Fear Factor Revisited

09-06-2020Fr. John's LettersFr. John Bonavitacola

Dear Friends,

My letter of 05/31/20 was entitled, “Fear Factor” and it was all about some of the fears that were being hawked by the hucksters of fear regarding the coronavirus. So, let’s see how those Fear Factors are holding up.

I listed as Fear Factor #1: asymptomatic people can transmit the virus. Of course, with that assumption we would need to fear just about everyone. Of the six million people in the US who tested positive, how many actually got sick? We’re not given that information. But this past week the CDC announced a change in its testing policy, namely that not everyone who has been exposed to COVID-19 needs to be tested but only those who have symptoms of the virus. Why the change? Large numbers of people who test positive for the virus never develop symptoms and never get sick from the virus. The reason for this is that the PCR test can detect very small levels of the virus, levels that are insufficient to make a person sick or be a transmitter of the virus. In order to transmit the virus a person needs a certain level or viral load. This is similar to the way the TB testing works. If you get the prong test for TB and it shows a positive result, it does not mean that you have TB but rather that you were exposed to TB, further testing is needed to diagnose if a person actually has the disease. For COVID-19, the newer rapid tests require a much higher viral load and will most likely, more accurately diagnose those who have the disease as opposed to those who were merely exposed. Think of it this way, sometimes you feel like you are getting a cold but you never develop symptoms. Most likely you had a low level of the virus and your immune system stopped it in its tracks. The same thing seems to be happening with this version of coronavirus. With this change in testing protocols, the CDC seems to be tacitly admitting that asymptomatic people don't transmit the virus.

Fear Factor #2 was that if you develop antibodies to COVID-19 you still may not be protected from the re-infection from the virus. This of course would negate much our understanding of how the immune system works. Recently a man in Hong Kong tested positive for the virus a second time. He was sickened by COVID-19 in April and recovered and recently he left the country and upon return was tested and tested positive. Researchers compared the virus he had in April with the new test and discerned the new infection was a different version of COVID-19 than he had in April (viruses are constantly mutating). So, his re-infection did occur. Bad news? Not really. Though he was re-infected he never developed the disease. This means his immune system, namely the antibodies he developed from his first infection, recognized the virus and fought it off. That’s really good news. Now how long immunity lasts is not known yet since we are way too early in dealing with this virus.

Fear Factor #3 was that we can’t be safe until a vaccine is found. Well if Fear Factor #2 is correct then no vaccine will ever be found. That is, if antibodies don't protect you, then a vaccine certainly won’t either since vaccines are designed to help you develop antibodies and immunity. So, since we are seeing that antibodies do work to fight this virus, a vaccine should do the trick as well. Again, the only question is how long will a COVID-19 vaccine provide protection? One of the most effective vaccines ever developed was for smallpox, it wiped that disease out. Some vaccines last for years and others like the flu vaccine only for a season. But either way a vaccine will be helpful and provide protection from the virus since we have evidence that antibodies for COVID-19 are functioning as they should.

Also, recently, the CDC announced that 6% of the 180,000+ deaths from COVID-19 in the US were from COVID-19 alone. All other deaths had at least one underlying chronic condition along with COVID-19. This is similar to the $u. Few people die from the flu alone but those with underlying conditions are at the highest risk for death from the flu. That tells us that as with the flu, those with underlying conditions need to take the usual precautions to avoid COVID-19. (And for COVID-19, the underlying conditions include: diabetes, cardiac disease, hypertension, pulmonary disease, chronic liver or kidney disease.) Those in the high-risk category are all those over 65yrs old. The AZ Health Dept. lists on their COVID-19 Dashboard that of the 5044 deaths in AZ, 3593 were 65yrs or older.

I gave honorable mention in the Fear Factor category to the politicization of medical treatments for COVID-19. But this now moves into First Place as unfortunately it doesn't look like much has changed on that front. In an extremely depressing statement the former editor, Dr. Marcia Angell of the New England Journal of Medicine stated: “It is simply no longer possible to believe much of the clinical research that is published, or to rely on trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of The New England Journal of Medicine.” The politicization of clinical research will make it very hard for many to trust that a vaccine will be safe and effective. Any resistance to a vaccine can be laid at the feet of researchers and clinicians who use research to further a political end. One example goes like this: Orangeman is bad, Orangeman supports the use of hydroxychloroquine, ergo hydroxychloroquine is bad. Not very scientific.

Still, a little more than 6 months into the Pandemic, the Fear Factors are losing their “BOO” quality. Those who are otherwise healthy have less to fear from this version of coronavirus than they did in March. Those who are high risk or have chronic conditions can still protect themselves and do what needs to be done to keep their immune system working. Add to that the development of treatments, and we are witnessing death rates continuing to decline even among the elderly and those with chronic conditions!

And remember, Be not afraid! He’s got the whole COVID-19 world in His hands!


Fr. John B.