We’re well over two years into the pandemic and there’s no signs it is slowing down anytime soon. Sure, mask mandates and restrictions have been lifted, but that doesn’t mean the virus has been eradicated and we’re in the clear. If anything, it’s riskier now because cases are rising and people have a greater chance of getting reinfected, which could have serious health repercussions. Eat This, Not That! Health spoke with  Dr. J. Wes Ulm, Harvard and MIT-trained MD, PhD with a background in bioinformatics, gene therapy, genetics, drug discovery, consulting and education who explains why it’s dangerous to get COVID multiple times and what it could mean long-term health wise. Read on—and to ensure your health and the health of others, don’t miss these Sure Signs You’ve Already Had COVID.

When asked what the risks of getting reinfected with COVID multiple times are Dr. Ulm says, “A great question and a critical topic that hasn’t gotten much coverage in the popular health press, but particularly relevant given the surprising adaptability of SARS-CoV-2 — the virus that causes COVID-19 — to mutate and generate new variants at a much faster clip than doctors and researchers had previously anticipated. The answer, from the research and clinical case studies conducted thus far, is that COVID infection carries a “cumulative risk” component to it. That is, the risk of long COVID syndrome, and of organ and tissue damage more broadly, appears to be elevated with each subsequent infection, simply because each bout with a variant of this coronavirus represents another instance of rolling the epidemiological dice for potential longer-term impacts.” 

Dr. Ulm explains, “To better illustrate, let’s assume that the risk of Long COVID after an acute infection is low, on the order of 10 percent, even though some studies are in fact indicating a higher risk factor (and for mild infections as well as rougher ordeals requiring hospitalization). If you get COVID once, you’ll have a one-in-ten chance of following up with persistent Long COVID symptoms such as severe fatigue, brain fog, disruption in taste or smell, or more severe manifestations (including deleterious effects on the lungs, heart, kidneys, or liver). If you suffer a second COVID bout, it’s another 10 percent risk of getting long COVID symptoms — independent of the first bout — and so people with two successive infections will be at 20 percent risk. A third bout? Hardly unusual given the virulence and contagion of the newer omicron variants, and now the risk is 30 percent of Long COVID. And so forth.” 

Dr. Ulm states, “Serial COVID infections pose a cumulative risk of mounting organ and tissue damage that increases with each infectious bout. I’ll get to the medical specifics on why this is in the next couple questions, but suffice it to say that SARS-CoV-2 has proven itself to be a much more formidable microbial adversary than almost anyone suspected in the spring of 2020. In fact, the potential for accumulating tissue injury has been one of the principal concerns of physicians and scientists as its remarkable capacity for mutation and immune evasion began to be discerned with the delta variant in the spring of 2021.”6254a4d1642c605c54bf1cab17d50f1e

According to Dr. Wes, “The cumulative risk factor has several important public health implications going forward. First, to put it bluntly, the epidemiological Holy Grail of herd immunity for COVID-19 is a pipe dream — it’s simply not happening. Herd immunity, through some combination of natural immunity and vaccine-mediated protection, might have been realizable if reinfections were rare, not severe, or generally limited. But one of the hard lessons of the omicron variants, from BA.1 in December of 2021 to BA.5 right now in the summer of 2022, is that SARS-CoV-2 is extraordinarily stealthy and capable of adapting and evading immune defenses.” 

Dr. Ulm tells us, “Previously infected individuals enjoy relatively sparse and short-lived protection against having another bout subsequently even within the same year, and a huge percentage of omicron BA.5 subvariant cases in July 2022 have been reinfections of those who’d battled the virus before, including other subvariants of omicron. There’s even some evidence that successive bouts with COVID may lower immune protections generally, through a still poorly-understood mechanism that hampers the responsiveness of blood lymphocytes that help to marshal and coordinate the biological defenses. It’s not quite the same thing as how HIV whittles down the “generals in the field” (the CD4 helper T-cells) that guide nearly all aspects of the adaptive immune response (specific for a particular disease-causing pathogen), but there have been some worrisome parallels observed. A second implication is that periodic boosters and re-vaccinations will be important, as we’re all familiar with for our flu shots, preferably with more variant-specific vaccines as they become available. A third implication is that vigilance particularly for indoor gatherings will continue to be significant for public health, and infectious control measures like updated air filtration, ventilation, and ultraviolet disinfection should be implemented where possible. This applies generally, but perhaps no more so than in schools, as children are at especially high risk of essentially contracting a daisy chain of back-to-back COVID infections. Furthermore, even though kids are no doubt at lower risk of severe acute COVID cases necessitating hospitalization, the newer variants are posing a greater threat to youth as well, and the prospects of long COVID and organ damage in kids from such recurring infections remain poorly understood.” And to protect your life and the lives of others, don’t visit any of these 35 Places You’re Most Likely to Catch COVID.

Wes Ulm, MD, PhD, is a physician-researcher, musician (J. Wes Ulm and Kant’s Konundrum) ,and novelist, and earned a dual MD/PhD degree from Harvard Medical School and MIT. He is part of the Heroes of the COVID Crisis series in relation to his ongoing efforts in the drug discovery and public health arena.

Heather Newgen