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Stephen Goldstein

@stgoldst

8 Mar

There's a lot of prediction and uncertainty on the future of #SARSCoV2 in the human population. I'll do a little thread explaining why I *think* it will end up similar to the 4 "common-cold" endemic CoVs, but the time-scale on which this happens is up to us.

There are currently 4 endemic human CoVs: OC43, 229E, NL63, HKU1. OC43 and HKU1 are sort of closely related, same for 229E and NL63. Overall, pretty divergent though. More different than SARS1 and SARS2, for example. They all came from animals, and they all cause mostly

pretty similar, mild disease. We're basically all infected in childhood, more than once. This is probably important. bmcinfectdis.biomedcentral.com/articles/10.11…

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Stephen Goldstein

@stgoldst

14 Jul 20

Credible case reports of #SARSCoV2 reinfections have started to emerge, in contrast to earlier reports that were certainly just persistent PCR+s. It's important to document these and studying such cases in large numbers will inform our understanding of SARS2 immunity. However

it does not mean that recovering from #COVID19 confers no protection. With any infection or vaccine, some subset of individuals are not going to develop lasting immunity. For example, the best vaccine we have, the measles vaccine is ~95% effective. That's great! Yet, if we

vaccinate 30 million people (approx # of US SARS2 infections) against measles, we'd expect up to 1.5 million susceptible to a measles infection. I think everyone agrees recovery from #SARSCoV2 isn't as "good" as a measles vaccine, so it makes sense that some people

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Stephen Goldstein

@stgoldst

4 May 20

I want to spend a bit of time clearly laying out where #SARSCoV2 probably comes from, and how it could have ended up in Wuhan. Though it can't be ruled out there is currently no, zero evidence for a lab escape scenario while there is ample precedent for zoonotic spillover.

Human exposure to animal viruses occurs every day worldwide, probably multiple times, due to our intense (and unwise for many reasons interactions with wildlife both directly and via agriculture. There are many examples of this resulting in zoonotic infection

and small outbreaks, epidemics, and pandemics that result in animal viruses becoming endemic in humans. Examples include SARS, Ebola, Marburg, smallpox, Nipah, Hendra, Measles, HIV, hantaviruses, arenaviruses and now-endemic human coronaviruses (OC43, 229E, NL63).

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