We write often of "hitting the home run." I believe that is the case here and in my enthusiastic appreciation of the article and its clarity, I am even thinking of "grand slam." We could use a few of those, eh?
Dylan, thank you for bolstering my hope that SARS Cov2 can be completely eradicated. Yes, seems a remote possibility, but many scientists and media outlets are rushing to say the coronavirus is here for good. Very discouraging, and also ignores its short life span in host, and absence of a known natural host. With enough people vaccinated, we should start seeing some local disappearances, like they have achieved in NZ. String enough of those together, and the virus might just run out of fresh meat (insensitive, yes, but from the coronavirus point of view, that's all that counts).
Today, 3/22/23, nearly 2 years after this was posted, I received a notice that this comment was "liked." This strikes me as odd, as I don't believe that this opinion has aged well.
At the time, there were still relatively few known cases of second infections. It is now well understood that after about 2-3 months from an infection or vaccination, you are once again ripe for the picking. Personally, I believe I was fortunate to make it to June 2022 before being infected (thank you, Omicron), albeit at a mild level which could not be confirmed by rapid test. This was followed in October with a bi-valent booster, and another infection mid February that felt like a REALLY bad cold.
Thus getting to Zeynep's point about novelty: the novelty of SARS CoV-2 has worn off, but the virus is here to stay.
Thank you! This is one of the topics that's really been bugging me in terms of the misunderstandings around it, and I'm so happy that I was able to coax Dylan into writing it for Insight! So well, too!
I very much appreciate the plain talk of this article and the clarity regarding the protections vaccines provide against severe Covid and variants. However, I am hoping for some clarification about the reassurance regarding vaccines and long Covid. I read the twitter thread that was linked to Footnote 2, so I understand the conjecture that mild illness with vaccination prohibits the virus from spreading past the upper respiratory tract. My question is why? Why is a vaccinated response (mild or asymptomatic) different from a natural exposure in predicting post-viral syndrome? Is this an answerable question (at least answerable to those without expertise in the immune system)?
To me, it connects to a point earlier on the article about chronic fatigue syndrome, etc, and other syndromes that seem to happen when adults are exposed to a virus for the *first* time in adulthood. There seems to be something particular about being an adult with no adaptive immune response and seeing a virus for the first time. If you’ve been vaccinated, however, you won’t be in that position even if you get reinfected and her mild disease. There will be an existing defense system of adaptive immune response. Even if it’s not perfect in preventing infection, in theory still so much better and less risk of long COVID than total novelty and no adaptive immune response.
This is what I gathered as well from the article. Still, it's interesting that the novelty factor is so rarely included when speaking of the implications for Long COVID - even the best explanations about etiology and individual differences (like Akiko Iwasaki's great threads and Medium post) seem to focus on processes by which the virus sticks around or autoimmune response gets out of hand. It would be easy to get the mistaken impression that additional familiarity with the virus only makes autoimmune over-response worse or more likely (especially since the second shot tends to make people sicker than the first, which is easy to conflate with autoimmune stuff though it's different). I wonder what Iwasaki would say about the role of novelty in her three alternative hypotheses.
I love essays like this that provide lay intuition to complex expert topics. Thank you Zeynep and Dylan!
Thank you! I really like how this framework brings so much together in a coherent manner.
Thank you for an amazingly well written article. It answered so many questions.
We write often of "hitting the home run." I believe that is the case here and in my enthusiastic appreciation of the article and its clarity, I am even thinking of "grand slam." We could use a few of those, eh?
Indeed!
Dylan, thank you for bolstering my hope that SARS Cov2 can be completely eradicated. Yes, seems a remote possibility, but many scientists and media outlets are rushing to say the coronavirus is here for good. Very discouraging, and also ignores its short life span in host, and absence of a known natural host. With enough people vaccinated, we should start seeing some local disappearances, like they have achieved in NZ. String enough of those together, and the virus might just run out of fresh meat (insensitive, yes, but from the coronavirus point of view, that's all that counts).
Today, 3/22/23, nearly 2 years after this was posted, I received a notice that this comment was "liked." This strikes me as odd, as I don't believe that this opinion has aged well.
At the time, there were still relatively few known cases of second infections. It is now well understood that after about 2-3 months from an infection or vaccination, you are once again ripe for the picking. Personally, I believe I was fortunate to make it to June 2022 before being infected (thank you, Omicron), albeit at a mild level which could not be confirmed by rapid test. This was followed in October with a bi-valent booster, and another infection mid February that felt like a REALLY bad cold.
Thus getting to Zeynep's point about novelty: the novelty of SARS CoV-2 has worn off, but the virus is here to stay.
Another homerun!
Thank you! This is one of the topics that's really been bugging me in terms of the misunderstandings around it, and I'm so happy that I was able to coax Dylan into writing it for Insight! So well, too!
Nice synthesis, Dylan. This clarified a couple terms and concepts I see all the time but had trouble getting fixed in my mind. Thank you!
I very much appreciate the plain talk of this article and the clarity regarding the protections vaccines provide against severe Covid and variants. However, I am hoping for some clarification about the reassurance regarding vaccines and long Covid. I read the twitter thread that was linked to Footnote 2, so I understand the conjecture that mild illness with vaccination prohibits the virus from spreading past the upper respiratory tract. My question is why? Why is a vaccinated response (mild or asymptomatic) different from a natural exposure in predicting post-viral syndrome? Is this an answerable question (at least answerable to those without expertise in the immune system)?
To me, it connects to a point earlier on the article about chronic fatigue syndrome, etc, and other syndromes that seem to happen when adults are exposed to a virus for the *first* time in adulthood. There seems to be something particular about being an adult with no adaptive immune response and seeing a virus for the first time. If you’ve been vaccinated, however, you won’t be in that position even if you get reinfected and her mild disease. There will be an existing defense system of adaptive immune response. Even if it’s not perfect in preventing infection, in theory still so much better and less risk of long COVID than total novelty and no adaptive immune response.
This is what I gathered as well from the article. Still, it's interesting that the novelty factor is so rarely included when speaking of the implications for Long COVID - even the best explanations about etiology and individual differences (like Akiko Iwasaki's great threads and Medium post) seem to focus on processes by which the virus sticks around or autoimmune response gets out of hand. It would be easy to get the mistaken impression that additional familiarity with the virus only makes autoimmune over-response worse or more likely (especially since the second shot tends to make people sicker than the first, which is easy to conflate with autoimmune stuff though it's different). I wonder what Iwasaki would say about the role of novelty in her three alternative hypotheses.