'Part of a New Normal': Covid Reinfections are Here to Stay

NBC News | By Akshay Syal, M.D. and Sara G. Miller

In 2020, Covid reinfections were considered rare.

In 2021, breakthrough infections in vaccinated individuals could occur, but again, the risk was low.

In 2022, that's no longer the case for either. As more immune-dodging coronavirus variants emerge, reinfections and breakthrough infections appear increasingly normal. 

The United States isn't currently tracking Covid reinfections. However, U.K. researchers have found that the risk of reinfection was eight times higher during the omicron wave than it was in last year's delta wave. 

“I would not be surprised if we see people get infected more than once per year,” Dr. Anthony Fauci, chief medical adviser to President Joe Biden, said in an interview with NBC News last week, though he added that he feels optimistic that it will eventually settle into becoming just a seasonal occurrence, like the flu. (Fauci, who has received two vaccine boosters, himself tested positive for Covid on Wednesday, saying he has mild symptoms.)

Of course, just because reinfections are possible, doesn’t mean people should give up on all efforts to prevent them; staying up-to-date on vaccinations and wearing masks indoors in places with high transmission still work to lower risk.

Here’s what we know so far about reinfections.

Can I be Reinfected if I’ve Already Had Covid, or Been Vaccinated or Boosted? 

To put it bluntly, yes. Experts are in agreement that reinfections are possible, even in people who have already been infected or those who are up-to-date on their vaccines.

“Reinfections, unfortunately, are not unusual for coronavirus,” said Akiko Iwasaki, a professor of immunobiology at Yale University. “It’s just the nature of this virus infection.”

The coronavirus that causes Covid is not unique — other types of coronaviruses that cause common colds can also reinfect, Fauci said. But those reinfections may occur every two or three years, because those viruses don’t change very much. 

That’s not the case for SARS-CoV-2, and particularly the rapidly evolving omicron subvariants, which are good at evading existing immunity. Combine that with the fact that people’s immunity naturally wanes over time, Iwasaki said, and “it’s not that surprising to see a lot of reinfections now.”

That’s especially true for people who were infected with the original omicron variant, dubbed BA.1, in the winter. The BA.4 and BA.5 subvariants — currently gaining a foothold in the U.S. — are quite different from BA.1, so “it’s no guarantee” that having a past omicron infection will protect you from subsequent subvariants, she said.

How Many Times Can I be Reinfected? 

It’s impossible to put an exact number on how many times a person can be reinfected, experts say.

With a high level of Covid currently spreading in the U.S., any of us have a good chance of being exposed to someone who is contagious — and becoming reinfected.

Whether a person is reinfected depends on the strength of the immune response when the person was exposed, as well as whether he or she has been recently vaccinated, said Dr. Julie McElrath, director of the vaccine and infectious disease division at the Fred Hutchinson Cancer Center in Seattle. Multiple exposures to the virus — which may not necessarily lead to symptoms — could have a silver lining, McElrath said.

Each time a person is exposed, the immune response matures and improves.

“We should consider reinfection as part of the new normal,” she said. “The hope is that with these multiple exposures continually improving antibody response will occur.”

Read Full Article for answers to the following questions:

• How long does Covid immunity last after infection?
• If reinfected, will symptoms be milder or worse?
• Are certain people more vulnerable to reinfection?
• Am I more likely to develop long Covid if I get reinfected?

COVID-19 Updates

What to Know About the Newest, Most Contagious Omicron Subvariants
It only took about a month for BA.2.12.1, an Omicron subvariant, to cause most of the new COVID-19 cases in the U.S. since scientists first spotted it in the country. But even newer iterations of the Omicron variant are spreading rapidly through the U.S. and are poised to outcompete past versions of the virus, reinfect millions of Americans, and extend the country’s current COVID-19 surge.

Read more @ Time

Omicron Less Likely to Cause Long COVID, Data Suggest
The SARS-CoV-2 Omicron variant may pose less risk for long COVID than the Delta variant, U.K. researchers reported.

About 4.5% of people who became infected with SARS-CoV-2 when Omicron was the dominant strain experienced long COVID symptoms, compared with 10.8% who became infected during the Delta period, reported Claire Steves, PhD, of King's College London in England, and co-authors.

