‘How long after I became infected with COVID-19 can I get it again?’ and other reinfection questions answered

(WHTM) – As we approach the third year of COVID-19 circulating in the United States, there are still many questions about the virus. It can feel like everyone you know has been infected with coronavirus lately, so we asked experts about reinfections, tests, and when you can get back together with people after catching COVID.

Question: How long after recovering from COVID-19 can anyone catch it again?

“The initial recommendation from the CDC was that once you had a COVID infection, for the next 90 days – the next three months – it was very unlikely that you would get COVID again. This has been the case pretty much all along, and I think it still holds, although you have to keep in mind that with omicron, omicron can infect people who had COVID, for example, back in the fall, so if you had the delta variant back in September, it only protects you from about 20% against omicron.

“One of the hallmarks of omicron is this concept of immune evasion; it can evade the immunity generated by a previous natural infection, and it can also to some extent evade the immunity created by immunization. “

– Dr. Joseph Contra, Head of Infectious Diseases, Penn Medicine Lancaster General Health

“We assume you are fully immune for at least 90 days … There is a lot of evidence that it probably goes up to about six months, but that’s a probability. And then the immunity to natural COVID infection probably drops, just like the immunity to the vaccine decreases with time.

“Part of the problem is that in a virus that just popped up a little less than two years ago, we obviously can not say you’re immune for more than two years because it simply has not existed long enough. So there is a lot of what i will honestly admit is guesswork but what i want to tell you we see is with omicron, we see a lot of breakthrough infections in vaccinated individuals, fewer breakthrough infections in people who have been vaccinated and have had a booster, and we are also beginning to see, but at a slower pace, people who have been re-infected with COVID.

“The good news is that if you are vaccinated, you are much, much less likely to get very sick.”

– Dr. John Goldman, Specialist in Infectious Diseases, UPMC

“Reinfection from SARS CoV-2 occurs. This is why the CDC has always recommended that patients with a history of COVID-19 be vaccinated after clinical improvement. Natural immunity to COVID-19 varies from patient to patient. Some medical experts have shown “Asymptomatic / mild infections do not generate the robust immune response in those who have experienced a serious infection. It is therefore difficult to predict an individual’s duration of natural immunity, which some studies mention may last 1-6 months.”

– Dr. Eugene Curley, MD, WellSpan Health

Q: How common are reinfections? Is there a difference between vaccinated and unvaccinated people?

“What we see is that reinfections are common, they occur with omicron, although we have not seen many people get really sick or end up in the hospital with reinfections. What we also assume is that as the antibodies gradually decrease from natural infection, we are likely to see more reinfections, and as the virus develops when it comes to new variants, we are likely to see reinfections.

“My impression is that we have several breakthrough infections in people who have had their first two shots, but not the booster. The one thing that is always extremely important – people sometimes say, ‘Well, if I’m going to be re-infected, if I have to have a breakthrough infection, so why should I be vaccinated? ‘ The real problem is that if you have a breakthrough infection, it’s probably very mild. We’ve seen breakthrough infections, but they tend to be something like a minor cold, a slight increase in allergies. We have people who become more ill, but they rarely end up in hospital. ”

– Dr. John Goldman, Specialist in Infectious Diseases, UPMC

“We are still learning how variants play a role in reinfection. Vaccinated individuals are not spared re-infection. However, the vaccines protect against serious illness, hospitalization and death in immunocompetent individuals who have been boosted.”

– Dr. Eugene Curley, MD, WellSpan Health

“In general, there is probably a five to ten times greater risk of becoming infected if you are unvaccinated, and you are probably 15-20 times more likely to die from COVID if you end up being hospitalized.

“If you’ve been vaccinated even though you may be infected … it’s probably mild, it’s probably going to take less time, you’re less likely to transmit it to someone else and get over it faster.”

– Dr. Joseph Contra, Head of Infectious Diseases, Penn Medicine Lancaster General Health

Question: If you are unvaccinated and get COVID-19, how long do you have to wait to be vaccinated?

