Your understanding is flawed.
Memory B cells hold the information on how to quickly ramp up and make more B Cells to produce antibodies quickly.
Memory T cells hold the information on how to quickly ramp up and make more T Cells, which act primarily as Antigen Presenting cells for the B Cells and the innate immune system to engulf particles (virus + antibodies). But there are other APCs in the body, the infection can be mediated effectively without the Memory T cells.
T-cells are important, no one disputes that, but they are not the lynchpin to fighting SARS-CoV-2. B cells are.
Everyone keeps focusing on antibody levels, but that is also factually incorrect. The immune system is not designed to keep a high level of anitbodies floating around in our blood to every pathogen we have ever been exposed to. That would be insanely inefficient. Instead the body fights off infection, lets antibody levels wane, and keeps a handful of Memory B Cells around to rapidly divide and re-ramp Antibody production should there be re-exposure to a pathogen.
The only way you would see continued, persistent, high levels of antibody would be:
1) the body doesn't ever clear the infection
2) the body is constantly re-exposed to significant pathogen (not a passing glance, but persistent)
I have been talking all along about the body's memory about previous infections and looking for that. Other than what you say about memory B-cells here, everything I have read everywhere else describes the memory of past infections as residing in the T-cells. Such as this article from the Science Daily:
How the immune system remembers viruses: Immune response: memory T cells are formed earlier than previously thought
An excerpt:
To bring the infection under control and maximize the defenses against the virus, these few antigen-specific T cells start dividing rapidly and develop into effector T cells. These kill virus-infected host cells and then die off themselves once the infection is cleared. Some of these short-lived effector cells -- according to the generally accepted theory -- turn into memory T cells, which persist in the organism long term. In case the same pathogen enters the body again, memory T cells are already present and ready to fight the invader more swiftly and effectively than during the first encounter.
I am unfortunately famous for not remembering the terms for things very well (a side effect of dyslexia). Internally I don't care what things are called, only the concept for things is important. For testing possible long term immunity for COVID, we need to be testing for whatever is holding the memory for making the antigen. Most sources call them memory T-cells, you call them memory B-cells. They could be called fizzy widgets as far as I'm concerned, I'm most focused on the concept.
I was using the terminology I have seen in many articles such as the one linked above. As I understand it Adaptive Biotech's test claims to be looking for those memory cells. If you see a problem in their test, please enlighten me. You seem to be the only source saying anything negative about their test. If there is a problem with it, I want to know.
The
NYT has a story today by Pam Belluck about several long-haul patients who still month after month later are requiring multiple hospitalizations for different aspects, really devasting to their normal life. The article also looks briefly at several studies of what hospitals have seen to date on these type of cases. Have to wonder what will happen to these people down the road. Will they be able to have coverage for medical care and will it ever get better for them? If the number of these cases grows what does that mean for hospitals? Hope you can read the article. I have a subscription but not sure the link will be viewable for you. Worth a read.
"...Now, studies reveal that a significant subset of patients are having to return to hospitals, sometimes repeatedly, with complications triggered by the disease or by the body’s efforts to defeat the virus.
Even as vaccines give hope for stopping the spread of the virus, the surge of new cases portends repeated hospitalizations for more patients, taxing medical resources and turning some people’s path to recovery into a Sisyphean odyssey that upends their lives."
He Was Hospitalized for Covid-19. Then Hospitalized Again. And Again.
I've been thinking for months that we should be thinking about COVID like polio, not the flu. It kills some people short term and it looks like that's around 0.5%, maybe as high as a little over 1%, but most people hear less than 1% chance of dying with most dying being older and they think it's an acceptable risk. However recent studies are showing that as much as 1/3 of people who had it are having some kind of long haul symptoms. Many of these are relatively minor such as more fatigue, but some percentage are left with permanent organ damage or permanent nervous system damage severe enough to ruin their lives.
I read many months ago that about 20% of cases required hospitalization and of those who recovered, about half had permanent organ damage. That's about 10% of infections. Even if it's really lower because of undetected cases it's still about 3-5%. On top of that most of the long haul survivors never had a case bad enough to need to go to the hospital. They just can't seem to get rid of all the symptoms. Some of these people are so fatigued all the time they sleep all night then have to nap several times during the day.
Even if it's just 10% who have life affecting problems that are permanent or very long term, that's a significant hit to the population and the economy. Many of these people will need ongoing medical help, quite a few will need to find new careers or won't be able to work at all, and we will probably see a fair number die prematurely over the next few years.
The stupid policy of going for herd immunity in the US means the US may end up with the largest percapita population of COVID disabled in the developed world.
