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REINFECTION means Vaccination May Not Be the Way to Eradicate COVID

Reports from Hong Kong of the world’s first documented Covid-19 reinfection have scuppered many countries’ strategies for ending restrictions. Reinfection implies immunity is short-lived, which could spell ruin for vaccine hopes.

Hong Kong scientists announced the reinfection on Monday, along with details of the man in question. He is a 33-year old Hong Konger recently returned home from Europe. Crucially, he is said to be in good health; presumably that means he is asymptomatic.

The man first had COVID in March, but only for three days. He left hospital after testing negative twice in a row for the virus – considered to be clear evidence that a person is no longer infected. Moreover, we know it is not the same case of COVID carried over, because the genetic sequences of the coronavirus were different in each of the man’s cases.

Really the first time?

But just as the first Covid case was unlikely to be the first human anywhere in the world to really contract the virus, there is no reason to believe that reinfection has not happened many times before now.

And in fact, within a day of the news from Hong Kong, a second apparent case of reinfection has arisen, this time in Russia. Sholban Kara-ool, the leader of Siberia’s Tuva Republic, was taken ill on Tuesday with an apparent second bout of Covid symptoms. Interestingly, and unlike the Hong Kong man, Kara-ool is experiencing symptoms, albeit different ones than he did the first time.

Individual cases aside, reinfection still appears to be the exception rather than the rule, and the WHO says that reinfection is rare. That said, the question is far from settled, and there is no telling how many new reinfection cases could soon materialise. But what does proof that reinfection is possible mean for getting back to normal? And in particular, what does it mean for the efforts to develop a vaccine?

Back to the drawing board

There is no question that if reinfection is a common event, it renders useless the ‘lock down indefinitely until there’s a vaccine’ strategy. (Perhaps that is why the news from Hong Kong has not been given much of a signal boost, in contrast with minor procedural updates on the dozens of vaccine projects.)

If a person’s natural immunity wears off after a few months (as is the case with other coronaviruses) then there is strong reason to suspect that immunity conferred by a vaccine would, too. Vulnerable people petrified of Covid would have to be injected twice a year just to have the courage to go out in public. What most people have been envisioning is a one-off vaccination that will put an end to this disaster. But that dream is vanishing quickly, as the similarity of SARS-CoV-2 to its coronavirus cousins becomes clearer.

It is worth reminding ourselves that coronavirus restrictions, including social distancing, business closures and travel bans, are only done on the proviso that there will be available (before too long) a vaccine capable of conferring the unexposed masses with long-lasting or permanent immunity. If we could peer into the future and see that, like AIDS and all other coronaviruses, SARS-CoV-2 will never have a vaccine, then we should of course return to normal at once. Only people’s immune systems can save them under those circumstances.

Similarly, if the notion of a one-off vaccine as envisaged by most people is stillborn, then all coronavirus restrictions are rendered pointless. On top of the ideas bonfire can be thrown COVID passports (immune people don’t stay immune), cocooning the elderly, and even herd immunity.

No new normal

With reinfection disappears the last ray of hope for the politicians who still want to put this behind us. Now, there may not be a way – not even a theoretical way – to return to any semblance of normality based on their depiction of the outbreak.

Therefore, this will never end until their depiction is reconsidered. That should be easy, seeing as it often bears only a spiritual connection to the basic facts. But the notion that COVID is dangerous by historical standards, or even by modern ones, is almost totally ubiquitous in the echelons of power. Those echelons have thus far only shown us one path out of this mess, though, and it centered on a comprehensive vaccine roll-out as soon as possible. If that path is no longer clear, then what are we all supposed to be hoping for? 

Peter Andrews, Irish science journalist and writer based in London. He has a background in the life sciences, and graduated from the University of Glasgow with a degree in genetics.

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