I'm not worried

[mellowtigger]

I was pleased to see this article appear on MSN a few days ago. The important point is that one of the images shows the possibility of "Viral persistence" in the GI tract. Technically, it is mostly old news, especially if you've been reading here over the years. That graphic they show in slide #3, for example, is information from this article in Nature Review Microbiology from 2023 January 13. I'm glad it's finally making mainstream news, even if it's buried in the story. That Nature article has over 1,000 citations, so I find it reassuring that it's being discussed broadly.

The USA's NIH Director, Dr. Monica Bertagnolli, spoke on video and said the following:

We see evidence of persistent live virus in humans in various tissue reservoirs, including surrounding nerves, the brain, the GI [gastrointestinal] tract, to the lung. ... The virus can persist in tissues for months, perhaps even years.

But if you read the written article (and extra archive copy) around that video, you'll note that hugely important Editor's Note at the top where NIH stepped in and insisted the Doctor didn't say what she said. The clarification they intend to insert potentially could be a valid interpretation of what she said, but her words also could mean exactly what they sound like. The interviewer backtracked and asked her again point-blank if viral persistence is really what she meant, and she said it was. I think the powers-that-be are sweating at the thought of their legal culpability when viral persistence is resolutely demonstrated, more than the smaller studies we have today that continue to suggest persistence. Our government told us the danger was over. They told us to give up precautions, while simultaneously telling us to remain cautious. (So it's not technically their fault if we misinterpreted the danger, right? Or so I expect they are hoping.) At least the mocking of their ridiculous directives (and more of it) was entertaining.

Anyway... you've heard of the new potential dangers of measles (Illinois, California, Ontario) and H5N1 (9 states)?

You're still maintaining your SARS-CoV-2 precautions, aren't you? You still maintain social distance and always mask around others, right? I do, and I still wipe my groceries after I get them home, and I'm not at all worried about potential outbreaks of measles and H5N1, both of which can be airborne too, however inefficiently. The one concession I've made is that I no longer put a raw egg into my orange julius smoothie. Any bird- or cow-related products must be thoroughly cooked. That's it. That's all I'm doing "extra" for these potential problems. Because the world changed in 2019 December, and I'm living in the new reality rather than trying to live in the past. Until businesses and governments realize that human settlements need air quality systems, the same way we need water systems for good health, I'm maintaining my own precautions.

I'm not worried.

Comments

[rebeccmeister]

Having not read the specific studies referenced: in which patient populations were persistent reservoirs studied? Those who experienced asymptomatic infections, or those who experienced severe systemic infections to the point where they were hospitalized such that it even became possible to sample those specific tissues?

Shingles doesn't sound like much fun, either; shingles are the result of persistent chicken pox virus that has emerged from an extended lysogenic phase and gone back into a lytic phase.

I also found it quite interesting (but also sad) that people have finally drawn a connection between Epstein-Barr and multiple sclerosis.

This is not to say that one should completely throw caution to the wind. Just to point out that there's almost always more to the story, and many factors to consider when deciding what sorts of risks to take.

There's a part of me that would like to believe that any reasonable and curious person can successfully self-educate, but I have to say that by now on that subject I also have some doubts.

[mellowtigger]

I backtracked that Microbiology article to what seems the initial claim of persistence at this article from all the way back in 2020 October. They had 21 people who were rehospitalized (indicating severe disease) and confirmed the second instance was the same viral infection (rather than reinfection), thus a rebound. That's old, though. The Lancet letter notes 9 studies that provided what the authors describe as "conclusive evidence for persistent SARS-CoV-2 infections", and those studies are from 2022 or 2023. At least four of those studies did include people who were known immunodeficient beforehand. (Since SARS-CoV-2 infection itself is known to affect the immune system, that might have something to do with the increasing chance per infection of developing Long Covid, finally reaching a threshold where it establishes permanence.) It calls for more studies, so we have better details about the percent chances and kinds of persistence, since SARS-CoV-2 seems to display all 3 that I've read about: immune privileged organ, syncytial spreading, or immune system compromise.

[rebeccmeister]

Thanks!

One of the big outcomes of the pandemic for me was developing a far better understanding of the concept of viral load, and why it can be extremely important to do everything possible to reduce viral load if/when one contracts an infection, whether SARS-CoV-2 or otherwise.

One reason why this doesn't get talked about as frequently when talking about potential treatments is because many of the methods that should get used to reduce viral load don't have major money-making opportunities attached to them. Paxlovid is one exception in that it is getting promoted, but then again, in my (certainly limited!) view it isn't that great a tool because there's still a rebound that happens.

Other methods include ramping up sick room air filtration (and/or overall ventilation - keep the windows open!), saline nasal rinses, and antiviral or virus-reducing nasal sprays. It seems that infections get started in the sinuses before migrating to other, more troubling destinations (deep in lungs; nervous tissue).

I also definitely now think differently about sharing air with other people, but weigh a range of factors when deciding how I will approach any particular situation. I will always and forevermore fly masked, but I will generally not mask up to teach or visit coffeeshops or restaurants at this point, unless I start to see signs of very high local disease transmission rates again. (e.g. stuff getting spread in the communal living situation of a college campus...which absolutely and definitely happens.).

[mellowtigger]

I've read many times over the years that people who survived the Great Depression tended to maintain behaviors that were, let's say, not well adapted to a new environment of plenty. I survived the last epidemic, and this new one provides several uncanny similarities that prompt a similar response.

epidemic #1	epidemic #2
initial infection can present as a mild flu, easily dismissed afterward	initial infection can present as a mild flu, easily dismissed afterward
the virus infects CD4 T cells and destroys them through apoptosis	the virus infects CD4 T cells and destroys them through apoptosis
many people who actively shed virus are asymptomatic	40% of people who actively shed virus are asymptomatic
most people who die are undesirable because of [x] or [y] trait anyway, so why mobilize government to create an effective prevention strategy?	most people who die are undesirable because of [x] or [y] trait anyway, so why mobilize government to create an effective prevention strategy?

Based on my experience, surviving an epidemic is about equal parts effort and luck. The effort I made was a common refrain in those days, "Expect everyone you meet is infected and shedding virus, then you conduct yourself safely for that situation." I didn't seroconvert last time, and I hope to stay the same this time. Years ago, I already had a deep vein thrombosis that doctors never explained why it formed, so I shouldn't risk a virus that causes clots. I don't expect other people, those who didn't experience the 1980s/90s the same way I did, to react the same way this time as last time. But I often feel like Larry Kramer when I keep advising, "Don't risk it. Stay safe out there." I want to see that everybody lives.

[rebeccmeister]

Thank you for taking the time to highlight where you are coming from! You make some good points here, all around.

[kathmandu]

Yes, I'm continuing covid precautions too. The beauty of that is since so many things are airborne / aerosol spread, and Covid is more catching than most of them, this also protects against flu, measles, etc.