[lex24]

Okie dokie, here we go.

Scientists have confirmed the first case of coronavirus reinfection in the United States: a 25-year-old Nevada man whose second round of the virus was more severe than the first. 

https://thehill.com/policy/healthcare/52...d-case-was

Neither appeared very severe. But it’s always good to have more to be worried and/or scared about. Maybe we just lock down forever.....

[lex24]

Okie dokie, here we go.

Scientists have confirmed the first case of coronavirus reinfection in the United States: a 25-year-old Nevada man whose second round of the virus was more severe than the first. 

https://thehill.com/policy/healthcare/52...d-case-was

Neither appeared very severe. But it’s always good to have more to be worried and/or scared about. Maybe we just lock down forever.....

[dabigv13]

Telling that this is the ONLY proven case of reinfection in the US. So it is not a common thing by any means. 

Also-

[Tweet]https://twitter.com/florian_krammer/status/1315792239768023042?s=20[/tweet]

the presence of IgM antibodies with the second infection implies poor or no immune response to the first infection.

[dabigv13]

Telling that this is the ONLY proven case of reinfection in the US. So it is not a common thing by any means. 

Also-

[Tweet]https://twitter.com/florian_krammer/status/1315792239768023042?s=20[/tweet]

the presence of IgM antibodies with the second infection implies poor or no immune response to the first infection.

[82lsju]

"Findings
The patient had two positive tests for SARS-CoV-2, the first on April 18, 2020, and the second on June 5, 2020, separated by two negative tests done during follow-up in May, 2020. Genomic analysis of SARS-CoV-2 showed genetically significant differences between each variant associated with each instance of infection. The second infection was symptomatically more severe than the first.

Interpretation
Genetic discordance of the two SARS-CoV-2 specimens was greater than could be accounted for by short-term in vivo evolution. These findings suggest that the patient was infected by SARS-CoV-2 on two separate occasions by a genetically distinct virus. Thus, previous exposure to SARS-CoV-2 might not guarantee total immunity in all cases. All individuals, whether previously diagnosed with COVID-19 or not, should take identical precautions to avoid infection with SARS-CoV-2. The implications of reinfections could be relevant for vaccine development and application."

https://www.thelancet.com/journals/lanin...7/fulltext

[82lsju]

"Findings
The patient had two positive tests for SARS-CoV-2, the first on April 18, 2020, and the second on June 5, 2020, separated by two negative tests done during follow-up in May, 2020. Genomic analysis of SARS-CoV-2 showed genetically significant differences between each variant associated with each instance of infection. The second infection was symptomatically more severe than the first.

Interpretation
Genetic discordance of the two SARS-CoV-2 specimens was greater than could be accounted for by short-term in vivo evolution. These findings suggest that the patient was infected by SARS-CoV-2 on two separate occasions by a genetically distinct virus. Thus, previous exposure to SARS-CoV-2 might not guarantee total immunity in all cases. All individuals, whether previously diagnosed with COVID-19 or not, should take identical precautions to avoid infection with SARS-CoV-2. The implications of reinfections could be relevant for vaccine development and application."

https://www.thelancet.com/journals/lanin...7/fulltext

[M T]

Telling that this is the ONLY proven case of reinfection in the US. So it is not a common thing by any means. 

Telling that this is the only PROVEN case of reinfection in the US, and we're finding out this particular reinfection 4.5 months after it happened. 
In this case, proof involved distinct genomes in the two infections, where there were alterations in each that weren't in the other. Plus some other test to prove the samples came from the same person.

(As far as I can tell, Santa Clara County cases aren't having their genomes entered into the database.  I don't know whether the genomes are being routinely gathered.  If not, I think SCC could never prove a reinfection.)

