SICK AGAIN — We’re at another one of those moments where it’s hard to know exactly what’s going on in the pandemic. People are out and about more now than ever — often unmasked — and at the same time, it seems like everyone has the virus. It’s hitting colleagues left and right, and if you’ve managed to avoid infection for almost 2.5 years now, you may be wondering: Is my time finally up? This week’s news that none other than Anthony Fauci tested positive probably didn’t help with those feelings. Then there’s HHS Secretary Xavier Becerra, who tested positive for the second time in roughly a month. To get a grasp on this stage of the pandemic, Nightly called Paul Thomas , an immunologist at St. Jude’s Research Hospital in Memphis, Tenn., who talked us through Becerra’s case, what Covid is teaching us about our immune systems — and what it means for the future of the pandemic. This conversation has been edited. Do we benefit from the same infection protection with Omicron as we have in the past? There are some recent reports hypothesizing that there’s something weird about Omicron viruses that mess up your immune memory. Those reports are incredibly preliminary, and we need, as a field, to be very, very careful. Because there’s nothing that I’ve seen data-wise so far that suggests there’s anything extraordinary about how our immune systems are evolving to respond to these new strains. In cases like Becerra’s, you have to ask whether or not it’s actually still the same infection. There are multiple case reports now with really good sequencing that shows that there are people who are positive, and then they go negative, and they come positive again. And it’s literally the exact same virus. It’s also possible it’s sort of a kooky case of reinfection where, assuming that this person is otherwise healthy, it’s probably that it’s two pretty different strains. With something like this, where everyone is getting infected, really rare events get magnified in a way. We have to be careful to put it in context of the overall dynamics of the pandemic. So if you had BA.1 around the holidays, your protection against BA.5 is probably not great? I’ve seen unpublished data about how different Omicron classic, BA.1, is from BA.5. They’re the farthest apart. But they go in that order: If you had Omicron classic, then you’re probably pretty closely protected from BA.2. If you had BA.2, you’re pretty closely protected from BA.4 and maybe even BA.5, so on. But if you got BA.1, you’re probably least protected against BA.5. That’s just going to be the cycle that we go through as this virus keeps evolving. Do we have any idea when this cycle ends? Unfortunately coronaviruses were generally understudied prior to this pandemic. We don’t really know with a lot of rigor, the way we do for something like the flu. It’s clear that one vaccination wasn’t enough to eliminate the virus. It’s still evolving. People still get infected. We have breakthrough infections. But I think we’re seeing signals that you’re starting to build up population immunity where people are showing more and more evidence of longer and longer-term protection, as we would expect. Sometimes it’s hard to see that signal through the noise of these waves of the pandemic, where all of a sudden everyone you know is getting infected. The vaccines have remained effective against severe disease and death, but what’s the next step to better combat these breakthrough cases as people are out and about more? I think most immunologists would agree that keeping the old vaccine is diminishing returns at this point. Like we do for flu, switching the antigen seems logical. We need a better system for how quickly we switch it. With the flu, you don’t do a whole clinical trial every time you switch the antigen, and you can do a six-month — or even less — turnaround. It would be great if we could get something moving a little bit faster. But the real wild card is, at some point, you’re going to get an immune memory response that’s actually pretty effective. And hopefully we see the virus kind of slow down a little bit. Welcome to POLITICO Nightly. Programming Note: We’ll be off this Monday for Juneteenth. We will be back in your inboxes on Tuesday, June 21. Reach out with news, tips and ideas at nightly@politico.com. Or contact tonight’s author at mward@politico.com or on Twitter at @MyahWard.
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