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The natural immunity delusion

Dennis Prager is 73 years old. He smokes cigars. He is also a daredevil, thrillseeker, living on the edge kind of guy:

Radio talk show host Dennis Prager informed his audience on Monday that not only does he have Covid-19, but he was trying to get infected in order to achieve “natural immunity.”

The 73-year-old said he tested positive last week and has not required hospitalization, thanks in part to receiving monoclonal antibodies. These can be effective in treating Covid for people with mild to moderate symptoms who also have a high risk of progression. But Prager also rattled off the unproven Covid Treatments They Don’t Want You To Know About™ that have become popular among many conservatives.

“I have, of course, for years – a year and a half, not years – been taking hydroxychloroquine from the beginning, with zinc,” he said. “I’ve taken z-pack, azithromycin, as the Zelenko protocol would have it. I have taken ivermectin. I have done what a person should do if one is not going to get vaccinated.”

The “Zelenko protocol” refers to a highly dubious regimen developed by a doctor in rural New York who claimed that he cured 100% of the Covid cases he treated using unproven remedies.

Prager then described how he deliberately and recklessly attempted to get infected with Covid:

It is infinitely preferable to have natural immunity than vaccine immunity and that is what I have hoped for the entire time. Hence, so, I have engaged with strangers, constantly hugging them, taking photos with them knowing that I was making myself very susceptible to getting Covid, which is, indeed, as bizarre as it sounded, what I wanted, in the hope I would achieve natural immunity and be taken care of by therapeutics. That is exactly what has happened. It should have happened to the great majority of Americans.

Prager then accused the Centers for Disease Control of opposing therapeutics thanks to “the corruption of the belief in the value of vaccine and only vaccine.”

I will never understand why these people are so hostile to the vaccine but will lilterally take anything some crackpot freak tells them to take and are happy to take the experimental, emergency use monoclonal antibody treatment that costs thousands of dollars compared to the $20 vaccine. And this is in spite of the fact their Dear Leader wants nothing more than to take credit for the miracle cure of vaccines and his people just won’t have it.

It’s one of the most bizarre cultural phenomena I’ve ever seen.

Chris Hayes looked into the “natural immunity is better” thing last night. It’s is also tryuly bizarre:

HAYES: As we reported last week, one of the anti-vax candidates for governor of Texas, Republican Allen West ended up hospitalized with COVID. Today, we are happy to report he`s out of the hospital, has recovered from this infection. But while he was still in the hospital, he tweeted something that caught my eye. “I now have natural immunity and double the antibodies. And if you`ve been paying attention to Republican politicians, the right-wing media, you might notice that natural immunity has become a sort of buzz term. (BEGIN VIDEO CLIP)

SEN. TOM COTTON (R-AR): The mandate is overbroad as well. It makes no accommodation for instance of people who have had Coronavirus and who have natural immunity.

BRIAN KILMEADE, CONTRIBUTOR, FOX NEWS CHANNEL: Look at the fact that they refuse to take in natural immunity even though more and more studies are showing it`s probably better than the vaccine.

SEN. RON JOHNSON (R-WI): The fact that this ministration won`t recognize natural immunity in these mandates.

UNIDENTIFIED MALE: It is infinitely preferable to have natural immunity than vaccine immunity.

UNIDENTIFIED MALE: Why would I get vaccinated? Why would I get vaccinated when you know I have better immunity than someone who`s been vaccinated?

(END VIDEO CLIP)

HAYES: The argument they make is essentially if you get sick with Coronavirus and survive, your immune system produces antibodies. And so, the logic follows that if that`s the case, why do you have to get a vaccine on top of that. And I`ve been following this discussion. It actually made me think, wait a second, what does the science say about what vaccines do for people who recover from Coronavirus? How necessary is it for them? And which last longer, vaccination or antibodies from an infection?

To get the bottom of that, I want to talk to Dr. Syra Madad, an infectious disease epidemiologist, Senior Director of the Special Pathogens Program at New York Health and Hospitals system. So, Doctor, let`s sort of start with the top line about what we know about the immunity conferred by having gotten through about of COVID and the immunity conferred by the vaccines.

SYRA MADAD, INFECTIOUS DISEASE EPIDEMIOLOGIST: Well, first, you know, I think we`re not talking apples to apples. So, there`s a big difference. The first one, we talked about natural infection, you know, generated from COVID-19 infection. First, you know, getting infected itself, you`re putting yourself at risk for severe disease, hospitalization, and death. That`s not even talking about the potential of long COVID.

So, first when you have natural infection, it is very variable to person to person and that`s two things that I`ll point out. First, it`s actually generating a robust immune response, and the second is the strength and durability of that immune response, and how long that will live.

So, first, we focus on generating that immune response to people that are naturally infected, it differs from person to person. There`s a lot of variability. It depends on the severity of the illness. It also depends on the immune system and the response that it generates.

The second aspect of it is durability of the thing. And that varies, you know, between age and health status. And so, there`s a lot of, you know, unpredictability with natural infection. And that`s not to say that individuals that have natural infection don`t have a robust response. You know, we have seen that.