How many might there be that weren't provable to be two different infections?   Note that the once-recovered patient went to the urgent care center with multiple symptoms of COVID and was NOT given a COVID test, presumably because he was thought to be immune to it because of his first infection about 6 weeks earlier.  "On May 31, 2020, the patient sought care at an urgent care centre with self-reported fever, headache, dizziness, cough, nausea, and diarrhoea, at which time chest radiography was done and he was discharged home."  (He went to a private doctor on June 5, at which time he was hypoxic & got the COVID test.)

Also of interest is that he had a negative PCR test on May 26 and then had symptoms first appear (for the 2nd infection) on May 28.  That 2 day interval is similar to what may have happened to the President.  (No mention of the possibility that he was exposed to the 2nd infection when he went to get the PCR test.  Nor did I see any mention of the reason & timing of the May 26 test.  Perhaps he was concerned he had been exposed.  Perhaps it was scheduled weeks before.)

Is there some way for the antibody tests to measure the level of antibodies for a person who has had the infection?  The simple yes/no test seems just to say the antibodies are above/below some threshold.   If a person doesn't develop sufficient level of antibodies, or if their level drops off, he/she might want to be more diligent about potential exposure or potential reinfection.

As I remember, the reinfections described on TWIV months ago involved two people (IIRC, both MDs) who thought they wouldn't be infected again (at least at that point).

[M T]

Telling that this is the ONLY proven case of reinfection in the US. So it is not a common thing by any means. 

Telling that this is the only PROVEN case of reinfection in the US, and we're finding out this particular reinfection 4.5 months after it happened. 
In this case, proof involved distinct genomes in the two infections, where there were alterations in each that weren't in the other. Plus some other test to prove the samples came from the same person.

(As far as I can tell, Santa Clara County cases aren't having their genomes entered into the database.  I don't know whether the genomes are being routinely gathered.  If not, I think SCC could never prove a reinfection.)

How many might there be that weren't provable to be two different infections?   Note that the once-recovered patient went to the urgent care center with multiple symptoms of COVID and was NOT given a COVID test, presumably because he was thought to be immune to it because of his first infection about 6 weeks earlier.  "On May 31, 2020, the patient sought care at an urgent care centre with self-reported fever, headache, dizziness, cough, nausea, and diarrhoea, at which time chest radiography was done and he was discharged home."  (He went to a private doctor on June 5, at which time he was hypoxic & got the COVID test.)

Also of interest is that he had a negative PCR test on May 26 and then had symptoms first appear (for the 2nd infection) on May 28.  That 2 day interval is similar to what may have happened to the President.  (No mention of the possibility that he was exposed to the 2nd infection when he went to get the PCR test.  Nor did I see any mention of the reason & timing of the May 26 test.  Perhaps he was concerned he had been exposed.  Perhaps it was scheduled weeks before.)

Is there some way for the antibody tests to measure the level of antibodies for a person who has had the infection?  The simple yes/no test seems just to say the antibodies are above/below some threshold.   If a person doesn't develop sufficient level of antibodies, or if their level drops off, he/she might want to be more diligent about potential exposure or potential reinfection.

As I remember, the reinfections described on TWIV months ago involved two people (IIRC, both MDs) who thought they wouldn't be infected again (at least at that point).

[dabigv13]

Undoubtedly there are more out there, as proving this with genomic sequencing requires the effort of a motivated researcher or clinician. Another was pubbed this AM, so now we have two in the US. 

But again, we're 8 or 9 months into this. If reinfections were common, we would know it.

[dabigv13]

Undoubtedly there are more out there, as proving this with genomic sequencing requires the effort of a motivated researcher or clinician. Another was pubbed this AM, so now we have two in the US. 

But again, we're 8 or 9 months into this. If reinfections were common, we would know it.

[Goose]

Undoubtedly there are more out there, as proving this with genomic sequencing requires the effort of a motivated researcher or clinician. Another was pubbed this AM, so now we have two in the US. 

But again, we're 8 or 9 months into this. If reinfections were common, we would know it.

