On 19 May 2023, the US Department of Health and Human Services (HHS) advised, “Repeat COVID infections increase your risk for both hospitalization and Long COVID.”
This advice1 comes on the heels of the US Center for Disease Control (CDC) updating its guidance on the use of masks in educational settings and air ventilation and filtration in public buildings. Masks are now advised for children over the age of two, and public buildings have new standards for air hygiene.
Why, just days after the US government and the World Health Organization ended the COVID-19 public health emergency, are public health agencies taking steps to limit the transmission of SARS-CoV-2 and highlighting the severity of COVID-19?
In fact, the US CDC makes a point of beginning its new guidance with the caution, “COVID-19 can cause serious health problems, so it’s more important than ever to protect your child’s health.”
The simple reason for the change of tone is the growing body of evidence disproving many ill-informed assumptions about how SARS-CoV-2 would interact with humans. Faced with a novel sarbecovirus, some commentators said it didn’t infect children, that children didn’t transmit, it caused mostly asymptomatic infection, the infection would clear in 10 – 14 days, herd immunity was possible, the virus wasn’t airborne, there would be no long-term sequelae, reinfection would be rare and/or benign, that repeat infection would not result in greater ill-health and/or organ damage, and that SARS-CoV-2 was not harming the immune system. Perhaps the most dangerous assumption of all was that we could tame a highly pathogenic sarbecovirus and turn it into a common cold.
Now, trusted public health and government agencies are correctly stating that repeat infections are harmful. They have started to realize what some commentators figured out in 2020 and 2021 – that SARS-CoV-2 is incompatible with our way of life.
This paper2, authored by a coronavirus specialist and some members of the John Snow Project, set out the long-term risks posed by the virus, and many of them have since come to pass. These weren’t guesses, they were inferences and extrapolations made based on textbook science, textbook immunology, and extensive study of coronaviruses, their characteristics, and effects on humans.
It is disappointing it has taken so long for public health agencies to recognize the reality of repeat infections, and this lack of vision has resulted in human suffering, disability, and death. No apology will be forthcoming from high profile commentators who have done so much damage with assumptions and conjecture they peddled as fact. And the public is paying little attention to the clear and unequivocal cautions and warnings being made by government and public health agencies, because politicians have created an illusion that SARS-CoV-2 no longer poses a serious threat to human health.
The continued hospital admissions, growing numbers of people with Long Covid, millions missing from the workforce due to increased long-term sickness, and rising excess deaths around the would show it clearly does, and these announcements from the US HHS, US CDC and others demonstrate that government officials are starting to understand the scale of the problem.
Public health bodies urgently need to engage politicians and others with significant platforms to help people understand endemicity does not mean we can return to prior behavior. HIV endemicity means the use of condoms, malaria endemicity means the use of nets, insect repellent and prophylactics. Endemicity of SARS-CoV-2 requires similar changes in behavior and means we should listen to the guidance of public health agencies such as the US CDC and World Health Organization, who are telling us that a vaccines-only approach to managing this virus is not enough.
If you would like advice on how to reduce your risk of COVID-19 click here.