It’s not unusual to have a suppressed immune system after a viral infection. The question is how well it recovers.

The problem with COVID-19 is that people are getting unusual infections weeks and months after infection, and the period between infections can be short.
That makes it harder to “recover” between acute bouts, and there is also a negative longer term trajectory due to a superantigen stimulating the immune system too much.

Which is why I keep saying #CutDownTransmission
Finally, there is experimental evidence that multiple white cell lines can be infected.

This needs further investigation and follow up.
(Caveat, some post COVID-19 infections/reactivation are not definitely causally linked yet.)
For example, post influenza we expect sinusitis, otitis media and pneumonia.

But we don’t expect to get flu again for a year, or more.

COVID-19 is far more frequent, and it’s impact on the immune system diverse.
Would you seriously contemplate having flu every 6-12 weeks, and all the post flu problems?

COVID-19 remains more severe than flu, and has a smorgasbord of complications to chose from.

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More from @NjbBari3

Apr 24
Single case report.

“This case appears to confirm the concerns that the CD4+ T-cell depletion associated with COVID-19 may promote the development of active tuberculosis from latent infection much like HIV does.”

sciencedirect.com/science/articl…
So far

🔴EBV reactivation
🔴Possible TB reactivation
🔴Possible reduced ability to manage adenovirus
🔴Possible increased susceptibility to mould infections

You can’t see a pattern?
Acquired immune deficiency.

That’s what we call it.

When you start off with a standard immune system, and then you end up in a situation where you can’t fight off pathogens, or even ubiquitous environmental bugs that we basically can’t avoid.
Read 6 tweets
Apr 23
Or… and just hear me out please…

We could control disease transmission so we have plenty of healthy adult workers.

#COVIDisBad4Business

smh.com.au/lifestyle/life…
When I was a kid, my Dad had a restaurant. I absolutely loved helping out, and yes, I can balance a LOT of plates on one arm.

But kids need to be kids. They should be at school/uni/TAFE/job they chose. Not driving forklifts or stepping in where adults left off.
How about we recognise the fact that we are making kids sick? The imaginary mini workforce is already under attack?

How about we #ProtectKids and give them space and time they need to grow?

Just a thought.
Read 4 tweets
Apr 23
Rabies 🤣🤣🤣. We want to live with a virus that’s going to make us more rabid? Great.
Just to clarify. If a virus shares one characteristic, doesn’t mean it shares all. Going rabid was a joke… not an actual clinical diagnosis.

But we do know cognition is impacted.
At least I think/hope it was a joke. 👀
Read 4 tweets
Apr 23
Right, you had a brief break from viruses… just one year… maybe a year and a half… then we gave you a virus, and it made you unwell, then we gave you lots of viruses, and it made you more unwell… so what we need to do is keep giving you lots of viruses until you feel better.
Just for the record, babies in utero would still have been born with maternal antibodies to previous pathogens, lots of non COVID pathogens were not controlled (like the RSV outbreaks), adenovirus is endemic and we carry it for longer than a year and half…
There are a handful of pathogens that genuinely have reduced in circulation, like flu, and so immunisation is more important now… but we didn’t actually go into a sterile vacuum. Our commensals and many non-COVID pathogens are still with us.
Read 4 tweets
Apr 22
Adenovirus can reactivate if immunocompromised. The source of infection may already be within the home or within the patient.

ncbi.nlm.nih.gov/pmc/articles/P…
“…severity of Ad4 infections in outbreaks appears to depend more on preexisting conditions in patients than on genetically determined, viral virulence factors…”
“Innate immune responses can create a state of adenoviral persistence, and repression of these host defenses can result in reactivation and dissemination of infection.”
Read 13 tweets
Apr 9
I think it would be good if people stop asking family members of vulnerable people when they will unmask and go on holiday… and what their off ramp is.

Like… is off ramp code for bumping off the vulnerable person in the household? Exit strategy via coffin?
The faster everyone accepts that some of us can’t even go to a dentist without a risk benefit analysis, let alone a dinner party, the happier we will all be.
Do I walk around asking you about your personal choice not to mask? What makes you think you can ask me why I do mask? I know that tone says you aren’t actually interested in the answer.

Let it go.
Read 4 tweets

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