Can you get the coronavirus infection a second time?
The short answer: No.
The number of people who have gotten well clinically and weeks later had a relapse of the illness with positive tests is very rarely seen and described. (I am aware of only one case study of a Japanese woman who appeared to get well associated with negative tests but then weeks later appear to relapse with the recurrence of positive tests.)
The long answer: This and related statements that are thrown about in the popular press really have to do with nasal swab tests that turn positive after a negative test in the recovery period.
We believe the currently available nasal swab tests to only be about 70-75% accurate. That means that if you did the test on ten people with COVID-19, three of them would test negative. If the current test is positive, then there is a high degree of accuracy that indeed you have the illness. If it is negative, it must be taken with a grain of salt.
Some have incorrectly diagnosed a positive test that followed a negative test as a recurrence of the illness. The more correct interpretation is that the negative test was falsely negative, and the follow up test was a true positive. (It’s a bit of head-spinning to understand, but it makes sense to those of us who think about the reliability of testing daily.)
The impact of this is that we know people can test positive up to two weeks after they have recovered clinically. So a negative test within that two week period needs a secondary follow up test to assure the virus has indeed been cleared from the nose and throat. This is particularly important if one is returning to work where there is contact with others.
However the complete immunology of this virus is still being worked out. How long immunity lasts is at present unknown. It is thought based on analysis of the similar coronavirus, the SARS-CoV1 virus, that immunity is long term, meaning 7 or more years.
There are apparently 70 vaccines in the pipeline for testing against COVID-19.
Interestingly only 60% of people in New York City say that they would readily accept a new vaccine against COVID-19. According to this report, the WHO is reported to say that
“vaccine hesitancy” was one of the top 10 global health threats that had already contributed to triggering the resurgence of a number of infectious diseases like measles and polio.
Also from this article
Coined in 1923, the term “herd immunity” refers to the percentage of vaccinated individuals required to protect an entire community from a disease. For COVID-19, herd immunity will require a significant immunization rate (some estimate it at 70%) to achieve meaningful protection.
We are very, very far from 70% of the human population becoming immune to this virus.
We’ll have to wait on the results of the few vaccines in actual human testing to know how to proceed.
(DISLAIMER: This is a bit of a rant.) Physicians taking and touting hydroxychloroquine
I have had several people send statements from personal emails or websites or relayed personal experience about this issue. It is painful to hear of physicians touting the safety of this medication and of their admission taking it daily as a way to prevent the illness. I have also seen it in my wanderings about the internet.
These physicians’ behavior and statements do not accurately reflect the current opinion of the much broader medical community, who sit cautiously waiting to be guided by something more than personal experience and opinion.
Despite its touted safety, hydroxychloroquine is not as safe a drug as claimed. The FDA recently reiterated the possibility of potentially life-threatening cardiac arrhythmias.
Dr. Gipson
Association of American Physicians and Surgeons
AAPS Letter Asking Gov. Ducey to Rescind Executive Order concerning hydroxychloroquine in COVID-19
https://aapsonline.org/aaps-letter-asking-gov-ducey-to-rescind-executive-order-concerning-hydroxychloroquine-in-covid-19/
The letter includes a link to peer-reviewed evidence.
I know this is anecdotal, however, I do know someone whose mother is in a Long Island Alzheimer Care Center. She is 94 with no other underlying conditions. She contracted CoVid-19 from another resident who was returned to the Care Center after being released from the hospital. This resident was still contagious (you have seen this process in the news I am sure). The 94-year-old developed CoVid-19 symptoms, was tested and treated immediately with HCQ-AZ combo (I believe this is referred to as ZPAC?). She was not hospitalized and has recovered from Covid-19. I am sorry I do not know the particulars as to dosage and length of time she was on the HCQ-AZ combo.
I must apologize for the long-winded response, but your comment triggered many thoughts.
First, thank you for the reference and interesting read.
Second, although the letter you reference does contain a link to peer-reviewed literature, the evidence presented is a mixture of uncontrolled studies, recommendations of working groups who appear to be convinced of the benefit of these medications, and basic science literature that provides a basis to suggest these medications would be helpful in humans.
The long list of references associated with that letter reminds me of the rhetorical tactic of convincing another of one’s opinion by overwhelming them with evidence, regardless whether the evidence really answers the question being presented. In this case, the evidence in the list does not prove the effectiveness of hydroxychloroquine in COVID-19.
Third, in terms of political presence and healthcare policy influence, the AAPS represents <1% of physicians in the US. Therefore as an entity expressing a consensus opinion in the medical and scientific communities, it is not a well-recognized organization. I raise this issue only to put a perspective on the source of the letter to Gov. Ducey.
Fourth, to date there are no controlled, randomized, double-blinded studies of the effectiveness of hydroxychloroquine in early COVID-19. That is the gold standard on which to base treatment decisions for the broad use of hydroxychloroquine. There are several NIH studies underway with that specific study design that will hopefully provide more clear answers.
Lastly, as is the case of using any medication when it is not been properly vetted to prove effectiveness, we may end up killing more people then we benefit. The total number of people prescribed hydroxychloroquine in these studies is fairly small when compared to the 100’s of thousands if not millions of people who would potentially be prescribed this drug under the assumed guise of effectiveness.
I am very sympathetic to the urge to treat quickly for a condition for which there is little available known treatment. A number of times throughout my career I have treated based on anecdotal experience or results from uncontrolled studies, only to have to retract those treatments when better evidence proves the initial impetus to treat wrong. When talking about giving millions of people a medication, I think it behooves us to be 100% sure of what we are doing. We are not at the level of 100% surety with this medication.
Sometimes the answers in medicine come quickly and other times much more slowly and with more patience than we would like.
Thank you again for your comments! I am grateful for the time you took to express your comments.