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Explainer: what do we now know about Covid-19 – and can you get it twice?
| World news | The Guardian 2020-05-25, 12:30 PM
Explainer: what do we now know about Covid6

19 9 and can you get it twice?
Your questions answered based on current knowledge and the latest research from
scientists
Coronavirus ; latest updates

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Scientists are learning more all the time about Covid-19. Photograph: Bsip Sa/Alamy Stock Photo
Nicola Davis
Sun 24 May 2020 12.24 BST
Can you catch the coronavirus a second time?

https://www.theguardian.com/world/2020/may/24/explainer-what-do-we-now-know-about-covid-19-and-can-you-get-it-twice Page 1 of 7
Explainer: what do we now know about Covid-19 – and can you get it twice? | World news | The Guardian 2020-05-25, 12:30 PM
That remains unclear. A key question is whether antibodies produced by the body following an
infection with the coronavirus provide some level of immunity, and if so, for how long.
But we do have some clues. “We know from ‘normal’ coronavirus studies done in the past you
can infect people after about a year following an initial infection,” said Dr Ben Killingley,
consultant in acute medicine and infectious diseases at University College London hospital.
Dr Joshua Schiffer, an expert in infectious diseases at Fred Hutchinson Cancer Research Center
in the US, added that any signs of reinfection would require detailed scrutiny.
“I have yet to see a definitive case of reinfection reported in the scientific literature [to date].
To truly prove reinfection, and discriminate from prolonged viral shedding related to the first
infection, would require sequencing of both the first and second viruses and demonstration
that the two viruses are genetically different,” he said, adding it will also be important to look
at symptoms and how long reinfection lasts.
“It is also important to recognise that documentation of one or a handful of reinfections does
not prove that this is a common, epidemiologically important event.”
What happened in South Korea, where patients tested positive after having
recovered from CovidC19?
This initially caused concerns, as experts feared the results might suggest patients had been
reinfected. However, the World Health Organization has since said the results were actually
false positives, a result of the test picking up particles of the virus within dead lung cells – but
this is not active virus. That’s because the PCR (or “have-you-got-it”) test is based on detecting
genetic material from the virus – on its own it does not reveal whether that virus is active, and
infectious, or not.
Why do some people have longClasting symptoms?

Some people with Covid-19 experience complications following an initial infection.
“In some persons they begin to feel well again and signs and symptoms including fever
decrease, but some then go on to develop respiratory distress and must be provided oxygen in
hospital,” said David Heymann, professor of infectious disease epidemiology at the London
School of Hygiene and Tropical Medicine. “It appears to be a delayed immune response that is
more serious in some persons and that reacts to remaining virus in various organs.”
Even some people who have had a mild experience of Covid-19 have reported experiencing
symptoms for several weeks or even months, although experts say only time and testing will
tell what the long-term implications are and how common this is.
Killingley said it was unclear what was behind such ongoing symptoms, but there are a range of
possibilities – including inflammation caused by the virus – although the mechanisms and risks
are, as yet, unclear.
Immunology professor Daniel Altmann, of Imperial College London, said such cases are
important to study.
“[We are] at the beginning of describing what may be a complex picture of chronic disease that
may ensue from the initial infection – coming and going in relapsing waves, sometimes almost
like a kind of chronic fatigue syndrome,” he said. “[These cases] may reflect examples of virus
not fully cleared, or alternatively, some kind of damaging post-hoc disturbance to immune or
inflammatory function,” he said.
Schiffer agreed such cases are cause for concern. “In the case of Sars CoV-2, my colleagues and I
are particularly worried about the possibility of prolonged periods of lung inflammation and/or
scarring,” he said.
Could the coronavirus lie dormant in the body, and then reactivate?
Experts say it is unlikely. “I know some have discussed ‘reactivation’ of virus, but this seems
unhelpful and unsupported to me,” said Altmann. “It’s a term that’s borrowed from other
viruses, especially the herpes virus family, that can hide in the body in a latent state to
reactivate years later. [There is] no evidence of that at all for coronaviruses.”
How long are people with CovidC19 infectious for?

A recent study of 60 coronavirus patients in China showed 10 patients tested positive for
Covid-19 after discharge from hospital. However, once again, experts say this could be down to
the test picking up genetic material from inactive virus, with other studies, including work in
South Korea, suggesting those who test positive with Covid-19 after recovering from the
disease are not infectious.
“It’s not uncommon to find virus in the nose or throat for up to four weeks after initial
infection, but tests to establish whether this is live infectious virus – as opposed to just genetic
material detection – are not normally positive for much longer than a week,” said Killingley,
adding: “I haven’t come across relapse cases whereby the initial infection acquired weeks ago
reignites itself into an infectious case.”
Schiffer had doubts: “In my view, the presence of Sars CoV-2 RNA many weeks after initial
infection may represent ongoing viral replication in cells, which also implies the persistence of
small amounts of “active” virus,” he said. “However, quantities are tiny and may represent the
dying embers of infection in the body.”
Altmann said that, asymptomatic cases aside, infectiousness correlates strongly with acute
symptoms, which typically last for up to 12 days, with a tailout to 28 days. “My sense is that in
the people who are feeling unwell long after this, it may not be virus, but some kind of immune
or inflammatory perturbation,” he said.
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Explainer: what do we now know about Covid-19 – and can you get it twice?

| World news | The Guardian 2020-05-25, 12:30 PM

Explainer: what do we now know about Covid6

Coronavirus ; latest updates

Can you catch the coronavirus a second time?

Why do some people have longClasting symptoms?

How long are people with CovidC19 infectious for?

News is under threat ...

Support the Guardian

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