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[41]Health

analysis: Three myths about COVID-19 -- and the biggest challenge that lies
ahead

[42]ABC Health & Wellbeing
/
By Professor Chris Goodnow
Posted Thu 28 Jul 2022 at 6:30pmThursday 28 Jul 2022 at 6:30pmThu 28
Jul 2022 at 6:30pm
Professor Chris Goodnow from the Garvan Institute of Medical Research.
Professor Chris Goodnow is an immunologist from the Garvan Institute
of Medical Research.(Supplied: Chris Goodnow)
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As an immunologist with four decades of research on antibodies under my
belt, I always felt like I had a pretty good handle on COVID-19.

But when I caught the virus in May, my hubris quickly turned into
humility.

COVID-19 left me with a serious heart complication that occurs in 2 per
cent of infected people, with the risk not diminished by immunisation
or prior infection.

It was a scary experience, and a sobering reminder that the virus isn't
done with us -- even when we are so desperately done with it.

Here I share a perspective on recent data that debunk three COVID myths
that many of us, myself included, have entertained more than we should
have -- and why I and so many others are working hard to stop endless
waves of reinfection.

Myth #1: It's just a cold now so let's get it over with

Like everyone, I'd grown tired of the pandemic and all the ways it has
upended our lives.

"Maybe it would be better to catch the 'rona and get it over with, now
that I'm fully vaccinated?" I wondered.

After all, isn't it just a cold in fully immunised people? And once
I've had it, won't I have acquired immunity that will mean I won't get
sick at all if I get it again?

That's certainly what I'd have hypothesised from four decades of
frontline immunology research into T and B lymphocytes.
[43]

Why COVID reinfection is happening more often

New COVID-19 subvariants have led to a higher rate of reinfection. But
people are still being told it might be shedding from a previous
infection. How can you tell the difference?
Two women wearing protective equipment, talking to a car passenger at a
COVID testing drive-through.
Read more

But for SARS-CoV-2, those assumptions appear flawed.

Last month, US researchers [44]shared the preliminary results of a
study looking at the impacts of SARS-CoV-2 infection and reinfection in
a cohort of more than 5 five million American veterans.

The researchers examined the health records of more than 250,000 people
who had been infected once; 36,000 people who had been infected twice;
and 2,000 people who had been infected three times.

They found that for every health outcome measured, the Hazard Ratio
-- a measure of how often something happens in one group compared to
another -- increased with each COVID-19 infection.
Graph shows risk of different health outcomes after one, two and three
infections.
Cumulative risks for different health outcomes in people with one, two,
and three or more SARS-CoV-2 infections.(Al-Aly, Z., Bowe, B., Xie. Y.
2022. Outcomes of SARS-CoV-2 Reinfection. Research Square.
https://doi.org/10.21203/rs.3.rs-1749502/v1)

The risk of cardiovascular disease, for example, increased after one
infection, but doubled in people who had two infections, and tripled in
those who had been infected thrice.

The numbers translate into 50 extra cases of heart disease per 1,000
people who've had COVID-19 twice.

Unfortunately, vaccination didn't seem to help: the cumulative risk of
heart disease was indistinguishable when the researchers split people
who'd received two or more COVID-19 jabs and those who hadn't been
vaccinated at all.

The researchers found similar cumulative risks with each reinfection
for pulmonary disease, clotting and blood disorders, neurological
disease, mental health problems, kidney disease, musculoskeletal
disease, fatigue, and so on.

These problems occur most frequently in the first month after
infection, but can emerge up to six months later.

Read more about the spread of COVID-19:

* [45]Scientists are future-proofing for the next pandemic. These are
the five viruses they're watching
* [46]Australia's COVID-19 winter wave has eased. Here's how
households are managing as spring arrives
* [47]Queensland to adopt new COVID-19 warning system as death toll
approaches 2,000

We know that COVID-induced heart problems aren't unique to military
veterans, either.

Because of the risk of sudden cardiac death in people with heart muscle
inflammation, competitive athletes at 10 US universities who tested
positive for COVID-19 were [48]systematically screened for COVID-19
induced acute myocarditis.

Researchers found 2.3 per cent of athletes had developed heart problems
deemed sufficiently grave to sideline them for 3-6 months.

The message from the data is clear: COVID-19 is not just a cold, and
having it before doesn't "get it over with".

Myth #2: Being fully immunised stops infection

If you're immunised and recently boosted, that stops you from getting
infected ... right?

That's another bit of hubris I carried -- up until very recently.
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and down arrows for volume. (BUTTON)
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Duration: 13 minutes 3 seconds13m
Play Audio. Duration: 13 minutes 3 seconds
Chris Goodnow speaks with the Health Report

In May, I'd had four shots, including one just the month prior, so the
emotional side of my brain wanted to believe I could finally ditch
masks and get on with life like it used to be.

I did, and was promptly infected.

Sadly, what was almost a reality during the Delta wave became a thing
of the past with the arrival of Omicron.

[49]Real-world data from the UK Health Security Agency shows the
ability of current vaccines to stop people getting infected has been
dramatically reduced in the face of what was, last December, the newest
and most immune-evasive variant.

Among people who received two AstraZeneca doses and a Pfizer booster,
protection against infection (10-14 weeks post-vaccination) had fallen
from 95 per cent against Delta to just 45 per cent against Omicron.
Graph shows vaccine effectiveness rates are against Omicron compared to
Delta.
The middle panel is most relevant for people who received two doses of
the AstraZeneca ChAdOx1-S vaccine and then a Pfizer BNT162b mRNA
booster.(UK Health Security Agency: COVID-19 vaccine surveillance
report: week 19)

By 20 weeks, the data indicates you've got zero protection against
infection with Omicron. Ditto for the Moderna booster if you received
Pfizer for your first two shots.