Some studies have shown that 10 to 36 percent don`t even convert, meaning they don`t have a long term response, you know, immune response. So, that`s, that`s concerning.

HAYES: Yes, there`s so — that`s — I mean, my understanding to the point you said that — so, there`s a huge chunk of people, a really significant chunk, and again, the data here goes all over the place that do get COVID, who come out of it, and don`t really have the presence of the antibodies that you would anticipate and expect. So, they`re not really immunized as far as we know.

And then there`s a really question — there`s a question about how long they last. And what do we know about how long — if you do create these antibodies in your body, like how long that lasts versus the vaccine?

MADAD: The longevity of, you know, our immune response, you know, is one of those things that we`re still finding out both with natural infection and with vaccination. But the one thing to note is that with vaccination, you can boost your immune response safely to have a better — you know, a robust immune response and to counter, you know, the central infections.

With natural infection, you can`t boost that, right? So, that means you`re going to have to naturally get reinfected again. And no one wants to go through that for the reasons I mentioned, because you`re risking a lot there. It`s like playing a game of Russian roulette. There`s a big gamble right there.

HAYES: Yes, that — this is a key point. I want to sort of give the top line to this one Nebraska medicine health system study that was published. More than a third of the COVID infections resulted in zero protective antibodies. Natural immunity fades faster than vaccine immunity. Natural immunity alone is less than half as effective as natural immunity plus vaccination.

So, there`s two points that seem to be important there. There`s actually as far as we can tell an additive effect if you`ve had COVID of also getting vaccinated in terms of the total level of protection you`re getting, whereas the argument being made you saw with Joe Rogan and others there is like, well, why do I need it because I`ve already got it?

To the best that we can describe, it seems like there`s actually a cumulative positive effect to get vaccinated. Is that the — is that our understanding right now?

MADAD: That`s correct. It`s unfortunate that natural immunity is being politicized, just like massacre flip sides, so it`s really unfortunate. But, you know, the bottom line is that vaccination is the safest way to build that immune response without risking illness, infection, and disease.

And if you`ve had natural infection, you get — a COVID-19 vaccine, you have an even better immune response. I`m actually in that category. I was, unfortunately, naturally infected last year. And you know, I — you know, and I`m fully vaccinated, so I have a pretty, you know, robust immune response. So, you know, a really great data on that as well.

HAYES: Well, so there`s a very interesting point here that I want to make, right? What you`re saying, and what a lot of people in public health are saying is that there`s this — there`s something sort of insidious in this idea of like natural immunity, because the way that you get natural immunity is you get COVID.

And what we`ve seen a little bit is the old sort of like chicken pox party idea. In fact, there`s even people who have cited that, right? Like — and Dennis Prager who was on the microphone saying, I have COVID right now, and that is infinitely preferable. The kind of logic that they`re actually propounding is like, it`s OK to get COVID, and then you`ll get it, and you`ll get natural immunity. And actually, we let the things spread.

And that`s precisely the sort of herd immunity idea we saw from Scott Atlas, the Trump advisor that was so disastrous in terms of guiding policy here in the U.S.

MADAD: That`s exactly right. It`s really unfortunate that this is a — you know, the debate that we`re having again, and again. And the science really speaks for itself right now in terms of which one is better, which one is giving you a more predictable and reliable outcome.

You know, through natural infection, you`re risking a whole lot, not just yourself, but you know, for the community. The one point that I`ll make is that a lot of these studies that we`re seeing first, they were pre-Delta. So, Delta was definitely a big game changer here in terms of the infection as well.

But as we`re looking at, you know, the studies that were conducted, a lot of them are looking at the survivors, right? They`re not looking at the people that died. Over 700,000, you know, Americans died of COVID-19. So, they`re basing it on survivors. And that also is variable as well.

So, if we look at just the number of people that have died, I mean, that`s majority through natural infection. So, that`s speaking volumes right there.

HAYES: Right. The classic example of survivor bias right there. I guess the final — the final point here would just be that there`s a sort of either collective reason, a policy reason, but even at the individual reason, there`s very — there`s good data suggest that if you`ve had COVID, getting vaccinated make sense. It boosts your protection against reinfection and also provides a comprehensive way to boost immunity in the future that is just, you know, a natural reinfection.

MADAD: That`s absolutely much more reliable. It`s much more durable. And as we learn more, we`ll probably see the longevity of our immune response. And you`re able to boost more, you know, in case that`s needed. Right now, obviously called that protecting against severe hospitalization and death.

Since these loons like Prager who are out there trying to get the virus obviously don’t wear masks they probably spread it all over the place once they get it. So that’s nice. I’m sure they will say they are helping give people the virus for their own good.

Yet, 700,000 people are dead in a year and a half for some reason.

I’m vaccinated and generally feel pretty safe going out in public. I observe the rules about masks and social distancing. But these people are making me much more nervous and while I’m still participating in the world within those parameters, I’m thinking twice about doing some things. In other words these fools are holding back the economic recovery by threatening to kill people with their ignorance and hostility — and are actually killing people in the process.

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