Eastern promises redux

Eastern promises redux

East Asians do seem to have more protection from SARS-CoV-2

 

I debated with myself if I should start off the New Year with this post. As you can guess from the title, this piece falls under the scientific category “I told you so”. But I am going to go ahead and pretend that this is all for the greater scientific good.

 

To jog your memory, a year and a half ago, during the middle of the second wave, I had suggested that death rates due to COVID-19 were lowest in the South-East Asian region perhaps because people living in the region were already exposed to close cousins of SARS-CoV-2 from the bat population in the region. I had also, whimsically, attempted to show a correlation of the deaths per million population by the distance from Hanoi. (http://randomramblings2018.blogspot.com/2020/07/eastern-promises-are-asians-relatively.html) The figure is reproduced below. (Figure 1) At that time, the counting of deaths was incomplete, and there was little scientific support for such a hypothesis. Two years in, there are some more intriguing data.

Figure 1: Per-capita deaths due to COVID-19 in Asian countries plotted against distance from Hanoi

 

Death data as on the 27th of July 2020, from https://ourworldindata.org/covid-deaths. There appear to be at least 3 distinct clusters of countries with differing per-capita deaths due to COVID-19, defined by their distance from Hanoi (colour coded blue purple and red). I haven’t shown Iran (186 deaths per million, 4500 km from Hanoi) in the graph as it is an outlier (and would need an unsightly y-axis). And excluding it does not alter the overall relationship. If we assume a linear relationship, distance from Hanoi appears to account for 60% of the difference in per-capita deaths from COVID-19.


Laos is Gotham City?

Sorry, couldn’t resist that! What else would you call a city which is protected by bats (albeit only coincidentally)? Before we get into that, here are some updated data on deaths due to COVID-19. (Figure 2) This time, I have only included the uncontroversial data from relatively rich countries (the data from Vietnam and Cambodia are included for comparison). I have excluded data from countries where the numbers are disputed (Russia) or still to be counted (India). I have also excluded countries which pursued a “zero-Covid” strategy (Australia, NZ, Singapore), or are still aggressively pursuing one (China). The figure shows a clear clustering of deaths per million population, with rates almost an order of magnitude lower among countries in the South-East Asian region. In fact, South Korea apparently has had NO excess deaths attributable to COVID-19! (https://doi.org/10.3346/jkms.2021.36.e280)

Figure 2: Cumulative deaths due to COVID-19 (per million population) in selected countries

 


The argument I am making is that these populations may be relatively protected from SARS-CoV-2 because of prior exposure to similar viruses from exposure to bats in the region. Recently, some virologists have discovered at least 3 viruses from several species of the horseshoe bat from the region around Laos, which share over 95% similarity with our current nemesis. Inexplicably (just to me; I am sure they had good reasons!), they have decided to call these BANAL-52, 103 and 236! (https://doi.org/10.21203/rs.3.rs-871965/v1) I wish that there will be more serious scientific research clarifying the immunology of exposure to these viruses will be done. So far, we have only seen politically motivated media pieces extolling the actions of small, rich, city states. (For more on this you’ll have to go read my previous piece! http://randomramblings2018.blogspot.com/2020/07/eastern-promises-are-asians-relatively.html; sorry!) Another rather interesting and unexpected finding that has recently emerged is that prior infection with the other coronaviruses that cause common colds may provide some protection from SARS-CoV-2! (https://doi.org/10.1126/science.abf4860)

What all this means

The fact that our immune system can mount an effective response against previously unseen pathogens is not just heartening in a generic sort of way. It also means that the other aspects of our response to these intruders, such as the cell-mediated response, honed by tens of thousands of years of immunological memory, are just as important as the antibody-mediated one (which we try to tweak by vaccines). This means that even if these fiendish viruses mutate away some of the antigens we target, we could find ways to trigger our body’s immune system to fight them off rather effectively. What all this also shows is just how little we know about anything. That’s a good point for all of us to keep in mind during the New Year!

  

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