For New York musician Erica Mancini, COVID-19 made repeat performances.
March 2020. Last December. And again this May.
“I’m bummed to know that I might forever just get infected,” said the 31-year-old singer, who is vaccinated and boosted. “I don’t want to be getting sick every month or every two months.”
But medical experts warn that repeat infections are getting more likely as the pandemic drags on and the virus evolves – and some people are bound to get hit more than twice. Emerging research suggests that could put them at higher risk for health problems.
There’s no comprehensive data on people getting COVID-19 more than twice, although some states collect information on reinfections in general. New York, for example, reports around 277,000 reinfections out of 5.8 million total infections during the pandemic. Experts say actual numbers are much higher because so many home COVID-19 tests go unreported.
Several public figures have recently been reinfected. U.S. Health and Human Services Secretary Xavier Becerra and Canadian Prime Minister Justin Trudeau said they got COVID-19 for the second time, and U.S. Sen. Roger Wicker of Mississippi said he tested positive a third time. All reported being fully vaccinated, and Trudeau and Becerra said they’d gotten booster shots.
“Until recently, it was almost unheard of, but now it’s becoming more commonplace” to have COVID-19 two, three or even four times, said Dr. Eric Topol, head of Scripps Research Translational Institute. “If we don’t come up with better defenses, we’ll see much more of this.”
Why? Immunity from past infections and vaccination wanes over time, experts say, leaving people vulnerable.
Also, the virus has evolved to be more contagious. The risk of reinfection has been about seven times higher with omicron variants compared with when delta was most common, research out of the United Kingdom shows. Scientists believe the omicron mutants now causing the vast majority of U.S. cases are particularly adept at getting around immunity from vaccination or past infection, especially infection during the original omicron wave. U.S. health officials are mulling whether to modify boosters to better match recent changes in the coronavirus.
The first time Mancini got COVID-19, she and her fiance spiked fevers and were sick for two weeks. She couldn’t get tested at the time and but had an antibody test a couple months later that showed she had been infected.
“It was really scary because it was so new and we just knew that people were dying from it,” said Mancini. “We were really sick. I hadn’t been sick like that in a long time.”
She got vaccinated with Pfizer in the spring of 2021 and thought she was protected from another infection, especially since she was sick before. But though such “hybrid immunity” can provide strong protection, it doesn’t guarantee someone won’t get COVID-19 again.
Mancini’s second bout, which happened during the huge omicron wave, started with a sore throat. She tested negative at first, but still felt sick driving to a gig four hours away. So she ducked into a Walgreens and did a rapid test in her car. It was positive, she said, “so I just turned the car around and drove back to Manhattan.”
This bout proved milder, with “the worst sore throat of my life,” a stuffy nose, sneezing and coughing.
The most recent illness was milder still, causing sinus pressure, brain fog, a woozy feeling and fatigue. That one, positive on a home test and confirmed with a PCR test, hit despite her Moderna booster shot.
Mancini doesn’t have any known health conditions that could put her at risk for COVID. She takes COVID-19 precautions like masking in the grocery store and on the subway. But she usually doesn’t wear a mask on stage.
“I’m a singer, and I’m in these crowded bars and I’m in these little clubs, some of which don’t have a lot of ventilation, and I’m just around a lot of people,” said Mancini, who also plays accordion and percussion. “That’s the price that I’ve paid for doing a lot throughout these past few years. It’s how I make my living.”
Scientists don’t know exactly why some people get reinfected and others don’t, but believe several things may be at play: health and biology, exposure to particular variants, how much virus is spreading in a community, vaccination status and behavior. British researchers found people were more likely to be reinfected if they were unvaccinated, younger or had a mild infection the first time.
Scientists also aren’t sure how soon someone can get infected after a previous bout. And there’s no guarantee each infection will be milder than the last.
“I’ve seen it go both ways,” said Dr. Wesley, a pathologist at Houston Methodist. In general, though, breakthrough infections that happen after vaccination tend to be milder, he said.
Doctors said getting vaccinated and boosted is the best protection against severe COVID-19 and death, and there’s some evidence it also lessens the odds of reinfection.
At this point, there haven’t been enough documented cases of multiple reinfections “to really know what the long-term consequences are,” said Dr. Peter Hotez, dean of Baylor University’s tropical medicine school.
But a large, new study using data from the U.S. Department of Veterans Affairs, which hasn’t yet been reviewed by scientific peers, provides some insight, finding that reinfection increases the risk for serious outcomes and health problems such as lung issues, heart disorders and diabetes compared with a first infection. The risks were most pronounced when someone was ill with COVID-19, but persisted past the acute illness as well.
After Mancini’s last bout, she dealt with dizziness, headaches, insomnia and sinus issues, though she wondered if that was more due to her busy schedule. In a recent week, she had 16 shows and rehearsals – and has no room for another COVID-19 reprise.
“It was not fun,” she said. “I don’t want to have it again.”
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
