Definitely Shin! But I believe in parts that small moments of slowing down will maximise your productivity! "Slow is smooth, smooth is fast"

Also sorry for the delay response on this I have been working around the clock in the lab.

But in regards to your question:

1) I agree with your proposed mechanism as it is something I discussed with my colleagues a few months ago for severe eosinophilic asthma patients. To add to your reasons for poor viral entry, airway inflammation for COPD or asthma patients render the airway smooth muscles cells have limited/reduced replicative capacity, this is in line with your "defective cellular replication".

2) All the reasons you have mentioned regarding low transmission rate in respiratory disease patients are all valid. These are also what consultants here are looking at as to why the prevalence is low. Something to consider also is that severe asthmatic/COPD also take oral corticosteroids which cause a systemic reduction inflammation, this may add to the low prevalence too.

3) A possible theory too is that many severe patients (for resp diseases) are also on biologics - monoclonal antibodies. These are used to block a certain cytokine/receptor to blunt a particular WBC e.g. mepolizumab for eosinophils. Therefore as part of the immune system is essentially silenced, it could be thought that other parts could be enhanced as a a result/to compensate. However this is just a theory at the moment (I thought of while typing this response haha). Therefore one of those heightened responses could be T-lymphocyte response.

So to answer your "is the above reasoning sound" I can say yes definitely.

I would welcome a further discussion if you would like? I am impressed with your understanding of the mechanism you proposed too!

email me if you would like: aamir@researchtribe.org