Epidemiologists estimate that more than 160 million people worldwide have recovered from COVID-19

Epidemiologists estimate that more than 160 million people worldwide have recovered from COVID-19. Those who have recovered have an alarmingly low frequency of repeated infections, illnesses or deaths. This immunity to previous infections protects many people who currently do not have a vaccine.
Earlier this month, the World Health Organization issued a scientific update stating that most people recovering from COVID-19 will have a strong protective immune response. Importantly, they concluded that within 4 weeks of infection, 90% to 99% of people recovering from COVID-19 will develop detectable neutralizing antibodies. In addition, they concluded—considering the limited time for observing cases—the immune response remained strong for at least 6 to 8 months after infection.
This update echoes the NIH report in January 2021: More than 95% of people who have recovered from COVID-19 have an immune response that has a lasting memory of the virus for up to 8 months after infection. The National Institutes of Health further pointed out that these findings “provide hope” that people who are vaccinated will develop similar lasting immunity.
So why do we pay so much attention to vaccine-induced immunity—in our goal of achieving herd immunity, our checks on travel, public or private activities, or the use of masks—while ignoring natural immunity? Shouldn’t those with natural immunity also be able to resume “normal” activities?
Many scientists have found that the risk of re-infection is reduced, and hospitalization and mortality due to re-infection are extremely low. In six studies covering nearly 1 million people conducted by the United States, the United Kingdom, Denmark, Austria, Qatar, and the United States Marine Corps, the reduction in COVID-19 reinfection ranged from 82% to 95%. The Austrian study also found that the frequency of COVID-19 re-infection caused only 5 out of 14,840 people (0.03%) to be hospitalized, and 1 out of 14,840 people (0.01%) died.
In addition, the latest US data released after the NIH announcement in January found that protective antibodies can last up to 10 months after infection.
As public health policy makers reduce their immunity to vaccination status, discussions have largely ignored the complexity of the human immune system. There are a number of very encouraging research reports showing that the blood cells in our body, the so-called “B cells and T cells”, contribute to cellular immunity after COVID-19. If the immunity of SARS-CoV-2 is similar to that of other serious coronavirus infections, such as the immunity of SARS-CoV-1, then this protection may last for at least 17 years. However, tests that measure cellular immunity are complex and expensive, which makes them difficult to obtain and prevents their use in routine medical practice or population public health surveys.
The FDA has authorized many antibody tests. Like any test, they require financial cost and time to obtain results, and the performance of each test has important differences in what a positive antibody actually represents. A key difference is that some tests only detect antibodies found after natural infection, “N” antibodies, while some cannot distinguish between natural or vaccine-induced antibodies, “S” antibodies. Doctors and patients should pay attention to this and ask which antibodies the test actually measures.
Last week, on May 19, the FDA issued a public safety newsletter stating that although the SARS-CoV-2 antibody test plays an important role in identifying people who have been exposed to the SARS-CoV-2 virus and may have developed adaptive immunity Action response, antibody testing should not be used to determine immunity or protection against COVID-19. Ok?
Although it is important to pay attention to the message, it is confusing. The FDA did not provide any data in the warning and left those who were warned unsure why antibody testing should not be used to determine immunity or protection against COVID-19. The FDA statement went on to say that antibody testing should be used by those with experience in antibody testing. no help.
As with many aspects of the federal government’s response to COVID-19, the FDA’s comments lag behind science. Given that 90% to 99% of people recovering from COVID-19 will develop detectable neutralizing antibodies, doctors can use the correct test to inform people of their risk. We can tell patients that people who have recovered from COVID-19 have strong protective immunity, which can protect them from reinfection, disease, hospitalization, and death. In fact, this protection is similar to or better than vaccine-induced immunity. In summary, people who have recovered from a previous infection or who have detectable antibodies should be considered protected, similar to people who have been vaccinated.
Looking to the future, policymakers should include natural immunity as determined by accurate and reliable antibody tests or documents of previous infections (previously positive PCR or antigen tests) as the same proof of immunity as vaccination. This immunity should have the same social status as the vaccine-induced immunity. Such a policy will greatly reduce anxiety and increase opportunities for travel, activities, family visits, etc. The updated policy will allow those who have recovered to celebrate their recovery by telling them about their immunity, allowing them to safely discard masks, show their faces and join the vaccinated army.
Jeffrey Klausner, MD, MPH, is a clinical professor of preventive medicine at the Keck School of Medicine at the University of Southern California, Los Angeles, and a former medical officer of the Centers for Disease Control and Prevention. Noah Kojima, MD, is a resident physician in internal medicine at the University of California, Los Angeles.
Klausner is the medical director of the testing company Curative and disclosed the fees of Danaher, Roche, Cepheid, Abbott and Phase Scientific. He has previously received funding from NIH, CDC, and private test manufacturers and pharmaceutical companies to research new methods of detecting and treating infectious diseases.
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Post time: Jun-18-2021