While the world awaits the development of a vaccine against the Covid-19 virus, the fate of those infected lies with the only proven weapon against it: the human immune system.
Millions of years in the making, this ecosystem of cells and biomolecules forms a defence system of staggering sophistication.
And the well-being of billions of people rests on understanding how it works to combat Covid-19 – and why, sometimes, it fails.
Whenever a lethal new virus rears its head, researchers race to find out how it manages to breach the body’s defences and mount an attack.
The latest evidence suggests the increased death-rate among smokers in outbreaks of influenza and Mers is likely to be seen with Covid-19
The nightmare scenario is that the new virus has found a way of dodging the immune system, triggering no clear symptoms, thus allowing it to be unwittingly spread by its hosts. HIV, the virus that causes Aids – which still kills about 700,000 a year – notoriously triggers a brief flu-like illness before stealthily wrecking the immune system over years.
It is now clear that Covid-19 is pretty conventional in its attack. And for most healthy people, the response is similarly standard.
Virtually everyone infected develops a fever – which, contrary to widespread belief, is part of the body's defences (sparking concern about taking remedies that combat fever).
In otherwise healthy humans, the immune system then sets about attacking the virus on several fronts. Immunoglobulin M, an antibody produced by the spleen, first sounds the alarm, while Immunoglobulin G both attacks the virus directly and marks it for attack by other agents.
Next into the fray are helper T-cells, killer T-cells and B-cells, which attack the virus with a host of biochemical weaponry. One team of researchers reported in Nature Medicine this month that the immune system of a healthy 47-year-old woman from Wuhan, China – site of the original outbreak – battled the virus for over a week until she recovered.
So far, the evidence is that most people can rely on their immune systems to bring them back to health. But it’s also clear that for some, the fight is far tougher – and sometimes ends in defeat.
The most obvious reason is having a weaker immune system. Elderly people are a case in point, along with having underlying health conditions. These increase the risk of being unable to survive the molecular war between the virus and the immune system.
No-one knows how long those who recover remain are protected against getting Covid-19 again
Smoking is also emerging as a significant risk factor, given its notorious link with impaired health and increased risk of respiratory disease.
The latest review of the evidence found the increased death rate among smokers seen in outbreaks of influenza and Mers is likely to be seen with Covid-19.
But cases of young, fit and apparently healthy people succumbing to Covid-19 are focusing attention on a tragic irony: that the sheer strength of the immune system response can prove fatal.
Researchers in the UK have warned that a significant number of patients with severe Covid-19 infections may have so-called cytokine storm syndrome, in which their immune system triggers severe inflammation.
Reporting their concerns in The Lancet, the team points out that markers of this syndrome have been seen in patients with severe cases of Covid-19, and state that "mortality might be due to virally driven inflammation".
If correct, this suggests that such patients may benefit from drugs that reduce the level of immune response. In the meantime, the researchers suggest that all patients with severe Covid-19 are screened for signs their immune system is doing more harm than good.
Meanwhile, other researchers are tackling another key question: how long do those who recover remain protected against the coronavirus that causes Covid-19?
For some viral diseases, such as measles, the antibodies created to fight the infection last a lifetime.
But coronaviruses are a potential exception, with infection giving only a few years of protection. No one knows how long antibodies against the Covid-19 virus remain effective. Until that mystery is resolved, it would be a mistake to claim a final victory over this global scourge.
Robert Matthews is visiting professor of science at Aston University, Birmingham, UK
Chef Nobu's advice for eating sushi
“One mistake people always make is adding extra wasabi. There is no need for this, because it should already be there between the rice and the fish.
“When eating nigiri, you must dip the fish – not the rice – in soy sauce, otherwise the rice will collapse. Also, don’t use too much soy sauce or it will make you thirsty. For sushi rolls, dip a little of the rice-covered roll lightly in soy sauce and eat in one bite.
“Chopsticks are acceptable, but really, I recommend using your fingers for sushi. Do use chopsticks for sashimi, though.
“The ginger should be eaten separately as a palette cleanser and used to clear the mouth when switching between different pieces of fish.”
