SamaGong, I agree and recognize that the analog

SamaGong,

I agree and recognize that the analogy is not an exact parallel to the situation with Covid.

For the Tb patients, HIV, poverty and failure to adhere to the requisite prolonged antibiotic regimen have allowed Tb to proliferate and develop multi-drug resistant variants.

Covid undoubtedly persists in HIV and other immunosuppressed patients who are not immune competent.

The key difference is that the selective pressure in these patients is the administration of rifampin and other antibiotics which the drive development of the drug-resistant variants.

With Covid, we know there is no specific treatment, so the selective pressure pressures include competition from wild type and other variants, favoring variants with higher transmission rates, and host immune response, favoring variants for example that evade detection and promote syncytia, so that the virus can move from pneumocyste to pneumocyte and evade cellular immunity.

HIV patients who not immune competent allow persistent unchecked reproduction with resultant mutation, but it is the response of the immune system among the healthy that is the selective pressure favoring the new variants.

Without that selection wild-type Covid would not be supplanted by the more fit variants.