I’ve warned before not to believe one single publication until it is confirmed by others, but this study looks solid enough, and there’s another that partially confirms it.
One of the things that has worried me most about SARS-CoV-2 is that it may not provoke robust immunity. That would leave us all vulnerable to it forever, and it would be impossible to stamp out. These studies suggest that a vaccine is possible, or at least that having had COVID-19 confers immunity. There’s no data about how long that immunity lasts, though.
Science magazine has a readable summary of the research. I’ll summarize the findings.
- Helper T cells, part of our immune system, recognize SARS-CoV-2 proteins and react to them, including the important spike protein that attaches to cells so that the virus can infect them.
- The T cell response is strong enough to suggest a vaccine is possible.
- In the second study, T cells from people who have not had COVID-19 responded to virus proteins. This may be because other coronaviruses, which cause colds, are similar enough to provoke the response.
You can bet that virologists working on vaccines are reading these papers, and the ones whose approach is immunization through viral proteins are feeling good about them. But it’s still a long way to a vaccine.
Open thread!
Crusty Dem
Similar results in Cell:
https://www.cell.com/cell/fulltext/S0092-8674(20)30610-3
Frankensteinbeck
I think there will be a vaccine, an effective treatment drug, or both well ahead of expected schedule. The entire world except the US is Hell bent to cure this plague. There are hard time limits, but curing it will be right up against those. And when the vaccine is ready, if it happens before November, Trump will fuck up the distribution and implementation. Normally it would be the greatest reelection gift he could get, but if it arrives he’ll find a way to squander that electoral bump.
leeleeFL
Thank you, Cheryl. Read this earlier, in a downstream thread. I hope that the Helper T cells are what have kept me free of this charming virus, because I am back at work in the food service industry for two weeks now, and so far I seem ok.
The area in Florida where I live seems, so far, to have avoided hot-spot status, but when the tourists come back for the beaches, I am really going to be worried. I won’t be waiting on them, but they will likely know or meet up with people I will be waiting on. To say nothing of shopping and such.
MattF
@Crusty Dem: Derek Lowe summarizes the Cell paper, and provides some background.
trollhattan
@Frankensteinbeck:
Even Trumpier, he’ll fuck it up scrambling to make money off of it. Trumplings and Kush will be his proxies.
WaterGirl
@Frankensteinbeck:
Maybe, maybe not. That depends not just on scientific breakthroughs, but also on being prepped to ramp up as soon as we think we have a winner(s).
If we don’t do any of the manufacturing prep work, I bet we lose something on the order of a year in getting whatever is discovered out to everyone everywhere.
Cheryl Rofer
@Crusty Dem: That’s the article I linked
Cheryl Rofer
@MattF: I can tell you haven’t read my post either
MattF
@Cheryl Rofer: I followed one of your links but not the other. I apologize. I’ll back out slowly now.
Calouste
@WaterGirl: Bill Gates said a month or so ago that he was going to finance building factories for the 7 most promising vaccines, fully knowing that most likely only one or two of them are going to be effective. He said that wasting a few billions on redundant factories was a great investment compared to the trillions the world economy is losing.
Cheryl Rofer
Even with a breakthrough, and it’s foolish to count on those, the most time-consuming part of developing a vaccine is testing it. The first clinical trial (that is, a trial in humans) is for safety. It would be tested in animals before that, to see if it does anything obviously horrible. The second clinical trial is to judge efficacy. Recruiting people for these trials takes time. You have to do the first before the second, and the animal trials before the first because it’s unethical do inject stuff into humans that might kill them.
The second clinical trial will take some time to see if, how, and when immunity develops, which may not be immediate. Several months is not unreasonable.
And then there’s scaling up. I’m not sure of the status of Bill Gates’s proposal to build several production facilities for different kinds of vaccines. It would be prudent to start building them now, but even with a ready facility, it can take a while to get production going smoothly.
So the end of the year looks very doubtful. I’m estimating two years as the earliest.
NotMax
Can’t find the link right at the moment but did see a mention that five of the recovered crew members who returned to duty on the Roosevelt have tested positive a second time.
ziggy
@Frankensteinbeck: Rick Bright said that we are not mobilized to manufacture and distribute a vaccine, even if an effective one becomes available soon. Then I also have no doubt that Trump will completely eff up the process, both on purpose and because his whole cabinet is incompetent, and he’s hamstrung anyone who is competent. He will try to get more vaccines to red states, blue states hosed, and purple states depending on who is governor and how he feels about them that day. We are going to be a sorry mess on election day, no matter how vaccine development proceeds.
