Lingering COVID-19 Questions, from Reinfection to Reopening

Introduction

This Straight, No Chaser looks at some lingering COVID-19 questions. Many of these have been prompted by a recent study. According to Reuters, S. Korea has reported that at least 116 people who were thought to have recovered from COVID-19 have tested positive for it again. This is an introduction to the reality that there still remains much that we don’t know about this virus.

Consider These Distinct Possibilities

The virus could be mutating in real time. Patients are getting reinfected.
Instead of patients getting reinfected, the virus is reactivating. In effect, it finds a way to “come back to life.”
These events are simply a result of testing errors. Some percentage of false positive tests will occur. Over millions of tests, the expression of false positives become realized as these cases. Furthermore, if a patient’s treatment is stopped too soon as a result of a false positive test, the reemergence of symptoms will appear to be a reinfection.

Lingering COVID-19 Questions

These events throw what we know and believe into uncertainty. Here are a few questions that now come to mind that are the focus of upcoming research efforts.

Does positive antibody testing mean we’re immune? That is understood to be the case. However, if the novel coronavirus actually has the ability to rapidly mutate, if additional strains develop, or if a reactivation mechanism exists, this may not be so. In other words, whereas we would be immune to “what was,” we might not be immune to a changed virus.
Is there a possibility that even in the presence of a positive antibody test, the virus could exist in a latent state and could still be transmitted to others, creating an infection, a la chicken pox/shingles? This is truly a worst-case scenario but is extremely unlikely. Unfortunately, based on the nature of the novel coronavirus, it has to be considered.
When will a vaccine will be ready? An effective vaccine would be a game changer. A vaccine that only works against the current strain in the presence of a virus that is able to mutate and/or develop additional strains would not be as effective.
When will preventive and curative medicines will be made available? There are current emergency provisions in place for certain medicines in the face of seeming life-threatening progression of the disease. Last minute use of experimental medicines can’t be the standard or sole recourse we have. The process of clinical research must continue.
Are we seeing a curve or a wave? Believe it or not, this is yet to be determined. If the exercise of removing the stay at home orders too soon isn’t precisely timed, the number of infections and deaths will go back up. We have seen this occur in other countries around the world. This is why it’s key to engage in community testing, contact tracing and antibody testing – still.

Until these lingering COVID-19 questions are answered, our understanding will be limited at best. Until we know these things, our ability to reopen the country for business and life approximating “normal” will be limited. We cannot currently say that we can answer these questions with certainty.

Perhaps you’ll take comfort in knowing where the standard lies. Generally, those that have recovered from COVID-19 will likely be immune if a second wave hits. According to Dr. Anthony Fauci of the White House coronavirus task force, “Generally we know with infections like this, that at least for a reasonable period of time, you’re going to have antibodies that are going to be protective…If we get infected in February and March and recover, next September, October, that person who’s infected –– I believe –– is going to be protected.” Stay tuned.

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