While I'm still hearing people talk vaguely about "strengthening the immune system" or "damping down overactive immune response", the picture that is emerging is much more complex. We have previously learned that this coronavirus, and probably others, manages to make the RNA it places in cells look like the cell's own mRNA, operating under a false flag as it were. The term
RNA cap turns up in searches. More complexity seems likely.
Here's
a financial press report on new work at Hong Kong University.
The paper which triggered the interview was published in
Immunity. This suggests that severe cases involve broad suppression of different types of immune cells: T-cells, dendritic cells, NK cells and monocytes. This is much more extensive than previous research has documented. In addition it affects both CD8+ "killer" T-cells and CD4+ "helper" T-cells.
The financial implications were that it may be more difficult to develop effective vaccines than commonly assumed, and harder to pick the eventual winner. This also means we need treatment options available before vaccines are effective and widely available.
This sounds a lot more like the mysterious immune disturbances seen in ME/CFS patients, though perhaps worse than most experience. We have virtually no studies of the acute infection which precipitates many ME/CFS cases, so I can't compare SARS-CoV 2 with these. None of us expected sequelae to last years when we first became ill, and many modern tests of immune function simply did not exist, for example during the
Royal Free Hospital outbreak of 1955.
Sheer speculation on my part: I've long thought we were dealing with a "two-hit" pathogen. I was exposed to the "Punta Gorda Flu" in 1956, but was only mildly affected. In 1957 I had "the worst flu of my life" when the
Asian flu hit. My father, who had survived the 1918 flu soon after he was born, was immune. There was some cross-immunity between H1N1 and H2N2. (I believe there was some H1N1 circulating prior to H2N2, but that epidemic was much smaller.) A disregulated immune system hit with a powerful ordinary pathogen could explain the wide range of severity patients experienced.
A personal note: the "Asian flu" was a prequel to our current pandemic. Despite being very ill, I never saw a doctor. Hospitals were overwhelmed. Prescriptions were made by telephone. Immunity came from surviving infection. There was little protective equipment. Most treatment was symptom-based and supportive. I don't believe there were any effective antivirals. The pandemic eventually burned itself out. There were 116,000 deaths in the U.S., which had a smaller population then (172 million), and 1.1 million deaths in the world. That last is probably an undercount.
