Montana Public Radio

Already Had COVID? You Should Still Take Precautions, Researchers Say

Dec 21, 2020

Reported cases of people getting reinfected with SARS-CoV-2, the virus that causes COVID-19, are rare in the U.S. and none have been confirmed by the federal Centers for Disease Control and Prevention. But researchers say studying possible reinfections could answer some big questions about the body’s natural immune response after being infected with the virus.

Libby resident Kaide Dodson says her bout with COVID-19 in early August was unbearable.

"I remember just thinking, I can't breathe. I cannot get a breath of air. So I was trying not to panic."

Dodson, who’s 39 years old, says she’s always been healthy, but it only took a few days before she wound up in the emergency room. Dodson’s husband Brad says that was hard on their family.

“At that point, the black hole of dropping somebody off at a hospital and not knowing when you’re going to see them again. That was rough on us. It was rough on me, having to go home and the boys saying, 'how’s mom?'"

After a night in the hospital, Dodson was discharged and tested negative about two weeks later. She again tested negative twice in October. In early November, Dodson began feeling sick shortly after her husband Brad tested positive for COVID-19. She went back for a rapid test and was positive.

Jennifer McCully, who heads the Lincoln County Public Health Department says, "Because she had symptoms that were pretty classic with COVID, and no alternative diagnosis for those symptoms, and a positive test, we considered her a reinfection.”

Dodson’s possible reinfection hasn’t been confirmed to the extent the federal Centers for Disease Control and Prevention lays out in its protocols, which call for extensive genetic sequencing of test samples. CDC hasn’t reported a reinfection in the U.S. based on its protocols. 

But researchers like Richard Tillett with the University of Nevada have conducted some of the early work using genetic sequencing to confirm a reinfection. In October, Tillett published a peer-reviewed case study in the medical review journal Lancet Infectious Diseases of a 25-year-old Reno, Nevada man that he says was reinfected. He explains that this case and others with genetic evidence backing them up have helped rule out worst-case scenarios of the virus mutating in troubling ways, or somehow going dormant in the body and reactivating at a later date.

"What we’ve seen in our one case that we observed, and in a handful of cases around the world, is no evidence that the virus evolving to evade people’s immune systems. The good news in that is that the virus isn’t outsmarting us, but that some folks get very unlucky twice.”

Confirming reinfections through this genetic sequencing process is hard because researchers need a person’s past COVID-19 test samples and local health departments don’t often keep those around. Possible reinfection cases like Dodson’s are also uncommon. 

Montana state health officials say they are only aware of a handful in the state. Officials with the federal CDC told MTPR in a statement that the agency doesn’t have an estimated number of possible reinfections in the U.S., something the agency says it's working to track. 

Tillet says tracking these possible reinfections is important in that if they suddenly spiked, it would be an alarm bell calling for more investigation into how the virus could be evading the body’s immune response a second time around. 

Tillett says there’s a lot we don’t know about reinfection, like how many people who are infected with SARS-CoV-2 twice are asymptomatic the second time. He says more research is needed to understand what makes people susceptible to reinfection in the first place.

"We would love to know what either happened, or didn’t happen that caused their immune system forget and allowed them to be naive to virus six weeks, or two months later.”

While reported infections are rare, bottom line, Tillett and others in the medical research field say reinfections are possible and people who’ve been infected once still need to take precautions. 

In Montana, more than 75,000 people have been infected with COVID-19. 

Vincent Rajkumar is a cancer researcher and expert in immunology at Mayo Clinic.

"I think people who’ve had COVID should still take precautions, particularly masks and social distancing, until we have a sufficient proportion of the population vaccinated. Because even though you may not have any symptoms from a reinfection of coronavirus, you could still pass it on to other people."

While the CDC hasn’t issued its guidance on the topic, Rajkumar, along with other experts, say people who’ve been infected should also get vaccinated.

As for Dodson, she still worries about getting infected again and plans to get a vaccine when one becomes available. 

"In the back of my head, I have that fear of, oh, third time's is a charm. Is there the possibility that I get this a third time, and it could be the final time."

That’s why she says she isn’t taking any chances and encourages other COVID survivors to wear masks and keep social distancing.