Why does the coronavirus sometimes strike young people?

It's usually clearcut.  The virus only strikes people with impaired immune systems -- people who have other ailments.  Old people normally have other ailments so they are very often affected by the virus.

And when young people get it, they are usually ones who are ill already. They too have other ailments.  But how come there are a few cases of young people being infected who seem otherwise healthy? Why does the virus single them out?  Why in their case was being young and healthy not enough to protect them?

The article from a major medical journal below shows why in at least some cases.  It shows that they have a genetic defect that weakens their immune system in crucial ways. That may not be the answer in all cases but it is clearly now an in principle explanation.  The vast majority of young people are safe


Presence of Genetic Variants Among Young Men With Severe COVID-19

Caspar I.van der Made et al.

Abstract

Objective:  To explore the presence of genetic variants associated with primary immunodeficiencies among young patients with COVID-19.

Design, Setting, and Participants Case series of pairs of brothers without medical history meeting the selection criteria of young (age <35 years) brother pairs admitted to the intensive care unit (ICU) due to severe COVID-19. Four men from 2 unrelated families were admitted to the ICUs of 4 hospitals in the Netherlands between March 23 and April 12, 2020. The final date of follow-up was May 16, 2020. Available family members were included for genetic variant segregation analysis and as controls for functional experiments.

Main Outcome and Measures:  Results of rapid clinical whole-exome sequencing, performed to identify a potential monogenic cause. Subsequently, basic genetic and immunological tests were performed in primary immune cells isolated from the patients and family members to characterize any immune defects.

Results:  The 4 male patients had a mean age of 26 years (range, 21-32), with no history of major chronic disease. They were previously well before developing respiratory insufficiency due to severe COVID-19, requiring mechanical ventilation in the ICU. The mean duration of ventilatory support was 10 days (range, 9-11); the mean duration of ICU stay was 13 days (range, 10-16). One patient died. Rapid clinical whole-exome sequencing of the patients and segregation in available family members identified loss-of-function variants of the X-chromosomal TLR7. In members of family 1, a maternally inherited 4-nucleotide deletion was identified (c.2129_2132del; p.[Gln710Argfs*18]); the affected members of family 2 carried a missense variant (c.2383G>T; p.[Val795Phe]). In primary peripheral blood mononuclear cells from the patients, downstream type I interferon (IFN) signaling was transcriptionally downregulated, as measured by significantly decreased mRNA expression of IRF7, IFNB1, and ISG15 on stimulation with the TLR7 agonist imiquimod as compared with family members and controls. The production of IFN-γ, a type II IFN, was decreased in patients in response to stimulation with imiquimod.

Conclusions and Relevance:  In this case series of 4 young male patients with severe COVID-19, rare putative loss-of-function variants of X-chromosomal TLR7 were identified that were associated with impaired type I and II IFN responses. These preliminary findings provide insights into the pathogenesis of COVID-19

SOURCE

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New pill that could prevent COVID-19 from entering body cells gets FDA OK for human trials

AI Therapeutics in Guilford received some exciting news from the FDA this week. Their drug, currently being used to treat some forms of cancers, will now go through 60-90 days of human trials at Yale and other locations across the country in an effort to prevent COVID-19.

Entrepreneur and genetics expert Jonathan Rothberg, Ph.D., shared details of the drug, Apilimod’s, promise, so far.

“A Gates Foundation study tested 13,000 compounds AI Therapeutics LAM 2 Apilimod, was the number one compound out of 13,000 tested and it stops the entry of the virus. You stop the virus from getting in the cell, you stop the virus,” says Rothberg.

He says the drug is already being used to treat some cancers.

“We know the drug is safe, it’s been safe in over 700 people but now we have to go from stopping the virus in a petri dish to stopping it in people we love, and that’s what is happening at Yale University.”

He says their goal is to demonstrate that in only a few days the pill is able to stop the effects of the virus and prevent a COVID-19 infection.

“The FDA has just given us approval to test it as a potential cure for COVID-19 and only after we show efficacy will we use it as a chemical vaccine,” says Rothberg.

He explained how COVID-19 enters our body: “The virus uses a mechanism similar to a garbage chute to get into your cell, and we shut it down and by shutting it down the virus has no access to the cell.”

Rothberg is also behind a company mass-producing $30 molecular home COVID tests that do not rely on antibodies. They are awaiting FDA approval. Rothberg came up with the idea in early March and his team went to work quickly.

Another one of his teams at Butterfly in New Haven created a hand-held ultrasound, revolutionizing patient testing around the world.

As for the drug, Rothberg says it has been tested in Wuhan, China and they have stocked enough compounds to make 5,000,000 pills if and when they receive the proper FDA approvals and clearances.

SOURCE 

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We need a Covid plan that is, dare I say it, sustainable

Comment from Australia, where the issues are similar:

When Victorian Premier Daniel Andrews blamed his own population for spreading the coronavirus, accusing them of flouting self-isolation rules (actually, his health authorities had given them the wrong advice), he threatened an extension of the current lockdown. Quite aside from the ugly blame-shifting by a leader who is yet to account for his government’s mistakes, few people seemed to consider the crucial sustainability question.

Can Victoria really keep going into lockdown? At what point does the balance between public health, economic wellbeing, community needs and individual livelihoods, deserve realistic evaluation? If you keep locking down, there won’t be much to lock down.

The whole country locked down in March and the federal government budgeted an unfathomable $130bn to sustain people through the following six months. They got the numbers wrong in a $60bn mistake that surely would have cost the Treasurer his job if the error had been to the other side of the ledger.

The wage replacement scheme has been extended by six months and $20bn but unemployment is still expected to top 9 per cent.

