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Medicine

A Man Caught Coronavirus Twice -- and It Was Worse the Second Time 253

According to a study published in The Lancet Infectious Diseases, a man in the U.S. caught COVID-19 for a second time and had a worse bout of illness. MIT Technology Review reports: The 25-year-old man tested positive for the first time on April 18, after experiencing several weeks of symptoms including sore throat, cough, headache, nausea, and diarrhea. He felt fully recovered by April 27, and tested negative for the virus on both May 9 and 26. But just two days later, on May 28, he developed symptoms again, this time with fever and dizziness too. He tested positive on June 5 and needed to be hospitalized after his lungs were unable to get enough oxygen into his body, causing hypoxia and shortness of breath. He had no underlying health conditions. The man has now recovered.

Being infected once does not mean you're protected from being infected again, even if such cases are still vanishingly rare, with just five identified out of nearly 40 million confirmed cases worldwide. That means people who have had covid-19 still need to stay vigilant, following the advice on social distancing, wearing face masks, and avoiding crowded, poorly ventilated spaces. This was not altogether unexpected: coronavirus experts warned us that other coronaviruses, such as the common cold, are seasonal. However, there are still many questions that researchers are racing to answer. How much protection does having covid-19 confer? Is that mainly through antibodies or T cells? How long does protection last? What does it mean for the medical treatments that are being developed, or for vaccines? Will we all require a yearly shot rather than a one-off vaccine, for example? If nothing else, this new case is a reminder of how much about this virus we still don't know.
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A Man Caught Coronavirus Twice -- and It Was Worse the Second Time

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  • Comment removed (Score:3, Informative)

    by account_deleted ( 4530225 ) on Tuesday October 13, 2020 @09:11PM (#60605040)
    Comment removed based on user account deletion
    • A dirty little secret is that vaccinations are never 100% effective either. Even for things like polio, measles, etc... It's just up around 90% or so, such that if most of the population is vaccinationated, you're unlikely to actually be exposed if you're part of that unlucky 10%(or 5% or whatever).

      There's a reason why most vaccinations require multiple injections and boosters later in life.

      Now, it does tend to make the disease less serious even if it doesn't make you immune, but note that I said "tend".

      • A dirty little secret is that vaccinations are never 100% effective either.

        You do not need perfection. Good enough will do. Vaccines have been enormously successful in virtually eliminating diseases that used to kill or disable millions of people. I think those results show that 90% or so effectiveness is fit for purpose.

    • by Roger W Moore ( 538166 ) on Wednesday October 14, 2020 @01:22AM (#60605516) Journal
      There are often freak examples like this with many diseases that we do have effective vaccines for. For example, mumps [immunize.org] and german measles (rubella) [netdoctor.co.uk]. So it by no means implies that a vaccine will not work although that certainly remains a possible outcome as it always has.
    • by hey! ( 33014 )

      No, it means a vaccine won't create immunity in 100% of the cases, which is true of every vaccine.

      The point of a vaccine isn't to give you perfect protection; if it were *all* vaccines would be useless. It's to reduce your chances of getting sick, and to establish herd immunity in the population.

  • One person, is that significant, especially 6 months ago when the testing methods were more error prone? Also the person was "reinfected" just a month later. No more antibodies after a month? The covid virus is new to the human body and makes quite a stir within the defense system, it's hard to believe the guy got even sicker being reinfected with the same virus in such a short time after the first infection.
    • Comment removed based on user account deletion
      • Not one, three? Still statistically insignificant (again, how such a tiny sample can be any significant, given the lack of knowledge, the complex technicalities, the detection process unreliability... and, again, the guy in this story was "reinfected" within a month? (symptoms were showing again, meaning he was reinfected before that)). Not really relevant.
        • the detection process unreliability
          There is nothing unreliable in the detection process, at least not in this case. They sequenced the genome, facepalm.

    • It would have been good to do a serology test 2nd time at least.

  • by grasshoppa ( 657393 ) on Tuesday October 13, 2020 @09:22PM (#60605072) Homepage

    It may not be common knowledge, but the same can be said for the flu; past infection does not guarantee future immunity ( to the same strain ), but given the numbers it's fair to assume you'll have a moderate amount of resistance to the immediate strain, as well as the current season's ancillaries.

    It would be exceptional if that WEREN'T true, not the other way around.

    • Please don't mix misinformation together. Past infection from a specific virus that makes up seasonal flu provides you immunity against that specific virus. Influenza is large mix of different viruses working their way through the population at different rates. This is also why vaccination against that virus is an imperfect estimation against which strain is likely to be prevalent in a given hemisphere a given year.

