
Immunology Is Where Intuition Goes to Die - pseudolus
https://www.theatlantic.com/health/archive/2020/08/covid-19-immunity-is-the-pandemics-central-mystery/614956/
======
medymed
Intuition can die often, but on the other hand many individual processes
within immunology are somewhat well characterized as far as biology goes, and
are amazing. The VDJ recombination process for B and T cell development is a
stochastic-engineering-like feat of self-driven mutation (not just slight code
changes but actually chopping up parts of our DNA and rearranging their order)
and is occurring constantly in huge numbers of developing lymphocytes to
generate structurally new proteins under very close scrutiny, allowing our
immune system to adapt to previously unseen infections.

[https://en.m.wikipedia.org/wiki/V(D)J_recombination](https://en.m.wikipedia.org/wiki/V\(D\)J_recombination)

~~~
bionhoward
It’s amazing to watch folks deny evolution while their bodies evolve new
immunity in real time

~~~
Terr_
The Long-Term E-Coli Experiment [0] is also pretty awesome, because not only
is is evolution seen directly in the lab, but frozen samples can reveal
exactly what steps turned out to be important.

[0] [https://en.wikipedia.org/wiki/E._coli_long-
term_evolution_ex...](https://en.wikipedia.org/wiki/E._coli_long-
term_evolution_experiment)

~~~
pas
[https://www.youtube.com/watch?v=yybsSqcB7mE](https://www.youtube.com/watch?v=yybsSqcB7mE)
(Harvard Mega-Dish antibiotic experiment)

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sgdpk
This is a nice summary of the basics of immunology and how it relates to SARS-
CoV-2.

It's good to see a piece that shows how complex the science behind COVID is,
in the middle of so many contradictory or over-simplified news.

~~~
schemy
>It's good to see a piece that shows how complex the science behind COVID is,
in the middle of so many contradictory or over-simplified news.

It's rather unfortunate how politicized the whole issue is. I got banned from
reddit for pointing out that without knowing what the r0 was for asymptomatic
patients any type of lock down tells you more about the psychology of the
person for or against it than about its effectiveness.

~~~
GlennS
At this point (and for a few of months now), surely you don't need to know the
R0 value?

Why not just look at other countries, see which have had the best outcomes,
and copy them?

~~~
schemy
>Why not just look at other countries, see which have had the best outcomes,
and copy them?

Because if the R0 value for asymptomatic cases is high enough you will need 2
week quarantine for all travelers and fortress boarders until the virus is
eradicated everywhere.

Something New Zealand is currently doing after implementing the most draconian
nation wide lock-down.

Do you support a barb wire wall around both the Canadian and Mexican border
with lethal force counter measures if anyone tries to pass and forced
isolation of all travelers?

~~~
GlennS
If you think New Zealand's approach is infeasible, perhaps instead take
inspiration from some of the countries with land borders that are doing well?

~~~
nradov
After some initial problems, Sweden appears to be doing well for the past
several weeks.

~~~
dmitriid
> doing well for the past several weeks.

How convenient of you to ignore all the weeks prior to "the past several" as
in: significantly higher mortality rates than any of its neighbours.

And the end result? Worst recession since WWII.

~~~
nradov
Almost all countries are in a recession now. Sweden appears to be performing
most of it's neighbors.

[https://www.npr.org/sections/coronavirus-live-
updates/2020/0...](https://www.npr.org/sections/coronavirus-live-
updates/2020/08/06/899776725/sweden-records-largest-gdp-drop-since-1980-but-
outperforms-many-other-eu-countri)

~~~
dmitriid
Once again, you conveniently choose to ignore everything but the past week or
so.

How about "Sweden has the largest recession since WWII. The largest single
quarter drop in the directly comparable time series. The drop (8.6%) is barely
above EU average (11.9%), and the economy is expected to drop another 4-10% by
October. They achieved this incredible economic feat by sacrificing 10 to 15
times the number of people compared to neighbours."

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klodolph
If you want a cartoon explaining some parts of the immune response in the
article--try _Cells at Work!_ It's on Netflix, last time I checked. It is
surprisingly technical.

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westoque
my takeaway from this is that the human body is actually really complex. even
the immunologists quoted cannot say for sure about how the body responds to
certain viruses. each one of us is unique and has different response levels.
however, it's good to know that children have more a aggressive immune system
response than older people and hopefully make their bodies somehow adapt to
the Covid-19 virus.

