Why Are Long Haulers Getting Reactivated Infections
When previously healthy people are getting COVID and becoming long haulers, it might be partly because they are immunocompromised and cannot put these viruses back to the dormant state. It could also be that they have high levels of inflammation that keep the viruses replicating.
There are a lot of different theories on how this happens. For example, some studies are showing that a reactivated, now chronic, EBV infection may underlie some long COVID symptoms.
While scientists try to pinpoint the exact mechanisms that are causing these viral reactivations in long-haulers, as well as how this could lead to future treatment options, these patients live in the bodies that hold the data. They’re documenting their struggles, symptoms, and survival mechanisms to rewrite history in the process.
Verywell spoke to 17 long-haulers about their experiences with chronic viral reactivations following infection with COVID-19. Many are still struggling over a year after their acute illness.
Here are their stories.
If You Live With Someone At Higher Risk
Family members at higher risk should spend as little time as possible in shared spaces such as kitchens, bathrooms and sitting areas. You should keep these spaces well ventilated.
The person at higher risk should:
- keep 2 metres away from you and others in your household
- sleep in a different bed where possible
- use a separate bathroom from the rest of the household
- use separate towels from the other people in your house, both for drying themselves after bathing or showering and for hand-hygiene purposes
- take their meals back to their room to eat if they can
The rest of the household should:
- clean any shared toilets and bathrooms every time you use them, for example wiping surfaces you have come into contact with
- consider drawing up a rota for bathing, with the higher risk person using the facilities first
- avoid using the kitchen while they are present.
- use a dishwasher to clean and dry the familys used crockery and cutlery
- wash them using your usual washing up liquid and warm water if you dont have a dishwasher
- dry all crockery and cutlery thoroughly, and use a separate tea towel if the higher risk person is using their own utensils
If you live with a higher risk person and its not possible to physically distance from them, phone the National Assistance Helpline to discuss your needs.
If You Do Not Have A Suitable Place To Do Your Enhanced Quarantine
If you do not have a suitable place to quarantine, you will be required to remain at a federal designated quarantine facility for the full period of 14 days. You will be directed to a federal designated quarantine facility where government representatives will work to confirm that all other options for quarantine accommodations within your own means have been exhausted.
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Can Recovered Coronavirus Patients Test Positive Again Here’s What To Know
Chiara DiGiallorenzo first started feeling sick on March 6. Shed recently flown to Los Angeles to visit her boyfriend, and she hung out with a friend who was in town from London. Her friend wasnt feeling well, but she figured he just had a 48-hour bug. Soon after, DiGiallorenzo and a few of her friends started to feel run down.
We all had high fevers, terrible body aches and no sense of taste nor smell, DiGiallorenzo, 25, told HuffPost. Her friends, all of whom are young and otherwise healthy, were able to beat the virus in a few days. But DiGiallorenzo, who has an underlying health condition, was still battling the sickness days later.
When she developed tightness in her chest, she decided to have a doctor check out her lungs and test her for COVID-19. A positive test came back two days later.
For about 10 days, DiGiallorenzo had a fever that ranged from 99.5 to 101.8 degrees Fahrenheit. On March 17, her symptoms cleared, and, according to the guidelines from the Centers for Disease Control and Prevention that state you are no longer contagious three days after your symptoms end, she was officially released from isolation.
But out of an abundance of caution, she got checked out one more time by her doctor. Even though she no longer had symptoms, she again tested positive for COVID-19 20 days after she experienced her first symptom.
Which Viruses Cause The Infections
The viruses at play here mainly fall under the Herpesviridae family. Most Americans carry a dormant version of herpesviruses. An estimated 87.4% of U.S. adults aged 14 to 49 years infected with HSV-2 remain asymptomatic with no clinical diagnosis. Likely over 95% of adults carry Epstein-Barr virus . After our immune system defeats any virus in the herpes virus family, that virus will burrow into our nerves and go into a dormant state.
Makeda Robinson, MD, PhD, an infectious disease specialist currently studying COVID-19 at Stanford University, told Verywell that what keeps the herpesviruses in that latent state are the body’s T cells.
“If you have fewer T cells, it can be more difficult to control these viruses,” Robinson said. “We know that during COVID-19, our level of T cells is reduced significantly and our ability to fight these Herpesviruses if they become more active may be impaired.”
In other words, when COVID gets into the body it depletes our T cells, which can allow for reactivation of a herpes virus during the acute phase of a COVID infection.
“If you’re infected with another virus, thats a stress to the body and immune system and that may be enough of a stress to trigger replication of these dormant viruses,” said Robinson, adding that research has shown that with EBV, specifically, “there is active replication in those cells post-COVID.”
