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We know why some people got Covid while others didn't (theconversation.com)
52 points by wglb 4 days ago | hide | past | favorite | 54 comments





I wonder if any of the Not Infected group were kindergarten teachers.

I knew someone who - at the start of being a teacher - got sick. Then at some point her body adjusted to the constant exposure to sniffly kids and she never got sick.


Her body didn’t “adjust”. She just built immunity against all of the common illnesses.

We went through the same thing when we sent our two to daycare. Just constantly sick for the first year/


I might describe the acquisition of immunity as a body adjusting.

Which fine, but it's not really clear that is what the other poster meant.

I'm presuming they have the common understanding of immunity to infectious disease of course.


You can’t build immunity against cold and flu, afaiu, and I doubt that “constantly sick” meant measles, chickenpox, etc. How does that work?

Edit: am I wrong here? Would like to know.


You're right that you can't build immunity to everything, but you do build immunity to a lot of stuff - namely many of the viruses that are colloquially called "a cold". Flu, Measles, Chickenpox and several others are best handled with vaccination.

My point was namely that your body doesn't actually "adjust". It doesn't reduce your symptoms or change your baseline response to a virus. You start getting fewer illnesses because you've encountered the most common ones that come around in your environment.


So you can become more immune to next year’s colds by being exposed to many of them in present? Didn’t know that, thanks. I thought it’s sort of a brand new virus signature every year that your immune system doesn’t know, by design.

> So you can become more immune to next year’s colds by being exposed to many of them in present?

I can't tell if your being genuine.

Colds aren't like the flu. The flu tends to surge in a way that has a semi-predictable set of strains. The annual flu shot is largely an educated guess on which strands of the flu are going to be most common that year.

There are dozens (hundreds?) of viruses that are responsible for causing colds all over the world. Just by the nature of how viruses spread and survive in a population, viruses strains tend to stay somewhat regional. You'll build immunity to the cold viruses common in your region, but you won't "pre-build" immunity to cold viruses from other areas. Overtime, though, virus strains permeate to other areas. People work together, people travel, etc, etc, etc. That means there's almost always a new "cold virus" that you can get exposed to.

For example, if you dropped 100 people on an island and isolated them, they may all transmit cold viruses among them - but over time colds would disappear on that island. Everyone would have caught every possible cold that was brought to the island. The virus might actually hang around in the population, but people would have immunity to it and not get sick.

However, if you just started dropping random people on that island, two things would happen:

(1) Those people would likely bring new colds to the island, which everyone on the island might get

(2) The island people might give the newcomers their colds

-----

Part of the reason people get sick so often when flying is because they come into contact with a LOT of people who have exposure to different virus pools.


I can't tell if your being genuine.

I am. My misconception was that cold viruses mutate rapidly and chances are low that it becomes dormant in an isolated group (given someone still bearing it). A common factoid/stereotype that I picked up somewhere and believed in. Thanks again for the explanation!


When I was in my mid 20's I went through a period where I had constant tonsillitis. I'd be on antibiotics and then get better for a week or two, then I'd just regress and become sick again.

After about 6 months of that I'd had enough and had my tonsils taken out.

Before the whole ordeal I became sick every now and then like most people, but afterwards it changed to where I no longer had to worry about any form of cold or flu, I just would seemingly not get them (as per the people in this study).


Considering they were able to identify a genetic difference in the groups, no?

That part wasn't clear to my layman's understanding...

> Lastly, we identified a specific gene called HLA-DQA2, which was expressed (activated to produce a protein) at a much higher level in the volunteers who did not go on to develop a sustained infection

So everybody has this gene, but it was more expressed in those who didn't get sick. What causes the difference? Something genetic or something environmental?


I'd love to get a confirmation on if that is what this means? Seems odd to reference it the way they did if we all have the gene. My reading was more that it would be like the gene for a certain hair color. But, my reading is a very naive one, to be sure.

Interesting but n=16 is a weak ass study

This wasn't a double blind trial. This was a "Do something and watch the results" activity.

