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Reinfection

Old 04-17-20, 12:10 PM
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Seattle Forrest
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Reinfection

There are a number of stories going around about people who got the novel coronavirus, recovered, and then got it again. That sounds implausible to me, but there seems to be some real concern about our immune response to this virus.

There are only so many hours in the day, and I haven't read much about this. There are some people in here who clearly know what they're talking about - you know who you are - and I would love to see some discussion about this in here.
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Old 04-17-20, 12:24 PM
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Some potentially related papers:

Clinical characteristics of the recovered COVID-19 patients with re-detectable positive RNA test
Reinfection could not occur in SARS-CoV-2 infected rhesus macaques
Duration of Antibody Responses after Severe Acute Respiratory Syndrome (2003 SARS)
Antibody Response and Disease Severity in Healthcare Worker MERS Survivors
Persistence of Antibodies against Middle East Respiratory Syndrome Coronavirus
The time course of the immune response to experimental coronavirus infection of man. (1990)

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Old 04-17-20, 12:48 PM
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WHO unsure antibodies protect against COVID, little sign of herd immunity

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Old 04-17-20, 12:51 PM
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Clearly reinfection is something that continues to be concerning and there doesn't appear to be an answer on the horizon soon. Some viruses (such as HIV) infer no immunity while others (such as measles) can be lifetime and there's a spectrum in between.

​​​​​​Much of the concern focuses on South Korea where 111 patients may have been reinfected but there could be many possibilities. The patients could have had earlier false negatives. It's also possible their bodies didn't build up sufficient immunity. In addition, it's possible immunity may not last long.

I believe most experts believe immunity is likely for several reasons including that we have not had a verified reinfection in the US with a large infection base. Note that there have been 690k cases in the US compared with 11K in SK.

One important fact though, from what I read none of the reportedly reinfected patients died.
​​

Last edited by Tony P.; 04-17-20 at 01:00 PM.
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Old 04-17-20, 12:54 PM
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The main thing I am gathering is that the more severe the fight the longer the immunity lasts.
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Old 04-17-20, 04:31 PM
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There are several studies using human plasma of recovered patients to augment treatment of other patients.

It is my belief that the rare anecdote of patients that recovered, then fell ill again hadn't fully cleared the virus from the body and lungs.
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Old 04-17-20, 05:20 PM
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Even with some acquired resistance through antibodies, it's likely the victim would need weeks or months to recover while avoiding re-infection. That's assuming they actually got sick and recovered. There will probably be some folks who barely get sick, recover quickly, and may suffer few or no long term problems.

Although I'm a firm believer in the value of vaccines and appropriate acquired resistance, there are risks. I used to work in hemodialysis when the primary concern was hepatitis (HIV was just entering the picture and we hadn't yet developed protocols). I got a gamma globulin shot with adverse reactions that took months to recover from. I had to quit my job and college for about six months. And it may have led to my later auto-immune disorder. Just one of the risks -- low probability but does happen occasionally.
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Old 04-18-20, 10:39 AM
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Originally Posted by canklecat View Post
a gamma globulin shot.
oh man, a what?
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Old 04-18-20, 02:53 PM
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Originally Posted by rumrunn6 View Post
oh man, a what?
Gamma globulin/immunoglobulin may not be a common treatment nowadays, I don't know. I've been away from patient care for decades, other than as caregiver for elderly family. When I worked in dialysis -- mostly hemodialysis, some peritoneal -- in the 1970s-early '80s, it was a fairly common prophylaxis or treatment believed to boost resistance against hepatitis.

In my case it wasn't administered for Hepatitis B, although we were routinely exposed -- I was very careful to avoid accidental needle sticks, and to wear PPE around patients known to have Hep B. But, ironically, I got Hep A from my then-toddler kids who got it from daycare. My family doctor was concerned about my work related exposure to Hep B since I was still working in hemodialysis at the time, and that I'd probably get Hep A from my kids.

So it was a calculated risk. Unfortunately I was among the minority who experience bad reactions, and it may have contributed to an auto-immune disorder that has dogged me for decades. And my usual battery of other military vaccines may have contributed, no way to be certain. Back then we got shots for everything, including plague. I remember that one in particular because many of us had the same side effect -- it felt like being stoned. Not unpleasant, just like the most potent cannabis you can imagine. Or so we supposed, none of us ever having actually partaken of the evil weed, as affirmed in our recruitment papers. But we all agreed that it was hypothetically exactly like the experience of being stoned which none of us had ever actually experienced. Allegedly.

