Many people who live in New York, a Covid hotspot from the beginning of the pandemic, seem never to have been infected. That’s true for a number of people in other places too.
As Lauren Mechling, a Brooklyn writer, tweeted recently, “To my fellow nyc humans who have never knowingly gotten Covid, what is the theory? That we actually did and never realized it, right?”
There are plenty of possible answers, as people replied to her via Twitter.
Some people had Covid but were asymptomatic.
Some were symptomatic but couldn’t get tested or didn’t believe the test results (which aren’t always accurate.
Some just didn’t get it, although they were exposed.
After the Gridiron gathering in Washington where so many people went unmasked and caught Covid, some people are wondering why they didn’t get it. One such person is Anthony Fauci, the national “covid czar.”
People not getting tested for Covid
Of course it’s possible that people do have Covid but just aren’t getting tested.
“‘I do think we are in the middle of a surge, the magnitude of which I can’t tell you,’ Zeke Emanuel, vice provost of global initiatives at the University of Pennsylvania, said,” NBC reported.
“Emanuel and other experts cite a lack of testing as the primary reason cases go underreported. At the height of the omicron wave in January, the U.S. was administering more than 2 million tests per day. That had dropped to an average of about 530,000 as of Monday, the most recent data from the Centers for Disease Control and Prevention.
” ‘The milder symptoms become, the less likely people are to test or show up in official case counts,’ said David Dowdy, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health.”
Covid testing inaccurate
Sometimes the tests are just wrong — or are taken too early. I have a friend who traveled overseas with a small group; the members of the group started to feel sick as they were scheduled to leave the country. Two had to stay behind, because they were barred from travel.
Arriving in the U.S., other members started to test positive. My friend had symptoms but didn’t test positive on nine tests taken over four days — a combination of rapid, in-home and PCR tests. Finally, on the 10th test, she was positive.
Because she had had Covid before, and because the circumstances suggested strongly that she had it again, she acted as if she had it. But her experiences point again to the mystery of the inaccurate tests — especially confounding now in allergy season, with the BA.2 variant on the rise.
We’ve been writing about the problem of inaccurate tests since April 2020. It’s also clear that the rapid tests and in-home tests are less accurate than the PCR.
Not everyone exposed to Covid gets it
Of course, not everyone who gets exposed to Covid actually gets it. That’s a mystery that’s waiting for an answer.
My daughter who was living with me while I had it didn’t ever test positive for antibodies. One of my friends never got it, though her husband did — and she shared a bed with him the night before he tested positive.
Dr. Dave Lee, a New York emergency room doctor who’s studied Covid infections, pointed out that “the vast majority of people infected with the polio virus don’t get polio.”
Similarly, he noted that infection with the Epstein-Barr virus, which causes mononucleosis, has been implicated in multiple sclerosis. “But the vast majority of people with EBV don’t get MS.”
He did say an outsize autoimmune reaction appears to be one of the signifiers of serious illness.
Coronaviruses in general are not that fierce, he said; they might cause croup or a little cold in some people. But for people who are susceptible to an adverse immune reaction, it might be worse. The same is true for something like a peanut allergy, he said; for most people, a peanut doesn’t cause any problems. But if you are susceptible, that peanut will spark a severe immune reaction.
“For most of us, we eat a peanut, our body doesn’t recognize it as some thing that it needs to, like go crazy about,” he said. “The SARS-COV-2 virus is like a cold virus and something that not everybody needs to go crazy about.
“Some people eat a peanut and basically their immune system goes in starts an allergic reaction that could literally kill them. And similarly, the SARS-COV-2 infection for subset of people: When they get infected, their immune system starts off the reaction that literally can kill them, or leave them debilitated. So that’s how I see it.”
Do some people fight off Covid? Who and how?
Anecdotal evidence exists that some people can resist Covid. But who are they? A group of scientists worldwide are partnering on the Covid Human Genetic Effort, which “aims to discover truly causative genetic and/or immunological anomalies, rare or common, and decipher in depth the molecular, cellular, and immunological mechanisms by which they underlie resistance to viral infection or disease, or predisposition to one or another form of severe disease,” according to the group’s site.
Among other things, they are examining what genetic factors may be present in people who were exposed and don’t get sick, as well as factors present in people who get extremely severe cases.
A recent paper published in Nature, with the effort as one of the co-authors, said, in part: “SARS-CoV-2 infection is benign in most individuals but, in around 10% of cases, it triggers hypoxaemic COVID-19 pneumonia, which leads to critical illness in around 3% of cases. The ensuing risk of death (approximately 1% across age and gender) doubles every five years from childhood onwards and is around 1.5 times greater in men than in women. Here we review the molecular and cellular determinants of critical COVID-19 pneumonia. Inborn errors of type I interferons (IFNs), including autosomal TLR3 and X-chromosome-linked TLR7 deficiencies, are found in around 1–5% of patients with critical pneumonia under 60 years old, and a lower proportion in older patients. Pre-existing auto-antibodies … which are more common in men than in women, are found in approximately 15–20% of patients with critical pneumonia over 70 years old, and a lower proportion in younger patients. Thus, at least 15% of cases of critical COVID-19 pneumonia can be explained.”