And consider this: "In these people, we were able to identify cells stimulated by a key antiviral defence response in both the nose and the blood. This response, called the “interferon” response, is one of the ways our bodies signal to our immune system to help fight off viruses and other infections. We were surprised to find that this response was detected in the blood before it was detected in the nose, suggesting that the immune response spreads from the nose very quickly."

This told us that one of our hypotheses about the virus was invalid. You don't need a lot of volunteers for that.


Smaller study sizes are ok if the effect is large.

I don't think your point is invalid; but as the siblings point out, sample size effectiveness really depends quite heavily on many factors. As an obvious/naive example, you wouldn't need a lot of participants to know that an acute poison is, well, poisonous. As you get ones with less of an acute effect, though, the number of participants needed goes up.

Similarly, they did controlled and deliberate exposures here.

So, I'm very excited to read follow ons to this study. Looks very promising to my naive eyes.


Despite rendering care for those affected and being exposed personally a few times by confirmed positives, I've not had it yet. I wonder why often.

Yes you have, everyone on planet earth has "had covid" by now.

We have known from a US Navy study early on where they tested and tracked everyone on an aircraft carrier regularly.

They found that like 98% of people who tested positive (PCR) never knew they had it or showed any symptoms. Like 99% of people who have "had covid" never even knew that had it, that it how mild of a disease it is. Without a major co-factor covid usually goes unnoticed.

My only question is why don't people seem to know what should be common knowledge about covid at this point?


Seven billion people, seven hundred million recorded cases, seven million deaths.

https://www.worldometers.info/coronavirus/

(long covid is not accurately recorded, but more prevalent than fatalities)


PCR positivity doesn't mean anything because the test is detecting viral fragments, not live virus. In fact it starts with a lysis stage that destroys whatever virus is in the sample so it can be detected.

So there's actually no contradiction between testing positive and never having had COVID, even if you use an invalid definition of COVID (viral presence) rather than a symptom based definition.


You can use some charity to the post, of course. They almost certainly mean "never had symptoms" and likely never tested positive on a test. So, even with your point that excessive testing could have shown that they had it; I think it is clear what they meant. And it is a puzzling situation.

I've never shown positive, while proactively checking with PCR.

It's painful, watching history be rewritten.

> Throughout the pandemic, one of the key questions on everyone’s mind was why some people avoided getting COVID, while others caught the virus multiple times.

It was not on everyone's mind. It was the exact opposite: pre-existing immunity was one of the many things that was officially forbidden to notice. The party line was that because SARS-CoV-2 was "novel", 100% of the population would become infected upon exposure. I have very clear memories of telling lockdown-obsessed people that the models assumed a 100% susceptibility rate yet the Diamond Princess outbreak had showed this was far from true, so the modeling justifying lockdowns was wrong. The response was usually derisive. Who are you, rando programmer, to challenge expert epidemiologists?

Another case that sticks in the mind: I was having dinner with some work colleagues. They were complaining about getting COVID repeatedly post-vaccination, and reacted with amazement when I told them I'd never had COVID and also never been vaccinated. One suggested I should report myself to the authorities so they could test me and find out how I could possibly be immune despite having never been sick. I laughed and said no, I'm not going to do that. Cue appalled expressions. How could you not want to help? Well, there are lots of people who have prior immunity, this has been known for years and the authorities have deliberately ignored us because they ignore anything they don't understand and thus can't model <bafflement, shock>.

Note that the nasal spray challenge study they talk about was done in 2022. Their citation for their claim that pre-existing immunity was previously "unproven" actually goes to a study of healthcare workers from 2021 which begins "Individuals with potential exposure to SARS-CoV-2 do not necessarily develop PCR or antibody positivity, suggesting that some individuals may clear subclinical infection before seroconversion." Although they didn't understand the exact mechanism, the wrongness of the public health assumptions was well known at the time by the relevant people and they said nothing.


While I agree with some of what was said here, most discussion of “pre-existing immunity” was around immunity acquired from already having had COVID, not immunity carried in from prior conditions. I thought the conversation (or lack thereof by prominent “establishment” sources) was more egregious, as adaptive/acquired immunity is a very well understood mechanism. It’s the same mechanism that vaccines are attempting to leverage.

