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Joe Chancellor's avatar

I know this is likely in response to the viral, scary article being passed around widely. I always appreciate your sane and comprehensive write-ups! Couple of curious questions ...

1) If re-infections are rare -- maybe at most ~27% of infections -- shouldn't we be running out of folks who've never been infected before? For example, we know that the number of people who've ever been infected in those under 18 in the US as of Feb 2022 was around 75% IIRC. Is it still possible that today (or very recently) 75% of new cases in those under 18 are from that incredibly shrinking 25% who had never been infected?

I know anecdotally, I don't have many friends who've still never caught COVID.

Methodologically, if we're not great at counting actual cases (I see some reputable people apply a 5x multiplier to current case counts in the US to estimate actual cases), wouldn't it also stand to reason that we've even more terrible at counting re-infections? It would be like lighting striking twice. I guess my question is whether or not we're undercounting cases and then by extension (squaring the probability), very much undercounting re-infections.

I feel like if reinfections were actually as rare as these numbers suggest, we should be running out of new folks earlier this year.

2) Part of the public horror about the danger of re-infection is that it goes against the public's prior understanding of the risks. Many folks believed it was "one and done" and there was some value to simply "getting it over with." Likewise, if there was some rare change of a re-infection, it wasn't anything to worry about because someone already had immunity.

I think the reason that article (as careless as it might have been with language and hyperbolic) went viral was because it was making a few key points. 1) It isn't one and done. The virus mutates more quickly than expected. Reinfections can definitely happen and they can even happen on a surprisingly quick timeline. 2) Re-infections pose some additional health risk. Whether that risk is the same as the initial infection or to a lesser degree, there is *some* additional risk associated with getting re-infected. Which leads to 3) Unmitigated transmission is a problem (both for individuals and society) and no matter your prior infection history, you should continue taking active steps to minimize your total number of infections. Even if you've had it, you should keep from getting it again. It's not necessarily "no covid" (almost impossible to avoid), but our philosophy needs to be "low covid" (as few infections as possible).

The well-intentioned "take-downs" I see of that article seem to miss the gist behind why it went viral in the first place.

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Gigi's avatar

How concerned should we be about cumulative risk (longer term) of multiple infections? I think this is a key point. It’s been such a struggle to get the general population to see that taking reasonable precautions to avoid infection and reinfection as we learn more about a novel virus is a reasonable goal for overall health at any age.

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