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The Immune System's Fight Against the Coronavirus
A central player in the fight against the novel coronavirus is our immune system. It protects us against the invader and can even be helpful for its therapy. But sometimes it can turn against us.
How does our immune system react to the coronavirus?
The coronavirus is — like any other virus — not much more than a shell around genetic material and a few proteins. To replicate, it needs a host in the form of a living cell. Once infected, this cell does what the virus commands it to do: copy information, assemble it, release it.
But this does not go unnoticed. Within a few minutes, the body's immune defense system intervenes with its innate response: Granulocytes, scavenger cells and killer cells from the blood and lymphatic system stream in to fight the virus. They are supported by numerous plasma proteins that either act as messengers or help to destroy the virus.
For many viruses and bacteria, this initial activity of the immune system is already sufficient to fight an intruder. It often happens very quickly and efficiently. We often notice only small signs that the system is working: We have a cold, a fever.
Interferons are a subgroup of signaling proteins that are normally secreted by infected cells. SARS-CoV-1, which was responsible for the SARS epidemic in 2003, appears to have suppressed the production of one of these interferons and thus at least delayed the attraction of immune cells. To what extent this is also the case with SARS-CoV-2, the name given to the coronavirus behind the current pandemic, is still unclear. However, interferons support the body's own virus defense and are now being tested as a therapy in clinical trials.
At a certain point, however, the host response is so strong that its effect can be counterproductive. For example, numerous immune cells can enter our lungs and cause the membrane through which oxygen normally passes from the air into the blood to thicken. The exchange of gases is restricted, and in the worst case, ventilation may be necessary.
Sometimes the reaction can overshoot and be directed against healthy cells as well. This could also be the case with the novel coronavirus. So drugs are also being tested that suppress an excessive immune reaction and that are already known from the treatment of autoimmune diseases. The balance between protective and overly aggressive immune processes in dealing with the coronavirus is currently a big mystery. This must now be investigated, says Achim Hörauf, Director of the Institute of Medical Microbiology, Immunology and Parasitology at the University of Bonn.
After a time delay, the acquired immune system finally sets itself in motion. It is different for every person and depends on what we have experienced and with which pathogens we have come into contact. While T cells help destroy infected cells, B cells form antibodies that can keep the virus in check. In the case of the coronavirus, these are neutralizing antibodies that bind to the spike protein of the virus. This is the site of attack of the virus, with which it enters the host, i.e. our human cell. Neutralizing antibodies specifically incapacitate the spike protein. Our immune system remembers the antibodies it has produced and is thus prepared for a new infection with the same intruder.
Is there an immunity? How long does it last?
The good news is that it is very likely there is an immunity. This is suggested by the proximity to other viruses, epidemiological data and animal experiments. Researchers infected four rhesus monkeys, a species close to humans, with SARS-CoV-2. The monkeys showed symptoms of COVID-19, the disease caused by the coronavirus, developed neutralizing antibodies and recovered after a few days. When the recovered animals were reinfected with the virus, they no longer developed any symptoms: They were immune.
The bad news: It is not (yet) known how long the immunity will last. It depends on whether a patient has successfully developed neutralizing antibodies. Achim Hörauf estimates that the immunity should last at least one year. Within this year, every new contact with the virus acts as a kind of booster vaccination, which in turn might prolong the immunity.
"The virus is so new that nobody has a reasonable immune response," says the immunologist. He believes that lifelong immunity is unlikely. This "privilege" is reserved for viruses that remain in the body for a long time and give our immune system a virtually permanent opportunity to get to know it. Since the coronavirus is an RNA (and not a DNA) virus, it cannot permanently settle in the body, says Hörauf.
The Heidelberg immunologist Stefan Meuer predicts that the novel coronavirus will also mutate like all viruses. He assumes that this could be the case in 10 to 15 years: "At some point, the acquired immunity will no longer be of any use to us because then another coronavirus will return, against which the protection that has now been formed will not help us because the virus has changed in such a way that the antibodies are no longer responsible. And then no vaccination will help either."