      COVID-19 is caused by one virus, which currently have two prevalent strains and an overwhelmi

      • Past infection from a specific virus that makes up seasonal flu provides you immunity against that specific virus.

        Actually, as most people simply bear through the flu, never reporting it to anyone, we have no idea if people can or do get reinfected with the same virus.

  • by BitterOak ( 537666 ) on Tuesday October 13, 2020 @09:26PM (#60605086)

    Being infected once does not mean you're protected from being infected again, even if such cases are still vanishingly rare, with just five identified out of nearly 40 million confirmed cases worldwide.

    But that's the million dollar question that really needs to be answered: is it vanishingly rare to get re-infected? If the answer is "yes", then for all practical purposes, we can ignore it. There is also a vanishingly rare chance you will get chicken pox twice, or the measles twice, but that's so uncommon, we just forget about it. On the other hand, if you're almost as likely to catch COVID-19 a second time as you are a first time, that has huge implications for how this disease should be managed. We really need to know one way or the other, and this summary seems to suggest that it really doesn't matter whether this is a vanishinly rare thing, or a common thing.

    • by bidule ( 173941 )

      It's like getting hit by lightning twice!

      I guess we don't know yet now many versions of COVID you can get in a row before being safe. If you go from 1-in-a-million chance of getting it the first time, to 1-in-2-millions chance the second time, the risk didn't go down much.

      It'd take the chance if the second time was 1-in-a-billion, that's enough order of magnitude to feel safe.

      • by Tablizer ( 95088 ) on Tuesday October 13, 2020 @10:20PM (#60605210) Journal

        It's like getting hit by lightning twice

        It's 2020, can't rule that shit out

        • There actually is a guy who got hit by lightning twice and survived it both times.

          • by asylumx ( 881307 )
            So you're saying everyone you know of who has gotten struck twice, has survived? Maybe we should throw lightning parties so we can all make sure we get struck twice!
          • by CheeseyDJ ( 800272 ) on Wednesday October 14, 2020 @07:52AM (#60606056)
            The world record for lightning strikes on a human is held by Roy Sullivan, a US Park Ranger who was struck seven times. He grew to believe that storm clouds were following him, and was struck a couple of times while trying to get away. Immediately after the seventh strike he also fought off a bear (!), and a few years later he shot himself.

            1. Sullivan's first documented lightning strike was in April 1942. He was hiding from a thunderstorm in a fire lookout tower. The tower was newly built and had no lightning rod at the time; it was hit seven or eight times. Inside the tower, "fire was jumping all over the place". Sullivan ran out and just a few feet away received what he considered to be his worst lightning strike. It burned a half-inch strip all along his right leg, hit his toe, and left a hole in his shoe.
            2. He was hit again in July 1969. Unusually, he was hit while in his truck, driving on a mountain road—the metal body of a vehicle normally protects people from lightning strikes by acting as a Faraday cage. The lightning first hit nearby trees and was deflected into the open window of the truck. The strike knocked Sullivan unconscious and burned off his eyebrows and eyelashes, and set his hair on fire. The uncontrolled truck kept moving until it stopped near a cliff edge.
            3. In July 1970, Sullivan was struck while in his front yard. The lightning hit a nearby power transformer and from there jumped to his left shoulder, searing it.
            4. In spring 1972, Sullivan was working inside a ranger station in Shenandoah National Park when he was struck again. It set his hair on fire; he tried to smother the flames with his jacket. He then rushed to the restroom, but could not fit under the water tap and so used a wet towel instead. Although he never was a fearful man, after the fourth strike he began to believe that some force was trying to destroy him and he acquired a fear of death. For months, whenever he was caught in a storm while driving his truck, he would pull over and lie down on the front seat until the storm passed. He also began to believe that he would somehow attract lightning even if he stood in a crowd of people, and carried a can of water with him in case his hair was set on fire.
            5. On August 7, 1973, while he was out on patrol in the park, Sullivan saw a storm cloud forming and drove away quickly. But the cloud, he said later, seemed to be following him. When he finally thought he had outrun it, he decided it was safe to leave his truck. Soon after, he was struck by a lightning bolt. Sullivan stated that he actually saw the bolt that hit him. The lightning moved down his left arm and left leg and knocked off his shoe. It then crossed over to his right leg just below the knee. Still conscious, Sullivan crawled to his truck and poured the can of water, which he always kept there, over his head, which was on fire.
            6. The next strike, on June 5, 1976, injured his ankle. It was reported that he saw a cloud, thought that it was following him, tried to run away, but was struck anyway. His hair also caught fire.
            7. On Saturday morning, June 25, 1977, Sullivan was struck while fishing in a freshwater pool. The lightning hit the top of his head, set his hair on fire, traveled down, and burnt his chest and stomach. Sullivan turned to his car when something unexpected occurred — a bear approached the pond and tried to steal trout from his fishing line. Sullivan had the strength and courage to strike the bear with a tree branch. He claimed that this was the twenty-second time he hit a bear with a stick in his lifetime.

