Coronavirus Files: Immunity, conspiracy theories and the road ahead

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By Lindzi Wessel

The Center for Health Journalism has begun offering a special newsletter geared to journalists as they report on one of the biggest and most complex stories of our times. Each Monday, while the pandemic runs its course, The Coronavirus Files will provide tips and resources and highlight exemplary work to help you with your work. The Center for Health Journalism’s Coronavirus Files Monday newsletter is curated and reported by science writer Lindzi Wessel. Have a suggestion or a request? Write us at editor@centerforhealthjournalism.org.

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Sign up for this Wednesday’s Webinar: Covering Coronavirus: Street Reporting Without the Street, April 22, 10-11 a.m. PT / 1-2 p.m. ET: With many reporters working from home, finding sources and connecting with your community can be more challenging than ever. This hour-long webinar will help reporters find health sources and affected people online, through social platforms and digital communities, with an emphasis on hard-to-reach and marginalized communities and led by Amara Aguilar, a USC Annenberg Journalism School digital engagement expert. This session will provide live, hands-on experience with at least three tools and provide more resources for health reporters working remotely. Sign up here.

And then there’s our April 29 webinar, Covering Coronavirus: Are You Listening to Your Community? Few outlets have been as nimble and innovative as Southern California Public Radio under Community Engagement Director Ashley Alvarado. Alvarado will share ideas on how outlets of all sizes can better serve their audiences with innovative methods for listening and generating story ideas. Alvarado manages a team that has personally answered close to 2,000 reader questions, that is sending 10,000 mailers to low-internet neighborhoods, creating digital support groups and more. Sign up here for the 10-11 a.m. PT/1-2 p.m. ET webinar.

Reporting Tips, Conspiracy Theories & The Road Ahead

Conspiracy theories are wont to crop up in any situation where concrete answers are hard to come by. Our current pandemic is no exception. Unfounded rumors about where the novel coronavirus came from have ranged from accusations that Microsoft co-founder Bill Gates created the virus for profit to concerns about a mysterious link between 5G towers and the infection (a theory that led to phone towers being set on fire in the United Kingdom).

Genetic analyses of SARS-CoV-2 refute the idea that the virus is man-made. But another theory — that the virus jumped from bats to humans in a Wuhan laboratory lacking adequate safety measures — seemed to gain credence this week due to a widely circulated Washington Post article, which reported that cables sent from U.S. embassy officials to Washington two years ago warned of safety problems at the lab. 

But evidence needed to confirm this scenario simply doesn’t exist. The existence of these cables alone cannot be considered a viable explanation for the origins of the coronavirus, cautions veteran biomedical reporter Jon Cohen of Science. 

“Extraordinary claims require extraordinary proof,” Cohen wrote in an email to the USC Center for Health Journalism. “A lab accident, given the lack of evidence that this lab had an isolate of SARS-CoV-2 or anything close to it, is an extraordinary claim. The cables are far, far away from extraordinary proof.”

How can reporters best talk about such unsupported but popular theories that have so strongly captured reader interest? In addition to pointing to scientific and other evidence, Cohen recommends evaluating the agendas that might be shaping these debates. 

“I think reporters of all stripes are well equipped to look at how a source’s agenda might shape arguments. . . . Clearly, there are Trump supporters who want to blame China to deflect blame from Trump. There are scientists who long have opposed gain-of-function research that genetically manipulates dangerous viruses, putatively to help us better understand them, to make them more dangerous. There are China critics. There are American critics. There are people who dislike animal research. All of these agenda factor into the mix,” he writes. 

“An agenda doesn’t make a person right or wrong. Just aim for full disclosure.”

Struggling hospitals

With millions of Americans forced to stay at home, it’s not surprising that the pandemic is wreaking havoc on restaurants, retail stores and other business across the nation. But lockdowns are also undermining the stability of one surprising and especially important sector: hospitals.

Many hospitals and other health facilities, like La Clínica de la Raza in Oakley, California, are facing major financial setbacks due to cancellations of elective procedures, a decision made by many health systems (and some cities and states) to stem the spread of coronavirus, keep hospital beds available and preserve scarce personal protective equipment. For most hospitals, though, such elective procedures are the main source of income.

The blow is particularly destabilizing for rural hospitals with less resources and smaller financial margins. For the Texas Tribune, Shannon Najmabadi describes the struggles of a small hospital in Titus County where “funding is a challenge even without a pandemic.” In Michigan, where hundreds of hospital employees have been laid off in the face of the pandemic, even rural hospitals that haven’t yet seen COVID-19 cases are struggling, according to The Detroit Free Press.

Massive financial losses aren’t unique to rural hospitals, but in many cases, these smaller facilities are at particularly high risk. And in communities where specialists are already hard to come by, losing one hospital could mean having nowhere to turn for many vulnerable patients.

Show Me the Science

Gaps in our understanding of how we develop immunity to COVID-19 represents one of the biggest challenges in predicting how the pandemic might play out. We know that with some viruses, like the one that causes chickenpox, a single infection can confer lifelong immunity, while other viruses can sicken us repeatedly. In an opinion piece for The New York Times, Harvard epidemiologist and infectious disease specialist Marc Lipsitch explains how studies on similar viruses can help experts make educated guesses about what COVID-19 immunity might look like. Past epidemics of the coronaviruses SARS and MERS offer clues, but our understanding mostly comes from the coronaviruses we see causing ailments like cold and pneumonia yearly, unlike those short-lived outbreaks.

