Inside Medicine. What Are You Seeing? [COVID-19 medical news]

Question for @Creekland and others in the know:

I recently had Covid. I was told if I had no longer had symptoms (except lack of smell), and no fever for 24-48 hours, it was ok to return to the world again after 14 days from testing positive (or from start of symptoms), since I was no longer infectious. I actually waited longer, and continue with all the restrictions (masks, distancing, sanitizer, etc.).

At the same time, I was advised to NOT re-test for Covid, because it will likely show positive results for about 3-4 months, since the test is very sensitive, and the virus stays in your system that long.

So I’m confused. Is the the small amount that is still in my system infectious (and if so, why then the 14 day quarantine limit)? OR, can I pick it up again while out, and although my own system will likely ignore it, I can transfer the newly acquired virus to someone else?

If the latter, then all those who are anxious to gather with their vaccinated friends or family, can still pick it up from their vaccinated friends, and potentially pass it on?

In terms of immunity from natural infection, it appears that immunity may result, but some people get COVID-19 more than once, indicating that they did not get full immunity from their previous infection.

In terms of immunity from Pfizer / BioNTech and Moderna vaccines, the trials did not check for how the vaccines affect asymptomatic infection or transmission (they checked for symptomatic, severe, or fatal COVID-19), so it is unknown what the effect is. Some experts believe that it is likely for there is an effect, but that is not certain.

But whether or not the vaccines stop asymptomatic infection or transmission, a private gathering in a private location among all vaccinated people is “safe”* for them.

*Yes, there are the unlucky few who do not get full immunity from the vaccines, but the trials found almost no severe cases and no deaths from COVID-19 among those vaccinated.

There is a lot they don’t know yet, so pretty much all advice is based upon what’s typical. Normally you’d be fine. If you’re an outlier (not typical situation), then maybe not.

When my guy had it he stayed home about a month after being told he was ok, but that was partially due to some of his symptoms hanging on (long hauler). He gradually got used to those symptoms, so goes out now - but he’s super, super careful about keeping distance and wearing a mask. He had it once and is still dealing with some of it. He doesn’t want it again. He doesn’t think he’s contagious after all this time (had it back in March 2020). No one - not even his wife - caught it from him unless she was asymptomatic. Back then tests weren’t common and now he’s told any antibodies would have likely worn off to know.

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There was something I read about Marines who had it and were retesting positive after having gotten the all-clear and having texted negative. They were talking re-infection, but I think it is more like lingering virus cells. My father had it in the spring and retested positive in the fall and then again before Christmas (with negative test in between). I don’t think he was reinfected, he just still had virus cells. I was thinking it was related to his being 89 and his immune system not being as strong. However, the Marines in the article would be young and healthy.

The peg link isn’t confirmed, so people should ask their doctors. PEG is the active ingredient in Miralax, and similar laxatives. Here’s one article. I am far from an expert in this!

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This is a really interesting article about a patient who had an active covid infection for 5 months where the virus mutated regularly inside the patient. The article includes a link to the published paper:

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I know that many people are saying that having the vaccine is not going to make Covid go away and it will be with us forever, so I assume that once it becomes less deadly or have long term affects, aka some kind of consistent therapeutic, that will be the more so when we can go back to normal. i know there is one in Israel in trials

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This is fascinating - wonder how many people actually have this type of COVID infection/reaction.

I thought it was fascinating too. Don’t know how many cases are like this, but kudos to the docs who thought to continue to sequence the patient’s changing covid infection, I am sure many other scientists are benefitting from this info.

This article is a little technical for me – so hard for me to summarize – but it looks really interesting:

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Looks like they are trying to predict the effects of theoretical mutations even though the mutations have not actually been seen in wild viruses. Those theoretical mutations that make the virus more dangerous could be pre-emptively targeted in vaccines even before wild viruses with such mutations are found.

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I’ve been double masking since day 1. I hope all those people who made fun of me remember that! :smiley:

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Why is the CDC basically saying that the vaccines are only good for 90 days, similar to those who have gotten Covid.? If one will need a booster every 90 days , and even once people are vaccinated we still all need to wear masks and SD, i am beginning to wonder about vaccines, versus treatments now.
More news from israel today

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Please cite your source?

In my reading of CDC literature, CDC says that they don’t know how long vaccine immunity will last until they study/track it (for months “in real-world conditions”).

" The CDC is now raising questions about how long the vaccines will protect people from contracting the coronavirus. It says that if you got the shot more than three months ago, you should quarantine for two weeks if you suspect you were exposed to someone with the virus just in case the vaccine is no longer effective."

“Just in case” is not equivalent to “basically saying the vaccines are only good for 90 days.”

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Exactly. The only thing that they do know is that transmission is extremely low within the first 90 days. CDC will continue to track and update:

https://www.cdc.gov/vaccines/covid-19/info-by-product/clinical-considerations.html

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and they are saying the same things for people who have recovered from Covid (that you are likely protected for 90 days). Even if they dont know, this is rather pessimistic . This is why so many people will refuse the vaccine, and we will never get back to Life as we once knew it.

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Basically, it looks like extra caution due to things being unknown (i.e. acting based on the worst case, even if the worst case is unlikely). But since people do not do well with uncertainty, people will assume that the worst case is certain, rather than a probably-unlikely possibility.

I optimistically suspect this 3 month rule for vaccinated people re. quarantines is temporary, and will get extended as we go and see that that immunity lasts longer. For now, we only have very few people (just people in clinical trials) who have had the vaccine for even 2 months. I have not seen one single shred of evidence that the clinical trial participants who received doses last fall have started to get infected, so I believe there is no evidence that protection from the vaccine wanes after 3 months. This seems like a cautious but arbitrary length of time, and I believe the CDC will work with trial managers to review their follow-up data and also observe countries such as Israel, etc that are ahead of us, to stay ahead of this. But it would be premature for them today to say, “if you’ve been vaccinated in the past 12 months, you don’t need to quarantine if you’ve been exposed to a close contact”. I am guessing that this 3 month rule was a BIG step, saying that vaccinated people don’t need to quarantine (!), and the future steps will be incremental steps from there, especially once we start having large numbers of people who start being more than 3 months out, really around the beginning of April. Maybe they will extend it to 4 months, then 5, and so on, assuming the data continues to show protection.

However, I doubt that it will get extended beyond 3 months for people who are not vaccinated but who have recovered. I think the level of virus they were exposed to and subsequently how strong an immune response they launched might have much greater variability vs. the known exposure to a given dose of vaccine. It may be that people who had very minimal exposure and barely tested positive might have shorter protection than people who launched a more hearty response, who knows. I haven’t read anything about studies following up on large numbers of recovered patients, mostly just can surmise that reinfection remains exceedingly rare given the over 100 million confirmed cases in the world, but haven’t seen a lot of data that segments reinfection rates based on severity of illness or frankly haven’t even seen more basic data on reinfection. Seems too unstudied to unleash a very generous quarantine-exemption plan.

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