How can we take advantage of the antibody response of the immune system?
Researchers are already collecting plasma from people who have successfully survived an infection with SARS-CoV-2 and are using it to treat a limited number of patients suffering from COVID-19. The underlying principle: passive immunization. The studies carried out to date have shown positive results, but they have usually been carried out on only a few people.
At best, passive immunization is used only when the patient's own immune system has already started to work against the virus, says Achim Hörauf: "The longer you can leave the patients alone with the infection before you protect them with passive immunization, the better." Only through active immunization can one be protected in the long term. At the same time, it is difficult to recognize the right point in time.
PCR (polymerase chain reaction) tests are currently used to find out whether a person is infected with the coronavirus. With the help of PCR, it is not possible to tell whether or not there is reproducible viral RNA; it is just a proof of whether the virus is still present, dead or alive. A PCR test cannot tell us whether our immune system has already intervened, i.e. whether we have had contact with the virus in the past, have formed antibodies and are now protected. Researchers are therefore working on tests that check our blood for the presence of antibodies. They are already in use in Singapore, for example, and are nearing completion in the USA. With the help of these tests, it would finally be possible to gain an overview of the unclear case numbers. In addition, people who have developed antibodies against the virus could be used at the forefront of health care, for example. An "immunity passport" is even under discussion.
Is it possible to become infected and/or ill several times with the coronavirus?
"According to all we know, it is not possible with the same pathogen," says Achim Hörauf. It is possible to become infected with other coronaviruses or viruses from the SARS or MERS group if their spike proteins look different. "As far as the current epidemic is concerned, it can be assumed that people who have been through COVID-19 will not become ill from it for the time being and will not transmit the virus any further," he says.
How long before you're no longer contagious?
A study carried out on the first coronavirus patients in Germany showed that no viruses that are capable of replication can be found from day eight after the onset of symptoms, even though PCR can still detect up to 100,000 gene copies per sample. This could change the current quarantine recommendations in the future.
According to the Robert Koch Institute, patients can currently be discharged from hospital if they show two negative PCR samples from the throat within 24 hours. If they have had a severe case of the disease, they should remain in domestic isolation for another two weeks. For each discharge, whether from hospital or home isolation, they should have been symptom-free for at least 48 hours.
Why do people react differently to the virus?
While some people get off with a mild cold, others are put on ventilators or even die of SARS-Cov-2. Especially people with pre-existing conditions and older people seem to be worst-affected by the virus. Why? This is the hottest question at the moment.
It will still take a very, very long time to understand the mechanistic, biological basis for why some people are so much more severely affected than others, virologist Angela Rasmussen told The Scientist. "The virus is important, but the host response is at least as important, if not more important," her colleague Stanley Perlman told the magazine.
Stefan Meuer sees a fundamental survival principle of nature in the different equipment and activity of our immune systems: "If we were all the same, one and the same virus could wipe out the entire human species at once. Due to the genetic range, it is quite normal that some people die from a viral disease while others do not even notice it. "
Achim Hörauf also suspects immunological variants that could be genetically determined. Since interstitial pneumonia is observed with the coronavirus, the focus is probably on an overreaction of the immune system. However, it is also possible that each person affected may have been loaded with a different dose of the virus, which in turn leads to different outcomes. And finally, it makes a difference how robust the body and lungs are: Competitive athletes simply have more lung volume than long-time smokers.
Reposted with permission from DW.
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By Alex Thornton
The Australian government has announced a A$190 million (US$130 million) investment in the nation's first Recycling Modernization Fund, with the aim of transforming the country's waste and recycling industry. The hope is that as many as 10,000 jobs can be created in what is being called a "once in a generation" opportunity to remodel the way Australia deals with its waste.
