with so many drugs/chemicals inside or outside our body? CoVs have better proof reading ability than the common flu viruses. So, it is easier for them to bolster their weak points when they appear to be threatened with a drug or a chemical or when face any difficulty in invading a host. Hence it may not be a good idea to give antibiotics or antiviral drugs to asymptomatic patients or patients with mild or moderate symptoms. Resultant mutations while inside the same host may produce more efficient progeny. Not surprisingly we have among us approximately 12000 mutations of SARS-CoV-2 as of now. 
As we know there are basically two different types of immunity – innate and acquired. Innate or native immunity develops as we are created inside the womb and is modified only little throughout our lives. When we talk about "increasing our immunity" we actually mention about boosting this native immune mechanisms. These are non-specific immunity, mean none of these recognize a specific organism in particular, and will attack anything when they feel it is a foreign substance, means not anything of our body's normal component, it may be a damaged cell of one's own body. The innate immune system comprises of physical and chemical barriers (skin, mucous membranes, cilia, eyelashes and other body hair, secretions like mucus, tear, sweat, saliva, gastric acid, bile etc), phagocytic cells, dendritic cells, natural killer cells, other innate lymphoid cells, blood proteins including members of the complement system etc. On the contrary, adaptive immune system becomes operational against a particular pathogen once it has invaded our body, evaded the innate immune system to multiply for some time so that some specific cells are programmed to recognize it to be a threat to our existence some cells in our body are programmed to produce proteins specifically to neutralize those antigens (whole or part of the pathogen), directly or indirectly. If our innate immune system is strong or we are exposed to only a small number of pathogens then these won't be able to produce the disease it is supposed to do. But if the innate systems are overwhelmed by a significant number of germs then these can produce the disease. But ultimately the adaptive immune response will kick start in a week or so and will overwhelm the germs and the disease will be cured. Unless of course the germs overpower the adaptive immune responses too, or a very strong and inappropriate immune response release way too much of chemicals needed to neutralize the invadersresulting in a catastrophe. If the person survives, the adaptive immune system will be keep that program so that the next time this organism enters our body, they can be singled out more easily and neutralized rapidly. 

Though it is widely touted that popping in some pills of different vitamins boosts the immunity and may prevent covid-19, there is still now no solid evidence to endorse this view. Some studies showed low vitamin D or zinc may make a person more prone to serious illness, but that does not mean an excess will make one more capable of fighting the illness, rather the opposite may also happen. Still people are spending billions of rupees to purchase supplements to 'protect' themselves. What will be the effect of a diet low in nutritious foods and high doses of synthetic vitamin pills only future can say. And obviously probably little research will be done to solve this puzzle, and those studies with positive findings of some sort or other will mostly be published for the common people in the mass media, and far more greater number of studies showing no benefit or adverse effects will be ignored or discarded for "lack of statistical significance" or "inadequate study designs".

Re-infection with all CoVs has always been common due to rather rapid diminution of the antibody levels after an infection. As for SARS-CoV-2, studies in different countries showed moderate antibody levels even after 3 to 4 months of an infection. One study conducted by Max Super Speciality Hospital, South Delhi, and the CSIR has shown that antibodies against COVID-19 can stay more that 60 days. Other research suggests that the memory B and memory T cells may impart immunity for periods beyond that too. A recent study on 600 patients done by the University of Arizona showed sufficient antibodies five to seven months after an infection, even after mild infections.  

Vaccines, if strategically produced, may serve as a good or better option for producing antibodies in sufficient quantities and for more prolonged period of time, for imparting some impression on the T-memory cells by which immunity may be acquired for indefinitely longer periods. But whether it will be achievable, or when and how many doses of vaccines will be needed or will be available for the masses and at what cost is still being discussed every day by the health professionals and other related and seemingly unrelated persons all over the media, medical and general.  Surprisingly many researchers are strongly vocal against an 'immunity passport' which some governments proposed to save their economy. This is in spite of the fact that most studies have shown sufficient amount of antibodies for 3 to 7 months after an infection. Even after a declined antibody level, memory cells will remain in the circulation, ready to kick start antibody production and other chemical onslaught against a known marauder. Even when the nature of the virus has changed a bit, existing antibody or primed memory cells may recognize some features of the intruder and minimize the infection substantially. On the other hand some thoughts also larks behind in the mind, does all these excess of vitamins, antibiotics, steroids, antiviral drugs etc create serious side effects (as our bodies are not habituated to work with that much pampering) and create a cytokine storm more likely during a second infection? As we have seen in case of rise of coronary heart disease and diabetes mellitus in the third world countries, especially in the South east Asia, after an more or less excess supply of foods than ever over the past few decades (the so called thrifty gene theory). 

Is this negative propaganda against immunity passport organized by some members of the industry, so that sale of vaccine can rake in trillions of dollars by forcing every persons to purchase several doses of the vaccine each year to be legally able to travel / work / study / play? That is a big question of great economic, physical, psychological, social, and political significance. Poor countries should spend some amount of money to get the answer soon. Without a proper answer our own economy may touch a minus fifty in near future. 


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