My reaction to the combination of Hep A and gamma globulin was not so pleasant. My kids got over it quickly. I pooped white poops for a week. I was so wiped out I had to quit work and the rest of that college semester. My family said I was never the same again, but it's hard to be sure from my perspective. After awhile many of us tend to change our baseline expectations to accommodate the new normal for how we feel -- energy, pain, etc. And my liver panels have been within normal limits since then, no indication of Hep B, although I've had to discontinue some meds that had higher risk of liver problems.

Supposedly gamma globulin/immunoglobulin are short duration and aren't known to confer lifetime immunity, but I've noticed a bit of a change in my resistance to common colds and flu. I used to get respiratory infections easily as a kid and young adult. But I can't remember the last time I had a common cold or the flu. I do have chronic upper respiratory inflammation and have had occasionally bouts with bronchitis and even pneumonia. But no serious infections. For that matter, I rarely get infections of any kind, and I heal quickly from cuts, scrapes, etc.
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Old 04-18-20, 04:05 PM
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Gamma globulin was a common injection as a prophylactic against Hepatitis A. I remember getting one prior to travel in the mid 1980s. You had to get a booster every six months. Now there are effective Hepatitis vaccinations.
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Old 04-18-20, 07:44 PM
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What is interesting is the murmurs about BCG vaccination helping with reducing the symptoms of Covid-19. There's been a fair bit of research into the lack of TB exposure leading to a rise in autoimmune diseases, like diabetes etc. Basically the body has evolved coping with TB, with TB gone the immune system is looking for something to do, and gets into mischief. The thought is immunisation with BCG will reset the immune system and reduce the chance of the cytokine storm that causes lung and heart issues in serious cases of CV-19. It's a can't hurt and may benefit situation... one issue however is a lot of western countries no longer make BCG, and there are many strains, of different effectiveness, so it's a slow process sorting out it all out https://kitayama.psych.lsa.umich.edu...rgetal_All.pdf
Currently there is a project looking into using BCG to cure diabetes, with real success, although on a very small sample size. The only issue is that the manufacturer of that particular strain, Sanofi, stopped making it, so the project can't restart because they need to start manufacturing it again, and the original manufacturer isn't interested as there isn't enough money in it. https://academic.oup.com/jes/article...ON-179/5483846
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Old 04-23-20, 10:42 PM
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Originally Posted by rumrunn6 View Post
oh man, a what?
You know, the stuff that makes that Banner guy turn into the Hulk! Jeez! EVERYBODY knows that!!!! 😉
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Old 04-24-20, 07:18 AM
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Originally Posted by CliffordK View Post
There are several studies using human plasma of recovered patients to augment treatment of other patients.

It is my belief that the rare anecdote of patients that recovered, then fell ill again hadn't fully cleared the virus from the body and lungs.

There's a lot of possible explanations including false negative tests, but this itself needs to be tested. Our "beliefs" here don't matter.

Early days on the plasma trials, no idea at this point whether that's actually working. Until there's some systematic trials completed (they're just started in the last week or so), right now we have little more than published anecdote on that.
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Old 04-25-20, 09:30 AM
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"No evidence" that recovered COVID-19 patients cannot be reinfected: WHO


...which means an effective vaccine will be much more difficult to produce (probably). Also (if this holds up) this will probably steer research more toward treatment regimes, as has happened with AIDS. Not happy news at all.
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Old 04-25-20, 10:29 AM
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Originally Posted by Seattle Forrest View Post
There are a number of stories going around about people who got the novel coronavirus, recovered, and then got it again. That sounds implausible to me, but there seems to be some real concern about our immune response to this virus.

There are only so many hours in the day, and I haven't read much about this. There are some people in here who clearly know what they're talking about - you know who you are - and I would love to see some discussion about this in here.
It's just scaremongering. The virus is similar to the other coronoaviruses it evolved from and that our immune systems evolved to deal with.

If you didn't produce antibodies you wouldn't recover. Your body has a way of remembering past antigens and so this should all work as normal.

You sometimes lose immunity because the virus mutates. Coronaviruses actually tend to mutate less than other kinds of virus and this one (which has been studied extensively) appears to be no different.
​​​​
People sometimes test negative and then positive again but this is most likely to because the negative was a false negative. It's quite easy to end up with not enough virus on the swab and so it doesn't show up.

The WHO are using weasel words of the form "there's no evidence the earth isn't flat" but extraordinary claims require at least a bit of proof...

There was actually a study done on monkeys in China in the early days that confirmed that after they recovered they couldn't be reinfected with SARS-COV2 (the virus that causes Covid-19). But to be honest by now so many people have been infected and recovered that it's pretty obvious they are staying recovered.

