Diary

Wash Your Hands


I wanted to publish this quoted article as something of value even though it’s source is a bit away from my usual references. I think the INFO is worthy your consider.

It’s so easy to react to COVID as if it was an isolated event in history. Seeing life in situ rather than in isolation seems to be a disappearing art. The world has cycles and patterns. Isolating our view of phenomenon only puts us at a disadvantage in a universe that functions with rigid laws and infinite variability. We cannot change gravity. All humans will die. The universe has no obligation to listen to our opinions. We have to fit into the bigger world, not the other way around.


Ever wonder why those signs are in the bathrooms at restaurants that say: All Employees Must Wash Their Hands? Well, take a little medical and historical journey with me as we address another comment/question I received that again had nothing to do with kink. The comment asked if “natural” immunity wasn’t as good or better than vaccination. The answer is absolutely positively no, with one slight caveat. But back to history. Bear with me.

Mary Mallon, a young Irish immigrant, got typhoid fever (caused my Salmonella typhii) at some point, and recovered. But Mary didn’t actually completely recover. Her immune system kept her disease in check, but allowed the bacteria to happily keep living in her gut. Mary became an asymptomatic carrier. Typhoid fever is spread by fecal-oral contamination (just like polio). Mary and the bacteria were locked in a stalemate, neither side killing the other. As far as anyone could tell, Mary Mallon was healthy, but she wasn’t. Mary was also a cook. A cook who didn’t wash her hands. Every time Mary defecated, she would contaminate her hands. The hands that then went on to handle the food she was serving to people. If Mary hadn’t been a cook, or if she had practiced correct hygiene, the world would never have heard of her. But since she was and she didn’t, you know her as “Typhoid Mary”. Hence, the little signs in the restaurant lavatories. 

The term “natural” immunity is a misleading term. The correct terminology is “disease-induced immunity”. The word “natural” was coined by people who have an anti-vaccine agenda. It was not by accident. Just as anti-abortion people are “pro-life” and the other side is “pro-choice”. If one side was “I’m going to force you to carry an unwanted fetus” and the other was “I want to kill my baby”, well, neither side would have much support, I suspect. Natural sounds nice, like organic. It has to be good if it’s natural, right? Well, uranium, radon, cyanide, hemlock, and gamma rays are completely natural, and I would not recommend exposing yourself. Also, that natural red dye in foods? It’s ground up beetles. Sounds less appealing now, eh? 

So the question is really “is disease induced immunity better than vaccine induced immunity?” No. Why? Because to have disease induced immunity, you have to have disease, and that disease can kill you at worst, make you very sick and let you spread it to other people, or give you long term disabilities. Just like Polio: if you survive it, you’re immune, but possibly paralyzed. Do you want Polio or do you want the vaccine?

As for Covid, vaccine induced immunity is very good. There is a .001% chance that the vaccine could harm you. Whereas, there is a much, much higher chance that Covid can harm you. In fact, 20% of you will end up in the ICU, and 5% of those in ICU will die. But people are very bad when making rational risk decisions. We get in our cars, where you have a much higher chance of dying every day than having a vaccine related hospitalization or death. Also, since the vaccines are biotechnology wonders, you don’t actually get the virus, so there is no chance of you getting the actual disease. But people are not good at understanding abstract concepts. This doesn’t just apply to medicine. Humans have implicit bias that is hard to overcome, regardless of what the math actually tells us. And people, by and large, don’t understand how vaccines work. It’s not your fault. The terminology is designed for scientific accuracy, not general understanding. 

Now here’s the little caveat, and I’m going to use some terminology that might require explanation. Vaccine induced immunity (at least with the current vaccines) is humeral immunity. That means the virus can and does enter your nose and mouth and can start a local infection before the antibodies (IgG and IgM) in your blood can attack it. So, you might get a little sick if you have an otherwise normal vaccine response. People with disease induced immunity have local immunity as well. There are IgA antibodies in the lining of their upper respiratory tract that can prevent the virus from getting any farther. Still, you have to survive a potentially fatal disease to get it, and, just like Mary Mallon, we do not know if asymptomatic carriers exist. There could be Covid Marys out there. Now, there are ways of designing a vaccine that provides local immunity. Back to our polio example, the oral vaccine worked better because polio enters through the GI tract, and the oral vaccine induced local immunity. A nasal spray Covid vaccine would likely do the same, if it can be developed. The goal in this case was to get an effective and safe vaccine as fast as possible, because this disease kills. It’s not perfect, but you are far, far less likely to get sick, and if you do, you are far, far less likely to get more than a little sick. There will be even better vaccines as time goes by, but you don’t have the luxury of spending 10 years developing a new vaccine in a pandemic. Don’t get me wrong; these weren’t “rushed”, they just used technology already developed for different diseases. mRNA vaccine work was done over many, many years (actually for Ebola).

The biggest problem, to be honest, is under vaccination. And I don’t just mean the percentage of people in rich countries that have the luxury of choosing not to get a vaccine. I’m talking about the billions of humans who do not have access to vaccines and who are currently serving as incubators for new and more deadly strains. This corona virus is a little unusual in that it has a higher tendency to mutate than most. That is the most significant problem we face. This disease is not going away until the majority of humans on the planet get vaccinated. It’s probably never going away regardless. It will go from pandemic to endemic, which means you’re gonna have to get vaccine top ups based on whatever strain is floating around (just like influenza). And that also means that disease induced immunity is also going to be less effective, FYI. That’s why you get colds every year. You’ve got disease induced immunity, just not to the newest strain running around.

I hope that answers the commenter’s question. I promise to get back to out regularly scheduled programming.

-Doc

thelockeddoc.com

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