Author Topic: COVID-19 Reinfection  (Read 47512 times)

Offline Tomorrow

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Re: COVID-19 Reinfection
« Reply #120 on: September 27, 2020, 01:15:13 AM »
Had COVID-19 before Pesach, had 920 titers in beginning May. Tested positive for antibodies but did not receive a level in mid July and last week.
Sorry if I ask so many questions, but life is short and there is so much to learn! Let's help each other be great!

Offline biobook

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Re: COVID-19 Reinfection
« Reply #121 on: September 27, 2020, 01:59:12 AM »
I also wonder what the affect of donating plasma has on antibodies. Have there any studies been done?

Completely a theory, but perhaps IgG antibodies may be reduced due to donations? But remaining T-cells would mean a mild reinfection like we have seen?

It's a reasonable idea, and I don't know if it's been studied, but I don't think it would pan out.  This is how I understand it:

1. People who donate convalescent plasma have it tested for antibodies, and are often asked to re-donate, several times, so the level does remain high for a significant time after the first donation.

2. When someone donates blood in general, it includes all sorts of antibodies - to measles, tetanus, recent colds, etc - and all sorts of hormones.  If loss of these antibodies had a significant impact on their immunity, we would see people getting sick soon after blood donation.  The donated blood also contains testosterone, which maintains beard growth, but facial hair doesn't typically fall out as a result.  Blood donations have been common for 80 years, without any obvious effects like this.

Two things might explain this:

A. These regulatory molecules (antibodies, hormones) are produced in much greater amounts than needed.  If 100 viruses enter the body, there need to be 100 antibody molecules to neutralize them. But it's a big body out there (if you're a teeny virus), so to ensure that an antibody finds a virus, the entire body is flooded with antibodies.  Perhaps 10 or 100 or 1000 times as many antibodies than are needed will be produced.  So if you lose 10% of the antibodies in a donation, you still have more than enough to fight infection.

B. I or others may have said something like "After an infection, B cells produce antibodies which may start to disappear after 6-12 months."  That's true, but I see now that it is oversimplified in a way that could be misleading.  It seems to imply that the B cell gets turned on, shoots out some antibodies, then B cell is turned off, and the antibody molecules that were produced hang around for 12 months.  That's not accurate. 

Moshol: Imagine a supermarket that has 100 people in the store whatever time you visit.  That doesn't mean that 100 people entered in the morning and spent the entire day there.  Rather, some entered, some left, and there was a steady state with an average of 100 people there at any one time.

Same with the antibodies.  After an infection, B cells get turned on, and start pouring out antibodies day after day after day, for months.  Each antibody molecule remains in the blood for perhaps a week or a month (different times for different antibodies, don't know re:corona), after which it's destroyed.  But the B cells are still producing new antibodies to replace them, so you have a steady state with sufficiently high antibody levels for several months. 

So, getting back to the convalescent plasma donations:  Yes, you lose some antibodies, but not enough to make a difference in your immune response.  And your B cells are still active so will quickly replace those lost antibodies anyway.

But you might ask, isn't it possible that the day you donate, your antibody level happens to be just above the level needed to fight infection, and after donation it's just below that level, and it will take a few days for the B cells to get the levels back up, and before that happens you spend Simchas Torah singing and dancing at an unmasked covid+ minyan... Is it possible that your chance of getting infected would be higher than if you hadn't donated?  Yeah, I suppose.  But probably not likely for most of us.  Maybe those who work with covid infected patients should avoid donating, but I don't think it's relevant for most people.

Offline Yard sale

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Offline aygart

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Feelings don't care about your facts

Offline yuneeq

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Re: COVID-19 Reinfection
« Reply #124 on: September 30, 2020, 09:45:01 AM »
Now you have me convinced that it can't happen.

This is where you need the WHO to weigh in
Visibly Jewish

Offline Yard sale

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Re: COVID-19 Reinfection
« Reply #125 on: September 30, 2020, 10:19:35 AM »
Now you have me convinced that it can't happen.
Don’t you read Baal Shem Tov Stories?