Overall odds of long COVID were about 20% to 50% less during the Omicron era -- defined as December 2021 to February 2022 in this study -- depending on age and time since vaccination, the researchers wrote in a letter to The Lancet.

Read more @ MedPage Today

FDA Panel Unanimously Backs Moderna's COVID Vax for Kids and Teens
A committee of independent vaccine experts recommended that the FDA grant an emergency use authorization (EUA) for the two-dose Moderna COVID-19 vaccine for kids ages 6 to 17 years.

The Vaccines and Related Biological Products Advisory Committee (VRBPAC) voted 22-0, agreeing unanimously that the benefits of vaccination outweigh the risks in two age groups: kids ages 6 to 11 years and teens ages 12 to 17. They recommended two 50-mcg doses for the younger kids and two 100-mcg doses for teens.

Read more @ MedPage Today

HHVBP Gives Providers More Support with Payers, But May Shrink Business Margins

Home Health Care News | By Andrew Donlan
 
Last Thursday, I moderated three panels at Home Health Care News’ VALUE event, sat in on another three and talked to dozens of attendees, both on the record and off.
 
There were plenty of highlights and insights that came from those conversations.
 
And while everyone seemed to not only have a good time, but also a productive one, my feeling is that the takeaways varied considerably from person to person.
 
Of course, some of that had to do with the diversified groups of providers involved. But mainly, it had to do with the overarching takeaway I had from our event: that most everyone in home-based care has a different definition of value-based care, and most everyone will take a different path to get there.
 
So while a shift toward value may be inevitable, there will be seemingly countless roads that lead there – not just one.
 
In this week’s exclusive, members-only HHCN+ Update, I explore what those different roads and definitions of value-based care may be, and also empty my notebook full of other learnings from the event.

Read Full Article

Older Adults Sacrificing Basic Needs Due to Healthcare Costs

Gallup | By Nicole Willcoxon, PH.D. 

Editor's Note: The research detailed below was conducted in partnership with West Health, a family of nonprofit and nonpartisan organizations focused on lowering healthcare costs for seniors.

WASHINGTON, D.C. -- The health problems Americans start facing when they reach 50 years of age are compounded when the high cost of healthcare prevents them from seeking treatment, taking their prescriptions or leading an otherwise healthy lifestyle. A survey of U.S. adults conducted by West Health and Gallup explored the various ways in which healthcare costs are affecting Americans aged 50 and older today.

The study shows that at least two-thirds of older Americans consider healthcare costs to be at least a minor financial burden. When looking at inability to pay for care, four in 10 report they are concerned; smaller but notable percentages are not seeking treatment, are skipping prescribed medicine or cutting back on basic needs such as food and utilities to pay for healthcare. These problems are generally worse for adults aged 50 to 64, as most do not yet qualify for Medicare, but they also affect those 65 and older.

Older Americans at Risk Due to Cost of Healthcare
More than a third of adults 65 and older (37%) are concerned they will not be able to pay for needed healthcare services in the next year, according to the most recent West Health-Gallup survey. The situation is even worse for older Americans who are not yet eligible for Medicare, with nearly half (45%) of adults aged 50 to 64 reporting the same concern level. This puts nearly 50 million adults aged 50 and older at risk for more severe illness and even death due to the cost of healthcare.

U.S. Department of Health and Human Services data show that out-of-pocket healthcare expenses for adults 65 and older rose 41% from 2009 to 2019; out-of-pocket expenses take up a greater proportion of individuals' expenditures as they age, because of an increase in demand for health services and the reality that Medicare does not cover all health expenses. People 65 and older spend nearly twice as much of their total expenditures on healthcare costs when compared with the general population, even with 94% in this age group being covered by Medicare.

As costs continue to climb over the next decade, the number of Americans 65 and older will also rise, by a rate of about 10,000 people per day, according to the U.S. Census. This rapidly growing group of older Americans -- which those currently 50-64 and aging into Medicare are entering -- is already saying healthcare costs are a financial burden (24% of those 50-64 call it a major burden; 48%, a minor burden). For substantial proportions of older Americans, this burden results in sacrificing basic needs to pay for healthcare -- about one in four adults 65 and older and three in 10 aged 50-64 cut back on food, utilities, clothing or medication due to healthcare costs. This hardship is experienced to a greater degree by older women and Black Americans.

Read Full Article and See the Data