Agree with that. It certainly can happen, but it isn't so common that it is obviously happening. One (of many) unanswered questions is how common are reinfections with the "same" strain of the virus. It makes sense that a virus that has mutated may not be defeated by antibodies that act against a now somewhat different set of antigens. It is also probable that some(very few)  people lose their immunity even to the same virus. As a general threat to society, this is important in that it preserves the disease in the population so that people without immunity can get it.

[Goose]

Undoubtedly there are more out there, as proving this with genomic sequencing requires the effort of a motivated researcher or clinician. Another was pubbed this AM, so now we have two in the US. 

But again, we're 8 or 9 months into this. If reinfections were common, we would know it.

Agree with that. It certainly can happen, but it isn't so common that it is obviously happening. One (of many) unanswered questions is how common are reinfections with the "same" strain of the virus. It makes sense that a virus that has mutated may not be defeated by antibodies that act against a now somewhat different set of antigens. It is also probable that some(very few)  people lose their immunity even to the same virus. As a general threat to society, this is important in that it preserves the disease in the population so that people without immunity can get it.

[BostonCard]

remember, though, that the human body produces antibodies against a lot of different antigens, so even if one part of one protein mutated to escape detection, there would still be other antibodies against different parts of the virus that still ought to be able to neutralize it.

As akiddoc noted, even in cases where a virus is very stable and immunogenic, some patients don't mount an adequate response and can get reinfected.  As long as that is a very uncommon occurance, it is not too big a deal.

BC

[BostonCard]

remember, though, that the human body produces antibodies against a lot of different antigens, so even if one part of one protein mutated to escape detection, there would still be other antibodies against different parts of the virus that still ought to be able to neutralize it.

As akiddoc noted, even in cases where a virus is very stable and immunogenic, some patients don't mount an adequate response and can get reinfected.  As long as that is a very uncommon occurance, it is not too big a deal.

BC

[JustAnotherFan]

Okie dokie, here we go.

Scientists have confirmed the first case of coronavirus reinfection in the United States: a 25-year-old Nevada man whose second round of the virus was more severe than the first. 

https://thehill.com/policy/healthcare/52...d-case-was

Neither appeared very severe. But it’s always good to have more to be worried and/or scared about. Maybe we just lock down forever.....

Interesting that you took it there. You okay?

---

"Findings
The patient had two positive tests for SARS-CoV-2, the first on April 18, 2020, and the second on June 5, 2020, separated by two negative tests done during follow-up in May, 2020. Genomic analysis of SARS-CoV-2 showed genetically significant differences between each variant associated with each instance of infection. The second infection was symptomatically more severe than the first.

Interpretation
Genetic discordance of the two SARS-CoV-2 specimens was greater than could be accounted for by short-term in vivo evolution. These findings suggest that the patient was infected by SARS-CoV-2 on two separate occasions by a genetically distinct virus. Thus, previous exposure to SARS-CoV-2 might not guarantee total immunity in all cases. All individuals, whether previously diagnosed with COVID-19 or not, should take identical precautions to avoid infection with SARS-CoV-2. The implications of reinfections could be relevant for vaccine development and application."

https://www.thelancet.com/journals/lanin...7/fulltext

I was just talking about this with someone who had to go to a wedding in the deep south this month for her sister. Parents got Covid already, and recovered, and were running around without a care in the world because they believe they are immune now. Maybe their chances of reinfection are effectively zero. But their behavior only fed (or was fed by) the behavior of everyone else at the wedding, taking zero precautions at all. Indoor reception by the way. 180 attendees. Plenty of old folks. Fingers crossed that they dodged a bullet.

[JustAnotherFan]

Okie dokie, here we go.

Scientists have confirmed the first case of coronavirus reinfection in the United States: a 25-year-old Nevada man whose second round of the virus was more severe than the first. 

https://thehill.com/policy/healthcare/52...d-case-was

Neither appeared very severe. But it’s always good to have more to be worried and/or scared about. Maybe we just lock down forever.....

