Category: pandemic

Pfizer vaccine deemed safe and effective by the FDA, and a question for readers

December 8, 2020 • 8:45 am

Ripped from the headlines of CNN!  Click on the screenshot to read:

Many of us know that the FDA is meeting Thursday to decide whether to approve the Pfizer vaccine for general use. If the approval occurs, vials of vaccine will be making their way across the U.S., ready for immediate transfer into the arms of Americans.

Now, judging by the headline above, it looks almost certain that the FDA will indeed approve the vaccine in two days, and the first ranks of Americans will start getting vaccinated. Who gets it first appears to vary from state to state, but, rightly, healthcare workers and nursing-home patients (and their carers) will almost always be the first in line—and that’s what the FDA recommended as well.  After all, if the vaccine is safe and effective, why wouldn’t it be approved?

The good news gets even better: it appears that some immunity is conferred even after the first dose, which appears by itself to be 50% effective (two are required for the 95% effectiveness). Flu vaccine—the single shot we should all have gotten already this year, is only between 40% and 60% effective. “Effectiveness” is the reduction of risk that you get when you are vaccinated.

From CNN:

An advisory committee to the US Food and Drug Administration on Tuesday released a briefing document detailing data on Pfizer and BioNTech’s Covid-19 vaccine candidate, which will be considered this week for emergency use authorization in the United States.

The document confirms that the vaccine’s efficacy against Covid-19 was 95%, occurring at least seven days after the second dose – an efficacy that had been previously reported by Pfizer. The proposed dosing regimen for the vaccine is to administer two 30-microgram doses 21 days apart.

However, the document also notes that the vaccine, called BNT162b2, appears to provide “some protection” against Covid-19 following just one dose.

The document describes the efficacy of Pfizer’s vaccine in the time between the first and second dose as 52.4%, but the document notes that “the efficacy observed after Dose 1 and before Dose 2, from a post-hoc analysis, cannot support a conclusion on the efficacy of a single dose of the vaccine, because the time of observation is limited by the fact that most of the participants received a second dose after three weeks.”

In other words, “the trial did not have a single-dose arm to make an adequate comparison.”

The document goes on to detail the safety profile of the vaccine as “favorable” and notes that the most common adverse reactions to the vaccine have been reactions at the injection site, fatigue, headache, muscle pain, chills, joint pain and fever.

Severe adverse reactions occurred in less than 4.6% of participants, were more frequent after the second dose and were generally less frequent in older adults as compared to younger participants, according to the document. The document adds that swollen lymph nodes also may be related to vaccination.

That’s good enough for me, and I’ll be taking the shots as soon as my doc recommends it—which I presume will be as soon as I’m permitted to get them.

A STAT-Harris Poll published last month, however, showed that the proportion of Americans willing to get vaccinated depends on the vaccine’s efficacy, but only weakly.  Below are those data in graphic form.  What’s disturbing is that if the vaccine were 50% effective, only 60% of Americans would be likely to get the shots. And even with over 90% effectiveness, which is the case with all the vaccines about to hit the market, the willingness rises to only about 63%—a pathetically low figure. I’ve heard that the acquisition of herd immunity in the U.S. to coronavirus requires that 70% of Americans have immunity; even counting those who were infected, the figures on willingness to get vaccinated doesn’t give us that level of immunity. However, it will protect those smart people who get the shots.

So here’s the question: assuming you can get the shots because you don’t have a condition that bars them, are you going to get vaccinated? (I’m assuming that the Pfizer vaccine, or one with similar effectiveness, is the one on offer.) If not, why not?

