How common are re-infections and how trust can defeat the virus: COVID, coming soon, episode 35

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Tanya Lewis: Hello! Welcome to Covid Quickly, Scientific American’s podcast series!

Josh Fishman: This is your quick update on the COVID pandemic. We tell you about the science behind the most pressing questions about the virus and disease. We demystify the research and help you understand what it really means.

Lewis: I’m Tanya Lewis.

Fishman: I’m Josh Fishman.

Lewis: And we’re Scientific American’s senior health editors.

Today we will discuss what we indeed know about re-infection with BA.5…

Fishman: And we’re going to talk about one factor around the world that keeps infection rates low: trust in the people around you.

Fishman: I’m hearing more and more stories of people getting reinfected with COVID only a month or two after recovering from a previous attack. Are these just stories, or is re-infection really more common now, with the BA.5 variant?

Lewis: Yes, I’ve heard those stories too. It is true that BA.5 is better at evading our immune responses from past infection or vaccination than any variant we have seen so far. But the truth is that there was an infection before does still give you some immunity – especially the previously suffered Omicron infection.

A preprint study conducted in Qatar, which has not yet been peer-reviewed, found that prior exposure to a non-Omicron variant gave people about 15 percent protection against symptomatic BA.5 or BA.4, linked option, and 28 percent protection against any infection with these variants.

Fishman: Okay, that’s something. How does Omicron pre-infection help?

Lewis: These individuals had significantly greater protection against re-infection with BA.4 or 5: 76 percent against symptomatic infection and nearly 80 percent against all infections.

Fishman: In other words, if you had Omicron in the winter or spring, you are reasonably well protected against re-infection.

Lewis: Correct. And while it’s entirely possible that you had an earlier version of Omicron and were still unlucky enough to catch a BA.5, you’re unlikely to catch the exact same variant twice in a short amount of time.

Fishman: Well, that’s good news. What about vaccination – how well does it protect you?

Lewis: We already know that vaccines are excellent at protecting against severe disease in all the variants we’ve seen so far. But amplifiers are also critical. Antibodies from vaccination weaken over time, making us more susceptible to infection. Fortunately, boosters can replenish this defense even against Omicron. The The CDC did a recent study when BA.2 and related variants were distributed. It found that people over the age of 50 were only 55 percent protected from being hospitalized with COVID four months after the first revaccination. But after the second booster, that protection jumped to 80 percent.

Fishman: Sounds like you’re telling us now is a good time to make sure you’re up to date on your booster shots.

Lewis: Of course. The reason we’re seeing more re-infections with BA.5 is partly due to its immune evasion ability—mutations in its spike protein that help it evade antibodies to earlier variants. And that’s partly because more people have simply had COVID and their immunity may have weakened since the first infection. Therefore, it is quite difficult to compare the risk of re-infection with different options.

But in general, if you’ve had or recently recovered from COVID, it’s safe to say that you have some protection from re-infection, and especially from severe consequences.

Lewis: Throughout the pandemic, we’ve all wondered why some people get infected and others don’t. Age, immune system responses, wearing a mask all matter. But you looked at another surprising factor: trust.

Fishman: It’s true, Tanya. All of these things that you mention really affect risk at the individual level. But looking across countries, the ones that do best during the pandemic — keeping infection and death rates down — are those where people trust each other and their governments the most.

Trust is more important than how rich a country is, or how many hospital beds it has, or whether it had a good pandemic preparedness plan.

Lewis: This is wild. Does trust really make that much of a difference?

Fishman: It does. Trust me.

Lewis: You just had to go there, didn’t you?

Fishman: Yeah. But let me explain this. The information comes from a study published in February in the medical journal Lancet. The authors studied 177 different countries and made dozens of comparisons of populations, governments and health care systems. They looked at the period from the very beginning of the pandemic, in early 2020, to when the Delta wave peaked in the fall of 2021.

Most of the variation in COVID outcomes simply cannot be explained by typical factors. I mean, you know the US has one of the highest infection and death rates in the world, but it also has a high per capita income, lots of hospitals and health workers, and a government that works pretty well — well, some of time, and at least compared to many other places.

Lewis: But it didn’t matter?

Fishman: Not really. Countries such as the Philippines, the Dominican Republic and Vietnam, which do not have US-type resources, had much lower infection and death rates during the study.

The authors say that in places like Vietnam, there was a really high level of trust in the government and in the people on the street.

Lewis: When you say “trust”, what exactly do you mean? How did they measure it?

Fishman: Ah, good question. It was through the big polls. Several years with them all over the world. And those polls asked people, basically, how much they trusted the officials and everyone else to do the right thing.

Lewis: But these answers can be skewed, right? People in countries with authoritarian governments may be afraid to give an honest answer.

Fishman: You are right. But there are places like Denmark without those fears, where people said they had really high levels of trust. And there are countries like the US, where people are not afraid of polls and have a much lower level of trust.

In fact, researchers estimate that if every country on the planet had the level of interpersonal trust that Denmark has, global infections would be 40 percent lower. That’s 440 million fewer infections.

Lewis: Wow. But trust is a social thing, part of a relationship. How does he fight the virus?

Fishman: In several ways. Trust makes it easier for officials to talk to people about the best protection measures. Strategies that engage communities, that involve them in solutions, help build that trust. The high rate is associated with high vaccination rates, as well as people agreeing to travel restrictions. Low trust and you get the bad combination of behavior and anger we’ve seen here.

Between people, neighbor to neighbor, trust makes people sure that everyone is trying to protect each other. Not to orphan Denmark, but SciAm just reported on crowd behavior in this country during the pandemic. People said they felt comfortable gathering because they believed their neighbors wouldn’t go outside if they felt sick and were likely to be vaccinated. What they really were.

Lewis: That makes sense. But some of these high-trust countries, such as Denmark and Vietnam, have recently seen outbreaks of infections.

Fishman: Well, new variants of the virus are easily transmitted wherever you go. Countries relaxed protective measures, and the infection went up. We will definitely need better coronavirus vaccines. But some injections of confidence would also help.

Lewis: Now you know. Thank you for joining us. Our show is edited by Jeff DelVisio and Tulika Boss.

Fishman: Hurry back in two weeks to see the next episode of COVID! And check SciAm.com to get updated and detailed news about COVID.

[The above text is a transcript of this podcast.]

How common are re-infections and how trust can defeat the virus: COVID, coming soon, episode 35

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