            https://www.guinnessworldrecor... [guinnessworldrecords.com]).
            https://en.wikipedia.org/wiki/... [wikipedia.org]

    • Summary says 5 cases of re-infection in 40 million cases. That's 1 in 8M probability of getting COVID-19 twice (not dying, since the article didn't say now many of the 5 died, if any) which is less than half the probability of being killed in a car accident in the United States in a single day (pre covid stats say ~100 fatal accidents per day, so 1 in 3.3M every day).

      • by mvdwege ( 243851 )

        5 known cases. For a virus that we have been studying for less than a year.

        I think some caution may well be advised. Until we know more about about how SARS-CoV-2 interacts with the human body, what we know now is: reinfection at least is possible.

        More research will tell us how common it is, and what the countermeasures might be. In the meantime, with the virus still rampaging through the population, urging caution seems to be common sense to me.

  • And I have no idea how. It was pretty mild, but I'll be extra vigilant going forward. Definitely don't want it again and worse than the first time.
  • So? (Score:5, Interesting)

    by markdavis ( 642305 ) on Tuesday October 13, 2020 @09:43PM (#60605108)

    >"Being infected once does not mean you're protected from being infected again, even if such cases are still vanishingly rare,"

    Does anyone deny that? Anyone who follows infectious disease knows that a very small portion of the public, with ANY pathogen, will not develop immunity the first exposure, second exposure, and sometimes ever. Probably because their immune systems were probably malfunctioning or weak. It happens. So?

    This sounds like just more unnecessary scare tactics. Until we have a vaccine and/or ample herd immunity, we have to be cautious. These 0.0001% people (or whatever the "vanishingly small" percent actually might be) can spread the pathogen when re-infected just like the people who were never exposed and then catch it.

    >"If nothing else, this new case is a reminder of how much about this virus we still don't know. "

    Um, we already know this is true about ALL pathogens through all recorded history, that some very tiny portion of people will not gain immunity. So how does THIS tell us something we don't already know rather than confirm something we do already know?

    • The thing about people who don't develop immunity when infected is that they're what's known as "immunocompromised" as their immune systems don't work as they should. In this article they make a point of bringing up the man in question was not only relatively young, but also did not have any underlying health issues like immune system deficiencies.

      Blind panic is obviously not helpful, but at the same time this casts serious doubts over the idea that the issue would blow over when vaccines become widely s
  • by Somervillain ( 4719341 ) on Tuesday October 13, 2020 @09:43PM (#60605110)
    There's not enough data yet to make a decision! I think the important takeaway is that we don't know enough about this disease. Is reinfection common? Well, we don't really know because we've seen reinfection, but this is one of the first times we've analyzed the genome of the virus in 2 infections. But we don't know if this man is an outlier or the norm yet. No one is going volunteer to be studied for reinfection. The question I want to know is what percentage of us are vulnerable to reinfection? 1% 10% 99%?

    I've had the flu multiple times in my life. I get a cold 1-2x a year. Most people do. Getting something once doesn't magically make you immune. We all know this.

    I hope people also know that no single solution will solve this. A vaccine won't protect against mutations and sometimes it just won't work for some percentage of people, so we need to do proper quarantine procedures. Social distancing is not sustainable, but we're going to have to settle for it while we're waiting on the vaccine. I am sure they will come out with interesting drugs to treat it so that it goes from fatal to just miserable for vulnerable patients.

    This is like 9/11 (was for Americans). We're not going back to normal anytime soon. This is a long term disruptive change to our daily lives. It'll get better every year, but be prepared. Life will be distinctly different before 2019 and after for at least a decade.

    I see the way forward as a mixture of vaccine, better drugs for treatment, better public hygiene and sanitation, and some disruptive changes for those who get infected, like quarantining, contact tracing, and social distancing. This is interesting news and data, but I don't think it should affect anyone's decisions or sense of well-being.
    • by Tablizer ( 95088 )

      No one is going volunteer to be studied for reinfection.

      It's possible somebody tested positive after being tested before, such as work protocol, but then falls ill enough later to make a hospital visit, where they confirm the second one. If reinfections were common, that situation would pop up fairly often.

