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By Dhruv Khullar
In March 2020, Chelsea Kay, a young music lover in her twenties living in New York, went to see the Australian band Rüfüs Du Sol give a packed concert at the Orpheum Theatre in downtown New Orleans. At one point, a murmur ran through the crowd: Tom Hanks had tested positive for SARS-CoV-2, the virus that causes COVID-19. Kay knew little about it until she learned, a few days later, that the states were definitive to slow the spread of the virus. . After traveling to his parents’ home in Chicago, fatigue began. Her mother took out a batch of chocolate chip cookies from the oven and thought, uh, I don’t feel anything. A few weeks later, when loss of smell became a well-known symptom of COVID-19, he learned he had the virus. “And that,” he told me, “was the first time I had it. “
Two years later, on a bloodless Monday in March, Kay woke up exhausted: she had trouble breathing and her head was racing. Wow, he thought, I feel like it. Although a COVID test came back negative, he developed fever, chills, afternoon sweating and mental confusion, and a momentary test came back positive. trouble climbing stairs. ” I’ve never experienced anything like this,” he told me. His mental confusion lasted for weeks.
With this hard-won immunity, Kay assumed she had earned a pardon. “You deserve at least six months, don’t you?” She told me, “It’s fine with me, I’ve been fine for a while now. “But by the end of June, he wasn’t feeling well in his back and his symptoms were about the same as in March. “It’s shocking,” he said. For example, COVID can happen again, anywhere, at any time. “One wonders if the cycle can continue indefinitely, if many of us will end up contracting COVID a quarter, fifth, or even tenth.
In the first year of the pandemic, when reports of coronavirus reinfections began pouring in, the phenomenon was thought to be incredibly rare — “a microliter-sized drop in the ocean,” as one virologist put it. As of October 2020, the global had recorded thirty-eight million coronavirus cases and fewer than five showed reinfections. Two years later, the bucket is overflowing. It is now transparent that not only will almost everyone get the coronavirus, but it is very likely that we will all have inflamed times. The virus evolves too efficiently, our immunity declines too quickly, and while COVID vaccines have proven remarkably durable against serious disease, they have failed to break the chain of transmission.
As more of us revel in repeated infections, we may feel that the virus remains a constant risk even when ignored, under the threshold of a full-blown crisis, but far more destructive than we might have accepted in earlier times. United, COVID is still on the verge of killing more than a hundred thousand people a year; Many of us have moderate concern that long-term reinfection will cause long-term damage to our fitness and quality of life. Has our war against COVID-19 stalled because a slow burn of disorders, weakness, and death will continue for years?
The experts I consulted for this story shared confidence that, despite the relentlessness of reinfections, our COVID-related issues are slowly starting to fade. They said that while coronavirus infections will bring dangers and that we will possibly still revel in an eraic outbreak. UPS and new variants, infections are expected to become less severe and less common as our immunity develops. Vaccines and therapy will also continue to improve, helping to mitigate the worst effects of reinfection. But the duration and severity of this transitional era are also important. How many times will we have to go through quarantines and triumph over the symptoms, worried about the severity of them?How many more surprises can the coronavirus also bring us?
The era of reinfection began in earnest last winter, when the Omicron variant first spread worldwide. A recent study conducted in Serbia found that for those who became inflamed in the first twenty months of the pandemic, the risk of reinfection increases but slowly: through six months, about one in a hundred people had become inflamed again; at twelve months, one in twenty; and at eighteen months, one in five. But Omicron has triggered reinfections. Nearly 90% of all reinfections occurred in the last month of the study, January 2022. (Researchers found that one in every hundred reinfections resulted in hospitalization and one in a thousand resulted in death. )By some estimates, the initial outbreak of Omicron caused ten times more reinfections than the previous Delta variant. And Omicron now circulates as even more contagious subvariants, such as BA. 4 and BA. 5.
How does the coronavirus infect us again now?” We’re probably all reinfected all the time,” Marcel Curlin, an infectious disease physician at Oregon Health, told me.
Basically, our threat of reinfection is based on 3 main factors: how much our immunity has decreased, how much the virus has changed, and how much we find ourselves. Our herd immunity increases with infections, reinfections, and vaccines. Booster shots are meant to slow the decline of our immunity, and the recently approved bivalent vaccines, which target the Omicron BA. 4 and BA. 5 subvariants, would possibly be helpful. But the immune formula will have to be judicious: it faces countless threats and cannot contain armies of state for each. Over time, our bodies reduce their defenses, and our reinfection depends in part on how temporarily and intensely they remobilize at the next encounter.
