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Covid Basics: Vaccines, Natural Immunity, Ivermectin and other Treatments

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Written by Marvin Keshner

I am trained as a Scientist, with a PhD in Electrical Engineering from MIT.   I worked for Harvard Medical School for 3 years in the 1970’s with the Framingham Study group that pioneered long-term human studies and proved that daily exercise can reduce the risk of heart attacks.

People need simple, balanced, and clear information from which to make their decisions.   Recently, while in line for a Covid test, my wife and I met a very sick, woman in her thirties.   She was running a 103 fever, and could barely talk or swallow.  We asked if she had been vaccinated.  “No.  There’s so much confusing information.  I didn’t know who to believe.”

Your immune system protects you.   If you have a weak immune system, you are more vulnerable to Covid.   A healthy lifestyle helps your immune system stay strong.  Daily multi-vitamins and extra vitamin D and zinc can help.   Excess weight, smoking, diabetes and other factors weaken your immune system.

Vaccines train your immune system to recognize a key part of the virus.   Your immune system responds to the vaccine by making billions of antibodies that stay in your bloodstream and immediately attack the virus, if you get infected.   In addition, the vaccine trains your immune system to make more antibodies when needed.   After 8 – 12 months, the level of antibodies in your bloodstream declines.  Antibodies are proteins, and proteins don’t last forever.   Without a high level of antibodies in your bloodstream, your response to Covid is slower.   When infected, your immune system takes several days to rev up and produce new antibodies.   Hence, the need for booster shots.

Without a vaccine, your immune system will detect the virus and respond.   However, without the training from a vaccine, your immune system response is much slower.   This gives the virus more time to replicate and infect millions of cells in your nose, throat, and lungs, and in blood vessels throughout your body.   This is why people without a vaccine get sicker and are of greater risk for hospitalization, long-term disability, and death.

After a serious case of Covid, your immune system has now trained itself.  You have developed natural immunity.   You will have antibodies in your bloodstream and are able to make more, when needed.  Like a vaccine, depending on which parts of the virus your immune system targeted, you may or may not have a strong response to the next Covid mutation.

Viruses mutate.   They take over your cells and make copies of themselves.  Often, the copies contain mistakes.  These bad copies are called mutations.   The vast majority of the mutations do not survive.   They don’t work.   A very, very small number of these bad copies do still work and try to go out, infect more cells and make copies of themselves.   Once in a blue moon, a mutation not only works, but is more effective in some way.

Wuhan, China The original virus from Wuhan, China was slow.   The first successful mutation developed in Europe and came to New York.   It transmitted much faster and quickly become the dominant variant.   Now, we have Covid Delta, which developed in India, and is the fastest and more contagious of all.  Delta is very fast and jumps off to an early lead over our immune systems.   Even young people, with their very strong immune systems, get sick.   Fortunately, for most young people, their immune system catches up and wins the war.

All of these variants developed at times and in places where there was no vaccine.   Vaccines did not create the mutations.  Mutations are an integral part of a virus spreading.   With more cases, there is more chance for the virus to spread, and more chance to create an effective mutation.   The only way to stop mutations is to stop the spread of the virus, not just in the U.S., but throughout the world.

In the U.S., if we continue to allow the virus to spread among unvaccinated people, eventually, at random, a mutation will occur that may be resistant to the vaccine.   This mutation will be able to inflect both vaccinated and unvaccinated people and will become the dominant strain.  We must stop the spread.  Every Covid case gives the virus another chance to develop an effective mutation.

Breakthrough cases There is much confusion about the role of vaccines.   Covid vaccines will not beat Covid by stopping every case.   There will always be breakthrough cases.   Vaccines beat Covid by reducing its ability to spread.   With a vaccine, people are 8 – 10 times less likely to become infected.   Their bodies quickly beat the virus and are only infectious for about 3 days.   Without a vaccine, it takes much longer for one’s immune system to rev up and beat the virus.   On average, without a vaccine, people are contagious for 10 – 15 days.  Combining these two effects, with a vaccine, people are more than 25 times less likely to infect other people—25 times less likely to spread Covid.

Covid vaccines not only will stop the spread, they will also protect you from hospitalization, long-term disability, and death.   In the U.S., almost 90% of people with Covid are not vaccinated.  Almost 90% of hospitalized Covid patients are not vaccinated.   Almost 90% of people dying from Covid are not vaccinated.

Slow the Spread In an unvaccinated population, without masks and without social distancing, on average, every person who gets Covid Delta infects 8 others.   The virus grows from 1 person to 8 people to 64 people and so on—increasing exponentially.  When everyone is vaccinated, each infected person infects less than 1 new person.   Plus ….  with masks and social distancing, an infected person exposes very few others.   Then, instead of growing exponentially, cases decline.   Eventually, daily new cases are very low, the risk of being exposed to Covid is very low, and masks and social distancing are no longer required.