“What I advise people to do is wait 90 days because we know you are immune for 90 days and if you have pre-existing immunity you can get more side effects from the vaccine. So I typically recommend 90 days. You can argue to wait, I think you are sure to wait up to six months, but because we do not understand much about when you really lose immunity, I would do it after 90 days.

“The one thing would be if you are immunosuppressed for some reason, I would do it right away because people who are immunosuppressed are likely to have less long-acting antibodies.”

– Dr. John Goldman, Specialist in Infectious Diseases, UPMC

“According to the CDC guidelines, you can wait for the 90 days, but in fact, people often tend to do it much earlier, and I would say as soon as you do not feel sick anymore, and as long as you” are outside your isolation period – seven, 10 or 21 days depending on your immune status – once you are over it and you are well, you can get the vaccine and there is no harm in getting it earlier than 90 days. “

– Dr. Joseph Contra, Head of Infectious Diseases, Penn Medicine Lancaster General Health

Q: How reliable are COVID-19 test results? Can you trust that a negative test result means you are no longer infected?

“It depends a bit on what type of test you take and when you test. What we have found is that antigen test detects about 2/3 of the positive cases compared to PCR. So if you take an antigen test, you have about 1/3 chance of missing a positive compared to a PCR.

“We have seen, especially in patients who have been vaccinated and have household contacts, that their first test is often negative and their second test is positive. So for example at UPMC, if you have had a household contact and you have symptoms, to get back to work you need to have a first test and then a second test three to five days later, both need to be negative. “

– Dr. John Goldman, Specialist in Infectious Diseases, UPMC

“Antigen tests (most home tests) are not as sensitive as PCR tests. Antigen tests are therefore more prone to false-negative testing. In certain situations (ie exposed / symptomatic person) a repeat test should be performed if the antigen test is negative. The antigen tests are good tools if you understand their limitations and the clinical context of the specific case. I recommend that patients talk to their health care provider about the results of home tests for immediate need for genetic testing, isolation, return to work / school, and treatment. “

– Dr. Eugene Curley, MD, WellSpan Health

“It depends a bit on the circumstances. Say you are in a household where someone has COVID and you start getting sick, you start getting cough and fever, the likelihood of you having COVID is very high. So if you get a negative test, I would consider it an unreliable result, especially if you use one of the websites, so in that situation you should go and get a PCR test at a medical facility.

“Home tests are able to detect infection after a few days after you become infected. The PCR test, on the other hand, detects it immediately. So the home antigen test will pick you up if you do it repeatedly, and remember that the sets typically comes with two cotton swabs, you’re not supposed to use it on two people, you’ll need to use it on yourself today and about 36 hours later, because the two tests are more likely to catch your infection if you have the.”

– Dr. Joseph Contra, Head of Infectious Diseases, Penn Medicine Lancaster General Health

Q: How long after you have been infected with COVID-19 can you safely reunite with other people?

“If (you or) your friend had a serious illness, which means they ended up in the hospital or ended up needing oxygen, you are advised to wait 20 days * before they are not contagious until you are sure to hang out with them.If you had a mild illness [and] provided you get better, provided you do not have a fever, without a test, 10 days, and with a test, you can test on day five, and if the antigen test or PCR is negative, you are sure you are considered to be non-communicable.

“The question is, the PCR often stays positive for 30 days and I’ve seen it stay positive for several months. And two … for example, if I were to hang out with an elderly parent or someone who’s in danger , I would not do it until day 10 without a negative antigen test, and I would probably wait until day 10 if the other person, if they got COVID, was at risk of becoming very ill.

“So serious illness – 20 days. Mild illness, no test – 10 days. Mild illness with a negative antigen test – on day five you can go back to work.”

* This is the number of days after the development of symptoms

– Dr. John Goldman, Specialist in Infectious Diseases, UPMC

“I would not trust tests done on consecutive days if one is positive and one is negative. But say that someone is infected and they get better after five days and they have another home antigen test and it is negative, that person can then go and be around others with very little risk of transmission. “

– Dr. Joseph Contra, Head of Infectious Diseases, Penn Medicine Lancaster General Health

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