In the midst of the Omicron variant wave, Sarah, a college French teacher, has just tested positive for coronavirus, with mild symptoms.
However, this is the third time since the start of the pandemic that the young woman has been infected with Covid-19.
Is this the sign that she has developed an immunity that protects her from serious forms, or from an immune response that has remained weak after several contaminations and a dose of vaccine?
“It's a joke!
It is not possible !
When Sarah saw the second small bar appear on her self-test, she couldn't believe it.
However, like around 400,000 people daily in recent days under the effect of the Omicron wave, the young woman did contract Covid-19.
This incredulous reaction is not because she thought she was impervious to the virus, but "because after two contaminations, I didn't think I was going to catch this fucking Covid a third time!
»
If the cases of reinfections have multiplied since the start of the pandemic, triple contaminations are rarer.
Are they a sign of weaker immunity?
Or the mark of a disease that, still unknown more than two years ago, is becoming an endemic virus, like the seasonal flu and the common cold?
The second time, "I lost my taste and smell"
Like millions of people, Sarah, a French teacher in college, spent the first confinement of March 2020 cloistered at home, with her husband and two children. “I only went out to do the shopping, always with my homemade mask and a good amount of hydroalcoholic gel. Like everyone else, we went to distance education, since the schools were closed, ”says the 39-year-old young woman. At home, the family is "in a cocoon", but on the occasion of the rare outings, the pandemic mode is activated. “It was psychosis, we knew nothing, so we were afraid of everything! From then on, the bise was abolished, ”recalls the young woman. When summer came, the family chose to leave Spain in favor of a vacation in France and “we rented a house to be sure not to meet anyone”.
At the start of the school year in September 2020, the mother of the family also returns to school.
“We had protocols, everyone wore a mask, I gave hydroalcoholic gel to each student and cleaned the tables between each class, says Sarah.
But as soon as the reopening, we had contaminations at the college, among the students as well as within the teaching team ”.
And at the end of September, when the second epidemic wave started, still with the original strain from Wuhan, Sarah tested positive for the first time.
“I had like a good flu: cough, fever, aches and fatigue, it put me to bed for a week”.
April 2021, France is going through its third epidemic wave. The original strain gave way to the Alpha variant, from the United Kingdom, which accounts for nearly 90% of infections. And who will cause Sarah's second contamination. "At the weekend, I learn that there are five cases in my class and on Saturday morning, I get up stiff, I have chills and I'm exhausted," she describes. The PCR test taken in the afternoon confirms it, “I was still positive”. After five days of this flu-like diet, the virus becomes more virulent. "I had five hardcore days of intense fatigue, and I lost my taste and smell." Four months later, in mid-August, Sarah receives her first dose of the Covid vaccine. “I was sick for two days, as if I still had the virus, but I told myself that I was protected”.
“I see more and more reinfections”
“Double contaminations are not uncommon, I see more and more of them in the hospital and I myself have just contracted Covid-19 for the second time”, confirms Dr Benjamin Davido, infectious disease specialist and referring doctor at Covid-19 crisis at the Raymond-Poincaré hospital in Garches.
Why ?
“The scientific literature shows that each new variant has a little more antibody neutralizing power,” he explains.
Between the Wuhan strain and Alpha, there was no big difference, so the risk of re-infection was very low, around 0.1-1%.
With Delta, the data collected in England showed a doubling of this risk of reinfection, then still very low ”.
But with Omicron, the numbers get carried away. A study from Imperial College London estimates that the risk of reinfection with Omicron is 5.4 times higher than with Delta, confirming that this variant, with its many mutations, leads to immune escape. Clearly: the immunity conferred by vaccination or by a previous infection is shorter, and much less effective. Thus, “Omicron, according to data from the Institut Pasteur, has a neutralizing power twenty to eighty times greater than the original strain, so we better understand the surge in the risk of reinfection”, comments Dr. Davido.
So it was that a few days ago, after her college daughter tested positive, Sarah was quick to develop suggestive symptoms again.
“Initially, I had nothing, and my first test was negative.
A few days later, I felt a little feverish, but nothing serious.
Despite my daughter's contamination, I told myself that it had to be a simple cold snap, I couldn't have it a third time!
But my husband, with slight hypochondriac tendencies, told me to redo a test immediately.
And it was positive, again!
This is where I understood the interest of the protocol providing for tests on D0, D + 2 and D + 4 ”.
A result confirmed by an antigenic test taken in pharmacies.
“Is this a sign of rotten immunity?
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“There I hallucinated, confides Sarah. At the same time, between work and my children, I was in constant contact, so it was a half-surprise”. But the young woman wonders: “Is this third light Covid the sign of a less aggressive variant, of an immunity which protected me from a more serious form, or of a rotten immunity? Because after two infections and one dose, I thought I had solid antibodies, but obviously that's not the case. I'm thinking of doing a full check-up to see if something is wrong with my body.
So should she be worried about her immune response? “We know that some are more sensitive to viral infections, and say that they contract viruses or infections every winter”, recalls the infectiologist. "It's true, every year I have at least one angina and one sinusitis", confirms Sarah. “The immunity of the mucous membranes is more or less strong depending on the individual, which makes them more susceptible to infection, explains Dr. Davido. It is also for this reason that vaccines in nasal form are being developed, in order to block the entry of the virus. This is probably the case for Sarah, but she has an immune system that responds well to the onslaught of the disease, since she develops mild forms of it. She can therefore be reassured: she will have a panel of protective antibodies, especially since when we had Omicron, this protects against Delta:cross-immunities operate”.
On the other hand, “it risks reinfecting itself with each new epidemic wave, but it will be less and less severe.
Moreover, according to the figures of the latest studies on Omicron, 10% of people who have already had Covid will be reinfected, so everyone will come across the virus, and we must expect a significant number of reinfections”, he warns.
Towards “an endemic disease”
“If I had it a fourth time, it would be schkoumoune! “reacts Sarah. But this scenario would be a sign “that we are still progressing towards collective immunity, probably in March. It is certainly not durable and does not prevent reinfections despite vaccination, but the disease will cause fewer and fewer serious forms, reassures the infectiologist. Covid-19 is finally on its way to becoming an endemic disease. Each time new variants with immune escape emerge, we will reinfect ourselves, like seasonal flu epidemics, where we generally have a new strain each year, while developing milder forms”.
For the infectiologist, these reinfections “will probably be our best vaccine against severe forms, but also the sign that the interest in vaccinating people who have no risk of severe form will become obsolete.
If the disease becomes endemic and today the conditions begin to be met, reinfections will restimulate the neutralizing antibodies, which will be worth a booster shot.
Booster doses would then only be indicated for people at risk of a serious form.
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