Supreme Court comes down on side of churches in New York’s pandemic restrictions on congregation size

November 26, 2020 • 10:00 am

In a new ruling, the U.S. Supreme Court overturned New York Governor Andrew Cuomo’s limitation of congregation sizes in churches during the pandemic.  The ruling was split 5-4, with new Justice Amy Coney Barrett voting with the conservative majority—affirming the side of the Roman Catholic Church, which brought the suit—while Chief Justice Roberts voted with the liberals. (Had RBG been alive, the vote would have been 5-4 the other way.)  Beside the unsigned majority opinion, there are separate concurring opinions by Justices Gorsuch and Kavanaugh, while there are dissenting opinions by Roberts, Breyer, Kagan, and Sotomayor in various combinations.

While the judgment affirmed that Cuomo’s order violated the First-Amendment guarantee of freedom of religion, one shouldn’t assume that the decision was purely one of religious conservatism, for this was a tough call.  You can read the opinion below (the unsigned majority take is short), or read the New York Times article about the decision (click on both screenshots below).

The Times’s article:

This ruling overturns two lower-court decisions affirming Cuomo’s decision to force churches to have 10 or fewer congregants during the “red-zone” phase of the pandemic.  One of the reasons the majority overturned this restriction (which has since been rescinded!) is that the numerical restriction was not imposed on businesses other than churches. Hence, one could construe that this violates the First Amendments “free exercise” provision by discriminating against churches.

From the majority decision:

In a red zone, while a synagogue or church may not admit more than 10 persons, businesses categorized as “essential” may admit as many people as they wish. And the list of “essential” businesses includes things such as acupuncture facilities, camp grounds, garages, as well as many whose services are not limited to those that can be regarded as essential, such as all plants manufacturing chemicals and microelectronics and all transportation facilities. See New York State, Empire State Development, Guidance for Determining Whether a Business Enterprise is Subject to a Workforce Reduction Under Recent Executive Orders, https://esd.ny.gov/guidance-executive-order-2026. The disparate treatment is even more striking in an orange zone.  While attendance at houses of worship is limited to 25 persons, even non-essential businesses may decide for themselves how many persons to admit.

Irreparable harm. There can be no question that the challenged restrictions, if enforced, will cause irreparable harm. “The loss of First Amendment freedoms, for even minimal periods of time, unquestionably constitutes irreparable injury.” Elrod v. Burns, 427 U. S. 347, 373 (1976) (plurality opinion). If only 10 people are admitted to each service, the great majority of those who wish to attend Masson Sunday or services in a synagogue on Shabbat will be barred. And while those who are shut out may in some instances be able to watch services on television, such remote viewing is not the same as personal attendance. Catholics who watch a Mass at home cannot receive communion, and there are important religious traditions in the Orthodox Jewish faith that require personal attendance. App. to Application in No. 20A90, at 26–27.

But against this, one could argue, as did Justice Sotomayor in her dissent, that businesses that didn’t have government-specified limits are materially different, in terms of viral spread, from church congregations, especially where congregants are singing loudly. From her dissent:

But JUSTICE GORSUCH does not even try to square his examples with the conditions medical experts tell us facilitate the spread of COVID–19: large groups of people gathering, speaking, and singing in close proximity indoors for extended periods of time.

As I noted, the case appears moot because the numerical limits obtaining at the time of the lawsuit have since been lifted (this was emphasized in the dissents). But the majority opinion took that into account as well, saying that Cuomo’s decision could be reversed, and rather than re-litigate the issue, I presume the court wanted to render an opinion that would be in place should that reversal take place:

The dissenting opinions argue that we should withhold relief because the relevant circumstances have now changed. After the applicants asked this Court for relief, the Governor reclassified the areas in question from orange to yellow, and this change means that the applicants may hold services at 50% of their maximum occupancy. The dissents would deny relief at this time but allow the Diocese and Agudath Israel to renew their requests if this recentreclassification is reversed.