What you’re describing, however, I would imagine is harder to test for/understand, and makes more sense that it wouldn’t immediately be at the forefront of the conversation. Genetic or otherwise inherent immunity would be hard to prove, and the mechanisms that result in that are probably not always immediately obvious in terms of what they even are, let alone how they work.


It's probably quite hard to explain at the microbiological level for sure, but you don't need to be able to explain it to understand how it will impact outcomes. You just need to be able to measure it.

Pre-existing immunity is by definition immunity that existed pre-exposure, immunity that comes from already being infected before was referred to as natural immunity. The latter was accepted as real right up until the vaccines arrived. The former never was, I guess it still isn't as this is just a university press release, not something formal from public health agencies.


And is there any reliable estimate of the prevalence of this a priori immunity?

This has been observed for all kinds of diseases; there's even someone who's immune to HIV. https://en.wikipedia.org/wiki/Innate_resistance_to_HIV

There's just not very many of them. And if the susceptibility is 99% rather than 100% that doesn't really make a difference.


Yes, from the Diamond Princess wiki page:

> As of 16 March, at least 712 out of the 3,711 passengers and crew had tested positive for the virus.[22][23] As of 14 April, fourteen of those who were on board had died from the disease.

Exposure on the Princess was 100%, which we know because everyone was confined to quarters yet cases appeared randomly throughout the ship without there being any locational clustering, which is only possible if the virus got everywhere. IOW it was capable of spreading between cabins and floors.

So the rate at which passengers went positive was something like ~20%, but half of those were asymptomatic, so the true susceptibility rate was more like 10%.

IIRC contact tracing studies found a similar susceptibility rate, based on how many people started testing positive when locked into their homes with a test-positive housemate. But I don't have a citation for that offhand, I'd have to go dig it up again.

IFR was in that case 1.9%, but this is biased high due to the age of the passengers which is very unrepresentative of the population. You could get more accurate IFRs using serosurveys.

Obviously, the modelling projections were all wrong by an order of magnitude just due to ignoring susceptibility alone. And then you have the IFR that was also way too high. Fix both of those and you can start to explain why the epidemiologist's predictions were so far off the real numbers. Also their models assumed very strongly that SARS-CoV-2 could not move long distances on air currents, but indeed that's not compatible with what happened on the ship. If you take all those factors into account then lockdowns did not make any sense as a policy (nor many other policies).


My buddy’s wife worked at a local “red zone” as a nurse 12 hours a day, and it didn’t feel to her like a seasonal flu.

I’m not an expert of any kind here, but I think the world got it right not risking itself for just a year of immobility, instead of turning it into a potential “don’t look up” scenario. Post-thoughts are always retrooptimistic and clear, but try to coordinate that in the moment at the country level without overestimating heavily.


> I’m not an expert of any kind here

You don't have to be an expert to have seen that it wasn't remotely sensible to react the way that people did - and that authoritarians, the whole world over, reacted stupendously irrationally and censored their opponents who said that perhaps we should keep things running as normally as possible and shelter the vulnerable. That was the consensus disaster response plan until George Bush took guidance from some girl's school science fair project.


Despite those precautions lasting until we got vaccines, the world life expectancy dropped noticeably:

https://commons.wikimedia.org/wiki/File:Life_expectancy_in_s...

https://ourworldindata.org/life-expectancy

> That was the consensus disaster response plan until George Bush took guidance from some girl's school science fair project.

I have no idea what you're referencing, but you do realise Bush wasn't in charge of the world even before he stopped being president, right?


I agree with most of what you said, but most people I know didn't assume or believe that exposure automatically meant infection. At the very least, we all found this out empirically very early on. Someone would get COVID and then text everyone they'd been in proximity with (even masked, 6 feet away, etc.) for the past week or so to let them know. Only a small percentage of the people exposed ended up getting sick in most of those instances. And even in cases where a decent percentage of people got sick (say someone had an indoor gathering that wasn't well ventilated), it was never 100%.

