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Can You Become Immune to the Coronavirus? Can You Become Immune to the Coronavirus?
(7 days later)
As the number of people infected with the coronavirus surpasses 450,000 worldwide, and more than one billion are locked in their homes, scientists are wrestling with one of the most pressing questions of the pandemic: Do people who survive the infection become immune to the virus?As the number of people infected with the coronavirus surpasses 450,000 worldwide, and more than one billion are locked in their homes, scientists are wrestling with one of the most pressing questions of the pandemic: Do people who survive the infection become immune to the virus?
The answer is a qualified yes, with some significant unknowns. That’s important for several reasons.The answer is a qualified yes, with some significant unknowns. That’s important for several reasons.
People who are confirmed to be immune could venture from their homes and help shore up the work force until a vaccine becomes available, for example. In particular, health care workers who are known to be immune could continue to care for the severely ill.People who are confirmed to be immune could venture from their homes and help shore up the work force until a vaccine becomes available, for example. In particular, health care workers who are known to be immune could continue to care for the severely ill.
Growing immunity in the community also is the way the epidemic ends: With fewer and fewer people to infect, the coronavirus will lose its toehold and even the most vulnerable citizens become more insulated from the threat.Growing immunity in the community also is the way the epidemic ends: With fewer and fewer people to infect, the coronavirus will lose its toehold and even the most vulnerable citizens become more insulated from the threat.
Immunity may also bring an early treatment. Antibodies gathered from the bodies of those who have recovered may be used to aid those struggling with the illness caused by the coronavirus, called Covid-19.Immunity may also bring an early treatment. Antibodies gathered from the bodies of those who have recovered may be used to aid those struggling with the illness caused by the coronavirus, called Covid-19.
On Tuesday, the Food and Drug Administration approved the use of plasma from recovered patients to treat some severe cases. A day earlier, Gov. Andrew M. Cuomo announced that New York would become the first state to begin testing serum from people who have recovered from Covid-19 to treat those who are seriously ill.On Tuesday, the Food and Drug Administration approved the use of plasma from recovered patients to treat some severe cases. A day earlier, Gov. Andrew M. Cuomo announced that New York would become the first state to begin testing serum from people who have recovered from Covid-19 to treat those who are seriously ill.
“It’s a trial for people who are in serious condition, but the New York State Department of Health has been working on this with some of New York’s best health care agencies, and we think it shows promise,” Mr. Cuomo said.“It’s a trial for people who are in serious condition, but the New York State Department of Health has been working on this with some of New York’s best health care agencies, and we think it shows promise,” Mr. Cuomo said.
The body’s first line of defense against an infectious virus is an antibody called immunoglobulin M, whose job is to stay vigilant in the body and alert the rest of the immune system to intruders like viruses and bacteria.The body’s first line of defense against an infectious virus is an antibody called immunoglobulin M, whose job is to stay vigilant in the body and alert the rest of the immune system to intruders like viruses and bacteria.
Days into an infection, the immune system refines this antibody into a second type, called immunoglobulin G, exquisitely designed to recognize and neutralize a specific virus.Days into an infection, the immune system refines this antibody into a second type, called immunoglobulin G, exquisitely designed to recognize and neutralize a specific virus.
The refinement may take as long as a week; both the process and the potency of the final antibodies can vary. Some people make powerful neutralizing antibodies to an infection, while others mount a milder response.The refinement may take as long as a week; both the process and the potency of the final antibodies can vary. Some people make powerful neutralizing antibodies to an infection, while others mount a milder response.
The antibodies generated in response to infection with some viruses — polio or measles, for example — bestow a lifetime of immunity. But antibodies to the coronaviruses that cause the common cold persist for just one to three years — and that may be true of their new cousin as well.The antibodies generated in response to infection with some viruses — polio or measles, for example — bestow a lifetime of immunity. But antibodies to the coronaviruses that cause the common cold persist for just one to three years — and that may be true of their new cousin as well.
A study in macaques infected with the new coronavirus suggested that once infected, the monkeys produce neutralizing antibodies and resist further infection. But it is unclear how long the monkeys, or people infected with the virus, will remain immune.A study in macaques infected with the new coronavirus suggested that once infected, the monkeys produce neutralizing antibodies and resist further infection. But it is unclear how long the monkeys, or people infected with the virus, will remain immune.
