The new normal is now.
For what seemed like a moment, COVID-19 became an unavoidable part of daily life more than two years ago – with no signs to suggest we’ll ever see the opposite again.
As we look to our lives ahead with waves of new “stealth” variants and subvariants, and seasonal vaccine reminders, it begs the question: Should we fear reinfection?
Doctors recently confirmed that people infected with an earlier variant of Omicron, which emerged and spread rapidly last summer, can indeed test positive for the new subvariant again.
Last week, as the latest strain – BA.2 or BA2.12.1 – made its presence known in New York and is concentrated throughout the Northeast and Midwest, the United States took a grim step: 1 000,000 deaths from COVID. Overall we lost over 6,000,000.
The Post spoke with NYU Langone Health infectious disease expert Dr. Michael Phillips about what we can expect from living with COVID as we know it.
Can you get infected twice with COVID – and who is at risk?
There is no perfect immunity to COVID. Regardless of severity or immunization, someone who tests positive for the virus can become infected again at some point.
“Our hospitalizations have increased over the past few weeks, especially with this new variant of Omicron,” Dr. Phillips told the Post. “But fortunately the vast majority of people [who] get the infection tend to recover without too much trouble.
But there is more at stake for some. People who have not received two doses of the mRNA vaccine, as well as those with weakened immune systems due to age, medications, pre-existing illness, or other clinical factors, such as poor fitness physically, are at higher risk of re-infection and becoming seriously ill. with COVID-19.
But Phillips warns that we are “developing[ing] a laissez-faire attitude about it. While some relatively young, healthy, vaccinated people can be re-infected with only a mild case, the person they pass it on to – potentially, someone with a weakened immune system due to age, medications, d Pre-existing disease or other clinical factors, such as poor physical condition – may not fare as well.
Omicron is “very, very different from previous Delta waves,” Phillips added. “I think it certainly changed our game plan.” Now more than ever, prevention efforts are focused on protecting those at greater risk of serious illness – and protecting yourself from COVID reinfection also means “protecting[ing] the most vulnerable.
Can you be re-infected with the same COVID variant?
It is certainly possible, especially in those who are not vaccinated. Unlike earlier variants, Omicron quickly evolved into multiple subtypes, causing simultaneous localized outbreaks. Meanwhile, it’s unclear how many positive COVID-19 cases go unreported, whether due to a lack of testing or symptoms warranting alarm. So whether to fear re-infection with the same niche strain may not be a pragmatic question to ask – because, by the time it is answered, a new strain may already be there.
“There are so many of these other variants in this big family of coronaviruses, and we typically get infected with three to four a year,” Phillips explained, most of which present as a mild cold.
Ideally, SARS-CoV-2 could fade into coronavirus obscurity like many others – but we’re not there yet, and it’s too early to tell if that’s a feasible prospect. “It’s still serious enough that we have to be very careful,” Phillips said. “We just don’t know enough about future variants for us to let our guard down any further.”
How soon after contracting COVID can you be re-infected?
This is another complicated question – especially for people with long COVID, who seem to harbor low, even undetectable levels of virus for weeks and months. For mild to moderate cases, people who test positive for COVID can expect their infection to clear within five to 10 days of the onset of their symptoms or since their test result was confirmed.
Emerging research suggests that the average immune system can fend off COVID reinfection for three to five months after the previous fight. That’s why, according to the Centers for Disease Control and Prevention, people who have had a confirmed infection in the previous 90 days should not be quarantined after coming into contact with another infected person.
But all bets are off about six months later, when antibodies start to wane, regardless of vaccination.
How long do COVID antibodies last?
Experts don’t know exactly. Although those who survive COVID appear to be largely protected against repeat or severe illness for up to five months after the previous infection, there is not yet enough data available to know how long these COVID-specific antibodies persist. , or even to confirm that the presence of antibodies guarantees immunity, according to the Food and Drug Administration.
Immune system B cells give rise to COVID-specific antibodies designed to attack the virus on sight, before it can enter tissue cells and reproduce. They begin to form within the first few days of infection or vaccination, and continue to grow for several weeks until they peak about three months later, when your defenses against COVID are strongest.
The good news is that the decrease in antibodies does not mean that we are completely defenseless, because some B cells will remember the tools they had before to create COVID antibodies upon reinvasion. (Plus, boosters help our immune system remember how to fight.) Meanwhile, our killer T cells, the immune system’s back-up line of defense, may not be as effective at stopping the virus from entering. the body, but they can detect an infected host cell – and destroy it before it multiplies into another cell. And although they are harder to track, they seem to be more faithful than ephemeral antibodies.
“These seem to remain much more robust,” Phillips said, adding that “the T-cell response is probably more important for the response to viral infections” in the long term.
Are COVID vaccines still effective?
More or less. Vaccines remain the best way to build up antibodies, the body’s main line of defense against serious illness from COVID-19. Although getting infected can also give rise to antibodies, it is not worth the risk.
“I’m strongly in favor of the vaccine, because of the issues that arise when you don’t get it,” said Phillips, who also hinted at alternative forms of vaccine technology on the horizon.
Regardless of type, antibodies have been known to wane about six months after the last infection or booster, making reinfection more likely to occur.
How often can you get a COVID reminder?
For those on the two-dose regimen, a second round should be done about six weeks after the first. However, it has been well over a year since the vaccine was introduced, meaning many patients have completed both cycles in 2021.
Doctors expect that every year, even seasonally revamped COVID-19 reminders could become the norm — much like the flu, but different and more troubling: a flu season only sees one or two major strains in the world, which gives researchers time to prepare vaccines. “It’s not that, kind of a constant change over the course of a ‘season,’” Phillips said, as COVID-19 did.
Currently, only those with weakened immune systems and those age 50 or older are recommended for a third vaccine by the CDC — which is, overall, a good sign.
Says Phillips, “We don’t have to be paranoid about a new strain emerging…but we have to be thoughtful and ready for it.”