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Sunday, April 19, 2020

Coronavirus: Can You Get It Twice? | Science Vs

Can you get COVID-19 infection again? In short, we don't know. If this strain of coronavirus, SARS-CoV-2 (the scientific name of COVID-19), is like chickenpox in its immunologic response, then we may have lasting immunity. If it's like the influenza virus (which mutates rapidly from one season to the next), then there may not be lasting immunity. From recovered COVID-19 infected persons, we know some have high levels of anti-COVID-19 immunoglobulins and some have very low levels (humoral immunity). So, the person-to-person variance of effective immunization may be a factor. Moreover, other immune mechanisms such as cellular immunity also play a role, but we haven't even scratched the surface of that possibility with this pandemic. To complicate the matter further, we know nothing about how long the memory cells (the cells that remember the virus so that you may mount a brisk response on re-exposure to prevent serious illness) may survive. In some infectious states, like chickenpox, memory cells may last a lifetime and in others, like tetanus, it may be a lesser time (that's why we get booster shots). The immune system is complex. But, infection control is simple. The same tenants that have always worked still work. There's a reason we say, "cleanliness is next to godliness." The challenge is behavioral--adhering to handwashing, covering coughs, social distancing. The challenge is social--isolation, loneliness, mood disturbance. The challenge is economic--when the potential economic consequences of adhering to the aforementioned become more costly than the economic benefit, the matter will be forced to accept the health jeopardy in order to get back to work. When that happens, we are in effect declaring the value of a life lost to COVID-19. For instance, one would not economically impair the economy to the consequence of losing lives to starvation, right? We would not accept that trade-off all that. We would conclude, "gramps, neighbor, friend, you may die from this COVID-19, I hope you don't, but I can't let my kids starve." Societally, we make such choices all the time. We just don't think about it in our day to day routines. There is science and statistical calculations to guide such breakpoints. The hard part of such decisions is not the math and science it's behavioral expectations and emotions.
from Rajesh Harrykissoon, MD

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