What Does 'Recovered From Coronavirus' Mean? Four Questions Answered
By Tom Duszynski
The coronavirus is certainly scary, but despite the constant reporting on total cases and a climbing death toll, the reality is that the vast majority of people who come down with COVID-19 survive it. Just as the number of cases grows, so does another number: those who have recovered.
In mid-March, the number of patients in the U.S. who had officially recovered from the virus was close to zero. That number is now in the tens of thousands and is climbing every day. But recovering from COVID-19 is more complicated than simply feeling better. Recovery involves biology, epidemiology and a little bit of bureaucracy too.
How does your body fight off COVID-19?
Once a person is exposed the coronavirus, the body starts producing proteins called antibodies to fight the infection. As these antibodies start to successfully contain the virus and keep it from replicating in the body, symptoms usually begin to lessen and you start to feel better. Eventually, if all goes well, your immune system will completely destroy all of the virus in your system. A person who was infected with and survived a virus with no long-term health effects or disabilities has "recovered."
On average, a person who is infected with SARS-CoV-2 will feel ill for about seven days from the onset of symptoms. Even after symptoms disappear, there still may be small amounts of the virus in a patient's system, and they should stay isolated for an additional three days to ensure they have truly recovered and are no longer infectious.
What about immunity?
In general, once you have recovered from a viral infection, your body will keep cells called lymphocytes in your system. These cells "remember" viruses they've previously seen and can react quickly to fight them off again. If you are exposed to a virus you have already had, your antibodies will likely stop the virus before it starts causing symptoms. You become immune. This is the principle behind many vaccines.
Unfortunately, immunity isn't perfect. For many viruses, like mumps, immunity can wane over time, leaving you susceptible to the virus in the future. This is why you need to get revaccinated – those "booster shots" – occasionally: to prompt your immune system to make more antibodies and memory cells.
Since this coronavirus is so new, scientists still don't know whether people who recover from COVID-19 are immune to future infections of the virus. Doctors are finding antibodies in ill and recovered patients, and that indicates the development of immunity. But the question remains how long that immunity will last. Other coronaviruses like SARS and MERS produce an immune response that will protect a person at least for a short time. I would suspect the same is true of SARS-CoV-2, but the research simply hasn't been done yet to say so definitively.
Why have so few people officially recovered in the US?
This is a dangerous virus, so the Centers for Disease Control and Prevention is being extremely careful when deciding what it means to recover from COVID-19. Both medical and testing criteria must be met before a person is officially declared recovered.
Medically, a person must be fever-free without fever-reducing medications for three consecutive days. They must show an improvement in their other symptoms, including reduced coughing and shortness of breath. And it must be at least seven full days since the symptoms began.
In addition to those requirements, the CDC guidelines say that a person must test negative for the coronavirus twice, with the tests taken at least 24 hours apart.
Only then, if both the symptom and testing conditions are met, is a person officially considered recovered by the CDC.
This second testing requirement is likely why there were so few official recovered cases in the U.S. until late March. Initially, there was a massive shortage of testing in the U.S. So while many people were certainly recovering over the last few weeks, this could not be officially confirmed. As the country enters the height of the pandemic in the coming weeks, focus is still on testing those who are infected, not those who have likely recovered.
Many more people are being tested now that states and private companies have begun producing and distributing tests. As the number of available tests increases and the pandemic eventually slows in the country, more testing will be available for those who have appeared to recover. As people who have already recovered are tested, the appearance of any new infections will help researchers learn how long immunity can be expected to last.
Once a person has recovered, what can they do?
Knowing whether or not people are immune to COVID-19 after they recover is going to determine what individuals, communities and society at large can do going forward. If scientists can show that recovered patients are immune to the coronavirus, then a person who has recovered could in theory help support the health care system by caring for those who are infected.
Once communities pass the peak of the epidemic, the number of new infections will decline, while the number of recovered people will increase. As these trends continue, the risk of transmission will fall. Once the risk of transmission has fallen enough, community-level isolation and social distancing orders will begin to relax and businesses will start to reopen. Based on what other countries have gone through, it will be months until the risk of transmission is low in the U.S.
But before any of this can happen, the U.S. and the world need to make it through the peak of this pandemic. Social distancing works to slow the spread of infectious diseases and is working for COVID-19. Many people will need medical help to recover, and social distancing will slow this virus down and give people the best chance to do so.
Tom Duszynski is a Director of Epidemiology Education at IUPUI.
Disclosure statements: Tom Duszynski does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.
Reposted with permission from The Conversation.
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"These are not just wildfires, they are climate fires," Jay Inslee, Governor of Washington State, said as he stood amid the charred remains of the town of Malden west of Seattle earlier this month. "This is not an act of God," he added. "This has happened because we have changed the climate of the state of Washington in dramatic ways."