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Re: COVID-19 Reinfection
« Reply #126 on: September 30, 2020, 10:45:23 AM »
Don’t you read Baal Shem Tov Stories?
What does YWN and The Besht have to do with each other, lhavdil?

Offline Yard sale

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Re: COVID-19 Reinfection
« Reply #127 on: September 30, 2020, 10:55:35 AM »
What does YWN and The Besht have to do with each other, lhavdil?
If you believe everything they say..... but if you don’t believe they can be true.....

Offline aygart

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Re: COVID-19 Reinfection
« Reply #128 on: October 01, 2020, 08:30:24 AM »
From a Lakewood Doctor


Quote
In addition, reinfections have begun to occur in Lakewood. That is to say that people who were sick with COVID-19 illness back then and developed antibodies back then are getting sick again with COVID-19 illness. These cases are not common at this time, but doctors are seeing this and COVID-19 reinfection is now an established fact. Immunity has been established to last about 3 months, and then, in some people, immunity disappears.
Feelings don't care about your facts

Offline Lurker

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Re: COVID-19 Reinfection
« Reply #129 on: October 01, 2020, 08:43:59 AM »
Just some DPs from relatives within the last 5 days: 1 reinfection (moderate case originally, standard symptoms, in bed for 4-6 days), 1 positive for antibodies (very mild case, headache, loss of smell), 1 negative for antibodies (moderate case, standard symptoms, in bed for 10 days).
Failing at maintaining Lurker status.

Offline drosenberg88429

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Re: COVID-19 Reinfection
« Reply #130 on: October 01, 2020, 08:45:28 AM »
Just some DPs from relatives within the last 5 days: 1 reinfection (moderate case originally, standard symptoms, in bed for 4-6 days), 1 positive for antibodies (very mild case, headache, loss of smell), 1 negative for antibodies (moderate case, standard symptoms, in bed for 10 days).

Reinfection was PCR or rapid?

Offline Lurker

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Re: COVID-19 Reinfection
« Reply #131 on: October 01, 2020, 08:50:29 AM »
Failing at maintaining Lurker status.

Offline yuneeq

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Re: COVID-19 Reinfection
« Reply #132 on: October 01, 2020, 04:09:53 PM »
Just some DPs from relatives within the last 5 days: 1 reinfection (moderate case originally, standard symptoms, in bed for 4-6 days), 1 positive for antibodies (very mild case, headache, loss of smell), 1 negative for antibodies (moderate case, standard symptoms, in bed for 10 days).

Some new DP's about some relatives- 2 reinfections.
1st had fever and bedridden for like a month, got it more mild this time around.
2nd never tested first time, but had classic symptoms for about 2 weeks, (fever, chills, aches) along with family members. Later tested negative for antibodies. And got reinfected again similar symptoms as the first time.
Visibly Jewish

Offline biobook

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Re: COVID-19 Reinfection
« Reply #133 on: October 01, 2020, 05:58:09 PM »
On the flip side (I wondered a while ago...)- someone with Antibodies that gets exposed to the virus, does that restrengthen the Antibodies? Did anyone out there who tested for antibodies 3 months+ ago retest? Are we seeing drastically different results?
I don't really know the answer, but I'm trying to think logically about this, based on the little I do know.  Please don't be fooled into thinking I have any expertise in this field, just because I use full sentences and Standard English.  If you think it sounds wrong, you're probably right, so feel free to offer corrections.

During your first infection, while you were feeling sick, your body’s immune cells (macrophages, B cells, T Helper cells) sensed the virus and worked together to get the B cells to produce antibodies to fight the infection. 

Even after you recovered, B cells continue to make antibodies, and if another coronavirus enters your body, the antibodies will recognize it and neutralize it so that it can’t make you sick a second time.
 
But as time passes, less antibody is produced, and you’re at risk of getting re-infected.   What @4yourinfo suggests is that you could get your B cells to keep producing antibody if you could re-stimulate them with the virus again and again, just like a booster shot renews your immune response. 

