“Change it had to come
We knew it all along
We were liberated from the fold that’s all
And the world looks just the same
And history ain’t changed
Cause the banners, they all flown in the last war”
The Who – “Won’t Get Fooled Again”
“Immunity”. Whether involving an individual wrangled in some type of illegal activity being proffered by authorities the opportunity to confess their act to avoid prosecution, or someone having built up an innate resistance to ward off the attack of a biological insult such as a virus, it’s this word that makes us feel safe. The problem arises when people improperly interpret, or simply do not understand the alternative outcomes of the processes that they assume would always work “perfectly” to achieve this state of safety. While it is understandable that being granted immunity for testimony for one or more criminal acts can help someone avoid legal trouble, what fiction presents really well—and is actually a real-life occurrence—is the retribution that could potentially be levied by the criminal associates of the parties that are charged, convicted, and punished. But what does this have to do with biology and the immune system, anyway?
As a former professor of a large undergraduate molecular and cellular biology course, I remember annually expounding to my students the dangers of “chicken pox parties”—to the point of describing them as “biological weapons”—when I was teaching about molecular recombination events that would generate antibodies against antigens. I would emphasize that the even the generation of sufficient numbers of antibodies to quell a viral infection would not guarantee that a virus would disappear from an individual forever, specifically, if that virus was able to lie dormant somewhere in the infected person, or be shielded from the immune system by recombining into its host’s DNA. I would also emphasize this parallel point when teaching about the lytic and lysogenic phases of bacteriophage – the class of virus that infects bacteria. As for the varicella-zoster virus—the pathogen behind chicken pox in humans—it’s the quiescent viral scenario that can occur, when virus particles settle into nerve cells of sensory ganglia and remain dormant in an inactive, “latent” form of infected people for many years. As it turns out, this is not a rare occurrence, with 95% of adults at risk for the recurring infection of the varicella-zoster virus that leads to shingles and roughly one-third of the U.S. population contracting this excruciating condition later in life. But even chicken pox has a small incidence of lethality, mostly in immunocompromised children and adults. Hence, the trend of selling and shipping presumed varicella-zoster-contaminated lollipops via U.S. mail was deemed illegal by federal law several years ago, basically being the online equivalent of parents’ “chicken-pox parties”.
As it turns out, history ain’t changed much for how American adults approach viruses that are not considered drastically lethal, either. Nor has their conception of how to gain that quick fix of “immunity” by exposure and subsequent infection. It goes without saying that at present, the novel coronavirus SARS-CoV-2—also referred to COVID-19—is rapidly spreading worldwide, and because the rates of lethality are low and symptoms anything less than profuse bleeding-out-the-eye-sockets, a subset of Americans are questioning the recommendation of the CDC and Governors of several states to continue to shelter-in-place to avoid COVID-19 spread. While this behavior is fodder for a blog post that belongs elsewhere on the interwebs, it is rooted in a minority (Editor: and foolish) concept that humans can safely gain and spread “immunity” by permitting themselves to become infected; thankfully, this is a notion that has been strongly rejected, with a majority of Americans willing to follow the advice of expert medical researchers and clinicians. But with this assumption—the word “safely” being key— there a handful of things that everyone should keep in mind:
1. Like any impactful educator, we must convey to our students/audience that the rules in the textbook or validated by experts online are only a snapshot of our understanding; those rules might not change, but deepening our understanding of a process could radically alter the questions we ask, how we ask them, and broadly open the aperture to previously unknown – and possibly lethal outcomes.
2. Some remedial searching of the current medical databases and literature from this author did not reveal any known evidence of a “latent state” of coronavirus, but just because it hasn’t been shown yet doesn’t mean that COVID-19 is incapable of lying dormant [Readers of this blog, feel free to comment if you are aware of any evidence of coronavirus latency, in general, or a basis for its plausibility].
3. We can in no way fly the banner of a “perfect immunity due to infection”, because some patients that have recovered from COVID-19 are re-testing positive. This speaks nothing of potential viral latency for COVID-19, or the medical outcomes should infected victims become re-infected now or years down the road, but these are still unanswered questions that must be addressed with this completely novel virus.
4. “Immunity (noun): the ability of an organism to resist a particular infection or toxin by the action of specific antibodies or sensitized white blood cells.” This definition applies if completely ahead of an infection and preventing its onset and any latent presence of the pathogen; alternatively, it could apply following the complete eviction of a pathogen from every single cell of the body. Immunity is not merely a person generating an immune response to a pathogen and then recovering.
In conclusion, it is clear that social traditions passed along generations provide familiarity, comfort, and possibly some type of relief from medical maladies, though the differentiation between placebo and trusted pharmacological treatment in those instances is non-existent for many. Protection against and liberation from illness is a strong behavioral driver and can serve to unify entire communities toward a common goal. But we as scientists, clinicians, and educators must underscore the power to knowledge and proper behaviors, particularly in the face of the unknown when it comes to individual diseases or pandemic states like that driven by viruses like COVID-19. Gaining “herd immunity” by enabling infections of COVID-19 rather than through vaccination is a possible Pandora’s Box for the infected: meet the old boss, same as the new boss – maybe soon, maybe in your golden years.