6 ms·

Is this study really just telling us that 90% of adults have had a cold in the recent past? edit: Not implying SAR COV-2 is "a cold". I'm implying it's a coro

Is this study really just telling us that 90% of adults have had a cold in the recent past? edit: Not implying SAR COV-2 is "a cold". I'm implying it's a coronavirus also like the common cold, hence an antibody study would have to be careful to select for the right one.

theknocker 6y ago
I think it's funny that your edit is necessary.
lazide 6y ago
It may also be telling us that the antibody tests and our understanding of how antibodies help in protecting against severe Covid may be wildly wrong. Vaccine data indicates overall immune response is protective, and can be successfully prompted, and that is correlated with antibody levels, but there may be more going on here.
- maxerickson 6y ago
  No, it's not telling us that. The antibody tests are designed with high specificity for particular antibodies, this study went out of their way to look for any reactivity.
  - lazide 6y ago
    Designed for, but except in a very small number of cases not actually validated in the field to perform that way - and the specific antibodies may not be a useful indication of a useful immune response in the way we think it is. We do not have the actual evidence to demonstrate it.
    - maxerickson 6y ago
      Which widely used antibody tests where not checked and validated against uninfected blood/individuals?
      - lazide 6y ago
        Pretty much any of those actually available to most people early on? [https://www.bloomberg.com/news/articles/2020-06-16/coronavirus-antibody-tests-are-suddenly-everywhere-and-confusing https://www.bloomberg.com/news/articles/2020-06-16/coronavir...] or even as of November 2020? [https://www.cdc.gov/coronavirus/2019-ncov/lab/resources/antibody-tests.html https://www.cdc.gov/coronavirus/2019-ncov/lab/resources/anti...] The emergency use authorizations allowed anyone who plausibly had a test to market it, even if it had not been independently validated in any way by anyone. Many folks just bought what they could find, even if it didn’t have an emergency use authorization. Combined with porous borders, e-commerce and the internet, lack of consequences for someone in China to ship junk here? We got buried in (at best) untested junk, and often outright scams. This has resulted in a rather predictable disaster when it comes to data and awareness - very few of the tests are being cross referenced to other data sources or tested against an independently verified data source, and even fewer (if any) are being evaluated by a independent party. The vast majority of tests in April have since been removed from authorization because they don’t work, don’t work well enough, etc. You can read a very nice paper from the FDA here summarizing it. [https://www.nejm.org/doi/full/10.1056/NEJMp2033687 https://www.nejm.org/doi/full/10.1056/NEJMp2033687] As far as I am aware, there is still no clear picture on which tests have actually been validated, by whom, and to what extent against what data set. Will they pick up variants, and if so which ones? With what accuracy? What are common field errors (collection problems, etc) that can lead to problems? What about manufacturing variance and supply chain issues?
        maxerickson 6y ago
        So I used the sophisticated strategy of searching for the first test on https://www.fda.gov/medical-devices/coronavirus-disease-2019-covid-19-emergency-use-authorizations-medical-devices/eua-authorized-serology-test-performance https://www.fda.gov/medical-devices/coronavirus-disease-2019... and up pops https://jcm.asm.org/content/59/1/e02104-20 https://jcm.asm.org/content/59/1/e02104-20 (it's a study validating the sensitivity and specificity of the test). You've raised the bar a long ways from except in a very small number of cases not actually validated in the field to perform that way to a comprehensive analysis of all tests that have even maybe been available. Of course, the 'very small number of cases' makes it impossible to argue without doing a comprehensive study, but it's clear enough that the widely used commercial tests were developed with the idea that they should minimize false positives and tested against pre-Covid serum.
- qbasic_forever 6y ago
  Yeah I saw a recent study that showed in monkeys the T cell response didn't really matter or do much for COVID-19. They looked at monkeys which had an illness that depleted their T cells and compared to healthy monkeys to see how an infection of COVID-19 went and saw surprisingly the T-cell depleted monkeys weren't much worse off. This is somewhat of a surprise since it was assumed T cells would be an effective way to neutralize COVID-19. Ultimately it just shows there are many more mysteries to this virus than solid answers. Preprint here: https://www.biorxiv.org/content/10.1101/2021.04.02.438262v1 https://www.biorxiv.org/content/10.1101/2021.04.02.438262v1
  - clairity 6y ago
    > "Ultimately it just shows there are many more mysteries to this virus than solid answers." it's not the virus but rather our bodies that are so mysterious. the virus is relatively simple in comparison (which is different from saying we know everything about it, since we obviously don't).
    - lazide 6y ago
      Nod, and we have a lot of practical ethical issues getting in the way (rightfully so) of figuring it out too. It is really hard to figure out realistic risks around exposures without doing field trials for instance. We could of had a much earlier vaccine rollout if we’d done double blind, intentional exposure studies (give someone the vaccine or saline, unknown to anyone, then stick them in the same room as a bunch of Covid patients with no protection) with early versions - which we could have done in March. We had 250+ candidates at the time, and about 3% were proven out, when I looked in Jan/Feb. To get somewhat useful data, you’d probably need to do that for at least a couple thousand folks (10k each arm would be my guess), so you’re looking at what, 5 million total in the study, 2.5 million exposed? Based on the best data we had at the time (assumed 3.5% fatality rate I believe?), that would have been 87k fatalities out of that group. [https://www.who.int/bulletin/volumes/99/1/20-265892/en/ https://www.who.int/bulletin/volumes/99/1/20-265892/en/ ], Currently seems like estimates are around 1-2% which would drop it to only 25-50k [https://www.nature.com/articles/s41392-021-00527-1 https://www.nature.com/articles/s41392-021-00527-1]. For many very, very good reasons that isn’t how we roll right now though, and we do have good technology for solving this either. Star Trek style ‘simulate’ mode is a looong way away in this space. Looking forward to it hopefully getting better soon though - a lot of money going into getting this figured out.