The idea that repeated exposure to a virus might maintain immunity, seems to have some support, at least after the immunity induced by a vaccination:

Some vaccines “can induce very strong immune responses.  In these cases, boosting may be necessary only at intervals of several years (if at all) in order to sustain life-long immunity.  Alternatively, the vaccinee may encounter the pathogen itself often enough to keep triggering memory responses without the need for more than a single dose of vaccine.”  (Primer to the Immune Response, Mak, Saunders, Jett, 2013, p 351)

I don’t know if there are diseases for which it is known that such repeated exposure triggers the immune system response, or if this is just a hypothesis.  Later they mention one specific disease, but it sounds like there is no definite evidence that immunity is triggered by re-exposure and that this explanation is hypothetical: 

 “…one dose of live, attenuated chicken pox virus] is sufficient to induce antibody production in 97% of school-aged vaccinees.  These antibodies persist in the circulation over several years, but it is unclear whether this persistence is due to the vaccine or to regular re-exposure to VZV (varicella zoster virus) in the community.  A booster dose of…vaccine at age 4-6 is therefore currently recommended.” (p 363)

So your hypothesis seems reasonable, but here’s why I think it’s not recommended that you act on it at this time:

Timing.  Let’s say you’re recovered, and you come in contact with the virus again over the next month or two.  This wouldn’t be expected to activate your immune system because your B cells are working at their peak, doing a splendid job of churning out antibodies.   The virus that you encounter at this time can’t even reach your immune cells to activate them, because the antibodies patrolling your bloodstream will knock it out of commission before it gets anywhere.  That’s a good thing, of course!  Your immune response is successful, so contact with virus at this point fails as a method to boost it further.
   
So, instead, you wait several months more and then expose yourself to a person infected with covid.  But your antibodies may have decreased so much that you no longer have sufficient immunity, so instead of boosting your antibody production the virus just makes you sick.  This is undesirable because your goal was to avoid getting sick! and at least some of those who get re-infected have worse symptoms the second time.  Note that this is different from a booster shot, where you’re exposed to a weakened virus that can stimulate the immune reaction but can’t cause the actual disease.

So you need to find that sweet spot, a time when your antibodies have started to decline, so that some viral particles are able to reach your immune cells to activate them, but before they’ve declined so much that you have insufficient antibodies to stop the virus from making you sick.  The problem is that we don’t know when that might be.  There’s a lot of variability in how humans respond.  Some might lose immunity after two months, others after two years.  So figuring out the time when you personally could risk re-exposure as a safe way to boost your immunity may not be possible.

You might say, “I don’t have to find the optimal time, I’ll just visit another covid patient for an hour every day for the next year.”  That might theoretically work to keep your B cells active, but I don’t know if anyone is quite that dedicated to bikur cholim. 

Dosage.  Even if you knew the best time for re-exposure, you wouldn’t how much virus you’re getting from this exposure, and the severity of response to coronavirus seems to be very dependent on the amount of virus that enters the body.  How much you get will depend on how the body of the infected person responds to the virus, how much they release when they cough or speak or breathe, how long you’re together, the movement of air in the room, etc.  If the dose you get is too low, it may not stimulate your immune response. Too high, and it could overwhelm the antibodies you’re producing at that point and allow you to get re-infected.  Again, this differs from a booster shot, when you get a carefully measured amount of weakened virus.

Viruses mutate.  Small changes occur in the coronavirus over time, and it’s possible that the antibodies you developed to the first virus will no longer stop a mutated virus that you’re later exposed to.
   
So I think it would be dangerous to intentionally re-expose yourself to corona with the hope that it might extend your immunity, because of the uncertainty regarding the optimal timing, dosage, and strain of virus, and because if it doesn’t work to extend your immunity it could lead to covid illness with its potential for serious long-term effects.   

But there may be a safe way to do this.  It’s called… wear a mask!  Wait.. hear me out.  This is a new idea.

In countries where mask-wearing is most prevalent, a high percentage of people who are infected with corona develop only mild symptoms or even none at all.  Two scientists from San Francisco suggest that this is because masks don’t work.

Huh?

