Coronavirus Survivors Have Questions About What Recovery Means

Hundreds of thousands of people are recovering from coronavirus. They have many questions about what recovery is like and what to expect — such as: Do I now have full immunity against the virus?

NOEL KING, HOST:

Medical experts tell us to expect many, many more COVID-19 deaths in the next few weeks, possibly even thousands per day. But we need to remember that a lot of people have gotten better. More than 260,000 people around the world have recovered - that's according to Johns Hopkins, which is following the numbers. NPR's Allison Aubrey has been looking into recovery. Hi, Allison.

ALLISON AUBREY, BYLINE: Good morning, Noel.

KING: So what does it look like to get better from this virus?

AUBREY: Well, recovery likely depends on a lot of factors - age, what risk factors and chronic conditions people had before they got infected with the virus. I've spoken to several doctors who've had COVID and are now recovered. They're back to work. One is ER doctor Rosny Daniel. He works at UC San Francisco. He told me the first few days of his illness, he had aches, chills, fever. He felt wiped out. Then he started to feel better.

ROSNY DANIEL: My symptoms improved for probably four or five days. Then I felt fine. And the scary thing is symptoms came back on Day 7 for me. So at that time, I started having some trouble breathing. I do have some comorbidities. I am asthmatic and pretty mildly asthmatic. I also have Type 1 diabetes. So it was kind of scary to develop that fever and trouble breathing a week into the illness.

KING: Well, that is scary because he has those underlying conditions that we hear are so dangerous with COVID-19.

AUBREY: That's right.

KING: What happened to him next?

AUBREY: Well, he did get better. He used his inhalers for the asthma. He was put on an antibiotic in the event that he had a secondary bacterial infection in his lungs. And he says within several days, he began to feel better. Now he says he feels back to normal. He's very healthy. He's a young doctor. Generally speaking, people with chronic heart or lung disease appear to be at higher risk, especially older people. But the CDC says there's not enough information to determine specific risks tied to each condition.

KING: OK. I want to ask you a question that has been circulating in my family and friend group a lot over the past couple of days. For people who have gotten it and then recovered, how do they know when they're not contagious anymore, when they can go back out into the world?

AUBREY: Well, the standards for health care workers are different than the guidelines for the rest of us. Rosny Daniel was off work for about three weeks; he's now back to work. And the process to be cleared back to work that his hospital uses is this.

DANIEL: The guidelines that we're using are 14 days past your initial symptoms, plus 72 hours of no symptoms.

AUBREY: And another way health care workers are cleared back to work is after two negative tests.

KING: OK, what about for the rest of us, though?

AUBREY: Well...

KING: When is it safe to stop isolating, go back to work maybe?

AUBREY: Yeah. The guidance from the CDC is as follows. People can stop isolating themselves when they've been fever-free for 72 hours, so three days after the fever ends, and this is without the use of any fever-reducing medicine. They should also see improvement in symptoms, such as cough. And this should be at least seven days from the onset of their initial symptoms. As more testing comes online, a negative test result would also inform the decision.

But, you know, it's worth noting right now the CDC says this is all based on limited information. So this guidance could change as they learn more.

KING: Do scientists know yet if a person can get reinfected? Or if once you get it, are you immune?

AUBREY: Right. Well, the CDC says the full immune response, including the duration of immunity, is not really fully understood yet. So while there's an assumption that people who've recovered from COVID will have some immunity, ER doc Rosny Daniel says there's also some uncertainty.

DANIEL: I hope I am protected against reinfection, and I hope that my antibodies are all ramped up and I'm protected from getting sick again, but I don't know that for sure. So I'm treating it as if I don't have immunity, and I wear full protection at all times, by our hospital's guidelines, to make sure I'm still protecting myself.

AUBREY: Now, I spoke to another physician who is also recovering from COVID. He's a cardiologist at Children's National here in the Washington, D.C., area. His name is Darren Klugman. And he says, eventually, this issue of immunity will be better understood, but he, too, says for now it's hard to be certain.

DARREN KLUGMAN: I don't think you can say for 100% certain that one is immune unless you have had serum testing of antibodies to the virus, and I have not had that. So while it is presumed that it's unlikely that one can contract this twice, I don't think that it's safe to say that one is immune unless you've had serum testing for antibodies.

KING: What is serum testing?

AUBREY: Well, the serum testing - it's not a diagnostic test. These kinds of tests are looking for antibodies, for looking for signs you've been infected and you have these antibodies now that can protect you. These tests are under development, but they're not widely available yet.

Now, Klugman says, in his case, he did feel poorly for about nine days. He had aches, chills, a fever for a few days. He said he slept a lot, had a real lack of energy. He quarantined himself in his basement, away from his family, for 14 days. But now he says he's back to normal.

KLUGMAN: No limitations at all. I feel excellent. I've been running. During our children's PE time at school, in their virtual PE, we do family fitness classes that we find online. And so yeah, I'm back 100%.

AUBREY: And he says as hard as this pandemic is - I mean, it's brutal with these thousands and thousands of deaths - we also need to be reminded that there are many mild cases. There is unpredictability here, but what was shown in China is about 80% percent of cases were considered mild.

KLUGMAN: The majority of people will have a mild to moderate flu-like illness like I had and will do just fine with this. Most importantly, however, is recognizing the symptoms early, isolating oneself and really strictly abiding by the quarantine rules.

AUBREY: He says this is the best way to protect yourself and to stop the spread of the illness.

KING: NPR's Allison Aubrey on the 260,000 or so people around the world who have recovered from COVID-19. Allison, thanks so much for your reporting on this. We really appreciate it.

AUBREY: Thank you, Noel.

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