- totalZero 6y ago
  "Wildly wrong" may be stretching it a bit, but you're not entirely off base. There's more to the vaccines than simply getting antibodies to show up in the blood stream. From https://www.reuters.com/article/us-health-coronavirus-science/mrna-vaccines-spur-lymph-nodes-for-longer-term-protection-covid-19-test-accuracy-may-vary-by-time-of-day-idUSKBN2B72J0 https://www.reuters.com/article/us-health-coronavirus-scienc...: Along with inducing antibodies for immediate defense, mRNA vaccines against COVID-19 also stimulate the lymph nodes to generate immune cells that provide protection over the long term, a new study confirms. The early wave of antibodies are generated by B cells called plasmablasts. In healthy volunteers, blood tests showed that two doses of the Pfizer/BioNTech vaccine induced "a strong plasmablast response," said coauthor Ali Ellebedy of Washington University School of Medicine in St. Louis. The immune cells that will produce antibodies upon exposure to the virus in years to come - called memory B cells - are generated by germinal center B cells found only in lymph nodes near vaccine injection sites, his team explained in a paper currently undergoing peer review for possible publication in a Nature journal. In repeated biopsies of volunteers' lymph nodes, "we saw a robust germinal center response," Ellebedy said. The responses lasted at least seven weeks, "with no sign of cooling down anytime soon," he added. "While we do not have long-term samples yet, it is safe to assume given the magnitude and persistence of the germinal center reaction that those individuals will develop a durable immune response" to mRNA vaccines. Moderna Inc's vaccine also uses mRNA technology.
whiddershins 6y ago
Can the common cold also be a rhinovirus?
- nradov 6y ago
  Yes most common colds are caused by rhinoviruses or coronaviruses.
- second--shift 6y ago
  yes, the "common cold" can be carried by rhinoviruses, coronaviruses, influenza viruses (maybe a mild case of 'flu' mistaken as a cold), and adenoviruses. this list is not comprehensive.
  - Leherenn 6y ago
    I've never really understood the link between "being cold" and catching the "cold". I assume it's because your immune system is somehow slower when you're cold, but the correlation seems pretty strong based on what I have observed. Other people and I very rarely catch a cold without being cold, and after being cold it's common to catch a cold. Are there *viruses floating (?) around constantly, and your body is severely less effective at fighting them off when cold? Is it just confirmation/survivorship bias? From what I can find online, there's a correlation, but it's pretty light on details about how strong it is.
    - second--shift 6y ago
      I'm pretty sure (unverified claim) that the "cold" description got linked with the illness in pre-germ-theory-of-disease days, where being outside in the cold for too long would imply one "caches a cold" when they feel ill the next day.
    - Izkata 6y ago
      https://www.etymonline.com/word/cold https://www.etymonline.com/word/cold > Sense of "indisposition involving catarrhal inflammation of the mucous membranes of the nose or throat" is from 1530s, so called because the symptoms resemble those of exposure to cold; compare cold (n.) in earlier senses "indisposition or disease caused by excessive exposure to cold" (early 14c.), "chills of intermittent fever" (late 14c.). Put less technical: shivering, runny nose, etc, are symptoms of both the common cold and being cold.
citilife 6y ago
It means their body responds to the virus, we aren't necessarily clear on why. Supposedly, this could be because they came in contact with SAR COV-2 OR some other virus which enabled the response. In this case, 77% of participants were in the medical profession and were evaluated between May and June 2020. I suspect they came in contact with SAR COV-2 and didn't even realize it (body fought it off). What this study is really suggesting is that your body either (a) has an immune response from previous contact (likely due to similarity with regular corona viruses) or (b) lots of people show no symptoms (we know this) and that they obtain an immune response from it. In either case, the SAR COV-2 is likely far-less dangerous in the sense that more people have it and there are less deaths per infection OR many of us have a natural immune response (more than previously suspected).
- maxerickson 6y ago
  The conclusion the study authors came to is different than yours: It is unclear whether this antibody reactivity may confer clinical benefits, for instance, modulating the severity of a SARS-CoV-2 infection.
- IgorPartola 6y ago
  Well, we do know how dangerous this virus is. This new data doesn’t tell us anything new because mortality rate is mortality rate and that’s that. What this data might do is help point to what further research to conduct to try to figure out why some people have such strong reactions to COVID while others have few or no symptoms at all.
  - nostromo 6y ago
    > mortality rate is mortality rate and that’s that Not really. Mortality rate is number of deaths / number of infections. We roughly know the total number of deaths. We have no idea what the total number of infections has been.
    - IgorPartola 6y ago
      For practical purposes, do you want to count these symptom-free infections in that calculation? Knowing this, would you want to do anything differently in how we handle this pandemic? I don’t see how this changes much at all about our present situation.