We also have to remember the original Omicron virus (B1.1.1.529) is now
just a bad memory from last Australian summer.

Because prior infection and vaccination don't stop the virus spreading,
Omicron has already spawned an even more heavily mutated offspring,
BA.5, which is three times better at evading our body's defences.

You should assume you have less protection now, and while it's
essential to get your booster, don't make the mistake of ditching masks
or social distancing just yet.

Myth #3: Variant-specific vaccines are the answer

Keeping up with COVID-19 variants [50]is like keeping up in a game of
whack-a-mole.
[51]

How soon can I get COVID again?

It will be hard to outrun becoming reinfected with a COVID variant in
years to come -- but you can still do things to protect yourself.
A young women wearing a face mask looks out of a window on board a
Transperth bus within the CBD.
Read more

Why can't we just adjust the vaccines to target variants like Omicron
with new mRNA vaccine technology?

The technology is quick, but the virus is quicker. In the seven months
since the original Omicron variant emerged, we've gone two steps
forward and three steps back.

In June, Moderna released the [52]preliminary findings of a trial
investigating how well its Omicron-specific booster performed in people
previously immunised and boosted.

Half the people in the trial received an Omicron-specific jab, while
the other half received Moderna's original booster (based on the Wuhan
strain).
Graph shows the effectiveness of Moderna's vaccine boosting
neutralising antibody levels.
The far right side shows people who have been immunised and boosted,
and also previously infected.(Chalkias, S., et al. 2022. A Bivalent
Omicron-containing Booster Vaccine Against Covid-19.
https://doi.org/10.1101/2022.06.24.22276703)

The trial showed that, among people who had been vaccinated, boosted
and infected (a large chunk of us), the Omicron-specific booster
increased neutralising antibodies to twice the level achieved with the
original booster. Two steps forward.

But what the trial also found is that average neutralising antibody
levels took a three-fold hit against BA.5. Three steps back.

While we've made progress with vaccines, we've not kept up with the
rate of "antigenic drift" in the virus.

This two-steps-forward-three-steps-back dilemma is likely to repeat
indefinitely until we devise a way to outwit the virus, by developing a
durable, variant-proof, transmission-blocking vaccine.

Can it be done? Nobody knows.

But around the world, scientific research groups like my own are
beginning to see ways that might work -- and are pursuing it with all
we've got.

What you need to know about coronavirus:

* [53]The symptoms
* [54]The number of cases in Australia
* [55]Tracking Australia's vaccine rollout
* [56]Which masks are best and is it OK to reuse them?

Making COVID-19 personal

You might find all of the above a bit dry and depressing. I get it.
We're all tired of what the pandemic has done to us and are ready to
move on.

And when you look at the numbers around cardiovascular risks, it might
even seem like pretty good odds.
[57]

Coronavirus questions answered

Breaking down the latest news and research to understand how the world
is living through an epidemic, this is the ABC's Coronacast podcast.
An illustration of a cell on an orange background with the word
'coronacast' overlayed.
Read more

If only 2.3 per cent of athletes had to be benched, and only 1.5 per
cent of veterans end up with heart problems on their first infection,
more than 97 per cent of people will be perfectly fine. So why worry?

I'm one of the 1.5-2.3 per cent, and none of this is dry, nor abstract
to me.

I'm lucky to have myocarditis on the mild end of the spectrum. But it's
enough to slow down my contributions to all-important medical research
efforts, and to have stopped me from doing other important things in my
life like surfing, swimming, biking, and hiking.

My prognosis is good as the heart muscle repairs, but that takes time.

So what's my plan, now that I know the risk of heart problems and other
poor health outcomes is just as high on a second or third infection,
and in the absence of a vaccine to stop BA.5 infection?

I'm dropping my COVID hubris and donning a mask.

Think about it.

Professor Chris Goodnow holds the Bill and Patricia Ritchie Chair, is
head of the Immunogenomics Laboratory at the Garvan Institute of
Medical Research, and professor and director of the UNSW Cellular
Genomics Futures Institute in the Faculty of Medicine at UNSW Sydney.
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and down arrows for volume. (BUTTON)
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Duration: 14 minutes 32 seconds14m
Play Video. Duration: 14 minutes 32 seconds
Mutations in the COVID-19 virus continue to pose a risk.
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Posted 28 Jul 202228 Jul 2022Thu 28 Jul 2022 at 6:30pm
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81. https://www.abc.net.au/news/2022-07-19/where-to-get-the-fourth-vaccine-shot-covid/101242424
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84. https://www.abc.net.au/news/indigenous-news-service/
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88. https://www.abc.net.au/news/2022-09-24/sydney-boy-5yo-dies-in-floodwaters-nsw-central-west/101470910
89. https://www.abc.net.au/news/2022-09-24/russians-shocked-as-vladimir-putin-announces-mobilisation-/101460252
90. https://www.abc.net.au/news/2022-09-24/backbreaking-work-for-kids-in-afghan-brick-kilns/101471300
91. https://www.abc.net.au/news/2022-09-25/world-bank-head-says-he-s-not-a-climate-denier-won-t-quit/101471820
92. https://www.abc.net.au/news/2022-09-24/nrl-penrith-panthers-defeats-south-sydney-rabbitohs/101470088
93. https://www.abc.net.au/news/2022-09-24/souths-panthers-grand-final-parramatta-eels/101471722
94. https://www.abc.net.au/news/2022-09-24/afp-monitoring-dark-web-for-stolen-optus-data-sold-online/101471256
95. https://www.abc.net.au/news/2022-09-23/penny-wong-russia-china-un-general-assembly-speech/101470142
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97. https://www.abc.net.au/news/2022-09-24/afl-grand-final-entertainment-robbie-williams-delta-goodrem/101470390
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