Interesting that you took it there. You okay?

---

"Findings
The patient had two positive tests for SARS-CoV-2, the first on April 18, 2020, and the second on June 5, 2020, separated by two negative tests done during follow-up in May, 2020. Genomic analysis of SARS-CoV-2 showed genetically significant differences between each variant associated with each instance of infection. The second infection was symptomatically more severe than the first.

Interpretation
Genetic discordance of the two SARS-CoV-2 specimens was greater than could be accounted for by short-term in vivo evolution. These findings suggest that the patient was infected by SARS-CoV-2 on two separate occasions by a genetically distinct virus. Thus, previous exposure to SARS-CoV-2 might not guarantee total immunity in all cases. All individuals, whether previously diagnosed with COVID-19 or not, should take identical precautions to avoid infection with SARS-CoV-2. The implications of reinfections could be relevant for vaccine development and application."

https://www.thelancet.com/journals/lanin...7/fulltext

I was just talking about this with someone who had to go to a wedding in the deep south this month for her sister. Parents got Covid already, and recovered, and were running around without a care in the world because they believe they are immune now. Maybe their chances of reinfection are effectively zero. But their behavior only fed (or was fed by) the behavior of everyone else at the wedding, taking zero precautions at all. Indoor reception by the way. 180 attendees. Plenty of old folks. Fingers crossed that they dodged a bullet.

[Mick]

I was just talking about this with someone who had to go to a wedding in the deep south this month for her sister. Parents got Covid already, and recovered, and were running around without a care in the world because they believe they are immune now. Maybe their chances of reinfection are effectively zero. But their behavior only fed (or was fed by) the behavior of everyone else at the wedding, taking zero precautions at all. Indoor reception by the way. 180 attendees. Plenty of old folks. Fingers crossed that they dodged a bullet.

Mrs. Mick and I have to go to a wedding in Los Angeles County next month for our goddaughter.  Nice knowing you all...

[Mick]

I was just talking about this with someone who had to go to a wedding in the deep south this month for her sister. Parents got Covid already, and recovered, and were running around without a care in the world because they believe they are immune now. Maybe their chances of reinfection are effectively zero. But their behavior only fed (or was fed by) the behavior of everyone else at the wedding, taking zero precautions at all. Indoor reception by the way. 180 attendees. Plenty of old folks. Fingers crossed that they dodged a bullet.

Mrs. Mick and I have to go to a wedding in Los Angeles County next month for our goddaughter.  Nice knowing you all...

[teejers1]

I was just talking about this with someone who had to go to a wedding in the deep south this month for her sister. Parents got Covid already, and recovered, and were running around without a care in the world because they believe they are immune now. Maybe their chances of reinfection are effectively zero. But their behavior only fed (or was fed by) the behavior of everyone else at the wedding, taking zero precautions at all. Indoor reception by the way. 180 attendees. Plenty of old folks. Fingers crossed that they dodged a bullet.

Mrs. Mick and I have to go to a wedding in Los Angeles County next month for our goddaughter.  Nice knowing you all...

Hey, it's still nice in November in LA.  Any chance of outdoor festivities?

If not, maybe you tell the hosts that "I just need to step outside to smoke . . . "

[teejers1]

I was just talking about this with someone who had to go to a wedding in the deep south this month for her sister. Parents got Covid already, and recovered, and were running around without a care in the world because they believe they are immune now. Maybe their chances of reinfection are effectively zero. But their behavior only fed (or was fed by) the behavior of everyone else at the wedding, taking zero precautions at all. Indoor reception by the way. 180 attendees. Plenty of old folks. Fingers crossed that they dodged a bullet.

Mrs. Mick and I have to go to a wedding in Los Angeles County next month for our goddaughter.  Nice knowing you all...

Hey, it's still nice in November in LA.  Any chance of outdoor festivities?

