Science Vs - Coronavirus: Can You Get It Twice?

Episode Date: April 17, 2020

We’re hearing stories of people getting this coronavirus, recovering, and then getting it again. So what’s going on: Does getting this virus give you immunity or not? To find out, we talk to virologist Dr. Kirsty Short of the University of Queensland and Dr. Robin Berzin of Parsley Health. Here’s a link to our transcript: https://bit.ly/3ajK5om This episode was produced by Meryl Horn, Wendy Zukerman, Michelle Dang, Rose Rimler, Sinduja Srinivasan and Laura Morris. We’re edited by Blythe Terrell and Caitlin Kenney. Fact checking by Michelle Harris. Mix and sound design by Emma Munger. Music written by Peter Leonard, Emma Munger, and Bobby Lord. A big thanks to all the researchers we got in touch with for this episode, including Dr. Marion Snyder, Professor Ann Sheehy, and Dr. Helen Petousis-Harris. Thanks also to Kyle Gunderson, Nora McKenna, Mike Pendleton, Hannah Wei, and Matt Weinberg. And special thanks to the Zukerman family and Joseph Lavelle Wilson. Learn more about your ad choices. Visit podcastchoices.com/adchoices

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Today on the show, if you've been sick with this coronavirus and you recover, are you safe or could you get it again? And this is something that a lot of people are wondering, including Matt. He lives with his wife and two kids on Long Island. And about a month ago, Matt started feeling sick. I got a fever, chills. I was freezing cold. Even though I pumped the heat up way high in my house, I was just freezing. Matt eventually got tested.

And yeah, he had coronavirus. And Matt and his family knew that if one of them had it, someone else might get it too. And that's exactly what happened. The same day that Matt got his test results back, his six-year-old daughter got a fever. We called her doctor, her, you know, her pediatrician, and the pediatrician said, well, you know, presumably she has coronavirus because I, you know, I have coronavirus. And we said, all right, what do we do? And the pediatrician says,

well, there's no cure. There's really nothing you could do. Give her Tylenol for the fever. Keep an eye on her. And if she stops breathing, call an ambulance. And you're like, okay. Those are the two things, you know? Like, keep her at home or she can't breathe. That was really scary, to be honest with you. Luckily, it never got that serious.

After a couple of weeks, Matt was feeling better. His daughter was too. And Matt figured, well, once they started to shake this, it would all be over. That was until he came across an article in the New York Times. And he thought, wait, what? It was a study that was talking about people that had tested positive for coronavirus, and then all their symptoms went away, and I think they even may have tested negative. And then they were tested a couple weeks later, and they actually were testing positive again. And it was confusing. And it felt like this huge bummer to Matt,

because he was already thinking about the things that he could do if he couldn't get sick again. Really, the first thing I wanted to do once I got better was, you know, presumably I can go grocery shopping for our family. If I am like Superman now, in a way, I should be able to go without getting sick. But actually, maybe that's not the case. So it's very frustrating and confusing, actually. It feels like you're in limbo a little, right?

Exactly. Like, what is that? Exactly. My wife and I were discussing this and saying, well, you know, if we know that we know for sure that I had it, right? And my daughter. And if presumably my son and my wife had it, but we don't know. But if we could get them tested with antibody tests and know that they had it and know that we were all effectively immune, we could go about our lives a bit. We could be part of the first group of people that kind of like goes back to work and

goes back to school and starts getting our lives back. And I know that that's what's needed. Well, that only works if you're immune. But if we're not that, then it's just, I don't really understand how this ends. If people don't get immune, how does the cycle end? So today on the show, once you've been sick, can you get this virus again and again? When it comes to this coronavirus, there's a lot of people saying, you're like, oh, okay. But then there's science. Okay, so to get to the bottom of this question of whether people who recovered from this virus can get sick again, I called up Kirsty Short, a virologist from the University of Queensland. She's currently studying the coronavirus and she's also one of my old pals from Australia.

Hello. Hello. Hello, how are you? Good, good. We can hear the birds in the background. Can you see them from where you are? Let me have a look out my window. What have I got? I've got a bush turkey, which is a weird, ugly thing that doesn't make any noise. And I've got a kookaburra. Oh, I'm so jealous. A kookaburra. I saw a pigeon today. Okay. So the first thing we wanted to talk to Kirsty about was why, generally speaking,

we don't get sick with the exact same virus over and over again. So one of the first things your immune system does when it fights a viral infection is start making these little proteins called antibodies. And we've been hearing a lot about antibodies in the news. So let's dive in and really understand how they work. It helps to picture them. Yeah. So, I mean, antibodies themselves, they essentially look like a Y. You can imagine them like a person holding their arms up doing a Y, as in YMCA. Okay, so say you have a virus entering your blood. Producer Meryl Horne talked to Kirsty about what happens next. You have the virus going around, the antibody

sees the virus, and the two arms of Y bind to the virus. Kind of sounds like lots of little hugs. I mean, I don't know if I'd call it hugs. Okay, so it's not exactly a hug. Rather, these antibodies grab onto the virus. And when they do that, the virus can't infect cells. Now, while the antibodies' little arms are grabbing onto the virus, it's also alerting other immune cells who are like... Saying, hey, this is a virus. Quickly, let's destroy this.