I was hoping that the regional pacts (Pacifica!) could somehow negotiate and get their own testing equipment, medicine and vaccines, and create their own vaccine manufacturing ability, but I haven’t heard of this happening. Hopefully it is happening quietly.
laura
Maybe it’s just me, but I cannot shake a sense of deja vu as the mysteries of hiv/aids and CV19 may have a common thread in T cells. Reagan was every bit as much in denial as trump is. The crushing recession of 1981 and 82 revealed an inequality more race than class based. Opiods instead of coke and crack. The politicization of the illness and demonization of its victims as deserving of a miserable and lonely death. Anthony Fauci faced fierce opposition to his recommendations to minimize spread. I worked at the grocery store in Guerneville along the Russian River. So much death. So much suffering. Philip was memorable because of his rage – just incandescent and bristling with anger as kaposi ravaged his body his face. I have never forgotten ringing up his items and being told he went home and died in his kitchen groceries surround his body. The San Francisco Chronicle documenting the entirety of what was first described as GRID. Randy Shilts’ work ultimately resulted in And The Band Played On.
I do not know who will emerge as CV19’s Randy Shilts but the times we’re in sure seems eerily familiar. Racing against time.
Cheryl Rofer
@NotMax: I saw something like that too. That happened in South Korea a while back, and they’ve found that those later positives were testing errors. I’m guessing the same for the Roosevelt crew.
lgerard
Developing a vaccine or therapeutic treatment regime may not be enough, as it doesn’t account for these people
I see figures of up to 20% of the population refusing a vaccine because they are afraid of being turned into one of Bill Gates’s houseplants.
Jim, Foolish Literalist
@Cheryl Rofer:
One of my many concerns is that trump will bully through a vaccine before it’s safe. Two years ago I wouldn’t have thought he could, but it astounds me the way the guardrails fall away for a third-rate, racist game-show host.
NotMax
@Igerard
Millions shambling through the streets shouting “
BrainsssWindooows!”:)
Aleta
H/t to Raven and AL who also linked to the Science article this a.m.
Cheryl Rofer
@Jim, Foolish Literalist: That worries me too.
Jeffro
Justin Amash is dropping out(!)
that was quick 😀
JPL
@Cheryl Rofer: Have you seen information about how long they think the virus was in the U.S.
lamh36
Hey guys…the HBCU streaming is LIVE now on YT https://www.youtube.com/watch?v=TapYJBMgn1E
Cheryl Rofer
@JPL: The best information seems to be that the case in Seattle was the first, or close to it. Trevor Bedford (@trvrb) is good on this.
Another Scott
@Cheryl Rofer: Thanks for the thread.
Larry Brilliant made the point in his interview with Franken that it took years and years to eradicate smallpox even after we had a safe and effective vaccine. He thinks we need a 3-6 year plan to get the job done with COVID-19 – the US continuing to act that everything will be fine in 2 weeks or 2 months is madness.
We know that Donnie’s going to say that the job is done once a vaccine is given emergency (instead of regular) approval. But it will still be years until everyone in the US can actually get it – let alone everyone on the planet. (And since it’s so infectious, outbreaks will continue until everyone is immunized.) Even when Biden’s team is finally able to get effective national management in place, we’re looking at extended disruptions from COVID-19.
Grrr…
From the https://www.worldometers.info/coronavirus/#news, the USA is probably going to cross 90,000 deaths today or in the next 24 hours. The UK is still racking-up ~ 500 acknowledged deaths per day. We still need effective treatments, also too.
:-(
Cheers,
Scott.
Roger Moore
@NotMax:
With anything like this, you have to ask what the false positive and false negative rate of the test is. It’s possible those positive tests after recovery are either false positives in the recent test or false negatives in the test that said they had fully recovered. There were some early reports of people getting reinfected, and they seem to have been mostly false positives in the retesting.
Just as a sanity check, if people have trouble establishing immunity after recovering, you’d expect a lot of recovered healthcare workers to get reinfected. That we aren’t seeing a lot of healthcare workers getting sick a second time is a strong indication that most people develop at least a short term immunity after recovering.