Our immune protections also put pressure on the virus to evolve around it. Viruses can replace so much that the framework has difficulty detecting and controlling them. The original variant of Omicron had at least thirty-two mutations in its spike protein, twice as many as Delta and, in recent months, its subvariants have accumulated many more. SARS-CoV-2 mutates faster than any of its coronavirus cousins, even faster than the world’s dominant influenza strain.
Finally, the likelihood that you will be reinfected depends on the “viral dose. “It’s more than just a numbers game: our immune cells want to be stationed in the right places. “It’s like genuine property in Manhattan,” said Florian Krammer, a virologist. at Mount Sinai School of Medicine, he told me, “Location matters. “COVID vaccines injected into muscles produce relatively high levels of antibodies in the blood and lungs, but not in the nose, mouth, and upper respiratory tract, where the coronavirus usually enters. (Natural infection seems to produce a longer-lasting immune reaction in the nasal cavity. )This is why scientists are so interested in mucous vaccines, which are administered through the nose or mouth. India and China have recently legalized such vaccines, but their effectiveness is still unclear.
These 3 points exist in a kind of balance, but the balance can change dramatically. Because Omicron is a more professional human infector than previous variants, we want much higher levels of circulating antibodies to prevent it from infecting us. “The intrinsic transmissibility of Omicron has replaced the rules of the game,” Harvard immunologist Dan Barouch told me, probably in a way that saves us from winning, if by winning we mean avoiding reinfection altogether. to SARS-CoV-2 in degrees that would absolutely block infection?Barouche asked. ” At this point, is the infection saving you even a realistic goal?”
Aubree Gordon, an epidemiologist at the University of Michigan, has followed many families in Nicaragua to perceive the dangers of COVID over time. Gordon’s research has shown that, on average, a first infection decreases severity at one time and a moment at a third. . But, for some, COVID continues to pose significant health hazards. “I was hopeful that one or two reinfections would get us to a position where COVID looked like other coronaviruses,” Gordon told me. “It looks like it will take longer but I think we’re going to get there anyway.
Gordon believes that one day, SARS-CoV-2 will infect us much less than in recent times. He pointed to a paper published in Nature Medicine that tested how sometimes other people became inflamed with other coronaviruses. (Virtually all have antibodies opposite) to the other 4 coronaviruses that affect humans, and normally cause only mild bloodless symptoms. )Researchers followed ten other healthy people for decades and found that while reinfections can occur as early as six months after a previous infection, the average time to reinfection was about 3 years. “And that’s for any infection, not symptomatic infection,” Gordon said. then. ” It’s possible that we’ll reach that balance five years from now, and maybe sooner,” he said. But it would still mean that many of us could contract COVID ten or more times in our lifetime.
Claudia, a special education instructor with a simple smile and short, curly brown hair, was pregnant when the pandemic began. (He asked me not to think about his last call to protect his privacy. )She and her husband remained encerrados. su Brooklyn apartment even after their daughter was born in October 2020. “Basically, the only time I left home was for my postpartum visit,” she told me. But the couple made the decision to take PCR tests and spend Christmas 2020 visiting their parents. . Its effects didn’t come until Christmas Eve, when Claudia and her mother were already cooing the baby. “My mom was, oh my God, panicking,” Claudia said. Did he still have COVID? »
His bright spot came a year later, when Omicron became the dominant variant and a wave of infections hit the school where he teaches. He had no symptoms and was surprised when a precautionary test came back positive. He had been in close contact with many students and teachers, and the school closed early for the winter break. “I gave everyone this little Christmas provision without realizing it,” he said.
Claudia’s third coronavirus infection, in September, was the worst, a reminder that infections and immunity do not follow predictable patterns. Her daughter, now almost two years old, developed a fever; Claudia temporarily experienced muscle pain, headaches, congestion and fatigue, and then lost her sense of smell. When we spoke a few weeks later, she most commonly came back, however, she told me, “I’m constantly smelling cinnamon, just to be sure. “Claudia is grateful to have escaped these relatively unscathed infections, but is wary of the long-term consequences. several things even after mild COVID,'” he told me. “I’m like, well, there’s nothing I can do about it now. “
People who become reinfected with the virus are much more likely to suffer from a variety of medical disorders in the coming months, including heart attacks, strokes, breathing disorders, mental health disorders and kidney disorders, according to a new primary study of U. S. veterans. UU. Compared to those who have not been reinfected, they are twice as likely to die. “We wrote this paper because, for most people in the United States, a first infection is now a thing of the past,” he said. Ziyad Al-Aly, lead writer of the study and head of studies and progress in the physical care system at V. A. The St. Louis told me, “You think, I had it once, I’m vaccinated, I’m stimulated. “Do I still have to go the extra mile to protect myself? The short answer is: yes, absolutely.
