Dr. Angela Rasmussen
Tue Oct 13
Virologist @Columbia. Write @Forbes. Host responses to emerging viruses & systems-level mind-blowing. And pugs. 1X Jeopardy! loser. Rep: @anniescranton. she/her
Okay, new paper out in @TheLancetInfDis.
Yes, this guy was reinfected.
Yes, he got sicker the second time around.
No, it doesn't mean that this is common or that reinfection leads to enhanced disease.
Dr. Angela Rasmussen
Tue Oct 13
I wrote about reinfection back in August when there was an asymptomatic case of reinfection reported in Hong Kong. Bottom line: with only a handful of cases, we don't know what this means.
@angie_rasmussen @IsabelOtt @TheLancetInfDis Also, note his time course of symptoms. Essentially a full month of symptoms. Much longer than most people. While interesting paper - this is simply not the average here and we mustn’t assume or treat it as though it is.
“Stay the course” is right @angie_rasmussen pic.twitter.com/ldbrVCyb7k
@angie_rasmussen @ChuckWendig @CT_Bergstrom I'll go with the virologist's assessment! Likely we'll continue to see more of these pop up, especially in areas with facilities that are doing a lot of sequencing. But agree, still seems pretty rare and not out of the ordinary from what would be expected.
@angie_rasmussen @MarionKoopmans @EricTopol Or frequent. We have been getting many clinical reports of re-infections (episodes of illness +ve PCR, long period of recovery with no symptoms, then 2nd illness episode +ve PCR). No clinical reason why virus could not be the same on 2nd episode if not much strain diversity.
@joel_mossong @angie_rasmussen @EricTopol It does require careful evaluation. We have seen several where load second time was very low, which we then consider late shedding. Reinfections should have quite different virus
@MarionKoopmans @angie_rasmussen @EricTopol If natural immunity is quite "leaky", then we would expect re-infections, even with similar dominant circulating strains like B1 variants. Agree that is important to monitor shedding but even more important to find evidence for transmission during 2nd episode.
This is the 1st USA documented reinfection
Conclusion: "All individuals, whether previously diagnosed with COVID-19 or not, should take identical precautions to avoid infection w/ #SARSCoV2."
Several more global cases are in process of peer review now. Appears rare, but possible
@EricTopol From public health standpoint, it's better to have single standard. Don't want people saying they don't need masks because they've already been infected. But could consider having previously infected health care workers assigned to care for COVID-19 cases (with full PPE).
Another confirmed re-infection just a few weeks later (I expected immunity to at least last a year). As @VirusesImmunity says in the Lancet, re-infection makes population immunity without a vaccine very unlikely. twitter.com/EricTopol/stat…
This point is very important. With the number of people infected with SARSCoV2 now approaching 40 million, expect to read a lot of case reports of one-in-a-million cases.
*but if you're a scientist or physician working on this, remember your Bateson: "Treasure your exceptions!" twitter.com/AdamJKucharski…
Kirby Institute: infectious diseases; hepatitis C; hepatitis B; health for people who use drugs
Genomic evidence for reinfection with SARS-CoV-2 in 25 yr old from US:
🦠 within 2 months of 1st infection
🦠 2nd infection more symptomatic
🦠 remains rare occurrence
🦠 immunity may still >several months in vast majority
🦠 not bad news re vaccine thelancet.com/journals/lanin…
"the patient was infected by SARS-CoV-2 on two separate occasions by a genetically distinct virus. Thus, previous exposure to SARS-CoV-2 might not guarantee total immunity in all cases."
Infectious Diseases physician and scientist, with thoughts on Infectious Diseases, Tropical Medicine, HIV Prevention, Public Health, and Global Health issues
Here is another credible case of #COVID19 reinfection ~6 weeks after initial infection. In this case the 2nd infection was more severe.
Still unclear how (un)common this is as there are only ~5 credible cases of reinfection documented to date.