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Key facilities
- Olympic-size swimming pool with a split bulkhead for multi-use configurations, including water polo and 50m/25m training lanes
- Premier League-standard football pitch
- 400m Olympic running track
- NBA-spec basketball court with auditorium
- 600-seat auditorium
- Spaces for historical and cultural exploration
- An elevated football field that doubles as a helipad
- Specialist robotics and science laboratories
- AR and VR-enabled learning centres
- Disruption Lab and Research Centre for developing entrepreneurial skills
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The biog
Born: High Wycombe, England
Favourite vehicle: One with solid axels
Favourite camping spot: Anywhere I can get to.
Favourite road trip: My first trip to Kazakhstan-Kyrgyzstan. The desert they have over there is different and the language made it a bit more challenging.
Favourite spot in the UAE: Al Dhafra. It’s unique, natural, inaccessible, unspoilt.
Gothia Cup 2025
4,872 matches
1,942 teams
116 pitches
76 nations
26 UAE teams
15 Lebanese teams
2 Kuwaiti teams
F1 The Movie
Starring: Brad Pitt, Damson Idris, Kerry Condon, Javier Bardem
Director: Joseph Kosinski
Rating: 4/5
The years Ramadan fell in May
Killing of Qassem Suleimani
MOUNTAINHEAD REVIEW
Starring: Ramy Youssef, Steve Carell, Jason Schwartzman
Director: Jesse Armstrong
Rating: 3.5/5
What is a Ponzi scheme?
A fraudulent investment operation where the scammer provides fake reports and generates returns for old investors through money paid by new investors, rather than through ligitimate business activities.
Rock in a Hard Place: Music and Mayhem in the Middle East
Orlando Crowcroft
Zed Books
Tonight's Chat on The National
Tonight's Chat is a series of online conversations on The National. The series features a diverse range of celebrities, politicians and business leaders from around the Arab world.
Tonight’s Chat host Ricardo Karam is a renowned author and broadcaster with a decades-long career in TV. He has previously interviewed Bill Gates, Carlos Ghosn, Andre Agassi and the late Zaha Hadid, among others. Karam is also the founder of Takreem.
Intellectually curious and thought-provoking, Tonight’s Chat moves the conversation forward.
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more from Janine di Giovanni
How green is the expo nursery?
Some 400,000 shrubs and 13,000 trees in the on-site nursery
An additional 450,000 shrubs and 4,000 trees to be delivered in the months leading up to the expo
Ghaf, date palm, acacia arabica, acacia tortilis, vitex or sage, techoma and the salvadora are just some heat tolerant native plants in the nursery
Approximately 340 species of shrubs and trees selected for diverse landscape
The nursery team works exclusively with organic fertilisers and pesticides
All shrubs and trees supplied by Dubai Municipality
Most sourced from farms, nurseries across the country
Plants and trees are re-potted when they arrive at nursery to give them room to grow
Some mature trees are in open areas or planted within the expo site
Green waste is recycled as compost
Treated sewage effluent supplied by Dubai Municipality is used to meet the majority of the nursery’s irrigation needs
Construction workforce peaked at 40,000 workers
About 65,000 people have signed up to volunteer
Main themes of expo is ‘Connecting Minds, Creating the Future’ and three subthemes of opportunity, mobility and sustainability.
Expo 2020 Dubai to open in October 2020 and run for six months
More from Neighbourhood Watch:
Specs
Engine: 51.5kW electric motor
Range: 400km
Power: 134bhp
Torque: 175Nm
Price: From Dh98,800
Available: Now
Benefits of first-time home buyers' scheme
- Priority access to new homes from participating developers
- Discounts on sales price of off-plan units
- Flexible payment plans from developers
- Mortgages with better interest rates, faster approval times and reduced fees
- DLD registration fee can be paid through banks or credit cards at zero interest rates
MATCH INFO
Iceland 0 England 1 (Sterling pen 90 1)
Man of the match Kari Arnason (Iceland)
Brief scores:
Day 1
Toss: South Africa, field first
Pakistan (1st innings) 177: Sarfraz 56, Masood 44; Olivier 4-48
South Africa (1st innings) 123-2: Markram 78; Masood 1-4
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Specs
Engine: Electric motor generating 54.2kWh (Cooper SE and Aceman SE), 64.6kW (Countryman All4 SE)
Power: 218hp (Cooper and Aceman), 313hp (Countryman)
Torque: 330Nm (Cooper and Aceman), 494Nm (Countryman)
On sale: Now
Price: From Dh158,000 (Cooper), Dh168,000 (Aceman), Dh190,000 (Countryman)