Waste Mountain<p>The need for a dramatic increase in Australia's recycling capacity pre-dates the COVID-19 pandemic. <a href="https://www.abc.net.au/news/2019-12-27/where-does-all-australias-waste-go/11755424" target="_blank">Australians create approximately 67 million tons of waste a year</a>, and like in many wealthy countries, much of that was sent overseas. That all changed when China announced it was <a href="https://www.weforum.org/agenda/2017/10/china-has-banned-foreign-waste-so-whats-the-future-of-world-recycling" target="_blank">banning the import of a huge range of foreign waste</a> and recyclables. Soon <a href="https://www.weforum.org/agenda/2019/05/malaysia-flooded-with-plastic-waste-to-send-back-some-scrap-to-source" target="_blank">other countries followed suit</a>, and Australia was forced to look for alternative solutions.</p>
Biggest exporters of plastic. Statista
Waste Export Ban<p>Australia has adopted a strategy of taking responsibility for its own waste. Starting in January 2021, it is phasing in <a href="http://www.environment.gov.au/protection/waste-resource-recovery/waste-export-ban" target="_blank">bans on the export of different forms of waste</a>. By mid 2024, Australia's home-grown recycling industry will have to deal with an extra 650,000 tons of waste plastic, paper, glass and tires.</p><p>"As we cease shipping our waste overseas, the waste and recycling transformation will reshape our domestic waste industry, driving job creation and putting valuable materials back into the economy," federal environment minister Sussan Ley said in a <a href="https://uk.reuters.com/article/us-australia-waste/australia-to-set-up-132-million-fund-to-boost-recycling-following-export-curbs-idUKKBN247060" target="_blank">statement to Reuters</a>.</p>
Timeline for Australia's waste export ban. Australian Government
Trash Into Treasure<p>The benefits to the environment of boosting recycling rates are well known – less landfill, less plastic in our ocean, reduced need for virgin materials, and lower carbon emissions. The Recycling Modernization Fund initiative aims to divert more than 10 million tons of waste from landfill, part of an <a href="http://www.environment.gov.au/protection/waste-resource-recovery/publications/national-waste-policy-action-plan" target="_blank">overall strategy to reduce the total waste generated per person by 10%</a>, and push <a href="https://www.environment.gov.au/system/files/resources/7381c1de-31d0-429b-912c-91a6dbc83af7/files/national-waste-report-2018.pdf" target="_blank">Australia's total resource recovery rate from 58% in 2017</a> to 80% by 2030.</p><p>But like many countries, Australia is focusing on the economic benefits of better waste management as well.</p><p>"This will mean Australia converts more waste into higher valued resources ready for reuse locally by manufacturers and brands in their packaging and products," Rose Read, CEO of the National Waste and Recycling Industry Council, <a href="https://uk.reuters.com/article/us-australia-waste/australia-to-set-up-132-million-fund-to-boost-recycling-following-export-curbs-idUKKBN247060" target="_blank">told Reuters</a>.</p>
Green Jobs<p>The great potential of the circular economy to create green jobs is being recognized across the world.</p><p>In the UK, the Waste and Resources Action Program has launched a <a href="https://wrap.org.uk/buildbackbetter" target="_blank">six-point plan which it claims could add $90 billion to the economy, and create 500,000 new jobs</a>. Investment in the circular economy forms a significant part of the <a href="https://www.nytimes.com/2020/07/14/us/politics/biden-climate-plan.html" target="_blank">$2 trillion climate plan that Democratic candidate Joe Biden</a> is taking into November's US presidential election. And the <a href="https://ec.europa.eu/commission/presscorner/detail/en/ip_20_940" target="_blank">European Union has put its Green New Deal at the heart of its plans for recovery</a> from the economic shock of COVID-19.</p><p>The World Economic Forum's <a href="http://www3.weforum.org/docs/WEF_The_Future_Of_Nature_And_Business_2020.pdf" target="_blank">Future of Nature and Business</a> report identifies 15 systemic transitions with annual business opportunities worth $10 billion a year that could create 395 million jobs by 2030.</p><p>As is the case with Australia's Recycling Modernization Fund, a combination of private enterprise and government investment can offer ways to get people back to work by building a more environmentally sustainable economy.</p>
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The Great American Outdoors Act is now the law of the land.