Sure, some of that was probably due to masking and distancing sometimes being effective. But most people I know intuitively got the idea that sometimes your body can fight off certain amounts of the virus, and you never actually become infected enough to test positive or show symptoms.

And yeah, there were some people who I didn't see at all for like 3 years. While I may have thought that was a bit much, that was their comfort level, so... so be it.


People saw, but how many really saw? Not many, I think. My post is now sitting at -3 (as expected), which is what usually happens on HN COVID threads whenever a new chunk of the narrative falls off and someone points out it was known from the start.

Whilst some people might have seen and registered the mismatch in private, very few were willing to point it out in public. Instead people acted as if everyone was guaranteed to be infected immediately. This incorrect belief about susceptibility rates was the basis of the models that predicted one giant wave in April 2020, it's what justified all the lockdowns, mandates, travel shutdowns etc. To point out that some people weren't getting sick was to attack the entire COVID narrative, because if you use a correct IFR and multiply by the real immunity rate, you get a number too low to pose problems to the health system.


> if you use a correct IFR and multiply by the real immunity rate, you get a number too low to pose problems to the health system

Both the "correct number" and the "real immunity rate" were not known at the beginning of the pandemic, and, had they been different, many more people could have died before we would have realized and taken corrective action. In the face of these unknowns, wouldn't you agree that being cautious was the more responsible course of action?


They were both known early on thanks to the outbreak on the Diamond Princess, which was a perfectly sealed environment yielding data on the worst case scenario (cruise ships are full of the elderly). Officials just ignored it.

But it was also known that IFRs measured early on in an epidemic are always too high, because the less serious cases don't get reported or detected. There's discussion of that problem in the literature pre-dating COVID. So you'd expect some attempt to compensate for that, which there wasn't.

And finally once more accurate data did become available, epidemiologists typically ignored it. They were still happily publishing models assuming a 1% IFR in 2021.

W.R.T. acting in the face of unknowns, no, would not agree. The precautionary principle can be used to justify literally any action no matter how crazy. It's informally called the politician's fallacy (something must be done, this is something, therefore it must be done). You do have to make decisions based on data. Not having data or understanding doesn't give permission to make everyone do literally anything you want. It means you can't take morally legitimate action until you do have that understanding.


> because if you use a correct IFR and multiply by the real immunity rate, you get a number too low to pose problems to the health system

You don't have to estimate, because the actual outcome in terms of number of infections frequently overwhelmed local health capacity in many countries. Certainly UK policy ended up in a loop of hospital overload -> lockdown -> rate goes down but still prevalent -> unlock -> infection rises.


Lockdowns had no effect on case numbers, as has been proven in several different ways by now. The Swedish healthcare system for example did not collapse.

People's understanding of the hospital situation have been badly distorted by the problem of officials lying about it, which happened distressingly frequently. Officials often just made things up when it came to hospital overload. They knew people wouldn't suspect they were lying and it would make people obey, which seemed to be their only priority :( Consider this case from November 2021 where the head of NHS England said “The NHS is running hot...We have had fourteen times the number of people in hospital with Covid than we saw this time last year”. That was not only a 100% false statement, it was absurd on its face. In reality hospital load was lower, not higher. FullFact wrote about it here:

https://fullfact.org/health/amanda-pritchard-nhs-hospitalisa...

Then when asked why she said that, the NHS lied again! They claimed the comparison was actually between August of each year because there was no more recent data, even as daily updated data could be downloaded from their own dashboard:

https://capx.co/why-is-the-head-of-nhs-england-peddling-dodg...

Nobody in the media challenged any of this. They were happy to repeat her lies uncritically. Now think about how often they did this without getting caught.

This wasn't a UK specific problem. Similar things happened in Switzerland: the government held a press release where they said hospitals were overloaded even as their own dashboards directly contradicted them, showing no unusual level of bed demand. It was remarkable that health officials so frequently said things directly contradicted by their own data, and how no "journalists" ever called them on it. Did these people even realize these dashboards existed at all? Often it seemed not.


