“Those who don’t remember the past are condemned to repeat it.” – George Santayana
This graph related to Kaposi’s sarcoma (KS) by @1goodtern has been making the rounds. I thought I would go into a little bit more of why it both doesn’t surprise me and why it gravely concerns me.
Classic KS normally appears in males of Mediterranean or Eastern European descent at 50-70 years of age. This graph is of 19 – 44-year-olds. One major exception to this is endemic KS in sub-Saharan Africa, where it is common in children and young adults. The only other population that this is commonly seen in besides AIDS patients is in organ transplant recipients due to immunosuppressive therapy
This has been my big concern with COVID. I keep thinking how the progression of HIV to AIDS is about a decade, yet here we are seeing some of the same sequela in just a few years after the onset of COVID.
Here’s the entire thread of graphs like this.
Thread by @1goodtern on Thread Reader App – Thread Reader App
Models suggested that by 2023, 70% of the US population had been infected. I wouldn’t be surprised by 80+% now. There is also some evidence suggesting that people don’t clear the virus. That could account for why we see less severe cases, particularly since mutations have mostly been antigenic drift. That would account for why there are fewer cases over time…people are still harboring a similar virus and maintain some level of antibody response. However, when an antigenic shift happens, we will have a much more serious surge.
The big concern I have is viral persistence. Fragments and proteins have been detected in blood and tissue samples two years after infection. That seems to suggest active, but perhaps latent infection causing chronic immune activation, autoimmune reactions, and the possibility of reactivation of other latent infections as a result, TB for one.
This is why I continue to wear respiratory protection except in my office where I have two HEPAs running. More importantly, it’s why I keep pushing others to do the same. I fear we are on the same trajectory as AIDS. I keep thinking that if HIV were airborne, would we require people to use respiratory protection? COVID is a far worse disease in the long term.
I have come to a much better understanding of the frustrations of Semmelweis (faced resistance and skepticism from the medical community) and the constant battle Sisyphus fought over the past five years.