Most people who became infected during the SARS epidemic — that virus is a close cousin of the new coronavirus, called SARS-CoV-2 — had long-term immunity lasting eight to 10 years, said Vineet D. Menachery, a virologist at the University of Texas Medical Branch at Galveston.Most people who became infected during the SARS epidemic — that virus is a close cousin of the new coronavirus, called SARS-CoV-2 — had long-term immunity lasting eight to 10 years, said Vineet D. Menachery, a virologist at the University of Texas Medical Branch at Galveston.
Those who recovered from MERS, another coronavirus, saw much shorter-term protection, Dr. Menachery said. People who have been infected with the new coronavirus may have immunity lasting at least one to two years, he added: “Beyond that, we can’t predict.”Those who recovered from MERS, another coronavirus, saw much shorter-term protection, Dr. Menachery said. People who have been infected with the new coronavirus may have immunity lasting at least one to two years, he added: “Beyond that, we can’t predict.”
Still, even if antibody protection were short-lasting and people became reinfected, the second bout with the coronavirus would likely be much milder than the first, said Florian Krammer, a microbiologist at the Icahn School of Medicine at Mount Sinai in New York.Still, even if antibody protection were short-lasting and people became reinfected, the second bout with the coronavirus would likely be much milder than the first, said Florian Krammer, a microbiologist at the Icahn School of Medicine at Mount Sinai in New York.
Even after the body stops producing neutralizing antibodies, a subset of immune memory cells can reactivate a response effectively, he noted.Even after the body stops producing neutralizing antibodies, a subset of immune memory cells can reactivate a response effectively, he noted.
“You probably would make a good immune response before you even become symptomatic again and might really blunt the course of the disease,” Dr. Krammer said.“You probably would make a good immune response before you even become symptomatic again and might really blunt the course of the disease,” Dr. Krammer said.
A crucial question is whether children and adults who have only mild symptoms still generate a strong enough response to remain immune to the virus until a vaccine is available.A crucial question is whether children and adults who have only mild symptoms still generate a strong enough response to remain immune to the virus until a vaccine is available.
Dr. Marion Koopmans, a virologist at Erasmus University in Rotterdam, and her team have screened antibody responses in 15 infected patients and health care workers.Dr. Marion Koopmans, a virologist at Erasmus University in Rotterdam, and her team have screened antibody responses in 15 infected patients and health care workers.
The researchers are also using banked blood samples from about 100 people who were known to be infected with one of four coronaviruses known to cause the common cold.The researchers are also using banked blood samples from about 100 people who were known to be infected with one of four coronaviruses known to cause the common cold.
If those samples show some immune response to the new coronavirus, too, Dr. Koopmans said, it might explain why some people — children, for example — have only mild symptoms. They may have antibodies to related coronaviruses that are at least somewhat effective against the new one.If those samples show some immune response to the new coronavirus, too, Dr. Koopmans said, it might explain why some people — children, for example — have only mild symptoms. They may have antibodies to related coronaviruses that are at least somewhat effective against the new one.
The quickest way to assess immunity is a blood test that looks for protective antibodies in the blood of people who have recovered. But first you have to have the test.The quickest way to assess immunity is a blood test that looks for protective antibodies in the blood of people who have recovered. But first you have to have the test.
Antibody tests are used in Singapore, China and a handful of other countries. But they are just coming to market in much of the West.Antibody tests are used in Singapore, China and a handful of other countries. But they are just coming to market in much of the West.
Last week, Dr. Krammer and his colleagues developed one such antibody test that could be scaled up in “days to weeks,” he said.Last week, Dr. Krammer and his colleagues developed one such antibody test that could be scaled up in “days to weeks,” he said.
The team validated the test in blood plasma taken from three patients with Covid-19. The researchers are seeking speedy approval from the F.D.A.The team validated the test in blood plasma taken from three patients with Covid-19. The researchers are seeking speedy approval from the F.D.A.
Updated June 16, 2020 Updated June 22, 2020
A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.
The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
Dozens of other labs are also at work on a dizzying list of tests, although they, too, are mostly based on slim data that has not yet been reviewed by other scientists.Dozens of other labs are also at work on a dizzying list of tests, although they, too, are mostly based on slim data that has not yet been reviewed by other scientists.
“No matter who makes them, as long as they’re reliable, that’s a super nice tool,” Dr. Krammer said. Because this is a new coronavirus, the test should deliver “basically, a yes or no answer, like an H.I.V. test — you can figure out who was exposed and who wasn’t.”“No matter who makes them, as long as they’re reliable, that’s a super nice tool,” Dr. Krammer said. Because this is a new coronavirus, the test should deliver “basically, a yes or no answer, like an H.I.V. test — you can figure out who was exposed and who wasn’t.”
