Thank you for this post davebugg. Now that we know you are an expert may I ask something? They can't cure the viral illness in case of HIV on flu either. We already know, that one can not be immune even if he had COVID-19 (we can catch it again). So I am I right thinking that the goal of scientists is actually to reduce the number of people who have it in one time? So the SARS or COVID-19 virus (and the risk to catch it) will be always there from now on, but humans will try to reduce the number of people who have it at one time?
I think it is important to know... even from the point of view of travelling to the Camino or elsewhere.
I want to explain, from my perspective, why it is impossible to accurately speculate or predict the endgame for COVID-19. As well as why I think the Moderators are correct, given the purpose of this Forum, in limiting discussion about the medical issues of COVID-19.
I'm
not an expert. There are some on this forum who
are virology and immunology professionals and Doctors.
My education includes a degree in Public Health, and for a couple of decades I worked for a public health district, involved with disease tracking and reporting, infectious disease control, and health provider trainings in bloodborne pathogen and environmental protection.
First. . for
any viral illness that humans become ill from, a percentage of those who recover will still be able to get infected again. Any notion by the public that there is always permanent immunity after you suffer a viral illness, or get a shot, is inaccurate.
Measles, chickenpox, influenza, colds, etc. all have percentages of those who will be at risk of becoming infected and ill more than once. While most people will gain a long-term level of protection - even a lifetime protection - due to passive immunity after an illness, there is always a percentage of the population who are at-risk of getting the illness again.
Reasons for this include the fact that some viruses, like those associated with getting a cold (rhinoviruses), number in variety by the hundreds, if not thousands. If you get sick from one Cold (rhinovirus), you can still become ill from a different variety. Symptoms are mostly identical, as is the outcome.
Then there are issues of how quickly a type of virus can mutate. Influenza is an example. Strains of influenza change so much and so quickly that many times they act just like a brand new virus. Past flu shots either do not work against a new mutation or strain, or the active immunization from a past illness or vaccination does not develop into a long term passive immunity.
Roughly speaking, this is the immune system's version of how you do not recognize a friend, because they grow a beard and wear sunglasses.
Looking at this in a different way, what
would be be new and unique, is if it is found that there
never is a reinfection, or a recurrence of illness, among all of those people who recover after getting COVID-19, whether or not they became ill with symptoms.
We are very much in the dark at this stage, about what the natural history of COVID-19 will be.
It remains unclear whether COVID-19 will be like a 'flu' virus that mutates just enough to require new vaccines every season. Or if it will be like a 'measles' virus where once ill or vaccinated, there is a long-term passive immunity. Or if, like a 'Chicken Pox', there is a risk, after vaccination or illness, of it creating a future syndrome in the way that Chicken pox can cause Shingles. Etc.
Pathogenesis is a term used to describe the process by which viral infection leads to disease. Much of COVID-19 pathogenesis seems clear, and is similar to most other respiratory viruses, - which would be expected due to the fact that these viruses all share similarities.
There is much about a COVID-19 infection and its illness that is unclear. Part of this is due to the actual and unique quality of this virus itself and how the human immune system responds to COVID-19. In some ways - as a new and unknown pathogen - it acts in a similar fashion to a known 'family' of virus. In other ways, it is expressing itself in unique and non-similar ways.
We have only had practical experience with this disease in large populations, in an open and transparent fashion, for about 4 months. Four months!!! Given this time frame, the number of discoveries and information from research on COVID-19, and where we are in the development of treatments and potential vaccines, has been moving at a Warp Factor speed.
It feels like a resolution to COVID-19 is moving like someone stuck in a marsh bog, but I wonder how much of that perception is based on a combination of:
1. An unrealistic expectation of current scientific knowledge and technologies.
2. The Fast Food mentality of the developed world, which expects instant resolutions to most everything, from Big Macs to internet connections.
It is vital that this tragic march of morbidity and mortality from COVID-19 be interrupted. It helps to balance our shared anxieties over COVID-19's damage to the world and people, with realistic expectations of where our true levels of scientific and medical knowledge exist.
The challenge for the scientific infrastructure and research community, is to define all of those unique differences of COVID-19. Challenges, like identifying even one, single portion of the virus that remains stable and consistent, despite multi-generational growth with mutational changes, to allow a vaccine to be developed.
Or identifying all the variations of illness that can occur with COVID-19, at every age range, so that effective and targeted treatments can be identified.
Or what the long term natural history of COVID-19 will be in the environment. . will it be a seasonal disease like our current influenza outbreaks. . . will it burn itself out and 'go away' once the COVID-19 pandemic outbreaks are over. . . will COVID-19 end up, in the future, being a toothless entity as our immune systems adapt to it; present in the world, but incapable of causing further disease outbreaks.
There is much we know, yet so much we do not.
All of the above means that there are, as yet, no concrete answers as to things like vaccines, treatments, and when the risk of new infections from COVID-19 will decrease to the point of opening tourism and travel again.
Everything discussed about COVID-19, as it pertains to treatments, vaccinations and when we can return to the
Camino de Santiago, is based on some form of speculation at this time.
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