Host and producer: Yi Ding
Writers: JiJi Wong and Creighton Ward
Chinese translators: Victoria Sheng, Stephanie Lu, and Chenxi Wu
Writer’s note: This piece was originally published as a Mandarin podcast audio, published on WeChat August '22. The original script was written in English and forms the basis for this article format.
[audio coming soon]
As of August 11, 2022, the CDC has even further relaxed their Covid-19 guidelines to the detriment of all, especially medically vulnerable people. The new guidance leaves pandemic mitigations almost completely up to individual choices. People exposed to the virus are no longer required to quarantine, guidance for the unvaccinated now matches the guidance for vaccinated people, students can stay in class even if they are exposed, and it is no longer recommended to screen people without symptoms. These new guidelines have further alienated people and essentially left the public to fend for themselves with little to no state support for any precautions in workplaces, schools, places of essential business, hospitals, etc. In light of these recent developments, we want to debunk several enduring Covid myths that have done irreparable harm to the public.
Firstly, according to the People’s CDC, an organization made up of public health practitioners, scientists, healthcare workers, educators, and advocates, current guidelines are based on manipulated data that makes the risk appear to be less than it actually is. “The map most often shared by the CDC, the Community Levels map, is not only misleading, but is also being used to justify the inaction of the federal government… By relying on this Community Levels map for months while the harder-to-find transmission map quickly turned red, the government was able to send a false message that the pandemic was largely over.” This has led to the public having a false sense of comfort that allows for us to accept current CDC guidelines. However, there has been mass outrage from many including those of us at Xin Sheng Project and the Disabled community. Some might call our reactions paranoid, but what do public health experts have to say about it?
For a perspective from an expert, we turned to a 1.5 generation Chinese American Eric Feigl-Ding. Eric is an epidemiologist, founder of the World Health Network, Chief of COVID Task Force at the New England Complex Systems Institute, and formerly a faculty researcher at Harvard University. In January 2020, he went viral on Twitter for sounding an early alarm about COVID-19 and pandemic preparedness, and has often been ahead of the curve in predicting pandemic trends as well as openly critical of current public health policy and the CDC. This is what he had to say regarding the newest CDC Covid guidelines: “The CDC guidelines were really disappointing, a lot of public health advocates had horrendous reactions to it. It basically said if you’ve been exposed to the virus, you don't need to quarantine, you don't need to test, we don't need to contact trace. It dropped social distancing, and they’re saying infection is nothing to worry about. It would be ridiculous to drop safety measures just because hospital beds are available but that is what the CDC is doing. They’re basically saying that we have to learn to live with Covid. Well, if Covid is here to stay, we need to fight it, not to lift up all mitigations. It’s not like we have some magic multivalent vaccine that stops all future variants, and we don't have any more money for tests.”
Speaking of preventative measures, one may turn to vaccines as a solution for preventing infection, hospitalization, or death. When asked about vaccine efficacy, Eric had this to say: “Covid is a RNA virus not a DNA virus, and therefore less stable and mutates much faster. It can reinfect billions of people a year and gives them that much room to practice. Most viruses like polio or smallpox infect a couple hundred or a thousand people tops in the US. It doesn’t have this huge volume of practice. The vaccine that we have has 95% efficacy against the original strain, but current strains have mutated so far from the original strain. The more you let the virus spread, the more you’re going to let it mutate. If you tell people don’t worry you won’t die the chance you get hospitalized is low, you won’t get reinfected, then the rate at which the virus mutates will speed up because there’s more room for it to practice and grow. That’s why it’s always a couple steps ahead of the vaccine. Until we have an adaptive vaccine for the current variant – which I don’t know if we’ll be able to keep up with that – the pandemic will get worse across the board. Right now, we’re falling way behind. Our two, three, four shots are still for the 1.0 strain from well over 2 years ago. Coronavirus is mutating faster than we can keep up with vaccines.”
However, Eric is not anti-vaccination by any means. Rather, he is advocating for better vaccine practices, increased funding of vaccine research, and overall better public health policy. With vaccine rollout being so slow and having lower efficacy than we have been led to believe, some people and public health policies have turned to embracing the idea of herd immunity. Herd immunity is the idea that we as a community will develop resistance to the spread of an infectious disease based on pre-existing immunity of a high proportion of individuals as a result of previous infection or vaccination. This implies that the majority of the population should just live with the virus, and that the pandemic will subside once we all are infected or vaccinated.
According to research evidence, neither vaccination nor infection will lead to herd immunity from Covid specifically. The strategy of herd immunity against covid was outlined in a controversial letter called Great Barrington Declaration of October 2020 that has been criticized for its mass infection solution to ending the pandemic. The notions of “herd immunity” and “hybrid immunity” for covid are problematic because this strategy of achieving herd immunity in the population was chosen under the assumption that immunity conferred by vaccines or infection would result in durable immunity to Covid.
