by Guest Columnist Sheila Page, DO
Following the initial 15 days to “flatten the curve”, as COVID 19 was progressively sweeping the nation, the restrictions on most of the American public were not lifted as expected. People desperately wanted to be able to save their businesses from ruin, allow their children to play sports again, and walk freely outdoors. They were teased with the idea that persons who recovered from COVID 19 infections would be able to test for antibodies and go back to work and be released from quarantine.1
This hope was quickly squelched by reports that seemed to show that the antibodies (IgG antibodies) did not persist, meaning the government-dictated mitigations would continue. 2,3
The prevailing message has been and continues to be that there is no treatment and no rescue from this virus other than absolute obedience to a set of perpetually changing rules. Various mitigation measures have been mandated to “flatten the curve”, a goal that has been changed to “slow the spread” of the virus. Other than hospitalization for severe disease, few solutions have been offered. Healthy asymptomatic people are quarantined for nebulous reasons that defy rational thought, but work well to scapegoat and shame non-compliant persons.
What is the truth?
Is it possible that solutions have been hidden in plain sight?
Science is the study of observable truth. Beginning with basic science, an understanding of pathogens and disease creates a foundation of truth on which we can build solutions.
What is herd immunity and why is it important?
Herd immunity is the natural resistance to the spread of a communicable disease in a community that occurs when a threshold of immune persons has been reached. The disease dies out because it has nowhere to go as the virus encounters a wall of immunity. Evidence shows that in the case of COVID 19, infection in only 10-20% of a population results in herd immunity, because the very important T-Cell immunity is already present in about 50% of the population.4
What is T-cell immunity? Why do young people do so much better with the COVID 19 infection than older adults?
T Cells identify and kill infected cells, and B cells produce antibodies.1 These are the cells that will attack the virus if the previously infected person encounters it again. The virus dies and is not transmitted by the immune person to others. T Cell immunity, which remains protective for years,5 is stronger in the youth, and they have cross-over immunity because of previous exposure to milder coronavirus infections (e.g. common cold). Cross-over immunity means that even if you have never been exposed to COVID-19, your T Cells may be effective against the virus anyway because of the similarities between the various strains of coronaviruses. This has been shown to be true for COVID-19. 6 However, as we age, we begin to lose T Cells, and are more susceptible to infection, which would explain one reason why the older members of the community are more susceptible to the illness.7
The Good News about T Cell Immunity
Studies focused on waning IgG antibody immunity to COVID 19 disregarded the fact that T Cell immunity has long term memory and is the primary protection against viruses. “A study published …in the journal Cell suggests that everyone who gets COVID-19 — even people with mild or asymptomatic cases — develops T cells that can hunt down the coronavirus if they get exposed again later.”8 We know that a substantial percentage, 50% or more, of the population has already developed immunity to COVID-19, either from recent infection or from previous common cold viruses. We can also be reassured that the youth in this country are very resistant to COVID-19 infection. They naturally present a wall of immunity to the virus, which helps prevent its spread to the rest of the population.
Understanding immunity is the first part of the solution. We cannot escape the reality of infectious diseases if we want to live and work in community with each other. We need to shift our focus away from social isolation of whole populations of healthy people. When we protect the vulnerable and treat the sick, especially in the early stage of infection, we have the potential to conquer disease. We can build hope on truth and understanding.
1. https://www.businessinsider.com/why-we-need-coronavirus-antibody-test-identify-immune-people-2020-3
** A special acknowledgment is due Dr. James Todaro, who took time to explain these concepts in a public forum and gathered the references to support it. He can be found on Twitter @JamesTodaroMD.
Dr. Sheila Page is board certified in Neuromusculoskeletal Medicine and Osteopathic Manipulative Therapy and treats a wide spectrum of patients from the newborn to the elderly, including patients with irreversible and terminal illness. Dr. Page has a special interest in children with disabilities, particularly those whose burden of care is difficult and who have been given little hope for a better quality of life.
“The care and protection of the most vulnerable among us is a responsibility I take personally. I am especially interested in treating difficult illnesses, offering a chance for healing and comfort to those who have lost hope. I am a strong advocate of fostering the individual doctor-patient relationship and preserving the integrity of medicine." —Sheila Page, DO
The impact of politics on the medical profession and the physician-patient relationship has been a motivating force for Dr. Page's efforts. Her interests include policy related to independent physician practices, access to care, charitable care, and sanctity of life issues. She has testified before multiple state legislative bodies on the topic of fetal pain and has been active in Texas promoting the private practice of medicine and testifying on issues that would impact the integrity of patient care. She has served multiple terms as President of the Texas Chapter of the Association of American Physicians and Surgeons. Dr. Page is an associate scholar with the Charlotte Lozier Institute and serves as Secretary on the Board of Directors of Lutherans for Life and served on the Advisory Council of Grace House Ministries. She is the founding Chair of the Fort Worth Osteopathic Study Group and President of District II of the Texas Osteopathic Medical Association and has served on multiple committees with TOMA. She is a delegate for the American Osteopathic Association HOD and served on the Professional Affairs Reference Committee in 2018.
Dr. Page received her Doctorate of Osteopathic Medicine from the University of North Texas Health Science Center, College of Osteopathic Medicine, in 1992, during which she completed an additional year of training as an Undergraduate Teaching Fellow, specializing in Osteopathic Manipulative Therapy. Following an internship at Northeast Community Hospital, Dr. Page practiced family medicine for seven years while working on her board certification in Neuromusculoskeletal Medicine (NMM). She has been practicing and developing her skills in NMM for 23 years, and currently has a private solo practice serving the Fort Worth area. Dr. Page works on referrals by word of mouth only and makes house calls for patients with advanced disabilities.
She graduated with a B.S. in Biochemistry at Texas A&M University in 1986 and then spent a year doing cancer research at MD Anderson Research Center in Smithville, Texas. She continued to do cell biology research while in medical school and has several scientific publications. Her most recent publication is The Neuroanatomy and Physiology of Pain Perception in the Developing Human, Issues in Law and Medicine, Fall, 2016.
Sheila has been married for 31 years to Ray Page, D.O., Ph.D., oncologist, and has 5 children, ages 15-28, whom she has primarily home schooled. She lives in Aledo, Texas, and is active in the St. Paul Lutheran Church. She has donated services to Sudanese refugees living in the Dallas-Fort Worth area. She loves gardening in her spare time.