<div id="e0008" class="rm-shortcode" data-rm-shortcode-id="ffc07febbf5d2d585ad06d3f43e2be56"><blockquote class="twitter-tweet twitter-custom-tweet" data-twitter-tweet-id="1290667833999929344" data-partner="rebelmouse"><div style="margin:1em 0">🚨Breaking News: The President has just signed the bipartisan #GreatAmericanOutdoorsAct. It will help: 🏗️ Restore… https://t.co/RPefKPMn7S</div> — Fix Our Parks (@Fix Our Parks)<a href="https://twitter.com/FixOurParksUS/statuses/1290667833999929344">1596554165.0</a></blockquote></div>
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By Andrew J. Whelton and Caitlin R. Proctor
In recent years wildfires have entered urban areas, causing breathtaking destruction.
Survivors left everything to flee the Camp Fire's path. Andrew Whelton / Purdue University
Wildfires and Water<p>Both the Tubbs and Camp fires destroyed fire hydrants, water pipes and meter boxes. Water leaks and ruptured hydrants were common. The Camp Fire inferno spread at a speed of one football field per second, chasing everyone – including water system operators – out of town.</p><p>After the fires passed, testing ultimately revealed widespread hazardous drinking water contamination. Evidence suggests that the toxic chemicals originated from a combination of <a href="https://doi.org/10.1002/aws2.1183" target="_blank">burning vegetation, structures and plastic materials</a>.</p>
Pipes, water meters and meter covers after wildfires destroyed them. Caitlin Proctor, Amisha Shah, David Yu, and Andrew Whelton/Purdue University
Dangerous Contamination Levels<p>Benzene was found at concentrations of 40,000 parts per billion (ppb) in drinking water after the Tubbs Fire and at more than 2,217 ppb after the Camp Fire. According to the California Office of Environmental Health Hazard Assessment, children exposed to benzene for a single day can suffer <a href="https://engineering.purdue.edu/PlumbingSafety/resources/Benzene-Levels-in-Water.pdf" target="_blank">harm at levels as low as 26 ppb</a>.</p><p>The U.S. Environmental Protection Agency recommends limiting children's short-term acute exposure to <a href="https://www.epa.gov/sites/production/files/2018-03/documents/dwtable2018.pdf" target="_blank">200 ppb</a>, and long-term exposure to less than <a href="https://www.epa.gov/ground-water-and-drinking-water/national-primary-drinking-water-regulations" target="_blank">5 ppb</a>. The EPA regulatory level for what constitutes a hazardous waste is <a href="https://19january2017snapshot.epa.gov/sites/production/files/2015-06/documents/tclp.pdf" target="_blank">500 ppb</a>.</p><p>In early 2019, California conducted contaminated water testing on humans by taking contaminated water from the Paradise Irrigation District and asking persons to smell it. The state found that even when people smelled contaminated water that had less than 200 ppb benzene, <a href="https://engineering.purdue.edu/PlumbingSafety/resources/Dissipatiion-of-Burn-Related-VOC-From-Water.pdf" target="_blank">at least one person reported nausea and throat irritation</a>. The test also showed that water contained a variety of other benzene-like compounds that first responders had not sampled for.</p><p>The officials who carried out this small-scale test did not appear to realize the significance of what they had done, until we asked whether they had had their action approved in advance by an institutional review board. In response, they asserted that such a review was not needed.</p><p>In our view, this episode is telling for two reasons. First, one subject reported an adverse health effect after being exposed to water that contained benzene at a level below the EPA's recommended one-day limit for children. Second, doing this kind of test without proper oversight suggests that officials greatly underestimated the potential for serious contamination of local water supplies and public harm. After the Camp Fire, together with the EPA, we estimated that some plastic pipes needed <a href="https://engineering.purdue.edu/PlumbingSafety/opinions/Final-HDPE-Service-Line-Decontamination-2019-03-18.pdf" target="_blank">more than 280 days</a> of flushing to make them safe again.</p>
Plastic pipes can be damaged by heat and fire contact. Andrew Whelton / Purdue University