Masks do work to stop much transmission of the virus, and so fewer cases occur in those masking countries.  And masks do work to prevent many severe cases, since the mask results in a smaller dose of virus getting through and therefore milder symptoms. But masks don’t work to stop all virus particles, with something like 20-80% of virus particles getting through (depending on mask properties and user behavior). So people wearing masks are frequently getting a tiny dose of virus as they go about their business.  Not enough to cause any symptoms, but perhaps enough to stimulate the cells of the immune system to make antibodies.
 
They’re proposing this to explain why people who had a severe infection often had many close contacts who developed no symptoms but do have antibodies.  The close contacts wore masks, and so the small dose of virus they got as a result may have stimulated antibody response without stimulating symptoms. 

It seems to me it could apply just as well to a person who has recovered from covid and is at risk of a second infection.  If these recovered people were to wear a mask as they go shopping, to shul, to work, to family visits, etc, they may be allowing the repeated inhalation of tiny amounts of virus on a regular basis, so that whenever their natural immunity starts to decline, there’s always another tiny burst of virus stimulating the reactivation of B cells to produce antibody, without stimulating a second bout of disease.

It’s just a theory, but in the absence of any other great ideas for preventing re-infection, it could be worth trying.

The scientists’ description of their idea
A Goldilocks Dose of Coronavirus:  Do masks provide a just-right amount of COVID‑19?

The NY Times science reporter included reactions from other immunologists:
A New Theory Asks: Could a Mask Be a Crude ‘Vaccine’?

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Re: COVID-19 Reinfection
« Reply #134 on: October 01, 2020, 07:22:04 PM »
@biobook Awesome post! What is your day job? Are you a teacher somewhere?

We all really appreciate your insights and the time and effort taken to research everything and write everything in an extremely clear fashion for all of us to learn.

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Re: COVID-19 Reinfection
« Reply #135 on: October 01, 2020, 08:29:55 PM »
I don't really know the answer, but I'm trying to think logically about this, based on the little I do know.  Please don't be fooled into thinking I have any expertise in this field, just because I use full sentences and Standard English.  If you think it sounds wrong, you're probably right, so feel free to offer corrections.
I think its all about the spacing...

Offline S209

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Re: COVID-19 Reinfection
« Reply #136 on: October 01, 2020, 08:37:30 PM »
@biobook What I take from your post is that the theory does have a solid basis in science, although you feel the risks outweigh the potential rewards.
Quote from: YitzyS
Quotes in a signature is annoying, as it comes across as an independent post.

Offline biobook

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Re: COVID-19 Reinfection
« Reply #137 on: October 01, 2020, 11:56:04 PM »
@biobook Awesome post! What is your day job? Are you a teacher somewhere?

We all really appreciate your insights and the time and effort taken to research everything and write everything in an extremely clear fashion for all of us to learn.
What? There are DDFers who have time for another job?  So much to read here, so little time.

Offline biobook

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Re: COVID-19 Reinfection
« Reply #138 on: October 02, 2020, 12:01:53 AM »
@biobook What I take from your post is that the theory does have a solid basis in science, although you feel the risks outweigh the potential rewards.
Almost.
There are solid scientists who refer to it, but I haven't discovered whether they know of actual evidence for it, or just that they consider it a reasonable theory. 
I feel the risks of possible re-infection outweighs the hypothesized but unproven possibility of being rewarded with extended immunity.

Offline ilherman

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Re: COVID-19 Reinfection
« Reply #139 on: October 04, 2020, 11:04:12 PM »
He writes positive PCR, negative PCR, antibodies and donated plasma, now headache and positive PCR. Mild symptoms the 2nd time.
Can very well be false positive. I know people who were positive on pcr with no symptoms, retested the next day and were negetive. Same goes with antibodies, a lot of false positives.

He had a headache and tested positive. And felt better right after. Might very well be fake positive and by chance had a headache.

Im not doubting this whole reinfection thingy but I believe we are missing facts. We are going through a change of weather now which causes colds. People get a cold and they think it's reinfection. They confirm it via pcr which is possibly false.

My main problem with this reinfection thing is how come the NYT hasn't picked it up? They only found one guy in Nevada out of the who US.
You can say what you think when you think what you say.