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COVID-19

Atlas shrugs

In its latest attempt to confuse the public about the science of coronavirus disease 2019 (COVID-19), the Trump administration has added Dr. Scott Atlas to the team advising the president.  Although Atlas may be capable of neurological imaging, he’s not an expert in infectious diseases or public health—and it shows.  He’s spreading scientific misinformation in a clear attempt to placate the president and push his narrative that COVID-19 is not an emergency.

Janeway’s Immunobiology, now in its ninth edition, would be an excellent place for Atlas to “brush up” on the facts and help him grasp what science is telling us about severe acute respiratory syndrome–coronavirus 2 (SARS-CoV-2, the virus that causes COVID-19)—that is, if he wants to understand the science. Take chapter one, where the biology of T and B cells is laid out.  Like antibodies produced by B cells, T cells recognize antigens on the virus.  But that recognition is used to generate cytotoxic T cells that then kill cells that are infected.  Specifically, “Cytotoxic T cells kill other cells that are infected [emphasis added] with viruses or other intracellular pathogens” (page 13). In other words, T cells are a help after infection but don’t prevent it.

I point this out in particular because over the last few months, there have been a number of studies examining whether someone can have residual T cells that are cross-reactive against SARS-CoV-2 and whether such an individual experiences less severe COVID-19.  These T cells could have developed during previous infections with coronaviruses that cause common colds.  A number of the highest-profile papers are from the labs of Shane Crotty and Alessandro Sette, one published in Science and another in Cell that was famously held up by Anthony Fauci, the nation’s foremost leader on infectious diseases and a member of the White House Coronavirus Task Force, during a congressional hearing.  Crotty and Sette suggest that these T cells, which appear in as many as 50% of COVID-19 patients, could decrease the severity of SARS-CoV-2 infection.  But as they caution in the Science paper, “Based on these data, it is plausible to hypothesize that pre-existing cross-reactive human CoV CD4+ T cell memory in some donors could be a contributing factor to variations in COVID-19 patient disease outcomes, but this is at present highly speculative [emphasis added].”  Many questions around this are yet to be settled, and it is most likely that exposure to a large a bolus of SARS-CoV-2 infection would overwhelm these cross-reactive T cells.

The hydroxychloroquine peddler (and physician turned investment manager) James Todaro seized on this for a Twitter thread, implying that the pandemic was now over because if you add the 50% of individuals with cross-reactive T cells to the 10 to 20% now infected, the world will have reached herd immunity (as first reported by Buzzfeed News).  This is absurd because T cells attack cells that are already infected (again, Janeway, page 13).  It’s no shock that a digital charlatan like Todaro would push this.  But what is far more frightening is that Atlas told Rush Limbaugh the same thing:  “Some people who have come down with a cold over the course of the summer,” says Limbaugh, “miraculously end up less likely to get COVID-19, according to Scott Atlas.”  Hilariously, Limbaugh’s blog post has the picture of Fauci holding up the Cell paper showing that the cross-reactive T cells are active against cells that already are infected with COVID-19.  Shane Crotty put together a long Twitter thread lucidly explaining the danger of these false declarations.

This episode represents a sad turning point in the saga of how the Trump administration continues to mishandle the pandemic.  For months, we have watched government scientists who advise the president squirm on TV when asked questions whose answers are sure to anger Trump.  Many scientists have called for these advisers, particularly Deborah Birx, to drop the mic and walk out rather than continue to equivocate.  I have taken the position that we need them to stay in place (as long as they stick to the science) to protect the public from true calamities like the possible approval of a vaccine that isn’t adequately tested.  None of them have deliberately spread scientific misinformation.  We may cringe when we see them struggle to answer simple questions, but they haven’t lied outright to promote the Trump narrative.

But Atlas is different.  He is spreading scientific misinformation.  He’s the anti-Fauci.