If COVID-19 infections lead to immunity that lasts a year or more, we should eventually develop so-called “herd immunity,” a form of protection that arises when enough people within a community are immune to an infectious disease that the disease no longer spreads easily, writes Lipsitch. But because we’re still learning how COVID-19 immunity works and because limited testing leaves us guessing at how many people have already been exposed, it’s hard to say if and when this could happen — and how many people might perish in the process. These are gaps in knowledge we should be aiming to fill quickly, argues Lipsitch, “not only to estimate the extent of herd immunity, but also to figure out whether some people can re-enter society safely, without becoming infected again or serving as a vector.”

The Road Ahead

A new study has dashed hopes for many holding out for an imminent return to normalcy. The computer modeling research, published Tuesday in the journal Science, suggests that without the creation of an effective vaccine, “prolonged or intermittent social distancing may be necessary into 2022” to avoid overwhelming the nation’s healthcare system. In other words, even if officials start to lift restrictions, we might have several more rounds of social distancing to look forward to over the next two years. 

The study was conducted by some of the nation’s most prominent disease-modeling experts, including epidemiologist Marc Lipsitch, but no model is without limitations, points out Mark Johnson of The Milwaukee Journal Sentinel. The study looks at what it might take to arrive at herd immunity without significant medical interventions and is based on certain assumptions about the behavior of SARS-CoV-2 that we still don’t have the data to confirm. For one, the model assumes SARS-CoV-2 will act somewhat like its closely related and better-studied cousins. And we’re also missing testing data that would help make predictions. If SARS-CoV-2 has been spreading faster than estimates suggest, it could mean more immunity than we think has already been generated through mild cases.

Regardless of the limitations, the study makes a compelling argument for the view that new medical interventions may be our best hope for righting the ship. A vaccine could obviously have a huge impact, but projections suggest we may not see one for 18 months or more. New treatments to help get people healthy and out of hospitals faster might also allow us to change course by increasing the number of patients the nation’s healthcare system can handle.  

A glimmer of hope?

This week, we heard the first whispers that a much-discussed drug might be working. Leaked preliminary results from a closely watched drug trial provide some grounds for guarded optimism.

The drug in question is Gilead Sciences’ antiviral drug remdesivir, and on Wednesday STAT reported that a Chicago hospital treating 113 severe COVID-19 patients with the drug saw “rapid recoveries in fever and respiratory symptoms, with nearly all patients discharged in less than a week.” Until the trial is complete, all data are anecdotal and shouldn’t be used to draw final conclusions, write Adam Feuerstein and Matthew Herper for STAT, “but some of the anecdotes are dramatic.”

In a video chat Friday Feuerstein and Herper answered questions about their reporting and discussed limitations of the study. Because the study is not yet complete, fatality and recovery rates cannot yet be calculated and compared against sick patients in the general population. Additionally, both participants and health care professionals knew which patients received remdesivir, and the study included no randomized control group to compare the treatment against. Such imperfections in study design will challenge researchers trying to separate out the drug’s effects from other factors, like better overall patient care, that might influence outcomes. Complete data from the conclusion of this study, STAT reports “could come any day.” Results from two other remdesivir trials underway will also help determine the effectiveness of the drug.

The Trouble with Preprints

As researchers around the world race to understand and propose treatments for the novel coronavirus, scientific publishers are seeing a massive surge in study submissions. That’s true too for preprint sites, which gather studies that have yet to undergo the lengthy peer review process typical for scientific papers. Designed to facilitate information sharing between scientists by allowing researchers to share results faster, preprint sites are now experiencing a boom in readership. But this comes with a major complication, writes Wudan Yan for The New York Times: Many of those readers are not scientists and “may not understand the studies’ limitations.”

Yan writes:

“Although preprints can rapidly add to important scientific discourse — a necessity during a pandemic — they often read like first drafts, and may contain language that risks misleading people who lack scientific expertise, says Samantha Yammine, a science communicator in Toronto.” The problem can be exacerbated further when journalists publish results from preprints without a careful vetting process.

More Resources

• Want to get a quick picture of the latest coronavirus numbers across the country? Check out The New York Times auto-updating page of stats and infographics. Here you can quickly see the country’s current and potentially emerging hotspots, review death counts by state and county and click into a more detailed overview of each of the 50 states, D.C., and Puerto Rico. 

• If you’re looking for a way to embed these graphics into your own stories, Stanford University’s Big Local News platform has developed an easy solution, in partnership with the Google News Initiative and Pitch Interactive. With its COVID-19 Case Mapper, you can create a county-level map of COVID-19 case counts and deaths. Click on your county to get data specific to your state, then hit “export and embed” to add it on your site. More details here.

• These are tough times for everyone. Though news readership is skyrocketing, many outlets are seeing their revenue tank as struggling companies are forced to pull advertising. Take a look to see if your outlet qualifies for Google’s Journalism Emergency Relief Fund. Applications are due April 29th

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