President Trump has claimed repeatedly that he might have become “immune” to the disease following his infection with COVID-19. There is an unmistakable political side to the claim; it plays down the seriousness of the pandemic as well as adds to the carefully crafted “strong man” image he has. Yet, the weight of those words is felt beyond politics. It reinforces some of the big misconceptions about the disease and can have real consequences for people’s lives.
One of these common misconceptions is, when someone gets infected with COVID-19, they develop immunity following recovery from the disease.
Dr. Mark Pandori, director of the Nevada State Public Health Laboratory, said a reinfection can happen and is a common knowledge among immunologists and virologists who work on immunity in the human body and infectious diseases.
“There is no special class of individuals here,” he said over a Zoom interview.
Pandori touched upon the fact that younger men and women seem to feel invulnerable because they feel the disease will not affect them as much as it affects old people.
Because of this faulty perception, a great number of young people are contracting COVID-19. Per Washoe County Health District’s records, people in the age range of 20-29 make up the largest number of active cases per 100,000 population. 
Young people are not invulnerable
In August, Pandori and his team found a case of reinfection in a man aged 25, with no significant underlying health conditions. He lives in Washoe County. The second time he tested positive for the virus, his symptoms were more severe and he had to be hospitalized with oxygen support.
Since then, there have been at least 12 recorded cases of reinfection around the world, Pandori confirmed.
This is a small number, yet it indicates that people, including the relatively younger ones with no serious preexisting health conditions, may get reinfected and the perception of individual immunity should be taken with a grain of salt.
Why does reinfection happen?
Asked why some people get reinfected where others don’t, Pandori explained what the medical team found in the reinfection case in Washoe County.
“The second virus had several genome alterations compared to the first,” he said. According to Pandori, the genome changes imply that this was a different type of coronavirus and may be why it was able to avoid immunity.
Another possibility is “the overwhelming of the immune system” by exposure to a large amount of coronavirus.
The third possibility is when a virus uses the antibody, the body’s defense against pathogens and viruses, to enter the immune cells. When infected with a virus, antibody and immune cells initiate a process to kill the virus. But certain viruses like dengue fever, yellow fever, Zika, HIV and coronaviruses prevent that process by using the antibody like a Trojan horse to breach the immune cells. The science term for this is antibody-dependent enhancement. The antibody “chaperones” the virus into the immune cells, said Pandori. SARS-CoV-1 (known more widely as SARS) tricked the immune cells in the same way, he added.
Scientists will need to test many more such cases of reinfection to understand why it happens, he said.
Can we achieve herd immunity?
If individuals don’t have immunity, then what does that mean for the concept of herd immunity? A lot of people, including some scientists, believe that herd immunity–disease resistance through a high percentage of a population having antibodies against that disease–is the way to fight COVID-19.
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said Thursday that the idea of herd immunity for COVID-19 is “nonsense” and “very dangerous,” “because what will happen is that if you do that, by the time you get to herd immunity, you will have killed a lot of people that would have been avoidable.”
He also sharply criticized the Great Barrington Declaration, an open letter by a number of medical scientists, academics and professionals from different parts of the world advocating for herd immunity and reopening the world in a controlled manner.
The letter says that people who are in low-risk groups should go out and lead normal lives for “better protecting those who are at highest risk.” But it does not explain how to understand who is at high risk and who is at a low risk while scientists like Pandori are still grappling to understand how reinfection can happen in a 25-year-old with no significant health vulnerabilities. Nor does the letter explain how free movement and mass infection will help the “high-risk” population or the already struggling American health system.
On Wednesday, the Infectious Disease Society of America–an association of over 12,000 frontline infectious disease scientists, physicians and public health professionals–released a statement as a rebuttal to “strongly denounce” the declaration. The declaration was released “without data or evidence, that states this crisis can be controlled in the absence of critical public health measures,” it said.
According to recent reports, the White House is considering following the recommendations by the controversial declaration, named after the Massachusetts town where it was drafted.
How to consume COVID-19 information? When is a vaccine coming?
Asked about the impact of COVID-19 related information and an avalanche of opinion through TV, social media and newspapers on the general public, Pandori made sharp remarks.
“Science is happening with this gigantic audience all of a sudden in the whole planet,” he said. “People that aren’t scientists are consuming science. Media which never had that much interest in science is now consuming science. Politicians [who] didn’t seem to have that much interest in science are consuming science. So every little finding is now looked at as an answer. And that’s actually not how science works at all! Period.”
So, is there no substance to the claims of vitamin-D providing a shield against the virus, a vaccine that’s around the corner, or the path of herd immunity that Sweden took and is struggling with?
As of Oct. 4, Sweden had the fourth highest total infections per million citizens in the EU region.
And that takes time. Getting a vaccine may take years, and even decades.
Pandori responded by explaining how “science works.” It “works when multiple different institutes or scientists make findings, and they start to make the same findings. And one study is never ever going to mean anything to anybody or any particular result of the pandemic.”
Yet, people in America and elsewhere are getting confusing information on a prospective vaccine. Political leaders around the world have announced that their administration is close to getting a vaccine. Disinformation campaigns have pushed wild conspiracy theories as well.
Recently, Russia has been accused of spreading false information against the Oxford vaccine. It says that anyone who takes the vaccine will turn into a monkey.
An expert like Pandori, however, suggested truth is much more straightforward, even boring, in comparison to speculations and outright incorrect information.
“We all have to behave or there is no chance. There’s nothing, no magic, no drug coming tomorrow, no vaccine coming tomorrow. There’s just absolutely no magic other than following the rules of social distancing and wearing a mask,” he said.
Nobody is bulletproof here. Pandori hoped people would understand their vulnerability to the disease. “If people don’t really understand that and [don’t] want to follow along any of those rules, it’s not going to make [it] better, it’s just not,” he said.