If not, maybe you tell the hosts that "I just need to step outside to smoke . . . "

[M T]

Mrs. Mick and I have to go to a wedding in Los Angeles County next month for our goddaughter.  Nice knowing you all...

L.A. is still Purple. 

Weddings (ceremonies only)
Outdoors only with modifications
See guidance for Places of worship and cultural ceremonies

It's adjusted cases/day/100K is 7.6 where 7 is the threshold for purple.  I'd say there is a very good chance it will move to red in November.
If it moves to red:

Weddings (ceremonies only)
Indoors with modifications
– Max 25% capacity or 100 people, whichever is fewer

The kicker is that November is one of the months in which rain might happen (3 days out of 30).  Hopefully the venue will have all under a tent.

Even if the ceremony is outdoors, there will be social pressure to interact indoors (wedding parties, etc.).
And, even at outdoor venues, bathrooms will be indoors.

Good luck.   (And do remember, as with Trump, even if you get COVID, you may not get too serious an effect.  You've seen various suggestions about precautions beyond social distancing.  None of them are proven, but use your judgement.)

[M T]

Mrs. Mick and I have to go to a wedding in Los Angeles County next month for our goddaughter.  Nice knowing you all...

L.A. is still Purple. 

Weddings (ceremonies only)
Outdoors only with modifications
See guidance for Places of worship and cultural ceremonies

It's adjusted cases/day/100K is 7.6 where 7 is the threshold for purple.  I'd say there is a very good chance it will move to red in November.
If it moves to red:

Weddings (ceremonies only)
Indoors with modifications
– Max 25% capacity or 100 people, whichever is fewer

The kicker is that November is one of the months in which rain might happen (3 days out of 30).  Hopefully the venue will have all under a tent.

Even if the ceremony is outdoors, there will be social pressure to interact indoors (wedding parties, etc.).
And, even at outdoor venues, bathrooms will be indoors.

Good luck.   (And do remember, as with Trump, even if you get COVID, you may not get too serious an effect.  You've seen various suggestions about precautions beyond social distancing.  None of them are proven, but use your judgement.)

[CardinalSagehen]

My parents have decided to go spend 5 days in December at the home of their good friends in Palm Springs, who were infected with Covid and fully recovered last month.  All four of them are 75-80 years old. While my first impulse was to criticize their decision, I ultimately determined that I couldn't legitimately tell them it was a bad idea.  I just focused on their not being dragged out to dinner or other moderate-risk activities by their friends, who are probably less careful now. Apparently, this has already been discussed and the plan is to cook and eat in.

Reinfection risk is definitely worth studying. But the talking point that some pundits are using on cable news - "we really don't know that you can't get reinfected quickly" - is misleading at best and misinformation at worst. (I'm acknowledging that reinfection is technically possible, but it must be exceedingly rare within 6 months and probably longer, or else we'd know for sure by now.) 

The more we spool people up on non-issues that can easily be rebutted by COVID deniers, the less traction we will achieve on basic sensible measures like mask-wearing.

[CardinalSagehen]

My parents have decided to go spend 5 days in December at the home of their good friends in Palm Springs, who were infected with Covid and fully recovered last month.  All four of them are 75-80 years old. While my first impulse was to criticize their decision, I ultimately determined that I couldn't legitimately tell them it was a bad idea.  I just focused on their not being dragged out to dinner or other moderate-risk activities by their friends, who are probably less careful now. Apparently, this has already been discussed and the plan is to cook and eat in.

Reinfection risk is definitely worth studying. But the talking point that some pundits are using on cable news - "we really don't know that you can't get reinfected quickly" - is misleading at best and misinformation at worst. (I'm acknowledging that reinfection is technically possible, but it must be exceedingly rare within 6 months and probably longer, or else we'd know for sure by now.) 

The more we spool people up on non-issues that can easily be rebutted by COVID deniers, the less traction we will achieve on basic sensible measures like mask-wearing.

[magnus]

Washington state is investigating 120 potential reinfections cases. All separated by 3 months. 

