It’s unusual to get started so early (0945hrs) but I began Mark Honigsbaum’s book “The Pandemic Century: A History of Global Contagion from the Spanish Flu to Covid-19” (Penguin books, 2020) over my morning cup of tea in bed. I haven’t got very far but felt I had to put a quote down from page 16 (there are pages all told):
Anomalies are a common occurrence in science. No two experiments are ever exactly alike, but by refining methods and sharing tools and technologies scientists are broadly able to reproduce each other’s observations and findings, thereby arriving at a consensus that this or that interpretation of the world is correct. That is how knowledge emerges and a particular paradigm comes to be adopted. However, there is no such thing as absolute certainty in science. Paradigms are constantly being refined by new observations and, if enough anomalies are found, faith in the paradigm may be undermined and a new one may come to supplant it. Indeed, the best scientists welcome anomalies as this is the way scientific knowledge advances.
Wearing another hat I have written a lot about statins, and how the paradigm of cholesterol-heart disease has been undermined by re-analysis of original data. It is interesting though that in that case the Inquisition (aka the hypothesis supporters, helped by statin manufacturers) have suppressed the Galileans who believe the earth is round (the Galileans being the cholesterol sceptics, marshalled by a network, THINCS). Honigsbaum uses the above paragraph to introduce the problem faced by those investigating the Spanish Flu when it became clear that it could be transmitted even when the best bacteriological filters were in place, proving that it was caused by something smaller – which of course we now know is a virus. But I use this preamble to introduce a piece of news reported today.
If you have been reading my blog regularly you will have read my views on the BAME community and why they appear to be especially susceptible to Covid-19. Blood group A? It may be more than that, if it is that at all. https://www.biorxiv.org/content/10.1101/2020.07.03.186296v1.full.pdf is a paper from Zeberg and Päälo, with this abstract:
A recent genetic association study (Ellinghaus et al. 2020) identified a gene cluster on chromosome 3 as a risk locus for respiratory failure in SARS-CoV-2. Recent data comprising 3,199 hospitalized COVID-19 patients and controls reproduce this and find that it is the major genetic risk factor for severe SARS-CoV-2 infection and hospitalization (COVID-19 Host Genetics Initiative). Here, we show that the risk is conferred by a genomic segment of ~50 kb that is inherited from Neandertals and occurs at a frequency of ~30% in south Asia and ~8% in Europe.
What, though is confusing (much as it is an explanation for the high prevalence in people of Bangladeshi origin) is that this gene cluster is almost absent in people of African descent, as the authors conclude:
Among the individuals in the 1000 Genome Project, the Neanderthal-derived risk haplotypes is almost completely absent in Africa, consistent with that gene flow from Neandertals into African populations was limited and probably indirect (Chen et al. 2020). The Neandertal haplotype occurs in South Asia at a frequency of 30%, in Europa at 8%, among admixed Americans at 4% and at lower frequencies in East Asia. The highest frequency occurs in Bangladesh, where more than half the population (63%) carries at least one copy of the Neandertal risk variant and 13% is homozygous for the variant. The Neandertal variant may thus be a substantial contributor to COVID-19 risk in certain populations.
So how do you explain the higher prevalence in them? The word multifactorial comes to mind… but I am also curious why there is such a high prevalence of this Neanderthal gene in Bangladesh.
Of course disparities have happened before. Honigsbaum notes that during the Spanish Flu epidemic the death rate in Maoris was seven times that of the white New Zealand population; in Guam one white sailor died but 5% of the local population did; white South Africans had a case fatality rate of 2.6% but for “Blacks, Indians, and Coloureds” it was almost 6%. Poverty? Genes? Previous exposure?
Meanwhile the New York Times reports a change in scientific thinking about transmission risk:
Elected officials in the United States are beginning to acknowledge that the rush to reopen was a mistake, as many of the hardest-hit areas in recent weeks have been places that lifted lockdown restrictions fastest. And one factor seems to be playing an outsize role in the uptick: indoor transmission from businesses like bars and restaurants.
…Scientists from 32 countries are now warning that airborne transmission of the virus indoors should be taken more seriously and are calling on the World Health Organization to revise its recommendations, which they say underestimate the dangers of transmission by tiny, viral particles that linger in the air indoors.
See an article by Morawska and Milton: (https://academic.oup.com/cid/article/doi/10.1093/cid/ciaa939/5867798)
The full article (pre-print, but accepted for publication) underlines the futility of a 1 or 2 metre distancing rule, as indoors spread can take place over tens of metres, not helped of course by air conditioning. As well as the two authors, 239 other scientists have approved the article. That’s an awful lot of scientists to put on a paper! Might they all yet be wrong? Meanwhile a mask seems very sensible, unless you have already had gene sequencing done on your own DNA which proves you don’t have that Neanderthal gene on Chromosome 3.
Dare I return to my hobby horse?
You won’t stop the spread. Testing is unreliable. The Office for National Statistics now says that of those testing positive for SARS-CoV-2 78% are asymptomatic. There may be ways of predicting susceptibility but they are not in common use. There is no vaccine yet. So why not concentrate on treating the cytokine storm syndrome induced by SARS-CoV-2? We know what to use and when to use it.
Oh, and another thing. Just like in wartime there is profiteering, with contracts awarded to companies that have never traded, but appear to have connections. See https://bylinetimes.com/2020/07/02/lifestyle-company-with-no-employees-or-trading-history-handed-25-million-ppe-contract/. Procurement is a good word to use, given its legal usage.