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Scientists Have A Few Theories About Why You Can Still Test Positive After You Feel Better
Health experts have a few guesses as to why some people may test positive for days, even weeks after they recover.
The first is that the COVID-19 test is detecting remains and traces of the virus, but not the live, infectious virus itself. Its been seen before that the remnants of the virus are detected but not the live, infectious virus, according to Singer.
Its possible that the immune system has destroyed the virus and youre just seeing lingering pieces of its genetic material, and thats what youre detecting, Singer said.
There is also the rare event where someones test produces a false positive, or a positive result when in actuality they dont have the virus, according to Singer. False positives arent common, but they do occur from time to time, mainly due to a specimen mixup or accidental contamination in the lab.
Health experts also suspect prolonged positives may be linked to deficiencies in the immune system.
Take Mark Jorgenson, for example, who was aboard the Diamond Princess cruise ship mid-February when one of the first COVID-19 outbreaks outside of Wuhan struck. Upon returning to America, Jorgenson who takes immunosuppressant drugs after two kidney transplants tested positive for COVID-19 on Feb. 23.
If You Take Part In Asymptomatic Testing
People in England who do not have symptoms of COVID-19 can take part in regular testing using LFD tests. Asymptomatic testing can help to identify people who may have COVID-19, but are not feeling unwell, so that they can take steps to reduce the spread of infection to others.
Asymptomatic LFD testing is most effective when tests are taken regularly, twice a week. More information on ordering LFD tests is available. If you test positive for COVID-19 by LFD test, you should self-isolate and follow this guidance. You should also request a follow-up PCR test.
LFD tests can be taken in 2 ways:
an assisted test is where the person takes the test themselves under the supervision of a trained operator, and this operator processes the test, reads and reports the result
a home test is where a person takes the test themselves and reads and reports their own result
If you have any of the symptoms of COVID-19, you should request a PCR test.
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How Do We Test For Covid Antibodies
When youâre infected with the virus that causes COVID-19, SAR-CoV-2, your immune system responds in a number of different ways.
One important response is to produce antibodies – these are special molecules in your body that recognise the virus and help to get rid of it, and provide protection against future infections.
One way of telling whether someone has been infected with COVID-19 is to look for the presence of virus-fighting antibodies in their blood.
There are two types of antibodies that we can test for:
- Anti-N tests look for antibodies that recognise a molecule inside the SARS-CoV-2 virus called the nucleocapsid . Anti- N antibodies are only produced if youâve actually been infected with COVID-19 .
- Anti-S tests look for antibodies against the spike protein on the surface of the virus these antibodies can be present after both a natural infection and a vaccine. This is because COVID vaccines are based on the spike protein.
If You Need Medical Advice
Health and care services remain open to help people with all health conditions, including COVID-19. Most people with COVID-19 will experience a mild illness which can be managed at home. Find out more about managing the symptoms of COVID-19 at home.
All routine medical and dental appointments should be cancelled while you are staying at home. If you are concerned or have been asked to attend in person during this time, discuss this with your medical contact first .
Seek prompt medical attention if your illness or the illness of someone in your household is worsening. If it is not an emergency, contact the NHS 111 online COVID-19 service or NHS 111 for other health conditions. If you have no internet access, call NHS 111.
If it is a medical emergency and you need to call an ambulance, dial 999. Inform the call handler or operator that you or someone in your household has COVID-19 or symptoms if that is the case.
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How Do Vaccines Compare To Natural Immunity
Immunity to COVID-19 can be acquired in two different ways, either through natural infection or vaccination. Both will allow the body’s immune system to produce antibodies that are necessary to fight the disease, but they are not entirely the same.
Natural immunity confers some short-term protection against infection, but data now clearly shows protection from natural immunity is not as long-lasting as from vaccination, Amber D’Souza, PhD, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health, tells Verywell. Among those who have had COVID, the risk of getting COVID again is higher among those who did not get vaccinated, than those who got vaccinated.
A recent Centers for Disease Control and Prevention study shows that unvaccinated people who were previously infected are more than twice as likely to get COVID-19 again compared to those who are fully vaccinated. This suggests that vaccine-induced immunity may be greater than natural immunity. Additionally, antibodies acquired from vaccines may be more likely to target new virus variants.
However, Albert Shaw, MD, PhD, Yale Medicine infectious diseases specialist and professor of medicine at Yale School of Medicine, tells Verywell that there is a lot of variation in the immune response from infection to vaccination. It can be difficult to compare the two.
Who This Guidance Is For
It is important that we all take steps to reduce the spread of coronavirus infection in the community to save lives and protect the NHS.