As reported by BNONews based on interaction with state health department

[magnus]

Washington state is investigating 120 potential reinfections cases. All separated by 3 months. 

As reported by BNONews based on interaction with state health department

[lex24]

Mrs. Mick and I have to go to a wedding in Los Angeles County next month for our goddaughter.  Nice knowing you all...

L.A. is still Purple. 

Weddings (ceremonies only)
Outdoors only with modifications
See guidance for Places of worship and cultural ceremonies

It's adjusted cases/day/100K is 7.6 where 7 is the threshold for purple.  I'd say there is a very good chance it will move to red in November.
If it moves to red:

Weddings (ceremonies only)
Indoors with modifications
– Max 25% capacity or 100 people, whichever is fewer

The kicker is that November is one of the months in which rain might happen (3 days out of 30).  Hopefully the venue will have all under a tent.

Even if the ceremony is outdoors, there will be social pressure to interact indoors (wedding parties, etc.).
And, even at outdoor venues, bathrooms will be indoors.

Good luck.   (And do remember, as with Trump, even if you get COVID, you may not get too serious an effect.  You've seen various suggestions about precautions beyond social distancing.  None of them are proven, but use your judgement.)

I went to a wedding in late August. About 50 people.  All outdoors. About half masked.  Reception 
lasted about an hour. A toast and light hors d’oeurves. Wedding party (about 15) stayed on site and spent the evening. No one got Covid.

You’ll be fine, Mick.

[lex24]

Mrs. Mick and I have to go to a wedding in Los Angeles County next month for our goddaughter.  Nice knowing you all...

L.A. is still Purple. 

Weddings (ceremonies only)
Outdoors only with modifications
See guidance for Places of worship and cultural ceremonies

It's adjusted cases/day/100K is 7.6 where 7 is the threshold for purple.  I'd say there is a very good chance it will move to red in November.
If it moves to red:

Weddings (ceremonies only)
Indoors with modifications
– Max 25% capacity or 100 people, whichever is fewer

The kicker is that November is one of the months in which rain might happen (3 days out of 30).  Hopefully the venue will have all under a tent.

Even if the ceremony is outdoors, there will be social pressure to interact indoors (wedding parties, etc.).
And, even at outdoor venues, bathrooms will be indoors.

Good luck.   (And do remember, as with Trump, even if you get COVID, you may not get too serious an effect.  You've seen various suggestions about precautions beyond social distancing.  None of them are proven, but use your judgement.)

I went to a wedding in late August. About 50 people.  All outdoors. About half masked.  Reception 
lasted about an hour. A toast and light hors d’oeurves. Wedding party (about 15) stayed on site and spent the evening. No one got Covid.

You’ll be fine, Mick.

[M T]

Washington state is investigating 120 potential reinfections cases. All separated by 3 months. 

As reported by BNONews based on interaction with state health department

Separated by 3 months by fiat, not by fact.
Their numbers, again by fiat, will not include any apparent reinfections if the doctors declined to order PCR tests on the second infection because they didn't believe in reinfections.

Next, I expect we'll be hearing that you can't get a reinfection in less than 3 months.
We don't know that these 120 are reinfections, but if you don't look for something, you probably won't find it.

I wonder if they'll review infections separated by less time if they find reinfections after reviewing possible reinfections separated by 3-6 months.

[M T]

Washington state is investigating 120 potential reinfections cases. All separated by 3 months. 

As reported by BNONews based on interaction with state health department

Separated by 3 months by fiat, not by fact.
Their numbers, again by fiat, will not include any apparent reinfections if the doctors declined to order PCR tests on the second infection because they didn't believe in reinfections.

Next, I expect we'll be hearing that you can't get a reinfection in less than 3 months.
We don't know that these 120 are reinfections, but if you don't look for something, you probably won't find it.

I wonder if they'll review infections separated by less time if they find reinfections after reviewing possible reinfections separated by 3-6 months.