Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus causes a spectrum of clinical manifestations, ranging from asymptomatic to mild, moderate, or severe illness with multi-organ failure and death. Using a new machine learning algorithm developed by us, we have reported a significantly higher number of predicted COVID-19 cases than the documented counts across the world. The sole reliance on confirmed symptomatic cases overlooking the symptomless COVID-19 infections and the dynamics of waning immunity may not provide ‘true’ spectrum of infection proportion, a key element for an effective planning and implementation of protection and prevention strategies. We and others have previously shown that strategic orthogonal testing and leveraging systematic data-driven modeling approach to account for asymptomatics and waning cases may situationally have a compelling role in informing efficient vaccination strategies beyond prevalence reporting. However, currently Centers for Disease Control and Prevention (CDC) does not recommend serological testing either before or after vaccination to assess immune status. Given the 27% occurrence of breakthrough infections in fully vaccinated (FV) group with many being asymptomatics and still a larger fraction of the general mass remaining unvaccinated, the relaxed mask mandate and distancing by CDC can drive resurgence. Thus, we believe it is a key time to focus on asymptomatics (no symptoms) and oligosymptomatics (so mild that the symptoms remain unrecognized) as they can be silent reservoirs to propagate the infection. This perspective thus highlights the need for proactive efforts to reevaluate the current variables/strategies in accounting for symptomless and waning fractions.
Highlights
This is a perspective based on the reports that have suggested antibody quantitation could be a prevaccination screening strategy and a single dose of COVID-19 vaccine may likely suffice for the already SARS-CoV-2 infected cohort [1,2,3,4,5]
This emphasis concerning the potential for single dose vaccination in prior COVID-19 individuals is relevant and timely, given the drastic decrease in new cases reported with that approach in many countries alongside a prolonged antigenic stimulation that has the likelihood of dampening the immune response via effector T-cells exhaustion, as has been observed with several other viruses [8]
Using a new machine learning algorithm developed by our team, we have reported that the total numbers of predicted COVID-19 cases to be significantly higher than reported across the nation and
Summary
This is a perspective based on the reports that have suggested antibody quantitation could be a prevaccination screening strategy and a single dose of COVID-19 vaccine may likely suffice for the already SARS-CoV-2 infected cohort [1,2,3,4,5]. These studies along with other findings similar to ours, have shown that the serological assessment of nucleocapsid (N)- and spike (S)-specific. Neutralizing when adjusted and compared to 1D was increased in the range between 2.6 and 26-fold in sero- group; between 1.3 potency and 1.7-fold in 2D sero+ group
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