Early in the COVID-19 pandemic, some of the questions Seattle Times readers were asking us just didn’t have solid answers yet. The coronavirus was new to the world, and scientists were scrambling to learn the basics of how it spreads and how it affects people.
Now, although the virus is certainly still novel, some answers — or, at least, some insights — have begun to emerge.
In this week’s FAQ Friday, we’re addressing two topics that have come up a lot this year in readers’ questions: How long a COVID-19 illness typically lasts, and whether someone who’s had the coronavirus can contract it again.
Can someone get infected by the new coronavirus more than once?
It can be hard to know for sure, but evidence is mounting that reinfection is possible.
Multiple cases have come to light this week, including a Seattle-area nursing home resident. Genetic testing by a team of Seattle physicians and scientists revealed the man hadn’t relapsed but rather had been infected with a slightly different variant of the virus.
He’s only the third person in the United States — and one of about 20 worldwide — confirmed to have experienced such a double whammy.
On Monday, the medical journal Lancet Infectious Diseases published a paper about a Nevada man who also was infected twice with SARS-CoV-2, the official name of the coronavirus that causes COVID-19.
The Nevada man, who was 25 years old and had no underlying conditions, was sicker the second time and needed to be hospitalized.
The Seattle-area man was in his 60s and has emphysema. He wasn’t as sick the second time around and has since recovered, Dr. Jason Goldman, an infectious-disease specialist at Swedish Medical Center, told The Seattle Times.
Documented cases of reinfection raise questions about the effectiveness of antibodies the body develops to fight the virus once infected. Reinfections appear to be rare, which indicates most people muster a protective immune response, but it’s unclear how long that lasts, Goldman said.
“And we still don’t know what level of immunity you need to be protected,” he said.
Importantly, while the local man’s second infection was from a different variant of the virus, researchers don’t believe his case or the Nevada man’s case was the result of the virus mutating to adapt to immune responses.
That bodes well for vaccine efforts. If the virus were mutating as a result of immune evasion, multiple vaccines might be necessary to ward off reinfection. But “for now, one vaccine will be sufficient to confer protection against all circulating variants,” Dr. Akiko Iwasaki, a professor in the Department of Immunobiology at Yale University, wrote in a paper accompanying the Lancet report.
Other instances of multiple infections, while rare, have been confirmed in South America, Asia and Europe.
About 100 people in Washington have tested positive for the virus and then tested positive again on subsequent tests, State Health Officer Dr. Kathy Lofy said during a news briefing Wednesday.
To be sure a person has truly been infected twice, it helps to have the original samples from the first test, but those are tough to come by, Lofy said.
“It’s hard to determine if it’s just from long shedding or a new infection,” she said. “We’re trying to retrieve samples from their original infection and having a hard time doing that.”
How long is a person typically sick with COVID-19?
This is tricky to answer because the virus can have wildly different effects from person to person.
COVID-19 can show up as a mild to moderate illness for a couple of weeks, or it can hit hard and lead to hospitalization or death. Older, sicker patients who survive tend to take longer to recover.
As we reported in a previous FAQ, some people with COVID-19 have reported symptoms that linger for as long as six months. These “long haulers” aren’t insignificant in number, but their experience isn’t the norm.
The World Health Organization says recovery typically takes two to six weeks. One U.S. study found that around 20% of non-hospitalized individuals ages 18 to 34 still had symptoms at least two weeks after becoming ill. The same was true for nearly half of people age 50 and older.
Among those sick enough to be hospitalized, a study in Italy found 87% were still experiencing symptoms two months after getting sick. Lingering symptoms included fatigue and shortness of breath.
People with mild cases begin to feel better within about one to two weeks of the onset of symptoms, Dr. Lisa Maragakis, senior director of infection prevention at Johns Hopkins Medicine, wrote on the school’s website.
Symptoms can develop five to 13 days after a person is exposed to the virus. Common symptoms include cough, fever, nausea, soreness and shortness of breath.
It’s hard to predict which patients will develop complications after their initial illness subsides. COVID-19 can affect nearly every organ, and long-term complications can include heart inflammation, decreased kidney function, fuzzy thinking, anxiety and depression.
It is unclear whether the virus itself or the inflammation it can cause leads to these lingering problems, Dr. Jay Varkey, an Emory University infectious diseases specialist, told The Associated Press.
“Once you get over the acute illness, it’s not necessarily over,” he said.
Seattle Times staff reporter Sandi Doughton contributed to this report, which also includes information from The Associated Press.
You can read last week’s FAQ Friday, which addressed some of the most common face-covering conundrums, at st.news/faq-mask-troubles. If you have a question you haven’t seen addressed in The Seattle Times’ coverage, ask it at st.news/coronavirus-questions or via the form below.