A Strategy to Battle Coronavirus Disease 2019 in the Hospital: Identify and Use the Power of “Immune Survivors”

Yamamoto, Hironori; Miura, Kouichi; Hagiwara, Koichi; Morisawa, Yuji; Lefor, Alan Kawarai; Sata, Naohiro; Nagai, Ryozo

The outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) poses serious health and economic problems worldwide. One of the worst scenarios is the collapse of the medical care system due to nosocomial infections. SARS-CoV-2 quickly spreads in closed spaces, crowded areas, and close physical distances, which frequently occur in Japanese medical facilities. Although we are making efforts to avoid such situations, healthcare workers always face the risk of developing a SARS-CoV-2 infection in the workplace because of proximity. Thus, we need to battle SARS-CoV-2 using a unique strategy. We propose a novel strategy to eliminate SARS-CoV-2 infections: measurement of antibodies against SARS-CoV-2 and using the power of “immune survivors.” We agree with using standard precautions and early isolation of patients with coronavirus disease 2019 (COVID-19) to block the spread of SARS-CoV-2 infection. However, we face difficulties carrying out these fundamental missions. Now, we focus on “immune survivors.” If healthcare workers acquired the neutralizing antibody against SARS-CoV-2, they are considered “immune survivors” with a low risk of reinfection with SARS-CoV-2. These “immune survivors” can contribute to the care of patients with COVID-19 on the front line. Also, these “immune survivors” can function as an envelope by surrounding COVID-19 patients. As a result, “immune survivors” can eliminate the spread of SARS-CoV-2 in medical facilities as well as in society. We understand that the concept of “immune survivors” needs further discussion. No information is available on how long or the titer of neutralizing antibody required for protection from infection. We have just started to measure antibody levels against SARS-CoV-2 in healthcare workers in our hospital. This project will provide further information in the battle against the SARS-CoV-2 infection. (Clinical trial registration number: UMIN 000039997)