It's Reinfection Time
This is an extra post because I felt like it was urgent. If you have ever considered forwarding one of my newsletters, please forward this one.
Here is my now ritual disclaimer. I’m still not an epidemiologist. And I really underestimated the severity of COVID when it first emerged. The analysis that follows is expert-ish, not expertise.
It’s reinfection time. I am seeing this in the data and I am seeing this in my own life. I’ve had five or six friends get their second COVID infection just in the last week, and I’m not the only person noticing the phenomenon. Some of this is because people had their first infection a year or two ago, and they have jobs that require lots of human contact. Their lives involve exposure and sooner or later a second infection was bound happen. (I wrote about this last month)
There is also a more ominous reason, and this is where we go from anecdote to data. The new virus variants aren’t being held off by antibodies the way they used to be. A prior COVID infection isn’t much protection any more. To quote the most excellent Katelyn Jeffries, “...lab studies show Omicron escapes infection-induced immunity, too. We are particularly worried about recent BA.1/2 infections (first Omicron waves)...Another study found BA.1 or BA.2 infection among unvaccinated people induced very low levels of antibodies against BA.4/5.” The rest is in her newsletter where she links the original source data. I also noticed this recent article in The Lancet.
So that would explain my friend in Texas who got COVID in May and then again in June.
Being vaccinated still offers some protection. Having previous COVID still offers some protection. Both a vaccination and a previous infection together offer the most protection. (This does not mean you should get infected on purpose for protection. Getting a COVID infection to protect against COVID infection is extremely stupid. Yes people really do this.)
If vaccination (and boosters) alone doesn’t protect you, and vaccination and a prior infection don’t protect you, what do you do? Well, this newsletter has a name for a reason.
You can think of COVID like hypothermia. You don’t protect against hypothermia by putting just a coat on, or a coat and a scarf. You put on a coat, and a scarf, and gloves and hat and boots. You avoid spending long periods of time in bitter cold. You make sure your house has heat and insulation and you put a blanket in your trunk in case the car breaks down.
So for COVID, you put on your vaccination coat, and your booster scarf and hat. But you also wear your mask (boots, maybe, in this metaphor?) and you avoid spending long periods of time in crowded environments. You make sure air circulation is good in the places you linger.
For the love of all that’s holy, you do not eat in restaurants indoors.
It’s not that vaccination doesn’t work against COVID, any more than a coat doesn’t work against hypothermia. It’s that it doesn’t work alone.
This news on reinfection is disappointing. Everyone’s coat has less insulation than we thought. That means we have to work harder on the other layers of protection. Take care out there.
Note: the science on this is evolving very fast. If you look at articles that are a year old, we were still predicting that natural immunity could last for years or even a lifetime. Those were predictions, and we predicted wrong. What we are measuring now is actual antibody protection in the lab and then reinfection rates in human populations. This is not a prediction - this is a measurement. Describing the future according to this measurement would be a prediction again.