There is no justification for that proposed course of action. It is clear that this matter is not moot. See Federal Election Comm’n v. Wisconsin Right to Life, Inc., 551 U. S. 449, 462 (2007); Friends of the Earth, Inc. v. Laidlaw Environmental Services (TOC), Inc., 528 U. S. 167, 189 (2000). And injunctive relief is still called for because the applicants remain under a constant threat that the area in question will be reclassified as red or orange. See, e.g., Susan

B. Anthony List v. Driehaus, 573 U. S. 149, 158 (2014). The Governor regularly changes the classification of particular areas without prior notice.3 If that occurs again, the reclassification will almost certainly bar individuals in the affected area from attending services before judicial relief can be obtained.

I suppose Left-wing sites might couch this as an unwarranted, pro-faith opinion supported by the usual suspects, who now include Barrett. And that may be the case, but it’s not a cut-and-dried issue. Here are my thoughts:

1.) It is supremely important to uphold the Free Exercise clause, just as it’s important to uphold the entire First Amendment, which includes freedom of speech as well as of worship.

2.) Nevertheless, when public safety is compromised by free exercise of religion, the former trumps the latter, as it has historically. Practicing one’s faith does not give you the right to endanger those who are not of your faith.  This gives courts the power to restrict religious practice if it, for example, is likely to spread coronavirus.

3.) But one cannot discriminate against churches in this respect, imposing sanctions on them that aren’t imposed on similar enterprises like businesses.

4.) HOWEVER, and this is the most important bit for me, is a church with a congregation limit of 10 equivalent to a business like Wal-Mart in which more than ten people are present at once—in a much larger space? I don’t think so, particularly when church congregants sing and pray without masks, a particularly dangerous way of spreading the virus via respiratory droplets.  I’m not sure whether the court’s decision, holding equivalence such as this, is justifiable, and Sotomayor makes that point. This is in fact a public health rather than a legal decision, and is not really within the court’s competence.

5.) As for the restrictions having changed, rendering the original lawsuit moot, I do agree with the majority that given the to-and-fro of restrictions during the pandemic, a judgment was still warranted. Whether this was the right one, I am not sure. But it’s better to have some opinion in place rather than having the matter re-litigated should restrictions once again be imposed.

Perhaps there are lawyers in the crowd here who want to render an opinion, and I have to say that I haven’t scrutinized the entire set of opinions minutely. But this decision doesn’t bother me as much, as, say, ones that pose more serious dangers, including those that restrict abortion or dismantle the Affordable Care Act. But those will be coming, for the court is now solidly conservative—even if Justice Roberts is mellowing in his old age.

 

Religion infects everyone

November 25, 2020 • 2:15 pm

If you click on the screenshot below from LiveLeak, or go to an article in the New York Post, you’ll see a pretty horrifying sight: an assemblage of thousands of unmasked and singing religionists celebrating during the pandemic in defiance of New York regulations:

What is it? An Orthodox Jewish wedding. The Post explains:

A Hasidic synagogue in Brooklyn planned the wedding of a chief rabbi’s grandson with such secrecy, it was able to host thousands of maskless celebrants without the city catching on.

Despite a surge in COVID-19 cases, guests crammed shoulder to shoulder inside the Yetev Lev temple in Williamsburg for the Nov. 8 nuptials — stomping, dancing and singing at the top of their lungs without a mask in sight, videos obtained by The Post show.

Organizers schemed to hide the wedding of Yoel Teitelbaum, grandson of Satmar Grand Rabbi Aaron Teitelbaum, from “the ravenous press and government officials,” says a detailed account in the Yiddish newspaper Der Blatt, the publication of the Satmar sect.

“Due to the ongoing situation with government restrictions, preparations were made secretly and discreetly, so as not to draw attention from strangers,” the paper reported in its Nov. 13 edition.

. . .The synagogue’s stunning willingness to host a potential superspreader event underscores what critics call the Hasidic community’s ongoing disregard and outright defiance of efforts to control the deadly coronavirus, which has killed nearly 25,000 people in New York City.

Ironically, the synagogue’s own president, R’Mayer Zelig Rispler, who openly urged Brooklyn’s Orthodox community to abide by coronavirus safety measures, died of COVID-19 last month at age 70.