On Wednesday, officials of Public Health England said they had purchased millions of newly developed antibody tests and were evaluating them for patients to use at home. Citizens who discovered they had been exposed and now had some immunity to the coronavirus might be able to return to normal lives, the officials said.On Wednesday, officials of Public Health England said they had purchased millions of newly developed antibody tests and were evaluating them for patients to use at home. Citizens who discovered they had been exposed and now had some immunity to the coronavirus might be able to return to normal lives, the officials said.
That would be particularly useful for health care workers. Those who know they have at least some immunity could be placed on the front lines of emergency care, sparing colleagues who have not been exposed.That would be particularly useful for health care workers. Those who know they have at least some immunity could be placed on the front lines of emergency care, sparing colleagues who have not been exposed.
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“If this really goes on for months at a time, for 18 months as some people have projected, having health care workers who are immune to the virus will be really, really helpful,” said Angela Rasmussen, a virologist at Columbia University in New York.“If this really goes on for months at a time, for 18 months as some people have projected, having health care workers who are immune to the virus will be really, really helpful,” said Angela Rasmussen, a virologist at Columbia University in New York.
But tests like these may not be of much use for diagnosis of coronavirus infection as it gets underway, because of the time it takes for the body to begin producing antibodies.But tests like these may not be of much use for diagnosis of coronavirus infection as it gets underway, because of the time it takes for the body to begin producing antibodies.
Dr. Krammer’s test picks up an antibody response as early as three days after symptoms emerge. Given that people may not show symptoms for as long as 14 days after infection, however, that is too late for the test to be useful as a diagnostic tool.Dr. Krammer’s test picks up an antibody response as early as three days after symptoms emerge. Given that people may not show symptoms for as long as 14 days after infection, however, that is too late for the test to be useful as a diagnostic tool.
Finding people with powerful antibody responses might help point the way to new treatments, however. Essentially, antibodies extracted from the blood of recovered patients are injected into those who are ill.Finding people with powerful antibody responses might help point the way to new treatments, however. Essentially, antibodies extracted from the blood of recovered patients are injected into those who are ill.
Several teams have already been working on such an effort, following early reports from China of success. A Beijing-based company called AnyGo Technology has provided 50,000 tests to the Chinese Center for Disease Control and Prevention, and to hospitals in Wuhan, Beijing and Shanghai, according to its founder, Dr. Le Sun.Several teams have already been working on such an effort, following early reports from China of success. A Beijing-based company called AnyGo Technology has provided 50,000 tests to the Chinese Center for Disease Control and Prevention, and to hospitals in Wuhan, Beijing and Shanghai, according to its founder, Dr. Le Sun.
Dr. Shangen Zheng, a doctor with the Chinese military, said his team had treated more than 10 patients so far, and data from many more patients treated with plasma in Hubei Province is being assessed.Dr. Shangen Zheng, a doctor with the Chinese military, said his team had treated more than 10 patients so far, and data from many more patients treated with plasma in Hubei Province is being assessed.
This approach is actually “something very old-fashioned,” Dr. Krammer said. It was used to save American soldiers infected with the hemorrhagic Hantaan virus during the Korean War, and to treat people in Argentina infected with the hemorrhagic Junin virus.This approach is actually “something very old-fashioned,” Dr. Krammer said. It was used to save American soldiers infected with the hemorrhagic Hantaan virus during the Korean War, and to treat people in Argentina infected with the hemorrhagic Junin virus.
Before the method can be put into wide use, however, scientists must work out safety issues, such as ensuring that the plasma taken from recovered patients is free of other viruses and toxins.Before the method can be put into wide use, however, scientists must work out safety issues, such as ensuring that the plasma taken from recovered patients is free of other viruses and toxins.
Pharmaceutical companies like Takeda and Regeneron are hoping to sidestep some of those questions by developing antibodies against the coronavirus in the laboratory.Pharmaceutical companies like Takeda and Regeneron are hoping to sidestep some of those questions by developing antibodies against the coronavirus in the laboratory.
Ultimately, it is only with these tests that scientists will be able to say when enough of the population has been infected and has become immune — and when the virus has begun to run out of hosts.Ultimately, it is only with these tests that scientists will be able to say when enough of the population has been infected and has become immune — and when the virus has begun to run out of hosts.
Reporting was contributed by Denise Grady.Reporting was contributed by Denise Grady.