theknocker 6y ago

I think it's funny that your edit is necessary.

lazide 6y ago

It may also be telling us that the antibody tests and our understanding of how antibodies help in protecting against severe Covid may be wildly wrong. Vaccine data indicates overall immune response is protective, and can be successfully prompted, and that is correlated with antibody levels, but there may be more going on here.

maxerickson 6y ago
No, it's not telling us that. The antibody tests are designed with high specificity for particular antibodies, this study went out of their way to look for any reactivity.
- lazide 6y ago
  Designed for, but except in a very small number of cases not actually validated in the field to perform that way - and the specific antibodies may not be a useful indication of a useful immune response in the way we think it is. We do not have the actual evidence to demonstrate it.
  - maxerickson 6y ago
    Which widely used antibody tests where not checked and validated against uninfected blood/individuals?
    - lazide 6y ago
      Pretty much any of those actually available to most people early on? [https://www.bloomberg.com/news/articles/2020-06-16/coronavirus-antibody-tests-are-suddenly-everywhere-and-confusing https://www.bloomberg.com/news/articles/2020-06-16/coronavir...] or even as of November 2020? [https://www.cdc.gov/coronavirus/2019-ncov/lab/resources/antibody-tests.html https://www.cdc.gov/coronavirus/2019-ncov/lab/resources/anti...] The emergency use authorizations allowed anyone who plausibly had a test to market it, even if it had not been independently validated in any way by anyone. Many folks just bought what they could find, even if it didn’t have an emergency use authorization. Combined with porous borders, e-commerce and the internet, lack of consequences for someone in China to ship junk here? We got buried in (at best) untested junk, and often outright scams. This has resulted in a rather predictable disaster when it comes to data and awareness - very few of the tests are being cross referenced to other data sources or tested against an independently verified data source, and even fewer (if any) are being evaluated by a independent party. The vast majority of tests in April have since been removed from authorization because they don’t work, don’t work well enough, etc. You can read a very nice paper from the FDA here summarizing it. [https://www.nejm.org/doi/full/10.1056/NEJMp2033687 https://www.nejm.org/doi/full/10.1056/NEJMp2033687] As far as I am aware, there is still no clear picture on which tests have actually been validated, by whom, and to what extent against what data set. Will they pick up variants, and if so which ones? With what accuracy? What are common field errors (collection problems, etc) that can lead to problems? What about manufacturing variance and supply chain issues?
      - maxerickson 6y ago
        So I used the sophisticated strategy of searching for the first test on https://www.fda.gov/medical-devices/coronavirus-disease-2019-covid-19-emergency-use-authorizations-medical-devices/eua-authorized-serology-test-performance https://www.fda.gov/medical-devices/coronavirus-disease-2019... and up pops https://jcm.asm.org/content/59/1/e02104-20 https://jcm.asm.org/content/59/1/e02104-20 (it's a study validating the sensitivity and specificity of the test). You've raised the bar a long ways from except in a very small number of cases not actually validated in the field to perform that way to a comprehensive analysis of all tests that have even maybe been available. Of course, the 'very small number of cases' makes it impossible to argue without doing a comprehensive study, but it's clear enough that the widely used commercial tests were developed with the idea that they should minimize false positives and tested against pre-Covid serum.
qbasic_forever 6y ago