Note as well that there’s only one woman in the crowd: the bride. The rest of the women are either absent or watching from screened alcoves above. This is one of the ways the Orthodox turn their women into second-class citizens.

Singing loudly is a great way to spread the virus, especially if you’re jammed shoulder-to-shoulder with other maskless people. And those fur hats must be great traps for respiratory particles.  Let’s hope this doesn’t convert one wedding into a bunch of funerals.

 

We interrupt our usual program for a pandemic update: Pfizer claims its coronavirus vaccine is 90% effective

November 9, 2020 • 7:00 am

If this is true, it’s excellent news. Click on screenshot to read the CNN report (see also the Washington Post report here):

An excerpt:

Drugmaker Pfizer said Monday an early look at data from its coronavirus vaccine shows it is more than 90% effective — a much better than expected efficacy if the trend continues.

The so-called interim analysis looked at the first 94 confirmed cases of Covid-19 among the more than 43,000 volunteers who got either two doses of the vaccine or a placebo. It found that fewer than 10% of infections were in participants who had been given the vaccine. More than 90% of the cases were in people who had been given a placebo.

Pfizer said that the vaccine provided protection seven days after the second dose and 28 days after the initial dose of the vaccine. The final goal of the trial is to reach 164 confirmed cases of coronavirus infection.

In a news release, the pharmaceutical giant said it plans to seek emergency use authorization from the US Food and Drug Administration soon after volunteers have been monitored for two months after getting their second dose of vaccine, as requested by the FDA.

I believe that 50% effectiveness is the threshold for FDA approval. And, of course, this is early days; but you can’t deny that this looks good so far.

A bizarre paper in an Elsevier journal suggests that Covid 19 is a geological/magnetic-like phenomenon and can be prevented by wearing jade amulets. Elsevier defends the paper.

October 30, 2020 • 12:30 pm

A really insane paper was just published in an Elsevier journal, Science of the Total Environment, a paper that connects the outbreak of covid with serpentinization phenomena known in geology, as well as the Earth’s geomagnetic fields. At the end, the authors (who hold respectable jobs) suggest that putting nephrite jade amulets on rats may protect them from getting coronavirus.  And maybe it would work for us, too!  It’s gonzo. Of course, we can’t blatantly dismiss it out of hand without at least reading the paper (which I did, and it was PAINFUL), but this nonsense comes about as close to being dismissible as a paper can from just reading the title and the abstract. Click on the screenshot to read the paper, get the pdf here, and see the reference at the bottom.

The “highlights”:

I’m not going to go through the results in detail, which are both experimental and correlational, but even the “experimental” results are correlational: the authors observed, in rats afflicted with a “COVID-19 like disease” (they don’t know its relationship to genuine virus), that dissected rats had deposits of “silicate/glasslike structures in the lungs and kidneys”, which they associate with serpintinization. There was no experimental manipulation; they just saw some of the rats in their colonies get sick (17 out of 92), and cut them open.

The rest of the paper is speculation based on correlations of the disease in humans with geological phenomena, leading them to their Big Hypothesis:

Here, we propose that the emergence of COVID-19 outbreaks resulted from the generation of LWMAs [long-wave magnetic anomalies] that exhibit resonance with ferromagnetic-like iron stores in humans, thus enabling the magnetic catalysis of iron oxides-silicate-like minerals and the associated SARS-CoV-2.

And so iron is important, and so is water and geology, so they support their hypothesis with statements like this:

Terrestrial water storage dynamics also account for the disproportionate deaths in populations with African ancestry in the United States during the vernal phase of the COVID-19 pandemic. Individuals with African ancestry disproportionally reside in basins within the coastal belt of the Greater Appalachian-Ouachita orogenic belt that spans the South to the Northeastern United States (the so-called Black belt). This so-called Black belt region has been experiencing increased terrestrial water storage over the past decades and experienced increased terrestrial water storage during the vernal phase of the COVID-19 pandemic.