Building Codes Could Make Areas Disaster-Ready<p>Our research underscores that community building codes are inadequate to prevent wildfire-caused pollution of drinking water and homes.</p><p>Installing one-way valves, called backflow prevention devices, at each water meter can prevent contamination rushing out of the damaged building from flowing into the larger buried pipe network.</p><p>Adopting codes that required builders to install fire-resistant meter boxes and place them farther from vegetation would help prevent infrastructure from burning so readily in wildfires. Concrete meter boxes and water meters with minimal plastic components would be less likely to ignite. Some plastics may be practically impossible to make safe again, since all types are susceptible to fire and heat.</p><p>Water main shutoff valves and water sampling taps should exist at every water meter box. Sample taps can help responders quickly determine water safety.</p>
<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="9540d7e271306ed417112042a3efc9a4"><iframe lazy-loadable="true" src="https://www.youtube.com/embed/GnlrzI1wdAI?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span>
The Smell Test Doesn’t Work<p>Under no circumstance should people be told to <a href="https://www.waterboards.ca.gov/press_room/press_releases/2018/pr122418_voc.pdf" target="_blank">smell the water</a> to determine its safety, as was recommended for months after the Camp Fire. Many chemicals have no odor when they are harmful. Only testing can determine safety.</p><p>Ordering people to boil their water will not make it safe if it contains toxic chemicals that enter the air. Boiling just transmits those substances into the air faster. "Do not use" orders can keep people safe until agencies can test the water. Before such advisories are lifted or modified, regulators should be required to carry out a full chemical screen of the water systems. Yet, <a href="https://doi.org/10.1002/aws2.1183" target="_blank">disaster</a> after <a href="https://pubs.rsc.org/en/content/articlehtml/2017/ew/c5ew00294j" target="_blank">disaster</a>, government agencies have failed to take this step.</p><p>Buildings should be tested to find contamination. <a href="https://www.purdue.edu/newsroom/releases/2020/Q1/study-your-homes-water-quality-could-vary-by-the-room-and-the-season.html" target="_blank">Home drinking water quality can differ from room to room</a>, so reliable testing should sample both cold and hot water at many locations within each building.</p><p>While infrastructure is being repaired, survivors need a safe water supply. Water treatment devices sold for home use, such as refrigerator and faucet water filters, are not approved for extremely contaminated water, although product sales representatives and government officials may <a href="https://undark.org/2019/09/19/camp-fire-california-drinking-water-carcinogens/" target="_blank">mistakenly think</a> the devices can be used for that purpose.</p><p>To avoid this kind of confusion, external technical experts should be called in assist local public health departments, which can quickly become overwhelmed after disasters.</p>
<div id="71cf9" class="rm-shortcode" data-rm-shortcode-id="e059d199e8368d282a31601e372e4dda"><blockquote class="twitter-tweet twitter-custom-tweet" data-twitter-tweet-id="1204068265980547075" data-partner="rebelmouse"><div style="margin:1em 0">The Los Angeles City Council's Planning and Land Use Committee signed off on an effort to expand the city's fire-re… https://t.co/fP8Z8mUq7R</div> — IntlCodeCouncil (@IntlCodeCouncil)<a href="https://twitter.com/IntlCodeCouncil/statuses/1204068265980547075">1575907219.0</a></blockquote></div>
Preparing for Future Fires<p>The damage that the Tubbs and Camp fires caused to local water systems was preventable. We believe that urban and rural communities, as well as state legislatures, should establish codes and lists of authorized construction materials for high-risk areas. They also should establish rapid methods to assess health, prepare for water testing and decontamination, and set aside emergency water supplies.</p><p>Wildfires are coming to urban areas. Protecting drinking water systems, buried underground or in buildings, is one thing communities can do to prepare for that reality.</p>
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