Yeah I saw a recent study that showed in monkeys the T cell response didn't really matter or do much for COVID-19. They looked at monkeys which had an illness that depleted their T cells and compared to healthy monkeys to see how an infection of COVID-19 went and saw surprisingly the T-cell depleted monkeys weren't much worse off. This is somewhat of a surprise since it was assumed T cells would be an effective way to neutralize COVID-19. Ultimately it just shows there are many more mysteries to this virus than solid answers. Preprint here: https://www.biorxiv.org/content/10.1101/2021.04.02.438262v1 https://www.biorxiv.org/content/10.1101/2021.04.02.438262v1
- clairity 6y ago
  > "Ultimately it just shows there are many more mysteries to this virus than solid answers." it's not the virus but rather our bodies that are so mysterious. the virus is relatively simple in comparison (which is different from saying we know everything about it, since we obviously don't).
  - lazide 6y ago
    Nod, and we have a lot of practical ethical issues getting in the way (rightfully so) of figuring it out too. It is really hard to figure out realistic risks around exposures without doing field trials for instance. We could of had a much earlier vaccine rollout if we’d done double blind, intentional exposure studies (give someone the vaccine or saline, unknown to anyone, then stick them in the same room as a bunch of Covid patients with no protection) with early versions - which we could have done in March. We had 250+ candidates at the time, and about 3% were proven out, when I looked in Jan/Feb. To get somewhat useful data, you’d probably need to do that for at least a couple thousand folks (10k each arm would be my guess), so you’re looking at what, 5 million total in the study, 2.5 million exposed? Based on the best data we had at the time (assumed 3.5% fatality rate I believe?), that would have been 87k fatalities out of that group. [https://www.who.int/bulletin/volumes/99/1/20-265892/en/ https://www.who.int/bulletin/volumes/99/1/20-265892/en/ ], Currently seems like estimates are around 1-2% which would drop it to only 25-50k [https://www.nature.com/articles/s41392-021-00527-1 https://www.nature.com/articles/s41392-021-00527-1]. For many very, very good reasons that isn’t how we roll right now though, and we do have good technology for solving this either. Star Trek style ‘simulate’ mode is a looong way away in this space. Looking forward to it hopefully getting better soon though - a lot of money going into getting this figured out.
totalZero 6y ago
"Wildly wrong" may be stretching it a bit, but you're not entirely off base. There's more to the vaccines than simply getting antibodies to show up in the blood stream. From https://www.reuters.com/article/us-health-coronavirus-science/mrna-vaccines-spur-lymph-nodes-for-longer-term-protection-covid-19-test-accuracy-may-vary-by-time-of-day-idUSKBN2B72J0 https://www.reuters.com/article/us-health-coronavirus-scienc...: Along with inducing antibodies for immediate defense, mRNA vaccines against COVID-19 also stimulate the lymph nodes to generate immune cells that provide protection over the long term, a new study confirms. The early wave of antibodies are generated by B cells called plasmablasts. In healthy volunteers, blood tests showed that two doses of the Pfizer/BioNTech vaccine induced "a strong plasmablast response," said coauthor Ali Ellebedy of Washington University School of Medicine in St. Louis. The immune cells that will produce antibodies upon exposure to the virus in years to come - called memory B cells - are generated by germinal center B cells found only in lymph nodes near vaccine injection sites, his team explained in a paper currently undergoing peer review for possible publication in a Nature journal. In repeated biopsies of volunteers' lymph nodes, "we saw a robust germinal center response," Ellebedy said. The responses lasted at least seven weeks, "with no sign of cooling down anytime soon," he added. "While we do not have long-term samples yet, it is safe to assume given the magnitude and persistence of the germinal center reaction that those individuals will develop a durable immune response" to mRNA vaccines. Moderna Inc's vaccine also uses mRNA technology.