Mike in NC
Should surprise absolutely no one, but in his latest column Michael Gerson describes how back in 2012 Trump came out as a full blown anti-vaxxer. Hopefully Fat Bastard can convince his MAGAts not to accept the coronavirus vaccine once it is successfully produced. Keep on chugging Chlorox instead.
WaterGirl
@Calouste: Sad that it’s not our government doing that.
Another Scott
@Cheryl Rofer: https://news.yahoo.com/covid-19-cases-us-carrier-despite-extensive-screening-233535032.html
What bothers me about that story is, we don’t know the reason. The Navy folks working on this aren’t stupid – they know that false positives can be an issue, they’ve tried to be careful, they know that billion-dollar missions depend on getting this right, but still these results were noteworthy enough to make the news. Why? I’m sure they want to know, too.
YY mentioned that China is going to a 3 week quarantine (at least in some cases). Should that be the new normal? Are we going to need to wear masks and do regular sterilizations even when all the tests indicate we’re all negative? How many tests, and when, is enough given the imperfections?
Still lots and lots of questions…
Cheers,
Scott.
Jim, Foolish Literalist
@Another Scott:
god, that’s so disheartening, I feel despair, then I tell myself to suck it up and think of everything other people have lived through, are living trough, in times and places and circumstances less privileged than mine
I’ve been seeing and hearing a weird kind of complacency in the last couple of days: Some obnoxious twitter troll (an author I’ve never heard of but enough people have to get a blue check) is taunting people who said GA and the South would see widespread infection; that goofy Bush advisor who declared himself an independent so he could scold Democrats on CNN is calling for people who caused so much “overreaction” to be ‘held accountable’ (what the ever-loving fuck?); on NPR’s Marketplace three financial journalists were talking about the economy starting to recover… Am I in a bubble that I think we are, at best, at the end of the beginning?
NotMax
If Dolt 45 completely had his way the country would have zero cases.
All the sick would be shipped to Greenland.
//
Jim, Foolish Literalist
@Jim, Foolish Literalist: Matthew Dowd– (ETA: I was so distracted by the Applebee’s book I forgot to include his tweet)
double-checking Dowd’s history I found this:
I can scarcely imagine a more parodic manifestation of Beltway CW than a book co-authored by Ron Fournier based on interviews of people eating at Applebee’s. They probably broke their arms patting themselves on the back for hitting that ideological sweet spot between Cracker Barrel and Chipotle. “The answer to Fred and Ethel’s political conundrum, is of course, Getting Serious About Entitlements. They of course don’t know they think that, but they do.”
chopper
@Jim, Foolish Literalist:
guess it depends on how it’s made, but a coupla hundred million doses aint gonna get brewed up quickly.
germy
https://twitter.com/pecunium/status/1256251756377448449
JPL
@Jim, Foolish Literalist: This morning when I was out shoppers at the grocery store were masked and social distancing. The aisles are one way. Of course, there were two asshole men, who had to prove that their dicks were an inch long. (sorry)
Anyway the GA numbers appear to have fallen or at least plateaued. I did have to stop at the pharmacy to pick up some Allergy D medicine and sign my life away The line above mine was initialed and in parenthesis was Covid-19. I did not like it but also release that I’m I did have a mask on. Employees have to deal with a risk all day.
Benw
@Jim, Foolish Literalist: what a moron. I wonder who in Matty’s world gets to pick the correct amount of reaction?
Sloane Ranger
Didn’t Trump say in his propaganda briefing last night that they were going to go ahead with manufacturing the 14 most likely to work vaccines so that lead times on the successful one will be reduced?
I know that’s a very thin branch to rest this on but he has appointed some General with a Logistics background to oversee the delivery.
My guess, if the economy is still tanked, Trump will run as the man who can get the vaccine out faster. After all, who knows what Biden and his commie advisers might do to eff things up?
opiejeanne
@Jim, Foolish Literalist: That’s a really stupid take, holding accountable those who did too much.
No one did too much. Not Inslee, not the Republican governor of Ohio (whose name has slipped my mind), not Newsom, not Cuomo.
randy khan
@Frankensteinbeck:
It occurred to me this morning that one reason for Operation Warp Speed (I repeat the name only to mock it) is that Trump wants to take credit for any vaccine. Given that everyone working on vaccines already is going as fast as possible, the odds are that Trump will deserve none of the credit, but he’ll try anyway. It actually would be the perfect chef’s kiss for there to be a vaccine and for the Trump Administration to screw up distribution by getting in the way. (That said, given the actual constraints on completing trials and producing a vaccine make it really unlikely one will be available in any quantity before the end of the year.)