However, this has not been the case, with the most glaring example being the subsequent surges of Covid after the first Omicron wave that lasted from December 2021-February 2022. Subsequent surges of subvariants of Omicron have occurred due to BA.2, BA.2.12.1, and most recently BA.4 and BA.5. The prestigious Sato lab in Tokyo has accurately predicted that each of these Omicron subvariants would become dominant due to their qualities of increased immune evasion and transmissibility. What this pattern indicates is that there is no herd immunity with SARS-CoV-2 unless we develop sterilizing vaccines that do not wane in efficacy and are effective against multiple variants. Vaccines have saved lives and reduced hospitalizations, but they wane in efficacy after just 3-4 months. As Eric expressed just now, we have no updated vaccines, and vaccine hesitancy is too high to rely on a vaccination-only strategy even if the variants didn’t evade vaccine-immunity.
So far, we have addressed 2 common misconceptions about covid as well as the neglectful CDC announcement. Our assumptions of covid’s transmissibility, most of which have at some point been questioned or falsified, contributed to poor early pandemic intervention and the increase of variants and reinfection. This is exacerbated by the CDC not properly informing the public of the risks and continuing to push vaccination as the primary solution to ending the pandemic despite research having proved the inefficacy of their solution. Knowing this, what does Eric have to say about the CDC’s public health response? “If you’re working inside the CDC how could you stand by this stuff? You have to speak out! It is just a complete dereliction of any public health responsibility. Prevention is the cornerstone.”
Prevention includes preventing infection as a whole, not just deaths. Why is this important? Infection, mild or not, can have long lasting detrimental effects on one’s health. In addition to the lack of public health mitigations to slow the transmission, the speed of Covid mutations, and thus mutation of the virus into worse variants, another reason that the “herd immunity” strategy has backfired tremendously is the immune-compromising effects that Covid itself has on the infected.
PhD immunologist Anthony Leonardi, who specializes in T-cell differentiation, has cautioned against the pursuit of herd immunity due to the damage that Covid can do to the immune system through T cell depletion since 2020. T cells are an important part of the immune system and help protect the body from infection. Dr. Leonardi has theorized that the superantigen motif on the Covid spike protein over stimulates the immune system and leads to massive T cell activity, then T cell exhaustion, depletion, and cell death. Covid can thus cause immune-mediated tissue damage, autoimmunity, and immunodeficiency from low T cell levels. (This theory and basic introduction to immunology is explained in the YouTube lecture “The T-cells are not alright”). This information is alarming when considering the government’s embracing of the herd immunity strategy outlined in the Great Barrington Declaration of October 2020. In the end, mass infection with Covid has produced more immune dysregulation and increased disability on the population level than immunity.
Knowing this now, what are some of the potential immune damaging effects of Covid infection, especially repeated Covid reinfections? On an individual level, Dr. Kerry Smith, a former general practitioner in the UK for the NHS and current long covid disability justice advocate, has had 5 Covid infections has T-cell counts resembling that of a person with AIDS (Acquired Immunodeficiency Syndrome). Yes, AIDS can be developed from repeat infections and long term diseases other than HIV. On a population level, it has been speculated that the widespread immune dysregulation has made the herd more vulnerable to opportunistic infections and allowed previously-eradicated viruses to make a comeback, which is particularly concerning as climate change is associated with an increase in zoonotic diseases as well. We will be battling both old and new viruses in the coming years with potentially less and less immunity as a society.
When speaking about post viral sequelae and illness with covid, we cannot ignore the urgency of addressing long COVID, also known as Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) if occurring from a virus other than covid, but both are essentially the same medically other than differing in the infecting virus. ME/CFS can develop after any viral infection, and leads to immunodefficiency and gradual breakdown of one’s nervous system that contributes to extreme pain, fatigue, sensory sensitivity, and more. Even if one manages to avoid it, there are some other concerns of post viral sequalae including evidence of acute pulmonary issues 18 months after initial infection. 60% of patients suffer long term sequelae 6 months after initial infection, and 30% experience at least one acute symptom a year after initial infection. Loss of smell/taste is caused by brain damage, and many people are nonchalant about it because they don’t make the connection that the loss of smell/taste is due to the brain no longer being able to process sensory input from the nose/mouth. Other post viral effects can include loss of hearing, vision, and dental problems.
One of the most concerning long covid complications is cardiovascular complications. Many may not know that cardiovascular issues are also prominent in long COVID due to Covid also being a cardiovascular disease and not simply a respiratory disease. This is not widely known because the CDC still indicates that it is just a respiratory illness even though studies evidence it being both a cardiovascular and respiratory, though it is spread via the respiratory system. Why is the distinction of the type of disease important? Well, it has a lot of implications in the short term for types of sequelae and for long term health post infection.
Cardiovascular diseases can be more dangerous than respiratory ones because the vascular system supplies and supports all other organ systems in the body, including our nervous system. On top of being immunocompromised, long covid patients have to be wary of various heart issues including developing postural ortho tachycardia syndrome (POTS), a condition that affects blood flow and causes the development of symptoms -- usually lightheadedness, fainting and an uncomfortable, rapid increase in heartbeat -- that come on when standing up from a reclining position and relieved by sitting or lying back down. To some, what’s more concerning than POTS is that some people have reported having minor heart attacks from early overexertion within 6 weeks of initial infection. This information about cardiovascular risk and the dangers of overexertion were known well before covid-19, as evidence of reduced pulmonary function was discovered in the previous MPXV outbreak and during the SARS1 outbreak.