FOR MANY PEOPLE who have recovered from Covid-19, the weeks and months after the virus bring complex, sometimes confusing, questions.
The new virus, which has caused untold damage to families, countries and economies around the world, started out as something of a mystery to scientists. After weeks of rapid work and intensive research, experts know a little more about it – but there’s still plenty more left to understand.
One of the most pressing questions, if the world is going to have to live with the virus for years to come, is whether actually contracting the disease and recovering from it confers immunity on individuals.
But, does this mean that those who have recovered are free to walk among us with few worries about packed public transport and crowded pubs? Not exactly, say health officials.
The discussion has taken on something of a renewed urgency as the country re-opens and thousands of people who have recovered from the virus prepare – along with the rest of us – to take part in the major easing of restrictions promised in Phase Three.
RTÉ Radio One’s Ryan Tubridy touched on the issue earlier this week, when he admitted that he wore a mask for the very first time in the supermarket.
“I did something I haven’t done before since this whole thing began,” he told listeners. “I went and bought some masks and I did my first shop in the supermarket with a mask at the weekend.”
The host of the Late Late Show, who recovered from Covid-19, admitted that for a while he’d thought he “was probably immune because I had it’.
But after weeks of reading and talking to people, he came to the conclusion wearing a mask might be for the best. “You don’t want to give it, you don’t want to get it,” he said.
He’s not the only person trying to decipher what the potential presence of Covid-19 antibodies means for his day-to-day behaviour.
“People have said it to me ‘you’re immune to it now’. I’d read up on it and I saw conflicting reports as to whether you’re immune to it or not,” student Fiachra Gallagher, who’s from Meath, tells TheJournal.ie.
He became ill on St Patrick’s Day, near the start of the crisis. “I woke up and couldn’t get out of bed.”
Since his recovery, he’s remained cautious. “I haven’t been going around as if I’m immune,” he says. He might feel a little safer going shopping, but he’s not deviating from public health guidance.
“My parents sent me out to do the shopping a few times because there’s less of a risk for me,” he says. But “there is so much research coming out and to someone like me, doing my own research, the overwhelming feeling is quite inconclusive”.
Suzanne*, from Drogheda, was forced to take four weeks off work after developing symptoms on 25 March.
“I don’t know if there is immunity,” she says. “No one seems to know if there is. I wouldn’t be complacent in queuing in the supermarket.”
Her father is in his eighties and she said she would be “devastated” if she passed on the virus to him or her family.
“I still haven’t visited family members. I just wouldn’t be sure I’m 100% immune,” says Suzanne. ”I’m as cautious now as I was in the beginning back in March.”
Michelle*, from north Dublin, is still feeling the long-term impacts of the virus after becoming ill alongside the rest of her family on 11 March.
Earlier this month, Deputy Chief Medical Officer Dr Ronan Glynn warned that anecdotal evidence was suggesting that some people are taking a long time to fully recover from the virus, even if they weren’t hospitalised.
This residual, long-lasting impact of the virus is what sets Covid-19 apart from other coronaviruses.
“Altogether, feeling properly ill, it was about eight weeks. I was sort of getting up, dragging myself through home school and going back to bed in the afternoon,” Michelle says of her experience.
She’s still bringing up blood in her phlegm and has pains in her kidneys, while she struggles with fatigue.
When asked about whether she sees herself as immune, she’s clear: “I’m not risking it.”
Unclear science
Immunity has dominated discussion of Covid-19 since we first became aware of the virus. From theories about ‘herd immunity‘ to ‘immunity passports‘, the idea has offered a glimmer of hope and a gateway back to normality.
Dr Cillian De Gascun, Director of the National Virus Reference Laboratory, says it all isn’t that simple.
While the National Public Health Emergency Team has recommended that all healthcare workers who have had the virus are treated as immune for three months, that guidance has not been issued to the general population.
“What we know to date,” De Gascun says, is that “there is a not a lot of evidence at this stage that re-infection occurs, at least in the short-term”.
So there is a possibility that having the virus does confer short-term immunity. But “that’s all the evidence we have,” he says.
A lot of this depends on studying antibodies of people who were infected. Antibodies are special proteins produced by the body’s immune system to help fight disease. They’re usually produced when an individual contracts an illness, although they are also produced when a person is vaccinated.
That doesn’t mean that everyone has who had the virus is equally immune. People who were asymptomatic might develop antibodies at a lower level, while those hospitalised might be expected to have a greater antibody response.
“We would expect, in a broad sense, re-infection would occur at some point because that’s what we see with other respiratory viruses,” says De Gascun.
“We would expect if people get re-infected it will be a milder infection. The question we don’t know the answer to is whether those people would be infectious and capable of transmitting the virus to someone else.”
Hence, health officials are asking anyone – even if they’ve had the virus – to follow public health guidance. Earlier this month, the HSE announced that it would be carrying out a study of more than 5,000 people aimed at measuring exposure to Covid-19 across the Irish population.
“We don’t know enough yet. We want everybody who has been infected to behave the same as everyone else. There is no guarantee they can’t be infected again and there is no guarantee they can’t transmit the virus to someone else,” says De Gascun.
*Some people who spoke for this article did not want to be idenitifed by their second names
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