On Understanding Our Immune System

Last week, The Atlantic provided a good overview of the human immune system and related pandemic dynamics in “Immunology Is Where Intuition Goes to Die: Which is too bad because we really need to understand how the immune system reacts to the coronavirus” by Ed Yong. The following are selected excerpts:

• “The thing is, the immune system is very complicated. Arguably the most complex part of the human body outside the brain, it’s an absurdly intricate network of cells and molecules that protect us from dangerous viruses and other microbes  … Immunology confuses even biology professors who aren’t immunologists.

• “Even the word immunity creates confusion. When immunologists use it, they simply mean that the immune system has responded to a pathogen—for example, by producing antibodies or mustering defensive cells. When everyone else uses the term, they mean (and hope) that they are protected from infection—that they are immune. But, annoyingly, an immune response doesn’t necessarily provide immunity in this colloquial sense. It all depends on how effective, numerous, and durable those antibodies and cells are.

• “Immunity, then, is usually a matter of degrees, not absolutes. And it lies at the heart of many of the COVID-19 pandemic’s biggest questions. Why do some people become extremely ill and others don’t? Can infected people ever be sickened by the same virus again? How will the pandemic play out over the next months and years? Will vaccination work?

• “Immunity lasts a lifetime for some diseases—chickenpox, measles—but eventually wears off for many others. As the pandemic drags on, we should expect at least a few instances in which people who’ve beaten COVID-19 must beat it again … If people endure a second bout with COVID-19, the outcome is again hard to call.

• “But for next year and beyond, modeling studies have shown that the precise details of the immune system’s reactions to the virus, and to a future vaccine, will radically affect our lives. The virus could cause annual outbreaks. It might sweep the world until enough people are vaccinated or infected, and then disappear. It could lie low for years and then suddenly bounce back. All of these scenarios are possible, but the range of possibilities will narrow the more we learn about the immune system.”

The full article, which is worth reading, is here  

OUR TAKE

• Given the complexity of human physiology, managing COVID-19 will 1) require a variety of vaccine and treatment approaches and 2) bringing solutions to market will likely take longer than expected.

• There is a need to better understand 1) what happens after a person is infected and 2) the longer-term health issues (e.g., lung, nervous system and heart problems.)

• Efforts in addressing COVID-19 may result in new health care insights, including better approaches for testing, cost management and therapy delivery.