whiddershins 6y ago

Can the common cold also be a rhinovirus?

nradov 6y ago
Yes most common colds are caused by rhinoviruses or coronaviruses.
second--shift 6y ago
yes, the "common cold" can be carried by rhinoviruses, coronaviruses, influenza viruses (maybe a mild case of 'flu' mistaken as a cold), and adenoviruses. this list is not comprehensive.
- Leherenn 6y ago
  I've never really understood the link between "being cold" and catching the "cold". I assume it's because your immune system is somehow slower when you're cold, but the correlation seems pretty strong based on what I have observed. Other people and I very rarely catch a cold without being cold, and after being cold it's common to catch a cold. Are there *viruses floating (?) around constantly, and your body is severely less effective at fighting them off when cold? Is it just confirmation/survivorship bias? From what I can find online, there's a correlation, but it's pretty light on details about how strong it is.
  - second--shift 6y ago
    I'm pretty sure (unverified claim) that the "cold" description got linked with the illness in pre-germ-theory-of-disease days, where being outside in the cold for too long would imply one "caches a cold" when they feel ill the next day.
  - Izkata 6y ago
    https://www.etymonline.com/word/cold https://www.etymonline.com/word/cold > Sense of "indisposition involving catarrhal inflammation of the mucous membranes of the nose or throat" is from 1530s, so called because the symptoms resemble those of exposure to cold; compare cold (n.) in earlier senses "indisposition or disease caused by excessive exposure to cold" (early 14c.), "chills of intermittent fever" (late 14c.). Put less technical: shivering, runny nose, etc, are symptoms of both the common cold and being cold.

citilife 6y ago

It means their body responds to the virus, we aren't necessarily clear on why. Supposedly, this could be because they came in contact with SAR COV-2 OR some other virus which enabled the response. In this case, 77% of participants were in the medical profession and were evaluated between May and June 2020. I suspect they came in contact with SAR COV-2 and didn't even realize it (body fought it off). What this study is really suggesting is that your body either (a) has an immune response from previous contact (likely due to similarity with regular corona viruses) or (b) lots of people show no symptoms (we know this) and that they obtain an immune response from it. In either case, the SAR COV-2 is likely far-less dangerous in the sense that more people have it and there are less deaths per infection OR many of us have a natural immune response (more than previously suspected).

maxerickson 6y ago
The conclusion the study authors came to is different than yours: It is unclear whether this antibody reactivity may confer clinical benefits, for instance, modulating the severity of a SARS-CoV-2 infection.
IgorPartola 6y ago
Well, we do know how dangerous this virus is. This new data doesn’t tell us anything new because mortality rate is mortality rate and that’s that. What this data might do is help point to what further research to conduct to try to figure out why some people have such strong reactions to COVID while others have few or no symptoms at all.
- nostromo 6y ago
  > mortality rate is mortality rate and that’s that Not really. Mortality rate is number of deaths / number of infections. We roughly know the total number of deaths. We have no idea what the total number of infections has been.
  - IgorPartola 6y ago
    For practical purposes, do you want to count these symptom-free infections in that calculation? Knowing this, would you want to do anything differently in how we handle this pandemic? I don’t see how this changes much at all about our present situation.