Barts-MS rose-tinted-odometer: ★★★★★
In anticipation of a second-lockdown at a meeting with colleagues last night I was asked the question about what positive experiences I could reflect on from the first lockdown. Firstly, no international travel and a focus on family, home life and the realisation that we can live more sustainably. Secondly, walking or running the talk. I decided to take my own prehabilitation advice seriously and I have managed to rehabilitate my physical and mental self and get my right hip working again. This is quite remarkable. Three years ago I had written off any future prospect of running long distance never mind a marathon. Six months into the pandemic and I am getting ready to try and complete a marathon in a months time. Why? Funding and important time-sensitive research for people with multiple sclerosis.
We have a problem with the current antibody tests for detecting past infection with coronavirus. The current assays are not sensitive enough and are not detecting antibodies in a large number of people with asymptomatic or mild infection and possibly in pwMS who are on certain immunosuppressive disease-modifying therapies, in particular the anti-CD20 treatments rituximab, ocrelizumab and ofatumumab. Detecting antibodies in these people is really important in that it would indicate that they have been exposed to the virus and therefore likely to have cellular immunity.
In response to this challenge and thanks to a grant from the Barts Charity, our group (Dr Kang and his team) have developed an ultrasensitive assay (GloBody) that will work on blood spots. Preliminary results show that the assay is detecting antibodies in samples that have been called negative with commercial antibody assays. This is not unexpected because the assay was designed to have amplification steps to detect very low levels of antibodies. We did this because we want to study low-level antibody responses in pwMS on and off different DMTs.
This assay will now allow us to test a large number of pwMS using self-collected blood spots to see if they have been infected with coronavirus and are now immune. The tragedy is we have been promised a grant to do the initial part of this study by a charity. However, as donations have dried up this charity can’t afford to give us the money to cover the initial costs of the study. This is when I took up your suggestion to crowdfund. To show how serious I am about the crowdfunding I have decided to run the virtual New York City Marathon. All I have to do is record a single 42.2km run using the GPS-tracking application STRAVA sometime between the 18th October and 1st November.
In reality, I started my training very late and don’t really have the time to get truly marathon ready. However, as it is so important for us to raise the money so we can get this critical time-sensitive research done I am going to give it a go anyway.
I would like to thank those of you who have already sponsored me. I would also like to urge you to donate to our cause. Even a small donation or £2-£5 would help. Microdonations all add-up.
Thank you.
CoI: multiple
Twitter: @gavinGiovannoni
Medium: @gavin_24211
Prof G who will actually be doing this project?
Some dosh sent! The news that antibody tests might be missing immune people is sensational! We are changing society, perhaps for ever, on the basis that herd immunity is unachievable without vaccines. Eyes on Sweden, who right now, seem to be doing better.
Many thanks.
Sweeden has sensiebly allowed the herd to become immune
I agree, but I doubt they are at herd immunity levels yet. They still had a problem with care home infections and have many more deaths than their neighbours.
We surely cannot compare strategy with Sweden, who I understand to have a relatively young, healthy population, and less of a touchy-feely culture that countries such as France. It is not true that they carried out no social distancing – they just did it more out of voluntary action rather than through imposition of rules. They have indeed had a lot more death than neighbouring countries, and are still a long way from the 60% or so requirement of herd immunity. Comparison between countries is fraught with difficulties, and that’s before you even begin to look at how the stats have been collated.
Prof G what route are you going to run? The London marathon route?
I am not going to run the London marathon route. I plan to run from my front door back to my front door using familiar routes I am training on. I don’t want any surprises on the day.
Go for it Prof G – get your running shoes on xxx 👍🏻👍🏻😄👍🏻😄
Thanks. I am doing just that!
to see if they have been infected with coronavirus and are now immune
Do you actually know for sure whether previous infection confers immunity? I had heard that there is evidence of cases of second infection emerging .
Yes, only 2 cases of reinfection have so far have been reported. It is likely to be a rare and uncommon event. Saying that coronavirus immunity wanes with time and the virus drifts, i.e. escapes immune surveillance. However, to study these events we need sensitive assays that are scalable etc.
Please not SARS-CoV-2 is just another virus; there is nothing extraordinary about it. As always humans as a species will adapt and evolve and learn to live with it.
There are more than 2 cases reported??
https://twitter.com/DrZoeHyde/status/1308742105708130308
out of those 11, 4 of them had worse symptoms the second time around.
Thanks
Still a tiny fraction and entirely in keeping with other coronaviruses and virological & immunological principles. Immune memory is specific and viruses drift to escape immune recognition. The latter is happening very rapidly with SARS-CoV-2.
Still not a reason to hypothesise that herd immunity will not work. If herd immunity doesn’t work with coronaviruses humans would have gone extinct millennia ago. If I had a choice right now I would rather have had mild to moderate COVID-19 than being vulnerable to primary infection, which is what I am 😉
The problem with herd immunity is that it takes a long time and involves the suffering of those who are weaker for whatever reason. So touting it as any solution is not humane. By the time there is herd immunity to the current coronavirus, the next novel / zootic pathogen will be wreaking havoc.
Yes and no. Another way of getting herd immunity is vaccination. It doesn’t only occur by wildtype infection.
Economists predict that the number of premature deaths from the economic effects of COVID-19 will be greater than those dying from COVID-19. This is another reason for Sweden’s approach; its economy has handled the pandemic better than most other economies.
Impressive distance at that pace! 🏃♂️🏅🎉
Another 10 miles is a big ask but plenty of room to start (a lot!) …s…l…o…w…e…r… relax, smile at everyone you see and still get round in about 4 hours 🙂
Hey, the advantage of the virtual Strava race is you pick the course, date and weather!
It’s many years since I ran long distance and quite a few since I ran at all 🙁 but my marathon medal was one of my proudest achievements that can never be taken from me.
Good luck, enjoy your marathon 🙂 and I wish the project team all the very best with the GloBody study.
Already donated, but will share with a few others.
CoI – self-interest pwMS with on anti CD20
The following paper was published on Sept. 17, 2020, and suggests prior exposure to the common cold may not provide cross immunity to COVID. Guess we need to stay vigilant. https://doi.org/10.1093/infdis/jiaa593
But it makes the case that the protection is antibody mediated. Evidence suggests it is T cells that are important. This is the mistake vaccine developers are making
Thank you Prof G!
I would give anything to be involved in this research as an anti CD20 patient I am so sure I had COVID in March although I had an antibody test which was negative via work. I still don’t know whether it was just a major coincidence that I had a dry persistent cough illness unlike any I’ve previously had, and that I never had covid at all, or whether I did and the test wasn’t sensitive enough, or even my Ocrelizumab stopped me developing antibodies.
I have just donated to you and wish you the best of luck!
Thank you. I want to stress that as patients on anti-CD20 therapies deal with COVID-19 relatively well they, therefore, must have good cellular immunity to the virus and immune memory. So even if they are antibody negative they could still be immune and protected from reinfection. Cellular immunity may be sufficient.