'These Aren't Wildfires'<p>Sam Ricketts, who led climate policy and strategy for Governor Jay Inslee's 2020 presidential campaign, tweeted on September 11 that "These aren't wildfires. These are #climatefires, driven by fossil fuel pollution."</p><p>"The rate and the strength and the devastation wrought by these disasters are fueled by climate change," Ricketts told DW of fires that have burnt well over 5 million acres across California, Oregon, Washington State, and into neighboring Idaho. </p><p>In a two-day period in early September, Ricketts notes that more of Washington State burned than in almost any entire fire season until now, apart from 2015. </p><p>California, meanwhile, was a tinderbox after its hottest summer on record, with temperatures in Death Valley reaching nearly 130 degrees Fahrenheit, according to the U.S. National Weather Service. It has been reported as the hottest temperature ever measured on Earth.</p>
<div id="29ad9" class="rm-shortcode" data-rm-shortcode-id="8346fe7350e1371d400097cd48bf45a2"><blockquote class="twitter-tweet twitter-custom-tweet" data-twitter-tweet-id="1306969603180879872" data-partner="rebelmouse"><div style="margin:1em 0">Drought-parched wetlands in South America have been burning for weeks. https://t.co/pjAKdFcKPg #Pantanal https://t.co/ImN2C5vwcp</div> — NASA Earth (@NASA Earth)<a href="https://twitter.com/NASAEarth/statuses/1306969603180879872">1600440810.0</a></blockquote></div><p>As evidenced by Australia's apocalyptic Black Summer of 2019-2020, fires are burning bigger and for longer, with new records set year-on-year. Right now, Brazil's vast and highly biodiverse Pantanal wetlands are suffering from catastrophic fires.</p>
#climatefires Started in Australia<p>Governor Inslee this month invoked the phrase climate fires for arguably the first time in the U.S., according to Ricketts.</p><p>But the term was also used as fires burnt out of control in Australia in late 2019. In the face of a 2000km (more than 1,200 miles) fire front, and government officials and media who <a href="https://www.dw.com/en/trump-climate-change-denial-emissions-environment-germany-fake-heartland-seibt/a-52688933" target="_blank">played down the link to climate change</a>, Greens Party Senator Sarah Hanson-Young and a friend decided that reference to bushfires was inadequate. </p><p>"We both just said, we've got to start calling them climate fires, that's what they are," the Australian Senator told DW.</p><p>Hanson-Young says scientists have been warning for decades that these would be the effects of global heating. "We've been told these kinds of extreme weather events and destruction is what climate change would look like, and it's right here on our doorstep," she said from her home state of South Australia — where by early September fire warnings had already been issued.</p><p>"Calling them climate fires was making it absolutely crystal clear. It is essential that there's no ambiguity," she said </p><p>Having deliberately invoked the term, Hanson-Young soon started to push it on social media via a #climatefires hashtag. </p>
How to Talk About the Urgency of Global Heating<p>The need to use more explicit language when talking about extreme weather events linked to climate change is part of a broader push to express the urgency of global heating. In 2019, activist Greta Thunberg tweeted that the term "climate change" did not reflect the seriousness of the situation. </p><p>"Can we all now please stop saying 'climate change' and instead call it what it is: climate breakdown, climate crisis, climate emergency, ecological breakdown, ecological crisis and ecological emergency?" she wrote. </p><p>"Climate change has for a long time been talked about as something that is a danger in the future," said Hansen-Young. "But the consequences are already here. When people hear the word crisis, they understand that something has to happen, that action has to be taken."</p><p><span></span>Some terms are now used in public policy, with state and national governments, and indeed the EU Parliament, declaring an official climate emergency in the last year. </p>
Words That Reflect the Science<p>But while the West Coast governors all fervently link the fires to an unfolding climate crisis, U.S. President Donald Trump continues to avoid any reference to climate. In a briefing about the fires, he responded to overtures by Wade Crowfoot, California's Natural Resources Secretary, to work with the states on the climate crisis by stating: "It'll start getting cooler. You just watch." Crowfoot replied by saying that scientists disagreed. Trump rejoined with "I don't think science knows, actually." </p><p>It was reminiscent of the anti-science approach to the coronavirus pandemic within the Trump administration, <a href="https://www.dw.com/en/donald-trump-admits-playing-down-coronavirus-risks/a-54874350" target="_blank" rel="noopener noreferrer">at least publicly</a>. Fossil fuel companies are also benefiting from his disavowal of climate science, with the Trump administration having <a href="https://www.dw.com/en/opinion-trumps-paris-climate-accord-exit-isnt-really-a-problem/a-51124958" target="_blank" rel="noopener noreferrer">pulled out of the Paris Agreement</a> and reopened fossil fuel infrastructure like the Keystone XL pipeline. </p><p>But the science community has responded, with Scientific American magazine endorsing Trump's Democratic presidential challenger Joe Biden, the first presidential endorsement in its 175-year history. </p><p>Hanson-Young says the use of explicit language like climate fires has also been important in Australia due to the climate denialism of politicians and the press, especially in publications owned by Rupert Murdoch. As fires burnt out much of Australia's southeast coast, they were commonly blamed on arson — a tactic also recently used in the U.S.</p>
Climate Rhetoric Could Help Decide Election<p>The language of climate has begun to influence the U.S. presidential election campaign, with Democratic nominee Joe Biden labelling President Trump a "climate arsonist."</p><p>Biden is touting a robust climate plan that includes a 2050 zero emissions target and a return to the Paris Agreement. Though lacking the ambition of The New Green Deal, it has been front and center of his policy platform in recent days, at a time when five hurricanes are battering the U.S. Gulf Coast while smoke blanketing the West Coast spreads all the way to the East. </p><p>People are experiencing the climate crisis in a visceral way and almost universally relate to the language of an emergency, says Ricketts. "They know something is wrong."</p>
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