Of course that doesn’t explain why, in a single area, blacks are more liable to get infected than are whites.

It goes on:

In the proposed hypothesis, ferromagnetic-like/superparamagnetic iron stores (i.e., ferrihydrite) in humans  is critical for resonant LWMA-mediated magnetic catalysis in COVID-19 pathologies. Iron stores are low in children and increases with age, with the highest levels in the elderly. Males have significantly higher iron stores compared to females. Consequently, COVID-19-induced morbidity and mortality risk are directly proportional to age, and male sex is also a significant risk factor for COVID-19-induced morbidity and mortality.

Yes, it smacks of quackery, but I’ll let someone like Orac go after the paper as a whole, for life is short.  Oh, there’s one more test they propose:

Furthermore, we propose that Nephrite-Jade amulets (a calcium-ferromagnesian silicate) developed by Neolithic Chinese Medicine to prevent thoracic organ disease, may prevent COVID-19.

. . . It is posited that Jade (including Nephrite) amulets protect the wearer against unseen nefarious forces that cause disease in thoracic organs. Indeed, the romantic language word, piedra de ijada (from which the English word Jade is derived) translates to the stone that prevents disease in organs in the side/flank of the body (thoracic organs). Additionally, the English word Nephrite is derived from the Greek word lapis nephriticus, which translates to the stone that cures kidney disease.

Future experiments and analysis in support of this hypothesis will determine 1) the genomic sequence of the polynucleotide molecules producing the SARS-CoV-2-like antigens in the laboratory rats using next-generation sequencing technology, 2) the ability of Nephrite-Jade amulets to prevent lethal COVID-19-like disease and associated SARS-CoV-2-like infection in laboratory rats in our colony during the equinoctial period. . .

Check out the paper’s bizarre “graphical abstract”, which is reproduced below.

Maybe Gwyneth Paltrow’s jade vagina eggs had something to them after all! Well, I will let the experimenters fit the rats with tiny jade amulets and see if they work. I’m betting not. However, in support of their hypothesis, I sometimes wear pounamu (nephrite shapes on necklaces) that I got in New Zealand (they’re a traditional Maori decoration), and I haven’t gotten Covid yet. Maybe we could do the experiment now with the many people in New Zealand, both white and Maori, who wear pounamu. Those who wear amulets should get covid far less often.

Of course Retraction Watch had to feature this paper, and so it did in the article below (click on the screenshot).

The site reproduces some baffled tweets by other scientists, and then inquired of the paper’s first author, Moses Turkle Bility:

We asked Moses Turkle Bility, a Pitt professor who is listed as corresponding author of the paper, whether he in fact wrote it. He confirmed that he did:

…I kindly suggest you read the article and examine the evidence provided. I also suggest you read the history of science and how zealots have consistently attempted to block and ridicule novel ideas that challenge the predominant paradigm from individuals that are deem [sic] not intelligent enough. I [sic] not surprised that this article has elicited angry responses. Clearly the idea that a black scientist can provide a paradigm shifting idea offends a lot of individuals. I’ll be very candid with you; my skin color has no bearing on my intelligence.

If you have legitimate concerns about the article and wish to discuss, I’ll address; however, I will not tolerate racism or intellectual intolerance targeted at me.

Every quack fancies themselves a Galileo, though most quacks are simply quacks. And there was no racism.

We asked Bility for evidence that “Nephrite-Jade amulets, a calcium-ferromagnesian silicate, may prevent COVID-19,” and whether promoting non-evidence-based interventions during a pandemic was a good idea. His non-answer:

Dear Dr. Oransky, please read and understand the article in its entirety, before you make a hasty decision. If I may speculate, you neither understand quantum physics nor spin chemistry; you are making a hasting [sic] decision based on your knowledge of the classical theories that dominate the biological sciences. Also, certainly you being a white male offers you the privilege to think that you have the right to determine who can propose ideas that challenges a dominant paradigm. Other cultures are not primitive, and people of color and indigenous people are not intellectually inferior. Before you jump to conclusions about this article, I suggest you understand quantum physics, and spin chemistry, and how it differs from classical theories, and then read my article. 