What if states are still locking down in a year? What if the virus is running rampant so that tourism and hospitality businesses cannot function 18 months from now? Would it be sustainable for wage replacement schemes, additional unemployment benefits and special industry stimulus packages to continue?

Scott Morrison, Treasurer Frydenberg and Health Minister Greg Hunt deserve enormous credit for putting Australia in this position; if an effective vaccine is readily available worldwide within a year, their response will rank as one of the world’s best.

But even if the current Victorian outbreak is suppressed and our national economy can operate relatively freely behind sealed international borders, how will we be placed in a year if the virus continues to run rampant across the world? How long can we continue to close ourselves off from overseas students, tourists and immigrants?

Would we simply be delaying the eventual spread of the virus across our nation? Would all our most drastic and costly measures have been in vain?

What we have done so far has our COVID-19 death rate per million people sitting at less than six, whereas the US is over 400, and in Britain and Spain it is more than 600. How long can we afford the policies that have delivered this staggering success?

We should thank our lucky stars that upwards of 98 per cent of infected people suffer minor symptoms only and the young are virtually impervious to the virus (compared to the Spanish flu which killed infants and healthy young people in their millions). We need ways of dealing with outbreaks that fall well short of closing businesses, crushing livelihoods and banning human interactions.

This is where widespread mask-wearing, social distancing and hygiene, coupled with protections for the vulnerable, offer vastly more sustainable options. We eventually might have to learn to live with the disease.

The economic sustainability of hard borders restricting interstate travel is highly questionable, especially for tourism and hospitality. And these measures hurt socially; communities like Albury-Wodonga and Coolangatta-Tweed Heads are being torn apart; families are being kept from each other.

Our politicians have been too eager to outsource decision-making to medical experts who have a singular focus on preventing infections, which we know can be stopped dead if we cease all human interaction.

This represents the “collapse of government legitimacy”, according to the Manhattan ­Institute’s Heather MacDonald, who has written about this phenomenon in the US.

“For three months, public officials abdicated their responsibility to balance the costs and benefits of any given policy,” she says. “They put the future of hundreds of millions of Americans in the hands of a narrow set of experts who lack all awareness of the workings of economic and social systems, and whose science was built on the ever-shifting sand of speculative models and on extreme risk aversion regarding only one kind of risk.”

MacDonald said the experts were “deaf to the pleas of law-abiding business owners who saw their life’s efforts snuffed out” as these decisions destroyed wealth through arbitrary decision making. This tragic summary sounds gut-wrenchingly familiar.

Secure in their permanent tenure, bureaucrats and publicly funded broadcasters have barracked for ever more draconian measures while the price has been paid by the unemployed and small business owners who have seen their hard-won assets eviscerated. As always, it is for politicians to carefully weigh-up costs and benefits.

Consider how the coronavirus measures have all but eradicated influenza infections this year and, according to the statistics, saved more lives than we have lost to COVID-19. Yet would we suggest imposing these lockdown measures every year, at these costs, to save 150 lives or so from flu? ­Obviously not, or else we would have done it ages ago.

Our leaders have changed their pandemic objectives on us without saying so explicitly. We were told initially that we were locking down to give authorities time to expand capacity within our health system so the pandemic would not overwhelm us.

Authorities tripled the availability of critical care beds nationally from just over 2000 to more than 7500 but, so far, the pandemic has not required more than 100 on any given day and fewer than 50 are being used now. We have ample surge capacity.

According to the original rationale, we ought to be more relaxed about higher levels of infection without shutting down society. So long as our hospitals are not overwhelmed, this might be more sustainable than lockdowns, especially if it is inevitable that we end up in this situation eventually anyway.

Instead, state politicians seem to be taking every infection case within their borders as a political blow. There is an absence of national policy as states ignore urgings from Canberra and shut borders and cities.

State governments seem able to shut down anything, except protests. And they are prepared to implement every pandemic ­response, so long as the federal government funds it.

This is the devolution of the federation; we are not all in this together, each state is in it for ­itself. It is not sustainable.

SOURCE 

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IN BRIEF

Trump ends Obama's socially engineered Affirmatively Furthering Fair Housing rule (National Review)

"People don't make a distinction ... from a South Korean and someone from Beijing": Joe Biden makes racist comments while accusing Trump of being racist (The Federalist)

Biden says America has "never" had a more racist president than Donald Trump. Here are eight. (PJ Media)

Michigan, Minnesota, and Texas: Three races that will decide Senate control (Washington Examiner)

Wall Street Journal boldly vows not to "wilt under cancel culture pressure" or yield to "conformity and intolerance" (UK Daily Mail)

Nailed it: Washington Redskins to use "Washington Football Team" name for 2020 (NBC Sports)

Mayor Lori Lightfoot has Christopher Columbus statues clandestinely removed from Chicago parks (Chicago Tribune)

Reality is enlightening: Democrat Oakland mayor votes down further police budget cuts after vandals defaced her house (The Daily Caller)

In landmark speech, Secretary of State Mike Pompeo says China is world's biggest threat (The Washington Free Beacon)

FBI interviewing Chinese visa holders suspected of hiding military ties (Reuters)

186,700 illegal immigrants from 130 nations stopped by coronavirus border closure (Washington Examiner)

Tesla will build its next Gigafactory in tax-friendly Texas (CNBC)

Do as I say, not as I do: DC mayor exempts many city and federal government workers from strict new mask order (JusttheNews.com)

Cancel-culture fallout: Majority of Americans (62%) afraid of expressing political beliefs (The Washington Free Beacon)

Redwood City, California, removed "Black Lives Matter" street painting after request for "MAGA 2020" mural (The Hill)

Policy: Making the stimulus checks count: How Congress can better target a second round of economic impact payments (American Enterprise Institute)

Policy: Executive order on drug price controls would backfire (Forbes)

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