This guidance is for:
- people with symptoms that may be caused by COVID-19, including those who are waiting for a test
- people who have received a positive COVID-19 test result
- people who currently live in the same household as someone with COVID-19 symptoms, or with someone who has tested positive for COVID-19
In this guidance a household means:
- one person living alone
- a group of people living at the same address and who share cooking facilities, bathrooms or toilets, or living areas. This may include students in boarding schools or halls of residence who share such facilities
- a group of people who share a nomadic way of life for example those who live on Traveller sites, in vehicles or on canal boats
This guidance applies in England.
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What Happens After You Recover From Coronavirus 5 Questions Answered
Even with the current inflated mortality rates, most people will recover from coronavirus.
Studies differ on how long recovered patients will remain infectious.
There have been isolated cases of reinfection, but questions linger.
The vast majority of people who catch COVID-19 will make a complete recovery. But this brings new uncertainties about how quickly we can expect to regain health and what our ongoing social responsibilities might be.
Talk of recovery might seem premature for Europe and the US, who are entering the virus peak phase, but the first wave of convalescents is coming through. Chris Gough, an anaesthetist from Oxford, UK, was one of these thousands, tweeting about emerging from this frightening experience: Day 6: Feeling a little better. Or, thought I was, but then fell asleep on the sofa for an hour. Still no desire to leave the house. Hoping tomorrow will bring much more energy.
On the other side of the curve, China where on 20 March there were no new cases reported can show the way towards beyond the coronavirus. Here are five key recovery questions:
Boosters Are The Primary Way The Government Plans To Tackle The Virus Over Winter As Data Shows Vaccine Efficacy Does Wane A Little And You Can Catch Covid Twice
The Government has announced that it will start offering booster Covid-19 vaccinations, with the first appointments expected next week.
All those who are clinically extremely vulnerable and anyone aged 16 to 65 in an at-risk group for Covid-19 will also be eligible for a jab.
These boosters are the primary way the Government plans to tackle the virus over the winter months, as data has shown that efficacy of the vaccine does wane a little over time and that it is also possible to catch Covid-19 twice.
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Its Also Not Clear How This Affects The Length Of Time Youre Contagious So Social Distancing Remains Vital
A recent small study from the Korean Centers for Disease Control and Prevention did suggest those who re-tested positive after recovering werent found to be spreading the illness. Researchers discovered that the patients were shedding dead virus particles, which cannot infect others.
More research is needed to fully understand the timeline, but the study is a is promising. Especially since post-recovery shedding has generally been under-researched, not just with COVID-19 but other infections as well.
According to Winslow, people could also generally be less contagious after theyve recovered than they were at the start or peak of their illness because of their lack of symptoms. It makes sense, given at the very least youre not coughing or sneezing as much, therefore youre not emitting respiratory droplets as easily.
For the most part, the infection seems to vary from person to person. People do shed the virus for a couple of days before they display symptoms and then theres also a number of people that really never get that symptomatic and yet can still probably shed the virus for several days if not longer, Winslow said.
This is exactly why social distancing and sheltering in place are so critical right now. The goal of these measures is to drastically decrease the transmission from either minimally symptomatic or asymptomatic people, Winslow added. We just dont know who is spreading the virus and how much.
A HuffPost Guide To Coronavirus
Unvaccinated People Are At High Risk For Getting Covid
Think you dont need to get vaccinated because youve already had COVID-19? Think again.
This virus can overcome a persons host immunity and cause a second infection, Dr. Esper says. Reports indicate that vaccination provides longer protection than natural infection.
Hes referencing a study that shows that unvaccinated people are 2.34 times more likely to be reinfected with COVID-19 than those who are fully vaccinated which drives home the importance of being vaccinated, even if youve already had the virus.
Almost all the cases that were seeing right now are people who have not been vaccinated, he says.
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Super Immunity From Breakthrough Infection After Covid
Can breakthrough infection after being fully vaccinated against Covid-19 really give you whats … being called super immunity on social media?
A breakthrough Covid-19 coronavirus infection may not be super to have. But can it actually give you whats being called super immunity on social media? In other words, can a severe acute respiratory syndrome coronavirus 2 infection after being fully vaccinated against Covid-19 bring you even greater protection? Well, a research letter just published in JAMA offered a small window into this super possibility.
If you search for super immunity on social media you will find plenty of posts such as the following:
Youll also find mention of the study described by the JAMA research letter. For example, Monica Gandhi MD, MPH, a Professor of Medicine at the University of California, San Francisco and HIV researcher, used the terms hybrid immunity and super immunity when tweeting about the study:
Healthcare workers at the Portland Veterans Affairs Medical Center receive COVID-19 vaccinations in … Portland, Oregon
Again, this was a limited study. Size does matter in such cases. While 52 may seem like a large number when it comes to bowling balls in your pants, it is rather small for a clinical study. Such a small sample size cant account for the variation that may be seen among different people and circumstances.