Tag Archives: Infectious mononucleosis

The presidential election will be decided in the next month — revision for clarity

Apologies to all for the previous post which was far murkier than it could have been.  The problem was that a ‘case’ of the pandemic coronavirus can mean 3 very different things.  These distinctions are tedious but crucial.

Meaning #1 — COVID19 — People who are clinically ill with the virus (official name SARS-CoV-2).  These are the people that  may die of the illness, although most do not.

Meaning #2 — The viral genome has been found in your saliva.

Meaning #3 — You have antibodies to the virus in your blood.

Here is the distinction between #2 and #3 — Antibodies (proteins) and genomes (RNA) are completely different chemically. Finding the actual genome (RNA in this case) of a virus in an individual  is like seeing a real bear up close and personal.  This can do you some damage.  In contrast, antibodies to the virus are made by an individual who has been infected by the virus in the past.       Antibodies are like seeing the tracks of the bear without the bear itself. You can’t see tracks without the bear having been present at some point in the past.  Antibodies mean you were infected at some point whether you knew it or not.

OK, so here’s another shot at what was I saying in the previous post.

I find it very sad that loosening the restrictions on activity has become so political. The left says that it will be a disaster and that cases and deaths will spike (meaning #1). As far as I’ve seen, they never say they hope they’re wrong.  The right says that deaths will continue, but the rate won’t increase.  There is evidence for both sides, but in the coming months we’ll actually have data one way or the other.

One thing is certain.  The number of cases of positive viral culture (meaning #2) will increase.  It has to because more people will be tested. So far, we’ve only studied around 1/1,000 of the population.  No one has ever said the lockdown will prevent new infection.  It hasn’t, but it has slowed things down.

I’m hoping that cases of COVID19 and death will not explode.  Not because I want Trump to win, but because getting people back to work  would be good for the country.  Should that happen, the anger of those who lost their jobs or businesses during the shutdown will be formidable.  Trump will win.

Should deaths from COVID19 explode (meaning #1) as restrictions are lifted, Trump is toast.

We should also get some idea of the percentage of the population who have been infected (manifest by antibodies to the pandemic virus meaning #3).  It almost certainly will increase, unless those already showing the antibodies lose them (which is unheard of happening this fast inFor  the antibodies we’ve studied in the past).

I’m cautiously optimistic that not much will happen when restrictions are eased. Here’s why.  All the studies on antibodies (meaning #3) done so far show they are 10 – 100 times more prevalent than cases where the virus is cultured (meaning #2).  For example 20% of Manhattan sampled population have the antibodies.  This implies that most infections with the pandemic coronavirus are asymptomatic.  

Another viral disease with a high prevalence of antibodies is infectious mononucleosis.  90% of adults in the USA have antibodies to mono, but far fewer than 90% were ever sick.

So the number of cases with positive culture (meaning #2)  isn’t what’s important.  It’s how many of them get sick with COVID19 (meaning # 1).  I think we have very good past statistics on the number of deaths and cases of COVID19   It will be clear if there is a spike in COVID19.

However be careful not to read too much into the first week’s statistics after restrictions are lifted, as there is a lag period of 2 – 11 days between infection and clinical illness.  Also try to understand which of the 3 meanings of “case” the article you are reading is talking about — this won’t always be possible.