Three myths about COVID-19 — and the biggest challenge that lies ahead
Professor Chris Goodnow is an immunologist from the Garvan Institute of Medical Research.
Professor Chris Goodnow: as an immunologist with four decades of research on antibodies under my belt, I always felt like I had a pretty good handle on COVID-19.
But when I caught the virus in May, my hubris quickly turned into humility.
COVID-19 left me with a serious heart complication that occurs in 2 per cent of infected people, with the risk not diminished by immunisation or prior infection.
It was a scary experience, and a sobering reminder that the virus isn’t done with us — even when we are so desperately done with it.
Here I share a perspective on recent data that debunk three COVID myths that many of us, myself included, have entertained more than we should have — and why I and so many others are working hard to stop endless waves of reinfection.
Myth #1: It’s just a cold now so let’s get it over with
Like everyone, I’d grown tired of the pandemic and all the ways it has upended our lives.
“Maybe it would be better to catch the ‘rona and get it over with, now that I’m fully vaccinated?” I wondered.
After all, isn’t it just a cold in fully immunised people? And once I’ve had it, won’t I have acquired immunity that will mean I won’t get sick at all if I get it again?
That’s certainly what I’d have hypothesised from four decades of frontline immunology research into T and B lymphocytes
But for SARS-CoV-2, those assumptions appear flawed.
Last month, US researchers shared the preliminary results of a study looking at the impacts of SARS-CoV-2 infection and reinfection in a cohort of more than 5 five million American veterans.
The researchers examined the health records of more than 250,000 people who had been infected once; 36,000 people who had been infected twice; and 2,000 people who had been infected three times.
The risk of cardiovascular disease, for example, increased after one infection, but doubled in people who had two infections, and tripled in those who had been infected thrice.
The numbers translate into 50 extra cases of heart disease per 1,000 people who’ve had COVID-19 twice.
Unfortunately, vaccination didn’t seem to help: the cumulative risk of heart disease was indistinguishable when the researchers split people who’d received two or more COVID-19 jabs and those who hadn’t been vaccinated at all.
The researchers found similar cumulative risks with each reinfection for pulmonary disease, clotting and blood disorders, neurological disease, mental health problems, kidney disease, musculoskeletal disease, fatigue, and so on.
These problems occur most frequently in the first month after infection, but can emerge up to six months later.
We know that COVID-induced heart problems aren’t unique to military veterans, either.
Researchers found 2.3 per cent of athletes had developed heart problems deemed sufficiently grave to sideline them for 3-6 months.
The message from the data is clear: COVID-19 is not just a cold, and having it before doesn’t “get it over with”.
Myth #2: Being fully immunised stops infection
If you’re immunised and recently boosted, that stops you from getting infected … right?
That’s another bit of hubris I carried — up until very recently.
In May, I’d had four shots, including one just the month prior, so the emotional side of my brain wanted to believe I could finally ditch masks and get on with life like it used to be.
I did, and was promptly infected.
Real-world data from the UK Health Security Agency shows the ability of current vaccines to stop people getting infected has been dramatically reduced in the face of what was, last December, the newest and most immune-evasive variant.
Among people who received two AstraZeneca doses and a Pfizer booster, protection against infection (10-14 weeks post-vaccination) had fallen from 95 per cent against Delta to just 45 per cent against Omicron.
By 20 weeks, the data indicates you’ve got zero protection against infection with Omicron. Ditto for the Moderna booster if you received Pfizer for your first two shots.
Because prior infection and vaccination don’t stop the virus spreading, Omicron has already spawned an even more heavily mutated offspring, BA.5, which is three times better at evading our body’s defences.
You should assume you have less protection now, and while it’s essential to get your booster, don’t make the mistake of ditching masks or social distancing just yet.
Myth #3: Variant-specific vaccines are the answer
Keeping up with COVID-19 variants is like keeping up in a game of whack-a-mole.
Why can’t we just adjust the vaccines to target variants like Omicron with new mRNA vaccine technology?
The technology is quick, but the virus is quicker. In the seven months since the original Omicron variant emerged, we’ve gone two steps forward and three steps back.
While we’ve made progress with vaccines, we’ve not kept up with the rate of “antigenic drift” in the virus.
This two-steps-forward-three-steps-back dilemma is likely to repeat indefinitely until we devise a way to outwit the virus, by developing a durable, variant-proof, transmission-blocking vaccine.
Can it be done? Nobody knows.
But around the world, scientific research groups like my own are beginning to see ways that might work — and are pursuing it with all we’ve got.
Making COVID-19 personal
You might find all of the above a bit dry and depressing. I get it. We’re all tired of what the pandemic has done to us and are ready to move on.
I’m lucky to have myocarditis on the mild end of the spectrum. But it’s enough to slow down my contributions to all-important medical research efforts, and to have stopped me from doing other important things in my life like surfing, swimming, biking, and hiking.
My prognosis is good as the heart muscle repairs, but that takes time.
So what’s my plan, now that I know the risk of heart problems and other poor health outcomes is just as high on a second or third infection, and in the absence of a vaccine to stop BA.5 infection?
I’m dropping my COVID hubris and donning a mask.
Think about it.
Professor Chris Goodnow holds the Bill and Patricia Ritchie Chair, is head of the Immunogenomics Laboratory at the Garvan Institute of Medical Research, and professor and director of the UNSW Cellular Genomics Futures Institute in the Faculty of Medicine at UNSW Sydney.