NotMax
@Sloane Ranger
Aren’t these types of vaccines cultivated in eggs? So millions upon millions upon millions would be needed.
Watch for when he or the family begin snapping up chicken farms on the Q.T.
germy
randy khan
There are a lot of people working very hard to find treatments and vaccines for this disease, many of whom have shifted from their regular work to do so. I am incredibly appreciative of their efforts.
Another Scott
A 3:24 video on the last case of smallpox in 1977 and what it took to eradicate it (including a 10-year plan from WHO). https://www.gzeromedia.com/dr-larry-brilliant-eradicating-smallpox
(via Larry Brilliant’s twitter feed.)
Cheers,
Scott.
swiftfox
If bat immune systems don’t use antibodies to fight this off, that may mean that this virus can bypass typical antibody reactions. undark.org/2020/05/05/covid-19-bats
MobiusKlein
If previous exposure to a similar Corona Virus helps protect from COVID-19, would it make sense to infect folks deliberately with the milder variant?
Like the cowpox vs smallpox?
Another Scott
@NotMax: There was a story (here?) a few weeks ago that the US literally has secret chicken farms just for producing the eggs for vaccines. For the flu, etc. The vaccines I’ve heard mumbled about for COVID-19 seem to be different (grown in vats, or something), depending on the type of course.
Anyway, we do seem to have some infrastructure independent of Trader Joe’s egg suppliers for at least some kinds of vaccines.
Cheers,
Scott.
Betty
@MattF: Always amazed at the complexity going on inside our bodies that we are unaware of. Fascinating stuff.
snoey
@swiftfox: It mostly means that bats have weird immune systems that tolerate all sorts of things including rabies.
Crusty Dem
@Cheryl Rofer:
Oops, indeed, was thrown off by the science vs cell links…
Somebody probably already beat me to it, I haven’t looked downthread (and even if I had, my brain is clearly swiss cheese right now), but one of the authors did an excellent twitter summary of the findings:
https://twitter.com/profshanecrotty/status/1261052353773363200
Roger Moore
@germy:
In a lot of ways, I think we got exactly the end of the world David Brin wrote about in The Postman. That described a world in which most people were trying to pull together and overcome their problems, but their attempts were undermined by preppers who wanted society to collapse. Unsurprisingly, those preppers were a bunch of racist, right-wing assholes.
Another Scott
@MobiusKlein:
Note the caveats, preprint, early, etc., etc.
(via Crusty Dem’s pointer to profshanecrotty
belowabove)Cheers,
Scott.
Another Scott
@Crusty Dem: Thanks for the pointer. Some good comments in that thread.
Cheers,
Scott.
LeftCoastYankee
This is very good news, or at least is much more positive than the ongoing deluge of suffering and nonsense. Thank you Cheryl!
Crusty Dem
@Another Scott:
Yeah, I’m a neuroscientist, so I can grasp some (but far from all) of the nuance from the paper. His twitter is remarkably clear and detailed, a must read..
Krope, the Formerly Dope
Nothing to be sorry for. There’s a significant chunk of Trumps base that clearly is compensating for…something. Driving down the road with a Trump supporting friend of mine a couple weeks ago, we came across an enormous pickup truck in full MAGA regalia.
Despite his political affiliations, my buddy couldn’t help but speculate as to how poorly the owner was equipped.
Martin
@Another Scott: We can make a lot of vaccines, but in the US tradition of efficiency of capital, we can only make just enough vaccine for our needs, and right now we need a LOT more, and nobody is quite sure how best to finance that. So that’s where we’re stuck – we can make a lot of vaccine, but it’ll take years to make enough. If you want it made faster, nobody knows how to get that paid for, because the GOP/Trump have made clear they aren’t interested in that kind of infrastructure.
Vaccines usually don’t confer a lot of immunity in their first iterations, and that improves with successive efforts. I don’t know to what extent that’s a function of how developing vaccines is, or how much of that is a function of how much better we’ve gotten at manipulating genetic material. It’s very possible we’ll dial straight into a really effective vaccine because genetic tech has gotten massively, almost unbelievably better just in the last decades.
