Perhaps the question to ask is how many times will you get sick from COVID-19?

Humans love black and white answers. In life that quest is usually futile but for some reason we continue to strive for that level of simplicity. As with life, the answer to the COVID-19 question consists of variables. The good news is that with only a basic understanding of those variables, we can all successfully navigate away from fear and in the direction of truth.

Let’s discuss three variables that factor into “catching COVID”.

Variable #1 The Disease

Unless you have been stranded in a remote, undersea village of mermaids, you know that COVID-19 belongs to a family of virus known as coronavirus. The common cold is a coronavirus. How many common colds have you experienced in your life? On average in the USA, 64% of those age 10-40 years old have symptoms related to the common cold 1-3 times each year. Do these people get sick from the same coronavirus each time? Not likely. There are 200+ known coronavirus strains that manifest as a common cold. Even if you were unlucky enough to catch 1-3 each year, you could be very old indeed before gaining some level of immunity to them all.

Coronavirus mutate to survive in changing environments. Small changes to the structure of these virus can disguise the virus and fool your immune system, allowing infection. When these virus come up against resistance from antibodies (produced by previous exposure or vaccination) they have to mutate to continue to survive. A mutation equals a new strain or “variant”.

The good news is that we have an immune system that has the ability to mitigate these exposures and restore us to a healthier state.

Variable #2 Your Immune System

We are designed with an elegant system of defense that when functioning correctly, actively works to reduce the risk of serious illness from new invaders and recurring infections. An important thing to note here is that your immune response is activated after there is infection (not illness). It does not somehow seek and destroy those little buggers outside of the body. So again, will you likely become infected by COVID-19 multiple times? Yes, it is likely…but the practical question to answer is will you feel sick each time you are infected?

We know that the immune system will produce antibodies and immune memory cells against invaders. This happens so that if the same virus infects the body again, the immune system can respond before the invader replicates enough to cause illness.

Prior exposure (infection) by one strain of virus may provide at least some protection against other variants of that virus. It may not prevent illness, but this crossover protection may inhibit the level of infection and make it a less severe illness.

Let’s consider two types of exposure that will elicit an immune response to COVID-19 or its varients: Natural and Artificial.

Natural exposure does provide the most comprehensive immune response to a virus. The antibodies and memory cells produced in response to a natural exposure to a pathogen are more comprehensive in the complexity of the protection they provide.

However, the downside is that the strength of the immune response will determine the level of protection that develops. A low response may mean that the same – unmutated virus – may be able to cause illness for a second time. There may also be little crossover protection to a variant of that same virus.

A strong response will generally create a strong and lasting protection through the production of memory B and T cells. Measuring this response has not been well developed. It would be clinically useful to develop a standardized methodology for determining the level of natural immune response and therefor the need for additional artificial interventions.

What are some things that may result in a reduced immune response? A reduced immune response may result from a low exposure to a pathogen (in this case a virus). Or the immune response could be reduced due to an unhealthy (diseased) immune system, incapable of a proper response. This why the elderly, those with complicating health factors or those using immune suppressing drugs are more at risk for more serious or even deadly consequences. Obviously, this is another reason why it is so important to do the things we can do with smart lifestyle choices to create and maintain a healthy immune system.

Artificial Exposure (aka vaccination) The basic premise of this approach is that once an infective mechanism is identified on a virus or pathogen, a specific countermeasure can be manufactured and concentrated. This countermeasure is injected into the body to provide a predictable concentration of artificial exposure to illicit a predictable immune response. Sounds very black and white and simple right? Obviously not, otherwise all threats from existing virus would have been eliminated by now.

Some amount of protection against the specific infection mechanism may be achieved in this manner and this may provide some protective value to mitigate the severity of disease. The downside is that the protection is not nearly as comprehensive as natural exposure. In other words, there are more gaps in the protective immune net. Also, often there are serious safety concerns about the contents of the vaccination solution and to whom they should be given.

When it comes to COVID-19 and it variants, because it is so new to our environment, both natural and artificial exposures have unknown durations of protection. Historically speaking with other pathogens, we know that natural immunity, once memory cells are present in the body, has proven itself to be effective. Vaccinations often require regular boosters until there is a natural exposure to complete the immune response. Perhaps in the case of COVID-19 this may be an approach for those populations that are at high risk of severe illness or death. That is presuming the vaccine is proven to be safe, especially over the long term.

Variable #3 End Game

There is growing consensus that the natural evolution of this type of virus is to become more inert over time. COVID End Game This path would allow COVID-19 to blend in with all the other coronavirus variants that circulate around this planet.

Eventually, either through natural repeat infection, perhaps combined with vaccination boosters and developing therapeutics, our adaptive immune system will react to this virus like the many types of coronavirus before… another common cold.

However, part of the end game may involve working through possible confusion regarding the difference between infection, illness and transmissibility. Soon many more of you, vaccinated or not, prior COVID illness or not, may experience a second, third or several positive COVID test results with or without symptoms. Subsequent illness from COVID-19 is expected to be less severe but remember there are many other little buggers out there that can make you sick too. Wouldn’t it be interesting to know just how often people are COVID positive and never know it? Is this trend increasing or decreasing? How would knowledge like that shape our perception of the disease? Our response? Our attitude toward COVID?

Say you are feeling fine and a random screening shows you are COVID positive, what will that mean? What if you have classic COVID symptoms but are COVID negative (confirmed) what does that mean? One thing for sure is just because you happen to test positive or negative for COVID does not mean it’s acting alone.

Let’s play this out for an example. You are feeling fatigued and have developed a 101.2 fever. Even though you tested positive for COVID-19 over one year ago, and had gotten very ill from it, you have a COVID rapid antigen home test kit and you decide to test. The test shows positive for the second time in your life. You do the honorable thing and self-isolate. Maybe you call your doctor and get some prescriptions or take your best natural remedies. Your health continues to degrade. Unknowingly you have COVID and Influenza A, and it’s the influenza causing your symptoms, not COVID. In this scenario, if clinical discernment is not applied correctly, the COVID therapeutics may not be helpful and the time wasted on them may give that influenza the time it needs to do serious damage.

Bottom line, we cannot presume illness is always COVID, not even in a pandemic. When we are ill and only test for one thing, by our actions we are presuming our illness is due to that one thing. We still need to have informed clinicians and better, more comprehensive, rapid testing involved to help navigate through the times ahead.

It is possible that we will see the arrival of more broad-spectrum rapid testing. It would be wonderful if these tests would also be able to tell the dominant pathogen and therefore the most likely cause of the symptoms being experienced.

COVID is just the latest member to join the ever-growing cast list of little buggers in our world. Like all the rest, it is likely that the majority of people with a healthy immune system will eventually learn to deal with COVID without much disruption. It is important that open, honest research continues, so that everyone, compromised immune system or not, has a chance at the best possible outcome.