I fear things may imminently become catastrophic across the Northern Hemisphere.
The more I learn about COVID the greater the similarities seem with Dengue Fever. I was reading into treatment methods and how they are now targeted to inflammation and use steroids and this set me down the Dengue track again.
Dengue is very similar;
"Typical dengue is fatal in less than 1% of cases; however, dengue hemorrhagic fever is fatal in 2.5% of cases. If dengue hemorrhagic fever is not treated, mortality (death) rates can be as high as 20%-50%."
What does that sound like? COVID is so far fatal in less than 1% of cases. But what if there is an ADE response to secondary infection, and what if this is the real reason Spanish Flu was also similarly deadly among populations prone to its wrath (in that case, the young and robust).
https://onlinelibrary.wiley.com/doi/full/10.1111/obr.13128?fbclid=IwAR1pFpFTmL5ve4an7oIEvBMsxNyu6mlCqDYiJ1abaAyTPUNDvjZ3yRJAnBA...
"Being an individual with obesity impairs the immune response to SARS‐CoV‐2"
"Influenza vaccination in adults with and without obesity results in equivalent influenza‐specific antibody titres at 30 days post vaccination, but antibody titres wane significantly more in adults with obesity compared with adults who are lean at 1 year post vaccination.163 Compared with influenza‐vaccinated lean adults, vaccinated adults with obesity have impaired CD4 and CD8 T cell production of key inflammatory cytokines IFN‐γ and granzyme B.151 Adults with obesity also have two times greater odds of influenza or influenza‐like illness despite a robust antibody response"
Now let's go back to Dengue....
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5819989/Hypothetically, obesity may affect the severity of dengue infection through the inflammation pathways. The increased deposition of white adipose tissue (WAT) in the overweight and obese individual leads to increase production of inflammatory mediators that were known to increase the capillary permeability and causes plasma leakage [25–27].
In 2013, Huy NT et al. published a systematic review and meta-analysis of 198 studies up to September 2010 on factors associated with dengue shock syndrome. In the sub-analysis of eight primary studies, the author found that obesity was no association between DSS and overweight or obesity [28]. Recently, in 2016, Trang et al. published a systematic review and meta-analysis of thirteen studies up to August 2013 on the association between nutritional status and dengue infection [29]. The meta-analysis of eight primary studies on overweight and obesity found no significant association between overweight/obese and DSS. However, the author failed to show substantial consistency regarding the relationship between studies and concluded that the effects of nutritional status on dengue outcomes were controversial. Similarly, both systematic reviews by Huy NT et al. and Trang et al. focused only on the association between nutritional status and dengue infection with studies up to August 2013.
"There were scarce and inconclusive shreds of evidence linking overweight and obesity with the severity of dengue infection [30, 31]. The number obese individuals susceptible to dengue will significantly increase with the increasing prevalence of obesity and increasing populations susceptible to dengue infection. With the hypothesized link between obesity and increasing plasma leakage, obese individuals may be at higher risk of developing severe dengue infection. Our review aims to summarize the current evidence on the association between obesity and severe dengue infection and to identify patients with high risk of severe infection. To our knowledge, this is the first systematic review and meta-analysis on the association between obesity and dengue severity."
"We first pooled the odds ratio for all fifteen studies [10, 31, 36–48] evaluating the association between obesity and dengue severity. We found that dengue patients who were obese have 38 percent higher odds of developing a severe presentation of dengue infection compared to non-obese dengue patients (OR = 1.38; 95% CI:1.10,1.73; p = 0.01; I2 = 36.7%) (Fig 2). We found no significant heterogeneity between studies (p = 0.08). There was no statistical evidence of publication bias based on the funnel plot (Fig 3) and Egger’s Test (p = 0.06). In sensitivity analyses using meta-regression, there was no statistical evidence of heterogeneity in obesity classification (p = 0.72), study quality (p = 0.84), nor study design (p = 0.67)."
Note that this study uses children who have a LOW risk of Dengue Hemmorhagic Fever and death - a study from Taiwan showed that mortality was also concentrated almost exclusively amongst the elderly (and also note Taiwan has LOW obesity, but the deaths were clustered amongst those with underlying illnesses and particularly hypertension).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4973177/"An unprecedented dengue outbreak involving more than 15,000 infections, including 136 dengue hemorrhagic fever (DHF) cases and 20 fatalities, occurred in Taiwan in 2014. The median age of the DHF cases was 71 years (range: 4–92 years) and most of them (N = 100, 73.5%) had comorbidities, of which the majority were hypertension (56%) and diabetes mellitus (DM; 27%). Only approximately half of the DHF cases (59/136) were classified as severe dengue, based on the 2009 WHO-revised dengue classification. The fatality rate for this DHF outbreak was 14.7%. DM (odds ratio [OR] = 3.60, 95% confidence interval [CI] = 1.22–10.63) and presentation with severe plasma leakage (OR = 6.42, 95% CI = 1.76–23.63) were independent risk factors for fatality."
These things all sound like.... the exact same as COVID....
If this is the case, the impending explosion of initial infections AND re-infections is likely to result in a MUCH higher overall mortality rate. Areas that have already achieved herd immunity are unlikely to see similar spikes in overall deaths but those who are overweight or obese are still at risk of dying again and they are likely to see manageable spikes in deaths in these populations.
But there is some potential that the Spring wave could be the worst of all. Also, Dengue does not have a working vaccine, for the reason of ADE.... this would also imply the same for COVID.
Essentially, if you are elderly-unhealthy or obese, and you get COVID, the similarities with Dengue Fever mean that your chances of dying upon reinfection are hypothetically ~2.5X GREATER than on initial infection. Or something like 1/4 or higher.
So, we hypothetically have "COVID Hemmorhagic Fever" waiting in the wings as autumn approaches. It would have a mortality rate of approximately 25% in vulnerable populations if it does exist, and data suggests it is very plausible this is the case. While I don't think COVID Hemmhorhagic Fever is likely to be widespread, it means that cases in areas that do have herd immunity, though fewer in number, are likely to be deadlier. And areas that are suffering primary waves have the potential to see oscillating waves of the virus during the next six months, which means these areas probably have very high potential of widespread COVID Hemmorhagic Fever IF it does exist.