But you can break almost all such engineering problems into two nearly distinct steps – making one of a thing, and making millions of a thing (you can ask Tesla all about that). How you design the one can make the effort of making millions easier or harder, but they are entirely different types of efforts, and all the energy being thrown at getting a vaccine into trials contributes nothing toward manufacturing millions/billions of doses. That’s a completely different effort by completely different people, and when the White House treats a vaccine as a trophy to hold up and not a way to save lives, there’s no point in focusing on the manufacturing problem. After all, that’s just going to be expense before the election and not benefit, so it’s politically harmful, not beneficial. When he talks about a vaccine by the end of the year, he means for him, not for us. Its a re-election trophy, not a cure to him.
I trust the development of a vaccine is in good hands. My guess is that it’ll require regular boosters. Keep your eye on the manufacturing news – that’s where the rubber will meet the road on this one. So far, it’s pretty dire. We will be at the end of the line for any foreign made vaccines, and we will probably be subsidizing their entire production because any foreign maker will know they have us over a barrel, and we can pay what they ask.
Raven
@Aleta: thx, I sent it to her last night when a genetics prof buddy sent it to me.
Roger Moore
@JPL:
I ran into a literal hedge fund bro not wearing a mask in the line to get into the farmers’ market this morning. While waiting in line, I got to hear about how masks are stupid and unnecessary, that COVID-19 isn’t much worse than the flu, that Sweden is doing great without any kind of restrictions, and that scientists are only pushing for a shutdown because they’re bored of waiting for a real pandemic and want to test the system. These idiots are out there.
Krope, the Formerly Dope
I know there isn’t a vaccine yet, but this is a reasonable assessment of how things will play out once one becomes available.
So if we can make enough of a vaccine for everyone, but don’t because of the money, isn’t money itself a problem?
If we’re worried about previously solvent businesses not being able to reopen, not because of mismanagment but because of an uncontrollable shock to the economy, isn’t money the real problem here?
If we can feed and shelter and care for everyone, but don’t because we’re more worried about executives and shareholders, isn’t money holding us back as a society?
And when the financial sector fucks up and millions lose their jobs and livelihoods, not due to any change in demand but because the people who mismanaged us into a dead-end can’t figure out how to pay people without getting dug out by the taxpayer, shouldn’t it be goddamn crystal clear that the way we handle the concept of money as a society causes far more problems than it could ever help?
zzyzx
@Roger Moore: That’s where I am. If this is going to be an issue, I expect to be seeing this happening a lot. When it only happens in very small amounts and only in a particular population, that screams testing error to me.
Jim, Foolish Literalist
@Roger Moore:
that’s some the-moon-landings-were-filmed-on-the-set-of-Lost-In-Space shit right there.
Martin
@Krope, the Formerly Dope: The amount of money isn’t a problem. Typical to most logistical problem in the US, the problem is which money, not how much money.
Yes, businesses going under will explode the cost of unemployment benefits and tank tax receipts, but those are different dollars from different budgets than HHS handing vaccine makers x billion dollars to ramp production, which they politically don’t want to do. So, we will waste $100 from our left pocket to ensure we don’t spend $1 from our right pocket. Even better, we will call that good fiscal management, or small government, or some other bullshit.
That’s basically federal, state, and local politics in a nutshell. Plenty of corporations have died on that hill as well. The way you overcome it it work up the political food chain to the people who control both the left and right pockets. Then you can explain that if they can just shift some dollars they come out ahead. But that’s the fed, and similarly the Senate, and they aren’t budging. If it doesn’t help them by November 3, they aren’t interested. Losing the election and literally everyone dying are equivalent failures in their eyes.
Sorry if I seem unusually dark these days. Sleep now brings with it recurring nightmares of me doing nothing other than reports about how many students have died in the last week (and being criticized that they aren’t rosier). For someone who almost never remembers dreams, it’s pretty jarring.
fxdshdw
This is interesting…
It implies that being intentionally infected with certain cold viruses may be a way to build immunity to COVID. Reminds me of Jenner using Cowpox in innoculations against Smallpox.
Krope, the Formerly Dope
I get that and that gets to the how the optics of how money is used affects the incentives. But I’m after something more basic.
People have needs, needs that our society should be able to meet on a fairly consistent basis (the current pandemic notwithstanding). But we don’t, we barely even try, and money is always at the top of the list of reasons.
Money is a tool. And at it’s best it can create a standard for what is equitable when trading goods and services. But that isn’t really what it’s being used for. It’s being used to allow a tiny portion of people to have a massive amount of power and influence, possibly more than actual elected officials.
