SARS-CoV-2 and "Textbook" Immunity - John Snow Project

Tweet

SARS-CoV-2 and "Textbook" Immunity - John Snow Project

 EXCERPT:

The term ‘textbook’ should not be comforting. Textbooks tell us we can expect SARS-CoV-2 to have a detrimental impact on human health and life expectancy if it is allowed to continue to spread and reinfect the population.

A new trope that aims to minimize the seriousness of COVID-19 has been doing the rounds recently – that SARS-CoV-2 is a ‘textbook’ virus that behaves like other common viruses. This trope promotes the views that first, nothing extraordinary has happened with SARS-CoV-2’s establishment in the human population, and second, that uncontrolled transmission is actually beneficial, because it will somehow build immunity and make subsequent reinfections inconsequential. Talking about SARS-CoV-2, one social media commentator stated, “As with other respiratory viruses, symptomatic re-infections tend to sharpen – not weaken, your immunity.”

There are two key issues in such statements. The first is the fundamentally misguided idea of a virus being or not being `textbook’ – viruses objectively exist independent of human textbooks, and if textbooks make false generalizations, then the problem is with the textbooks, i.e. the properties of each novel virus need to be considered on their own, not with a reference to a textbook model. The second is whether infection of SARS-CoV-2 or, indeed, any other virus is a net benefit because it ‘sharpens’ one’s immunity, and whether any ‘textbook’ virus in fact behaves in the claimed way.

It is worth noting that this is not a new assertion. Infection as a conduit for immunity has been made by commentators throughout history, and it is usually raised as an argument to counter any impetus for change. It was raised as a reason not to treat water and has been used by people resistant to mass vaccination campaigns^1,2. Some members of the medical and scientific community, and a significant proportion of the general public, believe exposure to pathogens through infection toughens us and is a net benefit to our health.

They could not be more wrong, and ill-informed statements about infection sharpening immunity show a lack of understanding of what the textbooks actually tell us about infection.