Were you on the front lines of the pandemic? Respectfully it sounds like you weren't. When nurses and doctors are using trash bags against a novel disease because supplies have run out—that's posing a problem to the health system. When they have to move ventilators from upstate NY to NYC—that's posing a problem to the health system. You're not going to find a source from an epidemiologist saying 100% of exposures lead to an infection. Otherwise you would have already posted it as part of your conspiracy theory.

They even deployed the national guard in areas to set up tent hospitals because the local hospitals couldn't keep up. The reason saying "not everyone gets sick!!!1!!" attacks the narrative is not because it's correct (although it is). It attacks the narrative because people can be asymptomatic carriers. Can't believe the same shit is being rehashed now, several years into a new endemic illness that could have been overcome with a global version of the lockdowns that Vietnam and China did (until realizing literally no other country cared enough).

Lastly—how the fuck is a government supposed to get the IFR absolutely 100% correct for a novel virus without rolling out mandatory testing and reporting? I don't know what people expect from the government. Magic I guess. Didn't lock down but you should have? Right to jail. Locked down but things weren't as bad as we thought? Right to jail.

The real criticism of the US government should be for the economic policy it chose to pursue over the real lives and health of its citizens. Don't expect that conversation on here.


Also note that in Washington State we had originally received a field hospital, but the quarantine was so effective at preventing our health system from collapsing that the army redeployed it to California by April.

There’s this constant misconception that the quarantine was about keeping people safe from COVID. It wasn’t. What it was about was preventing our hospitals from being so overwhelmed they could no longer treat emergencies or acute medical problems. The trigger for a lockdown here was pretty straightforward: over N% bed occupancy in the state hospital system was the trigger.


Yes, your post is down-voted by a logic and rational thought denialists. You are not attacking the view but you are attacking them because they have become believers of the Covidian Church

This kind of attack on people for disagreeing is what most of us come to HN to avoid. Conspiracy theories are fun entertainment but anathema to discussion.

I downvote comments that are uninteresting. The last thing I want to do is rehash politics that don’t matter anymore. Literally don’t care, stop talking.

Maybe this explains how I haven't gotten it yet despite being in proximity repeatedly (living with) someone who was positive, as well as being in groups where I was the only one who didn't end up with it. Fascinating.

I thought maybe I was resistant because I drink so much water, haha.


You may have had it and just never noticed it.

My wife tested positive, and as a precaution i went in for a test as well. Turns out i also had COVID-19, but during the week or so i tested positive, i didn't feel as much as a slight fever. There were litteraly zero symptoms.

My wife also had a pretty mild case, although it was more like a bad cold, and the kids had the same experience as me, zero symptoms.


I had the opposite. My wife and I sat in front of a lady hacking and blowing her nose on a 6 hour flight. A few days later my wife was sick and tested positive after 2 days. I was sick a day later, same symptoms, and never tested positive once after 3 tries. Possible we were sick at the same time with the same exposure with 2 different things? Maybe? But unlikely to me since we'd been on vacation together and to the same places for the last 10 days. Both of us were in the mild symptoms/cold symptoms range, so I also wonder if a home test just wasn't sensitive enough for me to test positive on for some reason.

I considered this, but tested frequently, always negative.

It also would've been likely I'd have transmitted it to someone and heard they got sick after I was with them.


> I thought maybe I was resistant because I drink so much water, haha.

I hope that was a joke.


^^ Obviously it's very unlikely to have significant effect, my family was amused because it's the only obvious thing I do differently from most people.

Understanding better this defense mechanism could allow us to understand even better of how it can be breached and design ... oh, wait...

My next question is, who has the gene HLA-DQA2 and why.

Parkinson's disease-associated SNP4 is correlated (r2=0.95) with variants that are associated with HLA-DQA2 expression.

https://www.ncbi.nlm.nih.gov/gene/3118#:~:text=HLA%2DDQA2%20....


Dang... safe from covid but at what cost

This is how genes like that evolve.

Keeps you alive at 30, kills you at 70. You got to reproduce so it counts as a win for evolution!


This is super irrelevant, sorry but the size is just too small



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