And they'll basically engulf that virus. So they'll literally eat the virus and destroy it. See, immunology is badass. Ultimately, the virus dies. And Kirsty says, we win the battle. I mean, that's how you've got to think of your immune response fighting viruses. It's all a battle.

It's all a battle. So that's how our It's all a battle. It's all a battle. So that's how our immune system wins the battle. And here's how we win the war. The war against future infections. You see, some antibodies stick around, hiding away in your blood. They will persist in your body. So that means if you're re-exposed to the virus, these cells are already in place. These antibodies are literally lying in wait for their nemesis, that one virus to come back. And if it does, these antibodies kick into gear. Your body starts making more and more and more of them until they destroy the virus, before you've had a chance to get really sick again.

So that's how your body typically uses antibodies to fight infections. But the big question is, does this virus follow the rules? Many of us have heard stories, like what Matt heard, about people seeming to get sick again straight after they got better. So is this virus different somehow? Well, there are some early promising signs to suggest, no, this virus isn't different. So around the US, labs are looking for antibodies

in the plasma of recovered coronavirus patients. They're doing it because they basically want to use it for an experimental treatment for really sick patients. We reached out to two of these labs, including one at Stanford University, and they told us that in testing several hundred patients, they found that virtually all of them had antibodies against this coronavirus.

Several preliminary studies have also come out showing that most people who recover are making antibodies. And on top of all that, we have evidence from a very small study where scientists infected monkeys called macaques with this coronavirus. And here's what happened. And what they saw is if they infected these macaques, they got sick, but they eventually recovered. And they infected these macaques, they got sick, but they eventually recovered. And from the recovered macaques, they took two and they reinfected them 28 days after

the initial infection. So after this reinfection, the two macaques, they didn't really show much signs of the disease. They didn't have any virus replication. They didn't get sick. So that was suggesting that they were protected from reinfection. But amidst all of this, there is a hiccup, one that's been getting a lot of attention. You see, two of the studies that we have seem to

be showing that not everyone who gets this coronavirus is pumping out antibodies. Like one study, which just came out, looked at 175 patients a few weeks after they got sick, and around 30% of them had very low levels of the antibodies that they were looking for in the study. And in a handful of patients, the researchers couldn't detect any antibodies at all. Were you surprised to read that? Yes and no. I mean, I guess my big consideration with these studies is that they're measuring antibody responses. So that's one arm of the

immune response. And we think it's really important, but it's also not the only aspect of your immune response. I like that you said that like a proud parent. You were like, you're very important, but there are siblings that also matter. You don't want to offend anyone. People dedicate their lives to studying antibodies. Antibodies are very important, but they're not the only aspect of your immune response. Kirsty says that while antibodies tend to get all the attention with their Y shape and their cute hugging thing, which isn't actually a hugging thing, there's a bunch of other pieces to our immune system that play an important role in whether you can get sick again and again and again. Like there's these cells that are basically

assassins. They can find and destroy viruses that they've seen before. It's something called a killer T-cell, which funnily enough is actually Dr. Anthony Fauci's DJ name. Killer T-cell. Another reason that we might not have to worry about these people who seem to have very low levels of antibodies is that we know that typically when people get reinfected with viruses, their body makes more antibodies. It's like they see the virus and then call in the fighters so their antibody count could bump up again. To me, it doesn't suggest any point of concern yet to say that, oh my gosh, we're going to keep getting reinfected and we're never going to get rid of this pandemic. I don't think that that's what this study is implying. It's more that, okay,

it's not as black and white as you get infected, therefore you get a very high antibody response. Okay, so far, so good. But then how do you explain these stories that Matt heard about people getting tested for this coronavirus, recovering, but then testing positive again? What's going on there? That's coming up after the break. Welcome back. We've just talked about how, so far, it's looking like most people who recover from this coronavirus do pump out antibodies, just like we'd expect.

But this can't explain the curious stories that are swirling around of people who got better, got a test showing they're negative, and then weeks later, got a positive test. So what's going on there? Yeah, I think we need to interpret these results with a little bit of a grain of salt. That's Kirsty Shaw from the University of Queensland again. And Kirsty says that what scientists think is happening in these cases isn't people getting reinfected, but rather crappy tests. You see, these tests work by swabbing way up someone's nose, looking for little genetic bits of the virus.

