There’s been lots of debate over how we should always take into account COVID-19 threat nowadays, three years after the World Well being Group declared a world pandemic. Masks mandates have fallen in some cities and public areas (although some areas or companies could require them), public well being officers are contemplating an annual simplified vaccine technique within the US and World Well being Group officers this week mentioned folks in higher-risk teams, not these of medium or low threat, ought to be the precedence in vaccine plans transferring ahead. 

These creating plans mirror a brand new state of the pandemic, as soon as the emergency expires within the US in Could, and a brand new option to deal with COVID-19, which has been circulating in varied types of omicron since late 2021. Whereas the burden of COVID-19 is simmering at a lot decrease ranges than earlier within the pandemic, the truth that the virus remains to be round making folks sick will finally spur the query (if it hasn’t already): What occurs whenever you get COVID-19 once more? 

COVID-19 reinfection occurs when you could have the virus for a second, third or fourth time, or extra. Whereas confirmed instances of it have been comparatively unusual within the early phases of the pandemic, many individuals have gotten COVID-19 greater than as soon as, or will get it once more sooner or later.

Here is what the consultants say about immunity arising from previous infections and vaccines, what it’s best to know concerning the threat of lengthy COVID after one other bout of COVID-19, and extra.

How lengthy does COVID immunity final?

A meta-analysis of 65 research printed in The Lancet in February discovered that safety towards extreme illness from prior an infection with COVID-19 is excessive with all previous variants, whereas safety towards reinfection, or getting sick once more, was decrease and declined fairly quickly with the omicron variant (BA.1). Maybe most significantly, the examine discovered that safety towards extreme illness for COVID-19, usually, remained excessive for 40 weeks (10 months). 

Dr. Christopher Murray, director of the Institute for Well being Metrics and Analysis and creator of the evaluation, says that whenever you speak about COVID-19 immunity, you have to take into account it as two elements: safety towards extreme illness, and safety towards an infection. 

Whereas safety towards getting contaminated with COVID-19 once more after you have already had it’s “not nice,” Murray mentioned, “immunity to stop extreme illness and demise is de facto fairly good.” 

Somebody’s threat of extreme illness or being hospitalized with the virus will rely upon various factors, together with their age (older adults have the best threat) or medical situations. However when it comes to your particular person immunity, be aware of the final time you had your immune system stimulated towards COVID-19. 

“The important thing factor to the person is to recollect when was the final vaccination you have had, or the final time you have been certain you bought contaminated,” Murray mentioned.

“We all know there’s sustained immunity for at the very least 10 months,” he mentioned, referring to safety towards extreme illness. “That’ll let you know when the clock begins ticking about immunity.” 

What’s modified in the way in which we take into consideration immunity?

“I feel now we’re seeing the worth of pure immunity that we did not know a 12 months or two in the past,” mentioned Dr. Mike Sevilla, a household doctor who practices in Ohio. “The inhabitants usually has already been uncovered to the COVID virus in a technique or one other,” Sevilla added, whether or not it was from the vaccine, an an infection or each. 

It additionally seems we have formally mentioned “goodbye” to the thought of herd immunity — the idea that sufficient of the inhabitants having immunity would additionally work towards COVID-19 and would cease its unfold. 

“You are not gonna cease the transmission of the virus simply by lots of people getting contaminated or vaccinated,” Murray mentioned. “That is a fairly large change in considering from two years in the past, I would say.” 

Are signs worse whenever you get COVID once more? What about lengthy COVID?

As a result of the variant somebody is contaminated with can partly decide the severity of their sickness, how sick somebody will get with a reinfection may rely upon whether or not they have been contaminated with a model of omicron or an earlier variant, in line with Sevilla.

“It actually depends upon after they had their an infection, versus whether or not they had it two or 3 times,” he mentioned. 

In response to the US Facilities for Illness Management and Prevention, signs throughout your reinfection with COVID-19, in comparison with the primary sickness, are prone to be much less extreme. Nevertheless, some folks get extra extreme sickness, the company notes. Testing, therapy and isolation pointers throughout your second or third COVID-19 an infection are additionally the identical as on your first.

Lengthy COVID is a lingering situation that ends in somebody experiencing lasting signs or psychological or bodily adjustments after their physique has cleared the an infection. Does getting contaminated once more improve the chance for lengthy COVID?

“It is exhausting to reply that one, however now we have seen a fairly robust hyperlink between severity and threat of lengthy COVID,” Murray mentioned. That’s, individuals who must be hospitalized or get very sick with the virus have a better threat of lengthy COVID usually. 

In response to an article by the American Medical Affiliation, every time you get COVID-19, your threat for creating continual well being points, together with organ harm, goes up. Harm to completely different organs within the physique is without doubt one of the many various methods lengthy COVID impacts folks. 

Researchers who printed a giant evaluation on lengthy COVID earlier this 12 months in Nature Opinions Microbiology wrote that early analysis suggests an growing threat of lengthy COVID signs with reinfection, however that early proof additionally exhibits a flipped relationship with sure immune responses in folks with lengthy COVID probably making them extra prone to getting the virus once more.

What medical doctors need folks to find out about COVID threat 

“We’re positively in a greater place, public health-wise, than we have been at first of the pandemic,” Sevilla mentioned, including that his focus is on his older and higher-risk sufferers, which embrace folks with diabetes, coronary heart illness and people who survived most cancers.

Murray says that for a lot of adults who haven’t got a well being situation that places them at larger threat of extreme illness, the impact of COVID-19 is milder and resembles influenza — a stark distinction to earlier phases of the pandemic when COVID-19 was rather more extreme, Murray added. However COVID-19 nonetheless doesn’t have a flat threat profile.

“The very aged are nonetheless at excessive threat, and in the event that they have not lately had a booster or been lately contaminated..then that is an actual threat,” Murray mentioned, noting that people who find themselves immunosuppressed also needs to “err on the facet of nice warning” when contemplating how a lot time has handed since their final vaccine or an infection. Up to date boosters that focus on the omicron variant can be found for kids and adults, so long as it has been at the very least two months since your final shot. (Be taught extra about staying up-to-date on COVID-19 vaccines on the CDC’s web site.) 

“Folks want to vary their mindset,” Murray mentioned. “It is not ‘you bought vaccinated, you are accomplished’ or ‘you bought contaminated, you are accomplished.’ Hold monitor of whenever you final had one thing that stimulated your immunity.” 

Older adults and folks with sure medical situations are additionally eligible for remedies together with Paxlovid, which cuts the chance of being hospitalized or dying in high-risk sufferers. You probably have signs of COVID-19 or get a optimistic take a look at, and you’re at excessive threat of extreme illness, attain out to your physician or pharmacist as quickly as potential to see your therapy choices. As outlined in a Medscape submit by Dr. Eric Topol, editor-in-chief of the publication and government vp of Scripps Analysis, the individuals who want therapy probably the most is probably not getting it. 

The truth that COVID-19 has develop into a extra manageable illness for many individuals partly displays that we’ve not had a considerably new variant since late 2021 or early 2022 when omicron grew to become dominant and began mutating into completely different (and extra contagious) variations of itself. Murray says that the chance for a brand new dominant variant which causes extra extreme illness or has immune escape (will get round safety from vaccines or previous sickness) is there, and can be “very regarding.”

However comparatively talking on the variant entrance proper now, Murray mentioned, “We’re doing nicely.”