Our incentives are all messed up. And it’s because of the outsize role money has been allowed to take in our society.
Nora
@Roger Moore: I was thinking that, too. It seems wrong to lump Brin in with those assholes when the whole point of The Postman is that people were rebuilding society and taking care of each other, and the preppers were the ones who were trying to destroy everything in the aftermath of the war. That’s one of my all-time favorite books, btw, and I will never forgive Kevin Costner for the godawful movie he made out of it.
Martin
Something that cheers me up.
A quote from the greatest congressperson in the country.
I really can’t express how much I adore her.
Krope, the Formerly Dope
@Martin: Don’t leave us in suspense, who is it?
Krope, the Formerly Dope
@Krope, the Formerly Dope: I got it, it’s Katie Porter.
Bill Arnold
@Frankensteinbeck:
If it happens before November, it will be very much more necessary to thoroughly defeat Trump and eviscerate the Republican party, to ensure equitable distribution of the vaccine. We’ve all see how the White House handled testing – tests for me, not for thee.
Another Scott
@Martin: France24 had a headline a few days ago that some French company was going to send their vaccine production to the USA first. The next day, the headline was that the company wasn’t going to do that…
:-/
Yeah, Donnie thinks he can throw money around to bribe companies to do what he wants for good headlines. He doesn’t seem to understand that other countries, and sensible governments and people, have different ideas about what’s important…
Cheers,
Scott.
Martin
@Martin: Oh, the link didn’t show up:
https://jezebel.com/car-enthusiast-katie-porter-doesnt-want-to-hear-about-y-1843484619
LivingInExile
Why not test any new vaccine on Republicans instead four legged animals?
EthylEster
@Frankensteinbeck wrote: I think there will be a vaccine, an effective treatment drug, or both well ahead of expected schedule.
Why do you think that? Did you ask the 8 ball? Inquiring minds….
ziggy
@Martin: Good to hear from you again Martin, always appreciate your insight. Sorry that this situation is weighing on you so much. I’m very fortunate in my job/life situation right now, but I’ve still been feeling rather glum lately also. It’s hard to be optimistic.
rikyrah
@NotMax:
😢😢😢😢
joel hanes
@Martin:
I trust the development of a vaccine is in good hands.
Because so much of the world-class research on infectious disease is done in other nations (e.g., Wistar Institute labs in Munich, Paris, and Vienna), and because Trump will not allow the US government to mount an effectively-coordinated effort, I think there’s a good chance that the first effective vaccine will be produced by a group not working in the US.
And if so, and if Trump is still in office, we can count on Trump to react badly, in a way that hurts Americans.
opiejeanne
@EthylEster: From “The Lancet”: https://www.eurekalert.org/pub_releases/2020-05/tl-pss050820.php
“…
opiejeanne
@opiejeanne: What caught my eye was the combination of Ribavirin and Interferon, which was the protocol for treating Hepatitis C when I was treated in 2005. Neither did much by themselves, but in combination the cure rate shot up to 50% to 90%, depending on which type you had, 1 through 4.
Interestingly, the lopinavir-ritonavir did nothing by itself, but the triple cocktail described shortened the duration of COVID-19, but only in patients with a mild to moderate case.
L85NJGT
Partial cross strain immunity would go to explain the 3,4,5 asymptomatic host hops seen in tracing, and some of the geographic disparities in intensity.
IIRC the Germans were having problems with false positives in antibody testing due to one of the common cold strains.
Catherine Lugg
@laura: Thank you. This does have a very 1983 feel to it, except it’s largely our seniors who are dying (with a large pool of everyone else to terrify). Reagan didn’t care then, and Trump pathologically wants people to die now. In the 1980s, we lost big steel. I wonder what we’ll lose with this go around?
Michael Cain
Re the remarks on the potential that prior exposure to different coronaviruses yields partial immunity to SARS-CoV-2… I’ve been reading academic papers (geez, the internet is wonderful for that) about the urban vs rural differences during the 1918 flu pandemic. The virus was much more lethal in rural areas. Some estimates are as much as a factor of 10. The most common hypothesis for the difference seems to be that urban folks benefited from a continuous low-level exposure to other types of flu that didn’t happen in the more isolated rural population.
If we get a repeat of that type of response, we’re just getting to the point where things get really ugly. The rural health care system is in worse shape and the pre-existing health risk conditions are more common.