COVID-19 FAQ #2

#1 Does getting the virus make you immune?

Most of us in medicine were fairly certain that getting the virus gave you at least some immunity.  Recent evidence shows that the body is making antibodies to the Covid-19 virus. What we don’t yet know is how long this immunity may last. Certainly at least a few months, maybe up to two years or more. A lot of this will depend on how quickly the virus mutates. The speed of mutation increases when the virus infects more people. The farther the virus mutates from the one you caught or the when you get the vaccine for, the less your immunity matters. Immunity is not an either or thing. You could have degrees of immunity, where you have minimal or partial immunity but have a less severe disease. Immunity can extend all the way up to total immunity. This means that once you get something you will never get it again. There is probably no virus that conveys total immunity to the total population. There are probably always people who only get partial or no immunity. In the COVID-19 virus it looks like the percentage of people that get limited or no immunity is very small.

#2 Will there be an effective vaccine for the virus?

I think so. There are currently over 165 vaccines in some stage of development. To understand what this means, it is important to know about the different phases of vaccine development. There are four basic phases for development before vaccines are approved. The first is a preclinical phase when vaccines are tested in the laboratory and usually in animals. Phase 1 is when they are tested on a limited number of patients looking for safety and dosage. In phase 2 there’s a larger trial usually several hundred people which is looking largely at safety before going to phase 3 trials. Phase 2 also allows some idea of effectiveness, but is not at all definitive.

Phase 3—where there are currently eight vaccines in large-scale trials—typically involves thousands of people. Though thousands of people seems like a lot, it is important to test a vaccine broadly enough to detect any potentially rare, potentially lethal, side effects before distributing it to hundreds of millions of people. It is in the phase 3 trial where we learn whether or not the vaccine will be effective. Right now the CDC is aiming for vaccines to be at least 50% effective to be considered viable. 50% effective means that if you gave the vaccine to 100 people, only half as many of them would get the infection compared to 100 similar people who didn’t get the vaccine. However, even of those people that got the infection, if they had received the vaccine recently they probably would experience a more mild case and be less likely to spread it.
Having a 50% vaccine would really slow down virus transmission in the population, but, more importantly, would protect more people from the long-term effects of COVID-19.

#3 When will a vaccine be available?

For the vaccines currently in clinical trials, our best guess as to when a vaccine will be safe and available to the wider population is early 2021. I want to point out that the speed with which these vaccines are being developed is phenomenal. A large part of the scientific world has turned its attention to producing treatments and vaccinations for the novel coronavirus. For a vaccine to be ready one year after research began on it is phenomenal.

#4 Should I or my children get the vaccine?

Once there is a safe and effective vaccine, yes. There are many long-term effects of infection with COVID-19 which are being discovered as more and more people recover from the virus. This occurs in people who have even mild cases. There are people who seem to have long-term lung damage from the lung injury they suffer while being sick. Another very concerning outcome is myocarditis, which is an inflammation of the heart muscle which can leave very young people with a damaged heart and congestive heart failure for the rest of their lives. A significant percentage of these people will likely ultimately require a heart transplant. Other serious complications are neurological in nature. Patients are having strokes, difficulties in cognition (thinking and concentration), and in many, having acute psychotic breakdowns.  This is making functional young and middle-aged adults non-functional. So, while the risk of death may actually be fairly low, the risk of long-term complications is not. Therefore, once there is a safe and effective vaccine, I will be recommending it to all my patients.

#5 Will life ever go back to normal?

Worldwide pandemics always change things for our society. That said, yes, there will come a day when we can get back together in large groups with our friends and family, our kids will go to school normally, we won’t necessarily have to wear a mask everywhere we go, and we don’t have to live in fear of catching this virus from anyone we come in contact with. That said, we should understand that pandemics are a fact of human life. Although we have been fortunate and had a long period of time without a major pandemic, the interconnectedness of the modern world makes rapidly spreading disease a certainty. So, chances are, our habits will change. Perhaps, like those in Asia, wearing masks in public will become commonplace.

Please continue sending me your questions and concerns. That’s the only way I’ll know what questions I should answer for everyone. Thank-you!