COVID-19 in the News

Three years into the pandemic, the immune systems of the vast majority of humans have learned to recognize SARS-CoV-2 through vaccination, infection or, in many cases, both. New evidence suggests that "hybrid" immunity, the result of both vaccination and a bout of COVID-19, can provide partial protection against reinfection for at least eight months and protection against severe disease or hospitalization for between six months and a year. But the durability of immunity is much more complex than the numbers suggest. "And that has more to do with the virus and how much it mutates," said Deepta Bhattacharya, an immunologist at the University of Arizona College of Medicine – Tucson.

Several virologists published a commentary in mBio that states that all of the evidence to date indicates that the COVID-19 pandemic started naturally when a virus jumped from animals into people. Felicia Goodrum, a professor of immunobiology at the University of Arizona, is one of the authors. She says work with viruses is highly regulated and more regulation could slow down vital research. "The worst case scenario that I fear definitely is that we are going to limit our preparedness and our ability to respond to coming pandemics," Goodrum said.

The Food and Drug Administration is considering a major shift in the nation's COVID-19 vaccine strategy. The goal is to simplify vaccination against COVID and perhaps adopt an approach similar that used for the flu vaccine, with annual updates to match whatever strain of the virus is circulating. Some immunologists and vaccine researchers consider simplifying the process along the lines of the flu vaccine is appropriate at this point in the pandemic. However, many questions remain about emerging booster strategy. "As far as the tools that we have right now, I think it just makes the most sense to plan to update each year as close as we can to the currently circulating variant," said University of Arizona professor of immunobiology Deepta Bhattacharya. "So I think all the things the FDA is considering make a lot of sense."

XBB.1.5, the highly contagious COVID-19 sub-variant currently fueling a widespread rise in case numbers, evolved from the Omicron strain of the coronavirus. Omicron was so genetically distinct from previous strains, and so quickly crowded out other versions, it prompted scientists to adopt a new nomenclature. "I am actually fine with not giving new Greek letters to subvariants of Omicron," wrote University of Arizona professor of ecology and evolutionary biology Michael Worobey in a statement, adding he's fine not naming Pi until another true variant emerges and begins to spread.

In the two-plus years that COVID vaccines have been available in the U.S., the basic recipe has changed just once. But experts say SARS-CoV-2's evolutionary sprint might not be the only reason immunity can get bogged down. The body seems to fixate on the first version of the virus that it encountered, either through injection or infection – what researchers call "original antigenic sin." "I really, really hate that term," said Deepta Bhattacharya, an immunologist at the University of Arizona. Instead, Bhattacharya and others prefer to use more neutral words such as imprinting, evocative of a duckling latching onto the first maternal figure it spots.

Timian Godfrey, a Navajo assistant clinical professor of nursing at the University of Arizona, traveled to the Navajo Nation in early 2021 to help with its mass vaccination campaign. Barriers to health care access and high rates of chronic diseases made the Diné community highly vulnerable; leaders responded with strict lockdowns and other safety measures. Getting vaccines into arms was the next phase of Navajo Nation's response. Godfrey said people waited in line for upward of four hours to get their vaccinations. "We heard so many devastating stories, but also the commitment of them knowing that this is what they could do for their family and to protect their loved ones," she said.

COVID-19 has killed millions around the world, including more than 1 million in the United States. But some people who have been infected have no symptoms at all. Others have the equivalent of a head cold. Some patterns are intuitive. Many of the deaths have been in people over age 70, or who suffer from chronic health conditions that undermine their ability to fight off the infection. But sometimes the variability of the illness makes little sense, a fact that has surprised Deepta Bhattacharya, professor of immunology at the University of Arizona College of Medicine – Tucson. "For instance, my dad and my sister both got it in May. My dad barely knew. He has asthma, and so he just thought it was just his asthma flaring up," he said. "My sister had a much rougher go of it. She had a pretty bad cough that lasted over a month. And they had the same vaccine history. They both had had three shots at the time that they got it."

As of last week, nearly all 50 states were seeing a high or very high level of respiratory illness, and the Centers for Disease Control and Prevention warned that rates will likely continue to increase. U.S. officials estimate that so far this season, there have been at least 13 million cases of flu, 120,000 hospitalizations and 7,300 deaths, including of 21 children. Doctors say the chaos has resulted in frazzled parents begging for antibiotics (even when they are told it won't help their children recover from viruses), shortages of basic essential medications such as fever reducers and albuterol to open airways, and a barrage of questions about the interaction of different viruses in our bodies. "When you take a pandemic and then add co-circulation of other viruses in the mix, you might expect to see some weird things," said Deepta Bhattacharya, an immunologist at the University of Arizona.

A lack of doctors entering infectious disease  fellowships – and the ensuing shortage of these specialists – has been a concern for years, with experts pointing to the comparatively low earnings these physicians make as a major disincentive for doctors considering which field to enter. University of Arizona assistant professor of medicine Saman Nematollahi, the associate program director of the university's fellowship, pointed out that throughout the pandemic, ID specialists were not just treating patients. They were drafted into setting up infection policies at their hospitals and serving as advisers to state and local governments, school districts and beyond. "We do it because we know how important it is to public health," said Nematollahi, who's involved with a group called the ID Fellows Network that promotes training and education. "But it's extra work that is not compensated."

Following a wave of protests, the government of China recently relaxed some of its most stringent zero-COVID protocols, and regional authorities trimmed back a slew of requirements for mass testing, quarantine and isolation. "Eventually, just like everyone else on Earth, everyone in China should expect to be infected," said University of Arizona professor of ecology and evolutionary biology Michael Worobey.