There is no crux with those who have recovered

There is no crux with those who have recovered
There is no crux with those who have recovered

BerlinAt the end of August, science journalist and biologist Cornelia Stolze wrote a text about those who had recovered for the Berliner Zeitung. She criticized that it does not make much scientific sense that those who have recovered from a corona infection are only considered protected for six months and they have to be vaccinated in order to get their rights and freedoms back. Your argument: Numerous studies have shown that an infection that has passed through confers long-term, possibly lifelong immunity. There could also be no question of the immune protection disappearing six months after the infection. Stolze also criticized the fact that in Germany an antibody test is not recognized as a certificate of immunity. The article met with great interest and was divided hundreds of times. The Berlin molecular biologist Emanuel Wyler took a closer look at the article – and contradicts it. A guest post.

September 2021, I’m standing on Alexanderplatz for a vaccination information booth and talking to passers-by about the corona vaccination. Many of them have already been vaccinated or will soon have their vaccination appointment. In the conversations with the hesitant and the unvaccinated, I notice a lot of uncertainty above all. A young man says he does not want to be vaccinated because he has heard that it will make you seriously ill. Then he could just endure the virus? He asks. The answer: Yes, it may well be that you are weak for a few days after the vaccination, have a fever or have aching limbs. But, and that is also the reason why the vaccination was approved and recommended in the first place: The risk of a serious illness is much greater with an infection with Sars-CoV-2.

Achieving the willingness to vaccinate in the population is the really challenging task for society as a whole.

Emanuel Wyler, researcher at the Max Delbrück Center for Molecular Medicine in Berlin

The encounter shows: From a scientific point of view, the way a vaccine works is very simple. This also applies to the latest generation, the very effective RNA vaccines that have been used billions of times around the world. But, as the well-known Berlin pathologist Rudolf Virchow stated after a typhus epidemic in 1848, both aptly and timelessly: “Medicine is a social science, and politics is nothing more than medicine on a large scale.” Applied to the current situation: That The most difficult part was not to develop the corona vaccine based on decades of research. The social and political part, namely to achieve the necessary trust of the people in medical research and the willingness to vaccinate in the population, is the really challenging task for society as a whole.

Photo: Felix Petermann

The author

Emanuel Wyler researches at the Max Delbrück Center for Molecular Medicine in the Helmholtz Association on herpes and coronaviruses and since the beginning of 2020 in collaboration with research groups from the Charité and the Free University of Berlin on Sars-CoV-2.

In his blog and on social media, he regularly clarifies scientific questions about Sars-CoV-2, classifies current reports on the topic and answered questions from various media in the corona pandemic.

More severe cases of Covid-19 after infection with Sars-CoV-2 are mainly suffered by unvaccinated people. This is especially true for those who need to be treated in hospital. It is particularly tragic when it hits people who, not because of conviction, but because of this uncertainty, did not get vaccinated. The uncertainty comes less from obvious misinformation, such as that the vaccine allegedly contains “5G nanochips”. The more problematic are the vaguely whispering contributions that raise the mood against the vaccination by exploiting, among other things, scientifically unresolved questions and uncertainties. For me, this also includes a text by Cornelia Stolze that appeared in the Berliner Zeitung at the end of August.

In this text, sentences like “Indeed, a lot is at stake in the government’s vaccination campaign. If antibody evidence were accepted as an immunity certificate, the minister could face a new fiasco ”or“ Even in medical practices where there was no cheating, it has been shown that vaccinated people often do not have antibodies against Sars-CoV-2 ”, in my opinion, mood against the vaccination made. Incidentally, the latter is an unsubstantiated claim. In a study with employees of the Charité Berlin in a group of 113 vaccinated persons, no antibodies were measurable in only one person. The author seems to believe that those who have recovered would be deliberately disadvantaged so that everyone could be vaccinated.

