This is a case update. I’ll also talk briefly about ADE and it’s impact on the current pandemic and the potential impact on the next SARS virus, if one ever happens.

Cases in the US continue to rise slightly. Outbreaks continue in Michigan, with some new cases also in the Greater New York Metro area and the Texas panhandle. Why is Michigan having such a hard time? Frankly, I’m a little mystified, especially since Michigan has been in strict lock-down through much of the pandemic. It’s now well known that the viral load upon infection has a large impact on the severity of COVID symptoms. Those who get a low viral load upon exposure have lower symptoms. I will speculate and say that perhaps some states with very strict lock-downs caused people to interact in ways that encouraged larger viral loads upon infection, like being with groups of people in private homes. Again, I’m just speculating. This may also explain the large and sustained number of cases in LA county this Fall and Winter.

California and San Diego County both have come to an equilibrium, with approximately 3000 and 200 new cases a day respectively. Neither appears to have experienced an Easter related bump in cases. The new lower caseload in the US is likely related to vaccination and natural immunity, and is likely to become lower still as we head into Spring and Summer.

Internationally, the caseload continues to increase, almost to Winter peak numbers.

ADE and the next SARS virus: I wanted to explain a little more about my continued concerns about ADE. As the pandemic progresses and we have numerous variants circulating around the world and the US, ADE does not appear to have had an impact on the current situation. This is certainly good news. If it did have an impact, we would be seeing additional deaths from the new variants, which we do not.

My continued concern comes because ADE impacts our ability to fight the NEXT virus. SARS viruses (SARS, MERS, SARS-2) have the ability to easily infect the immune systems of those previously infected with closely related but different strain of the virus. If a future strain of SARS comes out, let’s call it SARS-3 for now, ADE may become a big deal. I stress that this is only theoretical at this point. SARS was moderately infectious, but also very pathogenic, giving all known patients severe symptoms and killing 10%. It was actually less dangerous globally, since outbreaks tended to be detected early and quickly snuffed out. SARS-2 is highly infectious, but much less pathogenic. It’s greater global impact came from it’s very high infectiousness and very long incubation time, being passed even from pre-symptomatic patients. The tendency of all viruses is to become more infectious and less pathogenic over time, a pattern followed by SARS and SARS-2. If we have a SARS-3 someday, it will likely be even more infectious than SARS-2, but less pathogenic. On the other hand, MERS is more pathogenic than SARS, so this pattern doesn’t always follow. The next time another SARS coronavirus breaks out, we will need to be very careful initially until we understand the parameters of the new virus.

So what do you do if you had COVID or had a COVID vaccine if a SARS-3 comes out? If that happens, vaccine production will likely be much faster than this time. Be very careful with the virus initially, and get the new vaccine as soon as it is available to you, because you may be at greater risk for severe symptoms. I know some of this is confusing and counter-intuitive! Feel free to ask questions below!

Don’t fear, but be smart!
Erik