Treatments against Evolution of Resistance
Challenges in measuring time dependent confounders from treatment mediated confounders
A hypothetical example of an interesting consequence of 2nd order effects of a treatment having negative interaction with another treatment that follows which isn’t a known contraindication even though the order of treatment matters.
Unless onward transmission is 100% blocked during treatment with B, the risk of treatment B progressively failing cannot be eliminated as will the failure of treatment A.
This should lead to Treatment B failing if it’s associated with TreatA(Vaccine)→CondA(Cancer)→CondB(Severe Covid)→Progressive Failure of TreatmentA(Vaccine) against Condition B(Severe Covid) in those with Condition A (Cancer) with recent treatmentA (Vaccine).
That is, specific cancer patients should have an increasingly hard time with Omicron compared to delta if what I am saying is right and an imperfect therapeutic is widely deployed in a vulnerable population without blocking transmission and new infections. It should continuously enrich the pool of susceptibility with new Cancers and variants progressively penetrating innate immunity. If this for some reason is impossible then we shouldn’t see any improvement of infectivity between the left (normal lung) vs right (cancerous lung) over time.
If i’ve misunderstood or incorrectly analyzed, i’d like to understand and eliminate this scary possibility. Looking for any feedback.
Treatment A [Vaccine]
Prophylactic that imperfectly blocks infection
Prophylactic that inhibits innate immune response
Wide rapid deployment in those with Condition A
Promoting rapid progression of Condition B
Treatment B [Mutagen]
Therapeutic that imperfectly prevents replication
Therapeutic that’s associated with Condition A
Therapeutic that’s associated with treatment of Cond. B with Cond. A
Condition A [Cancer]
Treatment requires immunosuppressants
Preventing Condition B with Treatment A→More of A (Boost)
Preventing Condition B with Treatment B. after Treat. A
Condition B [Severe Covid]
Severe disease associated with Progression to Cond. A
Severe disease associated with trying Treat. A with prior Cond.B
Severe disease associated with trying Treat. A with past Cond.B