In fact, Cornelia Stolze’s assumption, namely the allegedly worse treatment of convalescents compared to those who have been vaccinated, can be explained quite easily. The first point is the duration of six months during which protection against re-infection is assumed. The reason for this is that immunity to the virus has mostly been measured with antibody tests over the past year. These were established shortly after the start of the pandemic and are easy to use. A small tube of blood is required; the test costs around 20 euros for self-payers. For comparison: tests introduced later on T cells against the virus – in addition to antibodies, another central part of the immune system – are six times as expensive at around 120 euros and a larger amount of blood is required for the tests.

Protection against corona? Antibody testing without PCR is not sufficient as evidence

Towards the end of 2020 it became more and more apparent that the amount of antibodies in the blood decreased significantly over a period of a few months. The preliminary conclusion, therefore, was that immunity does not last long after infection – hence the six month period. Much more complex studies, which were only completed this year, have now examined various parts of the immune memory that are not so easily measurable. They have shown that those who have recovered are still well protected against more severe illness after a new infection even after twelve months – which is why the Society for Virology advocates an extension to twelve months in a recently published statement. The period of six months was not introduced to pester people who had recovered or to promote vaccinations, but corresponded to the state of knowledge at the time – which can now be adjusted.

The second point that was criticized is that an antibody test without a PCR test is not sufficient to demonstrate protection against the virus. This is done with measles, for example: If the antibody test is above a certain value (which has been in place since 1990), this counts as an immunity card. Why doesn’t this exist with Corona? First of all, the question arises as to whether antibodies in the blood are at all a good value for determining immunity. Second, as with the measles virus, there are still no studies that indicate the threshold above which a certain person is considered to be adequately protected. So it is not true, as Stolze claims in the text: “This regulation contradicts the standards of independent science”. On the contrary: As with the measles virus, studies would be needed to show which measured value statistically indicates how much protection. Scientists or politicians would be accused of failing to carry out such large-scale studies in many countries, including Germany, even though a corresponding value is urgently needed. However, it should be remembered that the virus is still very young and research on corona is already working at tremendous speed and in many disciplines.

As with the flu, drugs directed directly against the virus are often late and their benefits are limited.

Emanuel Wyler

Another topic that is repeatedly cited against the corona vaccination are drugs against Covid-19, or: the lack of them. Here, too, it is occasionally suspected that there are machinations to promote vaccination behind it. The difficulty, however, lies in the biology of the virus. With acute viral diseases, and even more so with Sars-CoV-2 (which also makes it dangerous), there are no symptoms for the first few days after infection. When, among other things, a cough or sore throat set in, the immune system has in most cases already started to fight the virus. As with the flu, drugs that target the virus often come too late and their benefits are limited. Accordingly, a recently introduced drug from Merck was able to reduce the death rate by half. This is an important step forward, but not a definitive solution. Such substances are really effective in preventive use, as they would be possible, for example, in the case of coronavirus outbreaks in old people’s homes. But this field has not yet been adequately researched either.

What is actually dangerous with Covid-19 is not even the multiplication of the virus in the throat and nose, but rather through what follows afterwards: a misdirected reaction of the immune system. Among other things, this leads to the lungs becoming blocked and patients no longer able to breathe. The central drug for the treatment of Covid-19 is therefore dexamethasone, which has been known for 60 years and, like all corticoids, inhibits the immune system. We at the Max Delbrück Center, among others, are currently researching many other immune system suppressors. What they all have in common is that as a result of the subdued immune system, bacterial and fungal infections can occur with Covid 19 disease.

The patients must therefore be closely monitored. For the best possible application, the timing and dosage as well as combination with antiviral drugs must therefore still be intensively researched.

Unfortunately, there is no miracle cure for the Sars-CoV-2 virus – as there is for other diseases. Researching diseases and translating new scientific knowledge into therapies is a constant process of improvement. The RNA vaccines, which are mostly used in this country, are also not perfect. A third to half of those vaccinated have a fever, aching limbs, or tiredness for one to three days. Inflammation of the heart muscle is rare and even less dangerous, but is nonetheless a concern, especially in younger men. However, all of this is much less risky than the possible serious consequences of an infection with the Sars-CoV-2 virus. The corona vaccination is therefore not about the success or failure of the “government vaccination campaign”. It’s about how we can all defy this natural force of pandemic. And after sober consideration, vaccination is the best option in the current situation.

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