    • Actually, reinfection is almost impossible and doesn't happen, known already. Keep up, there is no problem. There will always be the 1 in a million outlier. Of course there will be mutations, this virus is a mutation of something that happened before, SARS.

  • by dohzer ( 867770 ) on Tuesday October 13, 2020 @09:50PM (#60605134)

    But Trump said he's immune! He said he's very immune, maybe even fully immune. Some say the most immune since Honest Abe Lincoln.

  • by WaffleMonster ( 969671 ) on Tuesday October 13, 2020 @10:27PM (#60605228)

    Seems like the media just likes to promote this garbage to scare people. A few outliers isn't worth anyone's time. Currently no data exists to suggest it is worth while for anyone who has had covid to assume they are not immune.

    Being infected once does not mean you're protected from being infected again, even if such cases are still vanishingly rare, with just five identified out of nearly 40 million confirmed cases worldwide. That means people who have had covid-19 still need to stay vigilant, following the advice on social distancing, wearing face masks, and avoiding crowded, poorly ventilated spaces.

    No fuck that. It's counterproductive to take the same precautions when the risk to yourself and others is "vanishingly rare".

    • It's not counterproductive, it's insane. Otherwise I completely agree.

      1 in 8 million is the sort of rate you see for ultra-rare genetic disorders and random mutations. Definitely not the sort of incidence you build policy on. Hell, it could be a simple statistical anomaly representing the five times multiple tests returned false positives (or samples were mislabeled, contaminated, etc.), and they simply had a misdiagnosed cold the first time.

    • Hear hear.

      This is important to document, and study for virologists and epidemiologist.

      This information is 100% irrelevant and should be ignore by the public.

    • It might be a few outliers, or else it might be entire cities [reuters.com].

  • The simple answer is that he likely never healed fully the first time. Early tests were notoriously inaccurate, it was a problem suffered all over the world. It's entirely reasonable that he got two false negatives in a row. It's also possible that he caught a couple of different variants of it.

    Think of it as being like a cold, which you can catch time and time again. Because it is a variation of the cold. We've never had a vaccine for the cold and we don't have any reasonable basis to think we ever would.

  • That would be almost impossibly unlikely

    It was just like with the flu, where every year there comes a new bunch of mutations around. Some worse, some less bad. AFAIK most recent strains are less bad but more infectious (makes sense, evolutionary-wise). So it would be interesting if this strain was worse. (And it would not be a successful strain.)

    Plis, oeople change over time too. E.g. were his lungs weakened from th first time? Did he start smoking?

    So I really don't appreciate those "Plaing stupid to bait p

    • Not impossible though. There really are outlier cases, such as people who had chickenpox twice. Sometimes the extremely unllikely happens and people get reinfected with something when 99.9999% of people won't. Of course the media tries to make hooplah over fear and misfortune.

      • As a note, "chickenpox twice" is actually fairly common. It's just that the second case is generally known as "shingles", as virus left in the spine reactivates after like 40-50 years when you have a stress event that weakens the immune system.

        That said, I have a relative who has an immune system that refused to memorize varicella-zoster. She had chickenpox six times as a child.

        Given the observed reinfection rates, I'm with the others, it can be just down to the quirks of the few immune systems. At this

  • An elderly woman in the Netherlands died from the second infection. The first time she was in hospital for 5 days, and she did have other medical issues, so she was extra at risk, aside from being 89. https://nos.nl/artikel/2352120... [nos.nl]
  • is what this individual, a 25-year old man, was doing to become infected twice.

    There's that old saying, "Once bitten, twice shy..."

    If the man became infected first time around for failing to follow safety guidelines, but then didn't change his behavior, it seems quite likely to imagine he is putting himself at risk of a second infection.

    We know that the virus is mutating as it moves between hosts, so it is entirely likely that even if this 25-year-old developed anti-bodies to the first strain, it i
  • ...doesn't mean we should all be hiding under our beds in the fetal position because of it.

    There are examples of babies born with hideous birth defects resulting in a lifetime of medical issues. That doesn't stop us making children.

  • with just five identified out of nearly 40 million confirmed cases worldwide. That means people who have had covid-19 still need to stay vigilant

    Disagreed. A reinfection rate of one in eight million means people DO NOT have to worry about this.

  • This patient caught two variants of Covid19 within 2 months. The article talks about how the RNA sequencing shows the variations and the probability of them happening in the wild (which is important to know in order to rule out the possibility of sequencing errors, amongst other things).

    There are lots of open questions that we can't answer with an N of 1, but this does show us that there are multiple variants of Covid19 circulating at least in Nevada.
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