"Maybe you’ll be fine. Or maybe you won’t." Why Medical Researchers Are Worried About COVID (Part 1 of 3)

Part 1 of a 3-Part Interview With Dr. Arijit Chakravarty, "5 Years of the COVID Pandemic"

Dr. Arijit Chakravarty is the CEO of Fractal Therapeutics, a science services company based in Cambridge, Massachusetts, that “offers model-based drug discovery and developmental services that help make drug R&D more efficient.” When the COVID-19 pandemic emerged as a global threat in early 2020, the company decided to employ its modeling expertise in “building a clearer understanding of the public-health risks” associated with the policies being implemented by the CDC and the White House, and international health agencies in general.

The interview was edited for clarity and shortened, with many of the scientific terms defined to provide readers insight into the issues at play.

Benjamin Mateus (BM): It was over five years ago when the medical community in Wuhan began to recognize that the patients coming in with respiratory illnesses were infected with a novel SARS-like virus.

Fast-forward to today, and COVID-19 is both ubiquitous in our day-to-day conversations and still very prevalent as a respiratory pathogen in the global community. Close to 30 million people have died due to the pandemic, over 410 million people are now living with Long COVID globally (probably more due to low reporting and lack of a diagnosis), and one can assume that the majority of the world’s population has been infected with COVID on average at least three times. Are there any initial reflections you would like to share on the five-year anniversary of the start of the COVID-19 pandemic?

Arijit Chakravarty (AC): Yes. This is what failure looks like. We are looking at it. No one ever said when the concept of public health emerged in the 19th century, “We really need an organization that is committed to serving as the doula for every newly emergent pathogen that pops out of the wild.” The idea that emergent pathogens need to be shepherded into endemicity, this has never been in any public health mission statement.

What we have done is take something that should never have established itself in human communities in the first place and have built a public health consensus around the concept of repeated mass infection.

So, yes, this is what failure looks like. And that sort of normalization of infectious disease is something that we are facing the consequences of now, societally, because those attitudes have crept into other aspects of our society as well. This idea that vaccines are bad, and infections are good. Conflating the idea of coexistence with nature with coexistence with pathogens is a dangerous mess—it will take years to undo this. Honestly, we haven’t had attitudes like this about infections since before biblical times.

There really is no historical precedent for this. No society in the world ever said, “Oh, you’re infected? Let’s let it spread.” This whole concept of pox parties being a thing is ludicrous. But that’s exactly where we are today. Quarantines used to happen in the 14th century with plague. This uncritical acceptance of infectious disease as a sort of lord and savior is brand new.

And it couldn’t happen at a worse time. We’re now extremely interconnected. There are more people on the planet than ever before, and diseases can spread rapidly. And the only people that you can really lay this at the door of is public health. Where public health should have been out there saying, “These are the risks of getting COVID. These are the repeated risks of COVID,” for which the science is extremely unambiguous. (There are tens of thousands of papers on these topics).

“If people really understood the science behind all this, they would have a very different attitude.”

Instead, Public Health was saying, “Masks are the scarlet letter of the pandemic,” in the words of former CDC Director Rochelle Walensky. Or “If you have been vaccinated, the pandemic is over for you,” which is what Biden said. Trump and his people based their playbook on the phrase, “The cure cannot be worse than the disease.” I’m using the US as an example, but you can do the same thing with other countries like Britain, Canada or pretty much any other country in the world. And every single time both public health and politicians have served as cheerleaders for an infectious disease that has clear-cut long-term consequences. None of this was necessary.

BM: You raised a very important point. If you just open a public health textbook, any history book or a novel that was set in the Victorian period, in the 19th century, much of the discussions or descriptions centered on issues of the various diseases that were killing people and, in particular, children. You read the novels of Charlotte Brontë, Charles Dickens or even the playwright Anton Chekhov, death from pathogens is central to their stories.

