The Phenomenon of COVID Rebounds, Reinfections, and Long-COVID

a virtual meeting on a laptop screen with people wearing covid face masks

A lot of companies and businesses temporarily lost workers in droves to infection at the start of the COVID pandemic. For many, it took weeks to recover for a not insignificant amount we are now learning it will take months, to years to recover. So now, it’s obviously discouraging when employees get infected for a second or third time, disrupting productivity even further. 

Thanks to COVID variant, Omicron, reinfections are on the rise, resulting in 10% of daily U.S. infection cases being classifiable as reinfection. What that means is, a tenth of individuals who currently have the virus are suffering for a second time, sometimes a third—often with as little as three months or less in between cases. 

Meanwhile, other individuals who contract COVID recover, test negative, then test positive again just a few days later. So, why does this happen? 

There are theories regarding reinfections and rebounds, and why they seem to be more common now than during the proliferation of the Delta variant. Below, we’ll take a look at data and examine how these perplexing cases may be inextricably linked to Long-COVID. 

Rebounds, reinfections, and Long-COVID

By this point, thanks to the news cycle, most of us might be familiar with the concept of COVID rebounds. In late July, President Biden tested positive for the virus. Then, after a Paxlovid treatment, he tested negative, only to test positive again four days later. 

This high-profile case, however, is just one example of the ongoing phenomenon especially common with these latest COVID variants. As many as 27% of individuals who get COVID will experience a “rebound,” in which symptoms reemerge 2 to 8 days after initial recovery. 

Some COVID rebound cases have been connected to the antiviral Paxlovid. Paxlovid is a treatment proven successful in preventing serious cases in 89% of instances when prescribed, but some COVID patients on the drug—including Biden and Dr. Anthony Fauci—experience a rebound. 

While the cause is uncertain, there are common theories. One, in particular, is that those patients treated with Paxlovid who experience a rebound might be carrying a high viral load in the first place, making it hard for Paxlovid to fully combat the virus. 

Ultimately, though, any certainty about this treatment and rebound causes remains elusive. Luckily, rebounds seem to pose little threat to businesses, since most individuals who suffer from a COVID rebound usually have light symptoms and recover in about 3 days. 

Unlike rebounds, reinfections occur at least 90 days after an individual’s full recovery from COVID. Generally, this could take a few to several weeks, but if a recovering patient struggles with Long-COVID, it could take months or even years. 

COVID reinfections have appeared to be milder than most first-time cases, although not always. Each reinfection case in a single individual seems to increase the chances of contracting Long-COVID, which remains prevalent in asymptomatic or light COVID cases.

The term “Long-COVID” (also called post-COVID conditions, or PCC), refers to symptoms that last from 1 to 3 months after initial infection and apparent recovery. These include shortness of breath, fatigue, brain fog, coughing, and dizziness. However, more serious side-effects of a bout of Long-COVID can include increased risk of diabetes or heart disease. 

Around one in five of initial COVID virus cases end up as Long-COVID, and anywhere from .5% to 2% of those cases will have a very difficult road ahead with debilitating symptoms, maybe for years to come. 

Reinfection versus resurgence

So, reinfections are worryingly common, and each time someone gets COVID there’s an approximate 1 in 5 chance it becomes Long-COVID. But what is causing COVID reinfections? 

According to theories in the medical community, reinfection can be due to new, highly transmissible variants that bypass immunity gained from previous infection, which wanes as the number of antibodies goes down rapidly. 

That being the case, individuals usually have little or no immunity just 3 to 6 months after getting COVID the first time, making reinfection a great possibility. 

Another theory, only recently confirmed in relation to a relatively small number of reinfections, is that the virus itself simply never leaves the body. You heard that right. Once contracted, COVID may hide latent for a period of time, only to reemerge within a few months. 

In certain cases, scientists affirm the term “resurgence” is more appropriate than “reinfection.” 

As mentioned above, new data has shown the virus may hang around in the body for months, a phenomenon that has been witnessed in coronaviruses in the past. Scientists can sequence the genetic code of a COVID infection, and have seen that the code of a supposed “reinfection” is, in fact, nearly an exact match to the initial infection, meaning the virus simply resurfaces. 

What this new data means for employers

If a COVID infection can resurface, and bring with it the risk of Long-COVID, it means employers have an even greater responsibility to protect workers from infection. 

As the FDA acknowledged recently, home testing simply isn’t doing the job of preserving best-in-class safety. A typical home antigen test is only 45% to 80% accurate, and there are better options available, like PCR testing or a highly accurate microfluidics test

Temporarily losing a large percentage of your workforce to COVID each new surge is costly. Losing key personnel to Long-COVID is a bigger risk, one that can cripple your business for months or years. The only way to offset that risk is with best-in-class COVID testing.