We can and will vaccinate our way out of this pandemic.   We have successfully vaccinated and beat smallpox, which is more deadly than Covid.  We beat polio, which is more debilitating, and measles, which is more contagious.   Covid Delta is almost as contagious as measles.  We will need about 85% (280 million) of our people either vaccinated or recovered from a significant case of Covid with natural immunity.   Currently, almost 210 million Americans have had at least one shot.   In addition, 30 – 40 million Americans have had a serious enough case of Covid to have developed natural immunity.   By December, we are likely to have a vaccine approved for kids 5 – 11.   Thus, we should be able to reach 85% in January, and hopefully sooner.

Safety Many people are concerned that Covid vaccines are too new and may not be safe enough.   mRNA vaccines like Pfizer and Moderna have been in development for 17 years, since after the 2003 outbreak of SARS, and during the 2012 outbreak of MERS—both caused by a Corona virus.  After 9 months and a billion shots, we have a good handle on short-term side-effects.Serious side-effects are very rare and easily treated.

However, the vaccine has only been used in humans for less than a year. We could find a previously undiscovered long-term side-effect. Again, the risk is low and must be compared with the risk of getting long-haul Covid.  One is unknown and unlikely.  The other is well-known and highly impactful.  After being sick with Covid, even if you were not hospitalized, about 30% of people have continuing symptoms, like brain fog and days of low energy. Some have developed internal blood clots that have damaged their lungs, heart, kidneys, or brain.

Treatments Vaccines, masks and social distancing are powerful tools, but we should also have effective treatments for people who have Covid.   Right now, the only proven treatment is monoclonal antibodies, which was given to President Trump, along with a steroid to prevent his immune system from overloading.  Unfortunately, this treatment is expensive, difficult to manufacture and not widely available.   Also, it is only effective if administered in the first few days, before a person is very sick.  Sadly, most people do not seek treatment until after they are very sick.   Often, it’s too late for the monoclonal antibodies to be effective.

Ivermectin may turn out to be a successful treatment for Covid.  We just don’t know yet. The excitement over Ivermectin started with a small group of human cells, grown on a plate and then infected with Covid.   This cell culture responded to Ivermectin as a treatment.   This was very, very encouraging.   Normally, this is the first step in a long process.   The next step is to test in animals, then a small group of humans, and finally a large group of humans.   Many promising drug treatments fail somewhere along the way through this process.  The human body is very complex.   What works in a small group of isolated cells often does not work in the human body.

The excitement over Ivermectin was greatly diminished when reviewers noticed that some of the first human test data in the pioneer paper was faked, and the paper was withdrawn.    Please see the discussion in Nature:   Nevertheless, there is a community of researchers who are undaunted and determined to do these studies carefully.  They are committed to proving that Ivermectin is an effective treatment for Covid.  I hope they succeed.  We need an inexpensive and effective treatment.

Unfortunately, many people are sick now and cannot wait several months for the results of a careful study.   They have been told that Ivermectin is as safe as aspirin, to which I would note that, like all drugs, aspirin has side-effects; it can cause stomach ulcers and lead to excessive internal bleeding.

There are many questions about Ivermectin that need to be answered.  Is Ivermectin effective?  Does it work when a person is already very sick?  In what dose?  At that dose, is it still safe?  At the required dose, does it have side-effects?  Can those side-effects be easily managed?

We know that a large dose of Ivermectin is putting people in the hospital.  What we don’t know is whether or not a safe dose will be effective.   We also don’t know if, like the treatment with monoclonal antibodies, Ivermectin is only effective when accompanied by a steroid that keeps the immune system for overreacting.  Let’s get the answers to these questions as soon as possible.   Effective treatments for Covid would be a big step forward.

Human health studies are very tricky to do right.  There are so many factors.  It’s so easy to jump to conclusions that turn out to be incorrect.  For example, if someone gets sick within a week of taking a drug or vaccine, was it the “cause”, was it one of many factors, or was it a coincidence. The only way to be sure is with a careful study, with large groups of people, in which one group gets the drug or vaccine and the other group does not.  The groups have to be carefully matched in age, health, sex, etc.

Israel As another example, the data from Israel that led them to start vaccine booster shots may not support booster shots for everyone at 8 months. The people who got the shot first were not a representative group.   They were old, often in poor health, and with weak immune systems. That’s why they got the shots first–to protect them.   Their immune system’s response would not be representative of the general population.   While many people over 70 have a number of health conditions, many others are quite healthy with a strong immune system for their age.   Recognizing this issue, our CDC has asked for a study with a more representative group before recommending boost shots for everyone.