~~~
IfOnlyYouKnew
It's two billion lines of spaghetti code created by iterative randomness and
implementing its own compiler (and, as a side gig, perl)

Parts of the code have evolved to code for two entirely different functional
segments depending on the direction they are read in, while others have
randomly duplicated and taken on entirely new functions over time. Energy has
become the specialisation of a type of bacteria that at some point somehow
avoided death after being eaten by a cell and instead founded its family of
somewhat strange but super-efficient metabolisers.

So yeah, it's complex.

~~~
missosoup
It's complex and beautiful.

"We are all just a somewhat interesting random arrangement of photons"

~~~
kazagistar
Its a nice sentiment but inaccurate. If you wanted a fundamental particle that
we are mostly made of, gluons would be a better boson to pick, since they make
up the majority of the mass/energy of subatomic particles in matter. Why would
you say photons?

~~~
doliveira
Our biological processes are caused by the electromagnetic force, which is
mediated by photons.

~~~
dwaltrip
Are you saying this because chemical bonds are largely due to electromagnetic
force? That is true as far as I am aware. Although it does seem like a
peculiar way to say it: "Our biological processes are mediated by photons".
But maybe that is just me.

Regardless, it still is incorrect to say we are simply an arrangement of
photons. The matter making up our body is composed of atoms, which are
composed of electrons, quarks, and gluons (fundamental particles in the
standard model).

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op03
How do the randomly located specialist T-Cells that "clone into a battalion"
after the messenger cell show up know where to go in the body? Do they just
fan out in all directions? Or is there some spl navigation mechanism?

Any good book reco's for the layman?

~~~
anotherboffin
Well a lot of the T cells will enter the bloodstream in order to spread
through the body. My knowledge of this is fairly limited but chemokines serve
as the navigation instruments in many cases: a site of inflammation or
infection will have immune cells expressing these signaling molecules that
will slowly diffuse and create a gradient. T cells (for example) will follow
this gradient to get to the site of interest (the process is called
chemotaxis).

No book recommendations off the top of my head, but I’ll post back if
something comes up.

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gverrilla
We are still in Middle Ages

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hirundo
Where intuition can't be relied on we must resort to experimentation. Animal
and virtual models can tell us a lot, but because immunology is so contingent
on the details, they can't make strong predictions about human responses.
Human testing is needed for that, and even then reactions over the population
can differ wildly.

But we've locked ourselves out of timely human testing. We are protective of
subjects to the point that even a global pandemic can't overcome long deadly
delays in testing vaccines.

So what's the alternative, Dr. Mengele? One simple word that Mengele didn't
bother with: consent.

We should create a category of fully informed, fully consenting adults that
are willing to subject themselves to human experimentation, even before
lengthy animal testing. Give them sufficient education, training and
evaluation to determine that they consent by strict criteria. Test them on
their knowledge, let them decide over months. And then let the scientists
administrate the test substance or placebo. With conditions monitored by a
research oversight committee.

Even if it were a risky and painful process that didn't make a subject any
richer, I predict that there would be hundreds of sincere volunteers. Both
fools and heroes.

We should let them. It could defer large numbers of deaths.

~~~
ineedasername
Those fully informed and consenting adults may very well have significant
selection bias and not represent the population very well. Meaning results
obtained from them would not be generalizable and could run the gamut from
ineffective treatment to dangerous or fatal when tried in the broader
population.

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nickthemagicman
This is such poor sensationalized fear-based reporting.

There are extremely well enumerated principles in immunology. There's always
exceptions in any sort of molecular biology and this article makes them sound
like they are the rule or the standard.

Covid is extremely tame compared to other pathogenic viruses.

You want a scary virus, look at ebola which destroys epithelial cells and has
90% fatality rate , look at HIV which integrates into your genome.

The article implies that Covid is special in some regard in how it attacks the
body. It's a standard virus. Every virus on the planet has people that are
susceptible to it and it kills them. Every virus on the planet can cause you
damage via immune system over response. That's how influenza kills and its way
better at it.

The entire human physiology and biology in general is crazy with exceptions to
every rule and millions of years of evolution makes it hard for us to
understand why.

All of biology is crazy and unintuitive from the tree of life down to
proteomics. But to say it so unpredictable is just false.

