Who Are the ‘Never-Coviders’?

December 14, 2022
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This post was originally published on this site

Plus your experiences without Covid.

A nurse prepares vaccine boosters at a Covid center in Washington D.C.
Kenny Holston for The New York Times

Today’s Virus Briefing is the last one for 2022. The year began as the surge in the Omicron variant in the U.S. was nearing its peak: On Jan. 20, nearly 160,000 Covid patients were hospitalized, the most at any point in the pandemic. On Feb. 2, the seven-day average of new reported deaths peaked at 2,669.

As the year comes to a close, an expected seasonal increase in Covid cases has begun. The seven-day average of daily deaths is up 65 percent from two weeks ago. With cases of the flu and respiratory syncytial virus, or R.S.V., also high, several cities and counties, including New York City and Los Angeles, have advised people to mask up.

But one of the most confounding mysteries of the pandemic remains: Some people have never had Covid, this season or ever.

While many people may have avoided infection through precaution or luck, “never Coviders,” scientists believe, are truly out there: People who are naturally immune and whose genetics could hold clues for treatment.

Jonathan Wolfe spoke with Times colleague Apoorva Mandavilli about how scientists are trying to find them, and what we might learn.

Does this really happen?

It probably is a real thing. There are other viruses for which we know there are people who are naturally resistant. The most striking example I can think of is H.I.V., where there is a mutation that makes some people resistant to getting infected with the virus. That’s actually been the key to curing the very few people that have been cured of H.I.V.

What’s going on inside people who have never gotten Covid?

We don’t know for sure.

One way for the body to be resistant to a virus is through genetic mutations. So, for example, the coronavirus needs what’s called an ACE2 receptor on a cell in order to latch on to it. If you have a mutation in that particular receptor, then the virus can’t get into your cells and can’t infect you. But that kind of mutation is likely to be pretty rare.

Genetics also plays a role in how severely people get sick. Some people have mutations in the innate immune system, which is like the first responder part of your immune system and is pretty generic. More specific reactions, like antibodies for a particular virus, appear later in an infection.

We know now that people who have mutations in that first responder system tend to have very severe disease. So the flip side is also likely to be true: Some people may have mutations that prevent them from getting infected at all.

Couldn’t they just be asymptomatic?

People who are asymptomatic are still infected. The virus is in their bodies, but they have no visible symptoms, or really mild symptoms. That’s very different from what we’re talking about here — somebody who doesn’t get infected at all. But it’s been really difficult for researchers to home in on the difference between these two groups, because so many people have been infected by now.

What do you mean?

There were a lot of people who thought, “Oh, I’m immune to the virus.” I’ve even had friends say that to me: “I haven’t gotten it yet. Scientists should study me.” Some researchers did begin studying people who had not gotten Covid. But then Omicron came along and infected nearly everyone. Some scientists were very frustrated because they basically had to start over. On the other hand, those people were not “never Coviders” anyway. So the studies may take longer, but they’ll be based on people who truly can’t get infected.

Some scientists are studying health care workers and caregivers who really should have gotten infected because they had such high exposure, but didn’t. The idea is that knowing what causes somebody to not get infected might help us figure out treatments for infection.

How many true “never Coviders” are there?

We don’t know because there are so many unknowns. We don’t know if all the people who say they haven’t gotten it yet really haven’t had it, or had it and didn’t know. We also don’t know if they’ve just been incredibly careful and so the virus just hasn’t had a chance to infect them yet.

Also, things got complicated after the vaccines were introduced because the vaccines gave some immunity against infection. But the actual number of people who are totally immune to the virus, for whatever reason, is probably pretty small.

What if I’ve never been infected?

If you haven’t gotten it yet, that’s wonderful and you’re lucky, either because you’re genetically lucky or because you’ve managed to dodge the virus. But I wouldn’t assume that you are naturally resistant and throw all precautions to the wind. The chances you’re naturally immune are fairly low. And as Omicron shows, it may be that you just haven’t met the right variant yet.

We asked you how you think you might have avoided Covid so far, and got over 10,000 responses.

“I spent the pandemic taking care of a friend with cancer and avoided everyone just to focus on him and make him feel safe. He passed away in February and I started going out again and seeing new people, but I still haven’t caught it! Either I am immune or I have a Covid guardian angel (him).” — Jessica Choe, Brooklyn, N.Y.

“Healthy constitution. Rarely got colds or flu even before the pandemic, plus early precautions, masking, vaccines, boosters, working from home and luck. Two and a half years with nary a sniffle, so we’ve given up our masks, dine indoors, socialize and party regularly now. Probably jinxing myself as I type.” — Katherine Fife, Davis, Calif.

“I think neither my husband nor I have caught Covid mostly due to luck. We don’t have kids. We maintain a small, close circle of friends that shared the same views on how best to navigate the pandemic. We also had the benefit of living in Wyoming at the start of the pandemic, a place that isn’t densely populated. We’ve since moved to Okinawa, Japan, and have become embedded in a culture that prioritizes public health and welfare over the individual. Mask-wearing is normal here, making it easier for us to continue the habits that have kept us safe and healthy these past almost three years.” — Jillian, Okinawa, Japan

“I have no idea. Stupid luck? Providence? l quarantined in the basement when my husband had it (mildly) in January 2021. He now suffers from PASC, or long Covid, and it has forever changed and devastated our lives.” — Malia Schaefer, Cincinnati

“Because I’m immunocompromised, I knew I had to do everything I could to not get infected. In the first year of the pandemic, I almost exclusively lived in quarantine. From then on, I always worked with an FFP2 mask, never took the bus or train, was never in the supermarket without a mask and avoided places with a high risk of infection. I have all vaccinations. Even today, I always wear a mask in public facilities. Those around me tried keeping me safe, always testing themselves before they came to see me. I am very grateful for that.” — Julia Litschke, Essen, Germany

“I was sent home to WFH early in the pandemic because I had just finished chemo and radiation. I’ve been working remotely for two years now. I also got the vaccine as soon as it was available. I’ve gotten every booster, including the bivalent vaccine. My mask protocol is: Check your surroundings. Is there a ceiling? Wear a mask. Is there a crowd? Wear a mask. Neither? Take it off. That being said, I suspect I have been infected but was asymptomatic or mistook it for an allergy.” — Kim Haas, Pittsburgh

The ‘Tripledemic’

Coronavirus

Flu

Ebola

  • The Ugandan authorities hesitated to impose restrictions in the epicenter of the Ebola outbreak because of trauma from the Covid lockdown. That decision haunts the country.

Thanks for reading. We’ll be back on Jan. 4.

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