The author, who is black, is clearly defensive, and is blaming criticism on his race. But the insanity of this paper has nothing to do with race; it has to do with whether good science is being done, and it doesn’t look like it to me.

Finally, Retraction Watch went to Elsevier, whom I don’t like anyway because they’re price-gougers. And they defended the paper!

We’ve also asked Jay Gan, of the University of California, Riverside, and co-editor-in-chief of the journal, how it came to be published. Gan told us that Damià Barceló, the other editor in chief of the journal, handled the submission. Barceló told us:

The paper went through our standard reviewing process. It was  reviewed by two expert reviewers and only after  several revisions with the agreement of the reviewers it was accepted.

Well, lots of dumb papers get published, though relatively more of them in the humanities than in the sciences. This paper won’t do much harm to science or medicine, but it may damage the careers of its authors unless, by a million-to-one chance, they’re right. And certainly Elsevier doesn’t come out looking good on this one.

_______________

Bility, M. T., Y. Agarwal, S. Ho, I. Castronova, C. Beatty, S. Biradar, V. Narala, N. Periyapatna, Y. Chen, and J. Nachega. 2020. Can Traditional Chinese Medicine provide insights into controlling the COVID-19 pandemic: Serpentinization-induced lithospheric long-wavelength magnetic anomalies in Proterozoic bedrocks in a weakened geomagnetic field mediate the aberrant transformation of biogenic molecules in COVID-19 via magnetic catalysis. Science of The Total Environment:142830.

New article: coronavirus lingers on surfaces longer than we thought

October 14, 2020 • 9:45 am

While most cases of Covid-19 are surely contracted via interperson contact (hugging, respiratory droplets, talking next to someone, handshakes, and so on), this new article from Virology Journal, produced by five Australian researchers, suggests that the virus can linger on various surfaces substantially longer than we suspected, and those infection-bearing surfaces (called “fomites”) can carry a viral load large enough to cause infection. Remember when you thought that paper and cardboard could be “disinfected” by leaving it untouched for 24 hours, so that the virus would all die? That doesn’t seem to be the case, at least according to this paper.

Click below to read the screenshot; the pdf is here , and the reference is at the bottom.

The results can be conveyed briefly. The researchers inoculated live virus onto six types of surfaces that might be encountered by people on a daily basis: Stainless steel (cookware, etc.), polymer currency (used in Australia), paper currency (no longer used in Australia but used in many other places), a glass surface (cellphones, touchscreens, etc.), vinyl, and cotton fabric.  The materials were incubated at three temperatures (20, 30, and 40 Celsius, corresponding respectively to 68, 86, and 104 degrees Fahrenheit, respectively), and incubation was in the dark, as UV light kills the virus more quickly (hint, put your envelopes and packages in the light when disinfecting them).  The relative humidity was 50%, though higher humidity also decreases viral survival.

The virus titer is said by the researchers to “represent a plausible amount of virus that may be deposited on a surface”. Samples were taken over 28 days, and the amount of living (i.e., infectious) virus measured by standard methods.

The attrition of the virus due to death over time was measured in three ways: the D value (time at which only 10% of the original sample remained), the half life (time at which half the original sample remained), and Z values (the increase in temperature required to reduce the D value by 90%, in other words to kill 99% of the inoculate).

The table below tells you everything you need to know: the D values and half lives (latter in parentheses) for all six materials at three temperatures, as well as the Z values:

Now what we don’t know about these values, and what is really important, is how much virus has to remain on the surface before it loses its ability to infect you (remember, probability of getting infected is proportional to the amount of virus you pick up and transfer to your nose, mouth, or eyes). This isn’t discussed in the paper, but I’d say a reasonable precaution is the D value: 90% loss of titer.  Perhaps readers in the know can tell us after they’ve read the paper.

