Have you had COVID a second time? Or a third? If so, you are in good company.
New data from California’s public health department show that in the first three weeks of July there were more than 50,000 documented reinfections, accounting for 1 in 7 new COVID cases through the middle of the month.
And, as the Golden State approaches 10 million COVID cases since the start of the pandemic, the number of repeat infections is steadily climbing.
With highly contagious and immunity-dodging variants of the virus like the current king BA.5 battling for dominance, you can get COVID again just a few weeks after you recover.
San Jose Mayor Sam Liccardo joined the club this past week — two months after he first tested positive.
“Symptoms are minor, with intermittent grumpiness,” he tweeted Thursday. “My apologies to anyone I might have exposed in recent hours or days — please test and follow CDC guidelines.”
President Joe Biden’s positive test Saturday is different, a “rebound” of the virus, after testing negative for a few days, rather than a reinfection. His physician believes it is connected to a the anti-viral Paxlovid, prescribed to treat his illness after he tested positive July 21.
Reinfection data released for the first time by the California Department of Public Health in response to a request from this news organization show more than 350,000 reinfections in the past 46 weeks, with a significant climb since the first week of September during the delta surge when just about 2% of cases were known reinfections.
Over the years of shutdowns, social distancing, masking and vaccinations, we have done a lot to avoid getting COVID. But since early in the pandemic the silver lining of infection was a temporary hall pass of sorts, when you were unlikely to get the virus again regardless of your exposure.
Those who had tested positive and recovered had reason to feel protected for weeks and months afterwards.
“That probably wasn’t wrong before,” said Dr. Bob Wachter, chair of UCSF’s Department of Medicine, “but it’s clearly wrong now.”
Now, with a highly vaccinated population and the steady march back to business-as-usual, many have loosened their rules, relying more on the immunity provided by shots and previous infections. But those protections are waning, with time and with new variants.
“There’s a large group of people who had an infection who probably let their guard down,” said Wachter. “People have a hard time moving from their prior understanding to a new one.”
The new one? The immunity provided by previous COVID infections is becoming less meaningful at avoiding secondary infection, as back-to-back omicron variants have caused a prolonged peak of infections this summer. While it is unlikely to get the same variant a second time in less than three months, the rapid succession of new variants this summer made quick reinfections easier.
Sophie Meryash, an elementary school reading specialist in Oakland, has had COVID three times in 9 months. She and her girlfriend were very careful to avoid exposure until the summer of 2021 when they were able to get fully vaccinated. “We had a month of feeling euphoric,” said Meryash. But in early July, right before a vacation, she started feeling sick and tested positive.
“That was intense, we both had 102-degree fevers, lost taste and smell,” she said, and her symptoms lingered for a month and a half. In January, just a few months later, she started feeling sick again. Boom, a second positive test, at the height of the omicron surge.
When she got sick the third time, towards the end of the school year in March, she was not surprised. “I work in an elementary school,” said Meryash. “I’m around a lot of germs.”
She blames her place in the “thricer” club mostly on a weak immune system, and while her second and third illnesses were not bad, she is slightly concerned for herself and her colleagues with school starting again soon and the threat of new variants. “We are like petri dishes.”
Every day more people are joining the ‘”twicer” and “thricer” clubs: Over 14% of new COVID infections the week of July 16 happened among Californians who had already tested positive at least once, according to the most recent weekly data from the state.
During the first omicron surge this winter there were more than 45,000 reinfections in California in one week in January, the most reported in a week, but that was only 5.3% of all cases that week. Since then the percent of cases determined to be reinfections has nearly tripled.
But like all COVID cases, reinfections are an undercount. Only those who have taken a PCR test for each infection are counted in the state’s data, and we know that COVID cases are massively undercounted now that at-home rapid tests are readily available, and fewer of those infected are getting seriously ill.
“If 1 in 7 cases are reinfections, it begs for a new research agenda to understand the risk factors,” Wachter said, emphasizing that while the data show how frequently they are happening, we do not yet have good data on how severe these reinfections are, or how often they cause long COVID symptoms.
‘There is a silver lining,” said Dr. Peter Chin-Hong, UCSF professor of medicine and a specialist in infectious diseases, who thinks immunity might once again last months, if new variants come less quickly than the past few omicron variants did. “If BA.5 stays dominant, the three-month rule will kick in,” but the chances of that are uncertain, considering how quickly BA.5 followed BA.4 and BA.2.12.1 before that.
If you got COVID and recovered in the past few weeks, “you don’t have a get-out-of-jail-free card,” Chin-Hong warns, “but that does not mean you have to fear the virus, you just have to be aware, and test if you have symptoms,”
“After all, pandemics end at some point,” said Chin-Hong, “the population gets stronger and stronger.”