Fail, fail, fail, fail, succeed

Immunology and COVID-19 (Part 1)

Here in NYC, we’re now approaching the sixth week of the COVID-19 outbreak, and I keep thinking about certain questions regarding immunity. To be specific: Why are there people with people high exposure who don’t seem to get it?

“A Mexican immigrant, said she had kept her distance from her mother’s household in East Elmhurst as the virus ripped through its seven members last month, infecting all but one.”

– From the New York Times article “A Tragedy Is Unfolding: Inside New York’s Virus Epicenter,” by Annie Correal and Andrew Jacobs

Why would one person living in close proximity with six infected people not get it? One might imagine that they somehow developed antibodies without becoming ill, but we don’t know, and the article doesn’t give any more information about this particular case.

I’m about to go back to work in the ER after a few days off. It’s not unreasonable to say I have been exposed hundreds, perhaps even a thousand times, yet, at least at this point, I don’t have it.

I’m talking about the worst and most prolonged exposures – performing CPR on the infected, taking an active role in many intubations, performing hands-on care to hundreds of the infected, triaging hundreds more, being in enclosed spaces with COVID positive patients deliriously tearing off their masks and coughing at close distance while I’m putting in IV’s. Mind you, I am extremely disciplined about wearing my PPE, but any healthcare professional will admit that this isn’t foolproof protection. And let’s be clear – this doesn’t mean that I won’t come down with it in the future, but still, I find it curious. And I’m not alone.

So what’s going on here? It would be very interesting to do serum testing to see if these people have antibodies. The results would be useful on at least two levels. There’s a high likelihood they would have some immunity, and, if so, their plasma could possibly be used to treat the critically ill.

I know nothing about this virus is simple, I’m just an ER nurse in the middle of this shitstorm thinking out loud. If you want expert advice from an ER doc in the middle of this, follow Dr. Craig Spencer on Twitter.

As he likes to say: If it can’t find you, it can’t get you.

Do your best to stay away from other people.