But even if you use the half life, at 20°C, two days is a minimum for any surface save cotton (1.7 days). Paper loses half its virus load in three days, and glass in two. But remember, this is in the dark, and half-lives will be shorter in sunlight. Half-lives and Z values decrease dramatically at higher temperatures, though I think 20°C is what we should pay attention to because it’s close to room temperature.  If 10% of the original titer is not enough to infect you, you’ll have to wait 10 days for paper and 6 days for glass. Surprisingly, cotton cloth was the material that retained viable virus for the shortest amount of time.

The Z values show that an increase in temperature of about 15°C is enough to kill 99% of the virus existing at a given temperature.

The researchers also found that except for cotton, viable virus was still found on all surfaces after 28 days.

What’s the lesson for us? Well I can’t say (nor do I wish to purvey public-health advice!), because the crucial information—the amount of virus normally deposited on a surface, and how much of that must remain to give you an appreciable chance of getting infected if you pick it up—is missing. What the authors conclude is this:

The data presented in this study demonstrates that infectious SARS-CoV-2 can be recovered from non-porous surfaces for at least 28 days at ambient temperature and humidity (20 °C and 50% RH). Increasing the temperature while maintaining humidity drastically reduced the survivability of the virus to as little as 24 h at 40 °C. The persistence of SARS-CoV-2 demonstrated in this study is pertinent to the public health and transport sectors. This data should be considered in strategies designed to mitigate the risk of fomite transmission during the current pandemic response.

I guess we’ll have to leave it to the “considerers”, i.e., medical researchers and public health experts, to translate these results into recommended behaviors. But I think it’s smart to disinfect paper for two days instead of one after getting it, and use as little currency as possible (currency is like a circulating Petri dish, carrying E. coli as well as coronavirus. Use your credit card instead, and wipe it off with ethanol or wash it with soap and water after you use it. Put it in the machine, and don’t hand it to anyone unless you have to. Oh, and don’t let anybody use your cellphone.

___________________

Riddell, S., Goldie, S., Hill, A. et al. The effect of temperature on persistence of SARS-CoV-2 on common surfaces. Virol J 17, 145 (2020). https://doi.org/10.1186/s12985-020-01418-7

Covid 19 may hijack pain receptors, reducing pain and increasing the spread of the virus: a possible result of natural selection

October 8, 2020 • 9:00 am

The paper below, which has just been published (click on screenshot to go to page, then click the “download” button to the left to get the pdf), has a unique twist that may say something about evolution in pathogens, but the evolutionary angle hasn’t been mentioned. It’s a complex and technical paper, using rat models (i.e., tissue and analyses), to study whether the Covid-19 virus has the ability to reduce pain.

There’s also a publicity piece from the University of Arizona that explains the results in simpler language, and a two-minute video below that dumb things down a bit, but gives the gist.

From the publicity piece:

SARS-CoV-2, the virus that causes COVID-19, can relieve pain, according to a new study by University of Arizona Health Sciences researchers.

The finding may explain why nearly half of all people who get COVID-19 experience few or no symptoms, even though they are able to spread the disease, according to the study’s corresponding author Rajesh Khanna, PhD, a professor in the UArizona College of Medicine – Tucson’s Department of Pharmacology.

Rajesh Khanna, PhD. (Photo: Kris Hanning/University of Arizona Health Sciences)“It made a lot of sense to me that perhaps the reason for the unrelenting spread of COVID-19 is that in the early stages, you’re walking around all fine as if nothing is wrong because your pain has been suppressed,” said Dr. Khanna. “You have the virus, but you don’t feel bad because your pain is gone. If we can prove that this pain relief is what is causing COVID-19 to spread further, that’s of enormous value.”