And research is showing that sometimes the tests can miss the virus when it is actually there. So that means that potentially these individuals, they were recovering from the virus, they were given this false negative result, and then they came back, tested again, and the swabbing was just a bit more accurate and they detected virus. So that's not a true reinfection. Several studies in hospitals have come out showing that some patients are getting these flip-flopping test results. And these studies are saying, yeah, it's the bung testing.

And even though we're in the early days with this virus and the data we have is preliminary, one final thing to think about with this is that if you really could recover from this coronavirus and then get it again right away, it would make this virus a super weird outlier. Because that's what I'm trying to like work out, like what are the chances that this virus,

that like this headline virus that everyone is thinking about, like what's the chances this is the one virus that happens to have this like evil magical quality that it can reinfect you really quickly after the fact? The chance of that seems low. I would say the chance of that is very low. One thing I've learned as a virologist is you can never say never because viruses are constantly surprising me. But I would say that the odds of somebody getting an

infection, recovering, getting a good immune response, and then for that to wane within two months such that they get reinfected and get a similar course of disease as the first infection is very, very, very low. I would be incredibly surprised if we saw that. So all of this is a bit reassuring. It looks like you probably won't get this virus again straight after you recover from it.

But that doesn't mean you're safe forever. There are big questions about the long term here. We know from other viruses, like the flu, that we can get them, fight them off, and then end up getting walloped by them, say, a year later. Whether this will happen with this coronavirus is a big thing that bugs scientists like Kirsty. Where people are starting to worry is if it's six months, if it's a year,

you know, is the immune response going to persist for that long? And it makes sense that we don't know what's going to happen in the long term. Simply because this is a new virus and we only have records of it in the human population since December last year. OK, so we can't know how long our immunity might last for with this coronavirus. But what we can do is look at other viruses for clues. And this has led us to a few possible scenarios of how things might go down. Let's go through them.

The first one is basically the worst case scenario. It's what we're going to call the flu scenario. In this one, we do get immunity to this coronavirus, but then the virus mutates and it changes enough to outfox our immune system. There's other viruses where, like the flu, where if we've had it, you can still get the flu again next year because the strains of the virus change very quickly over time. That's Robin Burson, a doctor in New York City treating coronavirus patients. She used to work at Mount Sinai Hospital. And Robin says that in the future, we'll be looking to see if this virus not only mutates, but whether the virus will change so dramatically, so quickly that it'll be like our

bodies are seeing a new virus over and over and over again. Now, the flu has this evil superpower to hit us again and again because it mutates a lot and not all viruses are like that. Researchers have actually started to work out how fast this coronavirus is mutating. And they're saying it's a bit slower than the flu, which is promising. It suggests that perhaps this scenario won't happen. Now, onto our scenario two. We'll call it the best case scenario, that we could get immunity that lasts for years and years, and we never have to worry about this piece of s**t again. So there's certain viruses that we have, like the chickenpox, for instance. The chickenpox, having had it as a kid, for those of us like me who had to have it as opposed to having a vaccine

for it, and I remember the welts all over my body, that is one where if you've had it, then you are immune to it for a long time. Robin says that sometimes when we get older, this virus can come back as a different disease called shingles, but... Overall, the chicken pox is one where if you've had it, you're not going to get it again. So in the case of chicken pox, our antibodies and immune cells do a good job of protecting most of

us from getting sick again from it. Okay, our third and final scenario. We're calling this new phone. Who dis? In this scenario, you can still get infected when this virus rolls around again, but you won't get so sick the next time. This can happen with some milder coronaviruses. So for example, a study from Kenya looked at almost 50 people who got infected with one of these coronaviruses for two years in a row. And the second time, fewer of them had nasty symptoms. And here's why this can happen. If the virus isn't around you, your immune cells kind of forget they've fought this virus before and they can die off. It's kind of a use them or lose them situation. Here's Kirsty again. So that's why when we have vaccinations, some vaccination schedules,

they do a booster dose, right? You've probably been told you might need a tetanus booster. And that's because the cells that are making the antibodies tend to die off because they just don't remember what they're meant to be making antibodies to. Like with SARS, for example, one study looking at the antibody responses of around 170 people who got sick found that their antibodies dropped a bunch after three years. But Kirstie says the idea is that if you do get infected again, those antibodies that are left behind, they'll be like, oh yeah, I totally remember that. Okay. When this happens, your immune system pumps out more and more antibodies. And because it jumps into action faster, the idea is that you get less sick this time around. So it's better than nothing because

