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How do you know if you are recovered? How long does recovery last? Can you be reinfected? Are your natural antibodies similar to a vaccine? We have all the answers for you!

 

South Africa (20 January 2021) – The other day I asked a question: If a vaccination teaches your body to fight the virus, then shouldn’t a patient who has recovered be considered vaccinated against the virus too. But this led me down another path… how do you know if you are recovered? How long does recovery last, and can you be reinfected?

Luckily the National Institute for Communicable Diseases (NICD) put all the misinformation I was given by social media “experts” to bed! And it’s all GOOD NEWS!

How do I know if I am recovered?

The World Health Organisation (WHO) has determined – using available preliminary data – that the median time from onset to clinical recovery for mild cases is approximately 2 weeks, with that number now being moved to 10 days. This means approximately 10 after you have tested positive, if you have not been hospitalized for “critical symptoms”, then you should move to the “recovery” category.

It is important to note that there is a difference between being fully recovered and being ready to come out of isolation.

The following criteria are specified for de-isolation of a person who tests positive for COVID-19:

  • Symptomatic patients with mild disease (not requiring hospitalisation for COVID-19) can be de-isolated 10 days after the onset of their symptoms, provided their fever has resolved, and their other symptoms are improving.
  • Hospitalised patients with moderate-severe disease (who require hospitalisation due to COVID-19) can be de-isolated 10 days after achievement of clinical stability (i.e. from when they are not requiring supplemental oxygen and are otherwise clinically stable).
  • Asymptomatic patients can be de-isolated 10 days after their test.

Repeat PCR testing is NOT required in order to de-isolate a patient and is not recommended.

Can symptoms last longer than 10 days?

It is common for patients to continue to have symptoms for longer than the 10 days. Full recovery may take several weeks for some patients, especially for symptoms such as fatigue, cough and anosmia (loss of sense of smell).

Patients who are still symptomatic at the end of their isolation period can be de-isolated provided that their fever has resolved and their other symptoms have shown improvement. Patients admitted to hospital can continue their isolation period at home or at an isolation facility once clinical stability has been achieved.

When can I go back to work?

Employees can return to work:

  • 10 days after symptom onset for cases of mild disease
  • 10 days after clinical stability (e.g. after oxygen stopped) for cases of severe disease

Note: PCR testing is not required for return to work (exception: if a person remains asymptomatic in quarantine after a high-risk exposure to a confirmed COVID-19 case, a PCR test should be done when assessing the employee for an early return to work on day 8 post-exposure).

The distinction between the isolation period and returning to work.

The recommended isolation time is the period during which a patient is still considered infectious. This should be distinguished from the point at which a patient is medically well enough to return to work. Some patients, especially those who have had severe disease, may require to be booked off sick for longer than the above isolation periods.

Can you be re-infected with the new variant if you have already had COVID-19 from one of the older variants?

People who have recovered from SARS-CoV-2 infection are usually protected from being infected a second time (called re-infection).

This is because they develop neutralizing antibodies that remain in their blood for at least 5-6 months, maybe longer – scientists just don’t know for how long yet! Some recovered patients are showing signs of having antibodies a year later.

These antibodies bind to specific parts of the spike protein that have mutated in the new variant (K417N and E484K). We now know that these mutations have allowed the virus to become resistant to antibody neutralization.

The blood samples from half the people we tested showed that all neutralizing activity was lost. This suggests that they may no longer be protected from re-infection. In the other half, the levels of antibodies were reduced and so the risk of re-infection is not known. It is therefore important that people who have previously had COVID-19 continue to adhere to public health measures.

Protecting ourselves through masks, regular washing or sanitising of hands, cleaning of surfaces, and social distancing remain the best defence against all SARS-CoV-2 viruses, including the new lineage.


Sources: National Institute for Communicable Diseases (NICD)
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Brent Lindeque is the founder and editor in charge at Good Things Guy.

Recognised as one of the Mail and Guardian’s Top 200 Young South African’s as well as a Primedia LeadSA Hero, Brent is a change maker, thought leader, radio host, foodie, vlogger, writer and all round good guy.

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