The paper, “SARS-CoV-2 Spike protein co-opts VEGF-A/Neuropilin-1 receptor signaling to induce analgesia,” was published today in PAIN, the journal of the International Association for the Study of Pain.

. . .The U.S. Centers for Disease Control and Prevention released updated data Sept. 10 estimating that 50% of COVID-19 transmission occurs prior to the onset of symptoms and 40% of COVID-19 infections are asymptomatic.

“This research raises the possibility that pain, as an early symptom of COVID-19, may be reduced by the SARS-CoV-2 spike protein as it silences the body’s pain signaling pathways,” said UArizona Health Sciences Senior Vice President Michael D. Dake, MD. “University of Arizona Health Sciences researchers at the Comprehensive Pain and Addiction Center are leveraging this unique finding to explore a novel class of therapeutics for pain as we continue to seek new ways to address the opioid epidemic.”

In other words, the virus’s famous spike protein nullifies the effect of another protein, VEGF—one of the several proteins that normally causes pain. And that’s all ye need to know unless you work on this system.

But here’s where the evolution comes in. Remember, pain is an adaptation whose evolution was doubtlessly prompted by its ability to tell us that there’s something wrong, like “Hey, your hand is in the fire.” People who don’t feel pain, like those with Hansen’s disease (leprosy) and some rare neurological conditions, often incur severe damage to their bodies because they’re unaware of injuries. The reason Hansen’s sufferers lose their fingers and other bits is not because the bacteria eat away at those bits; rather, it’s because the bacteria numb feelings of pain, and so you start damaging your body without being aware of it. So pain is a good thing to have, even though it feels bad.

But if a virus that normally causes pain because it injures your innards can somehow block that pain, it might spread faster. This would be true for viruses like COVID-19, which is spread by human-to-human contact, and depends on its transmission for people going about and infecting others. If you take to bed because you’re in pain, the virus won’t spread as well.

And what that means is that mutant variants of the virus that reduce pain will spread faster than forms that cause pain. This differential would create natural selection for the mutants that reduce pain, and the virus “species” would evolve painlessness as one “symptom”.

As far as I can see, nobody in either the paper or the puff pieces have mentioned this possibility. Now we don’t know if this speculation is true, or if it’s just fortuitous that the spike protein blocks pain receptors. Further, while this might be an evolved property of the virus, it could also be an inherent property of the spike protein, evolved for other reasons, that simply allowed the virus to spread quickly.

I’m merely suggesting this as one possibility in a field called “Darwinian medicine,” which analyzes symptoms of diseases from an evolutionary viewpoint. Other suggestions from this area involve things like malaria. When you have a malaria outbreak, the malaise and fever put you flat on your back. And that facilitates the spread of the malaria pathogen (a protozoan), because that protozoan is transmitted by mosquitoes. When you’re prostrate in bed and sick, you’re not as liable to slap a biting mosquito as when you’re walking around, and so those protozoans that knock you flat will more readily find a mosquito vector. (This is all speculation, of course.)

Another suggestion involves the virus for the common cold. It doesn’t debilitate you, but rather makes you a bit grotty but still able to walk around—and transmit the virus to other people. If a common cold were to knock you out like malaria, the virus wouldn’t spread so well.

And so many of the symptoms that are caused by pathogens may well have evolved in those pathogens to facilitate their own transmission. This must certainly be true in some cases, but of course proving it is very hard to do. You couldn’t do experiments in humans, though I suppose you could in model animals like rats, but I wouldn’t be keen on hurting animals to test evolutionary hypotheses. (I even anesthetized all my fruit flies before killing them.) It is curious, though, that I haven’t seen this new and striking result mentioned as a possible example of natural selection in the virus.

Here’s the video, though you might not learn much if you’ve read what’s above.

h/t: Charles

Click to access 2020.07.17.209288.full.pdf