you're still going to be quicker than if you didn't have any cells present, but it might be not as quick as if you had complete immunity. So that's why you might get some really mild symptoms because the virus replicates a little bit and then your immune system kicks in really quickly. And that would mean if, say, she got coronavirus and recovered. So I wouldn't consider myself immune as such that I would be invincible, but I would be very hopeful that that potentially means that if you did get reinfected, it would be at worst a mild disease. So those are the three scenarios. Best case, it's like chicken pox. One and we're done. Worst case, it's like the flu. We have to deal with this every year. And then finally, new phone hoot is. The idea

that you could get it again, but it won't be so bad the second time. And the truth is, we just don't know what this is going to be. Okay, so given all this uncertainty, I wanted a gut check on what this means for the idea that we should all be getting antibody tests. These tests are getting rolled out in the US right now and elsewhere around the world. And there's talk of them being used as some kind of immunity passport so that if you've got antibodies,

you're clear to go to work or hang out with your other recovered friends. of them being used as some kind of immunity passport so that if you've got antibodies, you're clear to go to work or hang out with your other recovered friends and it's all safe. But is it that simple? I think it's a little bit more nuanced than that. We don't know how long that immunity lasts for. If you were antibody positive three months ago, you know, are you still able to go back to work or do you need a regular antibody test? It becomes a little bit complicated. So whether or not they're going to be this sort of easy solution for reopening and deciding who's safe and who's not, I don't think it's going to be that black and white. Okay. So big picture. So the question of whether you can get reinfected with this coronavirus, the answer is, it's complicated. Here's what we think about this.

Given what we know about viruses generally and the early data coming out about this coronavirus, we think that the majority of people who get sick and recover will get some immunity. And it's unlikely that they would get sick again soon after they recovered. The big emoji shrug, I don't know here, is how long that immunity would last. But really, only time will tell. And now for a bit of NCVC. Time for some non-coronavirus content. NCVC for short.

Hello, Science Versus producer Rose Rimla. Hi, Science Versus host and executive producer Wendy Zuckerman. So you've got our NCVC today. Yeah, I've got a good one. Ooh. Tell me, tell me, tell me. So last week, deep sea researchers announced that they have found what is perhaps the longest animal ever.

How long is it? It is 150 feet long. And in Australian, that's 46 meters. 46 meters? Yeah. What? How many elephants is that? How many giraffes is that?

I didn't come prepared with either giraffes or elephants, but I did look up blue whale. And it is longer than blue whales. Blue whales are at most 100 feet long. What? Tell me more. Who is this creature? Okay. It's called a siphonophore. Siphonophore? Yeah, you got it. Okay. It looks like a long, thin, translucent ribbon, basically. I can send you a picture. You want to see it? Yeah, I do. Whoa. It looks like a glowing piece of string. Yeah. Yeah, that's right. So what is this thing? It's kind of like a jellyfish. But the weirdest thing about it is that it's not just one animal. It's actually a

colony. Oh, it's made up of these little globby things. So after the first one is born, it makes a bunch of little clones of itself. And then they all live stuck together in this long chain. What? Yeah. And so like one of my favorite facts about siphonophores, aside from everything I just told you, is that most of them bioluminesce. They make their own light. And there's one that lives in the deep sea

that scientists discovered recently that puts out these little light-up flares in the darkness of the ocean. And it's thought that those flares are meant to lure fish to them to get gobbled up. Oh! Because it's not enough that these are communal, floating, light-up, goo animals. They're also predatory. And that's siphonophores.

Thanks, Rose. Thanks, Wendy. That's Science Versus. Hello? Hey, Meryl. Hey, Wendy. How many citations in this week's episode? We've got 88 citations.

88 citations. And if people want to see these citations, where should they go? Just look at our show notes and then follow the links to the transcripts. Thanks, Meryl. Bye. This episode was produced by Meryl Horne, me, Wendy Zuckerman, Michelle Dang, Rose Rimler, Sindhuja Srinivasan and Laura Morris. We're edited by Blythe Terrell and Caitlin Kenny. Fact-checking by Michelle Harris. Mix and sound design by Emma Munger. Music written by Peter

Leonard, Emma Munger and Bobby Lord. A big thanks to all the researchers we got in touch with for this episode, including Dr. Marion Snyder, Professor Anne Sheehy and Dr. Helen Petousas-Harris. Also a huge thanks to all the listeners at Science Versus who got in touch with us and who we spoke to, including Carl Gunderson,

Nora McKenna, Mike Pendleton, Hannah Wee and Matt Weinberg. And a special thanks to the Zuckerman family and Joseph Lavelle Wilson. I'm Wendy Zuckerman. I'll back to you next time.