Although fecundity rates—the number of children birthed—were very high among women, maybe less than half of these children, in the best case, made it to adulthood. The implementation of public health was a watershed period in human history. The social longevity and well-being were rapid and palpable. It was as if a terrifying period had passed because of the public health measures that were being implemented. People living in that period understood it well. They weren’t blind to these matters.

Meanwhile, you have all this wishful thinking. . .that somehow pretending like the whole thing is done has made the state of the pandemic better. That’s like—you’re sitting in your house and watching TV, and you smell something burning and you say, “I’m just going to finish watching my TV show, I’m not going to worry about that burning smell, or the smoke.” Maybe you’ll be fine. Or maybe you won’t.

AC: When you walk through any cemetery, there’s a children’s section—any cemetery of a certain age and you can walk through the children’s gravestones there. My grandmother was one of 12 children, she was born in the 1920s. India went through a series of bad outbreaks of infectious disease at the time, plague, the 1918 influenza—she was the only one in a brood of 12 siblings who survived.

At the end of the day the thing that we all must accept is, even if COVID doesn’t seem like a crisis now, things could still go sideways very quickly.

With COVID, there are three risks that remain on the table.

• The first risk is that you have a variant that comes through that has much higher immune evasion. As we pointed out in a preprint of ours, such a variant could very quickly infect a very large number of people—it would be both more transmissible and more deadly.

• The second risk is that COVID eventually weakens people’s immune systems repeatedly through repeated infections. Everybody gets it once or twice a year and they are much more likely to end up with other health crises.

• The third risk is that the virus faces no intrinsic penalty for becoming deadlier. We’ve shown in a paper of ours that the virus could theoretically kill everybody it infects and still do just fine for transmission. So intrinsic virulence increasing is also very much still on the table.

Meanwhile, you have all this wishful thinking that viruses always evolve to become milder (they do not). That immunity is building up in the population (it is not). Or that somehow pretending like the whole thing is done has made the state of the pandemic better. That’s like—you’re sitting in your house and watching TV, and you smell something burning and you say, “I’m just going to finish watching my TV show, I’m not going to worry about that burning smell, or the smoke.” Maybe you’ll be fine. Or maybe you won’t.

BM: When you look at the repeated curves of infection, a measure of the number of people who are becoming infected, it dawns on you COVID is not a seasonal virus. What you’re seeing during the troughs between peaks is the population immunity waning that makes everyone susceptible again. And then you see another huge spike of infections. And when you do count the number of people that are infected, you see at their peaks 1 or 2 million infections per day sustained for weeks, as with the summer wave. Now the acceleration phase of this peak is a straight wall up. It’s jaw-dropping. But more disconcerting is that there is nobody even discussing it.

AC: Agreed. I think it’s even worse than that. First, we’ve taken a very atavistic or primitive perspective on infectious disease. We are relying on disease and reinfections to manage the acute consequences of infection. The main reason why people aren’t dying at the rate they used to isn’t because of the vaccines at this point, because most people have minimal protection from the vaccines if they’re getting it once a year. Most people aren’t even doing that. (According to the CDC,the percentage of adults that have received the latest COVID vaccines tend to hover around 20%.

The main reason why people aren’t dying from COVID right now is, in my opinion, that they’re getting infected on a frequency that’s often enough that there’s some residual protection from the antibodies left over from the previous infection. And the antibody threshold that you need to prevent severe disease is quite low. So, people are topping up their antibody levels, through repeat infections, at a frequent enough basis that they’re not ending up in hospital acutely.

The problem with that strategy is that you’re still infected all the time. It has been well-documented that the virus can make its way into pretty much every tissue. These have many long-term consequences that are subtle but have huge implications.

Continue reading with Part 2, "The Relationship Between Covid and Cancer" in the Related Posts Below.

"Five years of the COVID-19 pandemic: An interview with Dr. Arijit Chakravarty" by Benjamin Mateus is republished with permission from WSWS.Org.