There are some caveats. The study has yet to be published in a peer-reviewed journal, and many veterans are older men with multiple physical conditions, so they are at greater risk than the general population. It is also possible that other people who are reinfected are others who are not. Al-Aly was careful to point out that a momentary infection is not necessarily worse than the first, but is worse than not getting reinfected at all. “But I think the concept that there is a major threat that accompanies reinfection is generalizable,” Al-Aly told me. Even when the health threats of an infection decrease, the cumulative threats of many infections deserve concern.
People deserve to do their best to avoid contracting and transmitting the virus, Al-Aly said: masking on public transport, staying home when sick, deciding on outdoor activities instead of indoor activities. Meanwhile, policymakers want to do more: conduct screening and remedy programs, fund next-generation vaccines, invest in public fitness services, improve ventilation systems, help paid medical leave. “Without mitigation measures, it is inevitable that most people will be reinfected,” Al-Aly said. “This is the value we are paying to move towards normality. It’s an exorbitant value. “
Recently, I called Florian Krammer, the virologist at Mount Sinai, and outlined a pessimistic scenario: a long-term one in which COVID reinfections are common, harmful, and inevitable. “When you say it like that, it sounds bad,” Krammer admitted. But I don’t really see it that way. There’s nothing special about the coronavirus, he argued. Yes, SARS-CoV-2 caused a global pandemic, but he believes it was basically because of its novelty. The virus as exclusive because we are so focused on it, is one of the most studied pathogens in the history of mankind, but it follows the same general rules as other viruses.
Viruses have caused a variety of rapid and long-lasting physical disorders. It’s just that “most people didn’t pay attention to it,” Krammer said. Long before this pandemic, for example, viral infections were linked to diabetes, cancer, heart disorders, and autoimmune diseases. Five years ago, in her e-book on the 1918 flu pandemic, journalist Laura Spinney wrote about other people who suffered from prolonged weakness, fatigue, brain fog, insomnia, and mood swings. “We were on lead foot for weeks,” recalls one woman. “It was also very difficult not to forget anything simple, even for five minutes. ” A workout driver “has never been the same” after his illness passed out while driving and caused an accident. In parts of Africa, post-viral syndromes were so prevalent among farmers that they are thought to have triggered a famine. Recent studies suggest that even non-pandemic influenza may be linked to widespread symptoms: According to the Oxford researchers, almost a third of people who contract the influenza virus today report symptoms that resemble prolonged COVID, and may experience the what you could call “long flu”.
Doesn’t that mean we deserve to worry about a superior reference disease in the long term, that the dangers of coronavirus reinfection will overlap with a pre-pandemic disease point?”Not necessarily,” Krammer told me. Actually, I think we’re going through to get back to pretty much the same state we were in before the pandemic. “Krammer argued that respiratory viruses compete with each other; One type of infection can make the others less likely, at least in the short term. (During the 2020-21 flu season, flu cases dropped so dramatically that the CDC couldn’t calculate the virus load. )After an infection, your airline cells remain in an antiviral state for a while, making it more complicated for other viruses to take up residence. It is also very likely that, during and after an illness, other people will replace your behavior. They stay home from work, skip dinner with friends, go through concerts and conferences. “In the long term, SARS-CoV-2 will be just another respiratory virus,” Krammer predicted.
Al-Aly was less optimistic. He sees little explanation for why COVID dangers necessarily drop to flu levels, and we’re not there yet. “We want to balance the need for normalcy with the need to protect people’s health,” he said. Still, he agreed with Krammer and other experts on one thing: The additional burden of a third, fourth, or fifth infection is more likely to be less than that of the first or second. Each new infection could be accompanied by marginal pain reduction. when reinfection will no longer increase the risk,” Al-Aly said. “Whether it’s the sixth, seventh, or nth infection, we don’t know yet. ” ♦
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