Horowitz: More good news: Immunity rising, virulence waning

As the virus appears to be slowing down in most regions, with enough people having gotten the virus to slow down the transmission, the panicmongers who are immune to good news are constantly trying to warn of reinfection. They are already building fear for a mass outbreak during the colder months of the year. But why do they assume that this virus breaks every rule of immunity instead of looking at the body of evidence observed over the past six months?

Throughout this virus, Iceland has produced some of the best literature studying critical questions about transmission of the virus. The Iceland study published in the New England Journal of Medicine searched for antibodies in 30,576 individual Icelanders and found that out of 1,797 tested people who'd recovered from COVID-19, 91.1% had detectable levels of antibodies. More significantly, they found that the serum levels had not declined four months after infection. So the concern that most won't produce antibodies or that they will wane quickly is unfounded.

But there is more to the story that portends even better news: People who were seriously infected produced even more antibodies. "Among recovered persons, antibody levels are higher in older persons and in those more severely affected by SARS-CoV-2 infection," wrote the authors. "Women, who tend to become less sick than men, had lower antibody levels in two spike protein antibody assays."

Also, the fact that a certain number of the presumed positive patients did not produce antibodies might be because they were false positives. "Since some diagnoses may have been made on the basis of false positive qPCR results, we determined that 91.1% represents the lower bound of sensitivity of the combined pan-Ig tests for the detection of SARS-CoV-2 antibodies among recovered persons," concluded the study (emphasis added).

The biggest challenge we face now is more psychological than physiological. There are signs that this virus might stay around for a long time, if not forever, but more in line with the other four coronavirus colds in terms of virulence. However, people still fear the virus as if it were at pandemic level.

A recent preprint study from biologists at Emory University and Penn State predicts that the virus will transition from an epidemic to an endemic pathogen that stays with us in a very mild form indefinitely. What are the consequences in terms of immunity? "Our analysis of immunological and epidemiological data on HCoVs shows that infection-blocking immunity wanes rapidly, but disease-reducing immunity is long-lived," wrote the authors. Their model analyzes "both the current severity of CoV-2 and the relatively benign nature of HCoVs [coronavirus colds]; suggesting that once the endemic phase is reached, CoV-2 may be no more virulent than the common cold."

We should therefore prepare ourselves for stories about people who already had the virus being "reinfected." But upon seeing these stories, you should immediately try to ascertain information about the severity of symptoms. While it appears quite possible to be reinfected with the virus, especially if it turns into a cold, it's extremely unlikely the same individual will face clinical-level disease resulting from that infection.