​​​

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Old 04-25-20, 12:06 PM
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...I bet that last year you were a Constitutional law professional. Amirite ?
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Old 04-25-20, 01:24 PM
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Originally Posted by 3alarmer View Post
.
...I bet that last year you were a Constitutional law professional. Amirite ?
A confused one with a tenuous grasp of facts
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Old 04-25-20, 02:24 PM
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I would very much like to think that antibodies prevent reinfection. That would be good news for a vaccine, for the time until we have one, and even for the hope of using "survivor serum" in the meantime, NY hopes giving it to doctors and nurses in advance can lower infection rates.

It intuitively makes sense, that's how it generally works. That doesn't really mean very much.

I'm still trying to understand. It sounds like this really is happening, enough to make some generalizations as @noisebeam pointed out. Has anybody seen anything about how common reinfection is? There are about 3 million known cases worldwide and 1 million in USA, for context.
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Old 04-25-20, 02:48 PM
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Originally Posted by Seattle Forrest View Post
It intuitively makes sense, that's how it generally works. That doesn't really mean very much.
It does mean quite a bit. This may be a new coronavirus, but so were they all at some point. It's still "just" a coronavirus from the point of view of the immune system. Of course it's possible that there's something weird about it that means you don't and this virus turns out to cause mass extinction of humans (and perhaps some other mammal species as well) but it's unlikely.
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Old 04-25-20, 03:00 PM
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Originally Posted by Seattle Forrest View Post
There are about 3 million known cases worldwide and 1 million in USA, for context.
810,000 worldwide listed as "recovered".
There have been quite a humber of health care workers or other high risk employees that have become infected, and would be at risk of reinfection.

One really needs to document recovery with swab tests and X-Rays in the high risk individuals, then monitor for future new infections.

Also look at the severity of second infections.

My thought is that on some individuals, the lungs or body isn't fully cleared, and can reactivate with the same original infection. RNA sequencing might help determine if it is a latent infection or new infection. But, one would either have to do a lot of sequencing, or at least store samples from large numbers of individuals for future sequencing.
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Old 04-25-20, 03:26 PM
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Originally Posted by guy153 View Post
It's just scaremongering. The virus is similar to the other coronoaviruses it evolved from and that our immune systems evolved to deal with.

If you didn't produce antibodies you wouldn't recover. Your body has a way of remembering past antigens and so this should all work as normal.

You sometimes lose immunity because the virus mutates. Coronaviruses actually tend to mutate less than other kinds of virus and this one (which has been studied extensively) appears to be no different.
​​​​
People sometimes test negative and then positive again but this is most likely to because the negative was a false negative. It's quite easy to end up with not enough virus on the swab and so it doesn't show up.

The WHO are using weasel words of the form "there's no evidence the earth isn't flat" but extraordinary claims require at least a bit of proof...

There was actually a study done on monkeys in China in the early days that confirmed that after they recovered they couldn't be reinfected with SARS-COV2 (the virus that causes Covid-19). But to be honest by now so many people have been infected and recovered that it's pretty obvious they are staying recovered.
Your post is a classic example of a little knowledge being a dangerous thing.

There's several coronaviruses that produce common colds and recovery from them bestows no long term immunity. Your body "forgets" how to make the effective antibodies shortly after clearing the infection. It's quite possible, even likely, that SARS-2 (Covid 19) shares that. It's not at all "an extraordinary claim."

WHO is making the very obvious point that we better know whether there is immunity before we institute strategies based on the assumption that there is.

Basically, your post is a bunch of assertions based on invalid assumptions, and you shouldn't be accusing experts of "scaremongering" when you really don't know much about the subject.
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Old 04-25-20, 04:03 PM
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...because "mass extinctions" is the only thing we really need to worry about. Thank you Dr.Science.

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Old 04-25-20, 10:47 PM
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MSM also kiting that vaccine might be impossible. So if there's also no or little immunity after infection, what then? 2-meter rule forever?
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Old 04-25-20, 11:44 PM
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The other caronaviruses that our immunity isn't long lasting for, how much time are we talking about until you "forget" how to fight this one?

Imagine we have a dose for everybody in America including the homeless. How quickly do you think we can administer them to everybody willing to get the vaccine? What % do you think would get it?
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Old 04-25-20, 11:52 PM
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Originally Posted by DropBarFan View Post
MSM also kiting that vaccine might be impossible. So if there's also no or little immunity after infection, what then? 2-meter rule forever?
We figure out how to treat it. Like tamiflu. Over time it mutates to become less harmful. Strains that provoke fewer symptoms spread more. It's natural selection.
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