26.MAY.2020 4 MIN READ | 4 MIN READ

As the SARS-CoV-2 (COVID-19) pandemic spreads and time passes, more is being discovered about the patterns and trends of the virus and whether there is risk of re-infection.

It has been reported that in China, where the disease is believed to have originated from, about 14% of COVID-19 patients who tested negative upon hospital discharge have been tested positive once again and re-admitted to hospital for observation.

While the immune response to this virus is not yet fully understood, experts think that these patients relapse because:

  • they hadn’t built up a strong enough immunity and are more susceptible to the virus a second time
  • the original infection was “biphasic”, meaning the virus lies dormant in the body until the patient becomes symptomatic with the same infection again.
  • the test results were flawed

The report also showed that some patients who tested positive again appear to be asymptomatic. While there has been no documented asymptomatic transmission to date, according to World Health Organisation (WHO), it doesn’t mean that a transmission of the virus from a person who does not develop symptoms will not occur. This is why if you have already been through the COVID-19 virus, you should still take all the precautions you can to avoid re-infection and rehospitalisation, for the sake of you and your family’s health.

What you can do to reduce the risk of re-infection

1. Wash your hands frequently

Wash your hands thoroughly with warm water and soap before and after both preparing food and using the bathroom as well as after you return from the outdoors. Wash your hands again after using your phone or laptop and other commonly handled objects around the home. Be sure to lather up to the wrists, between your fingers, and under your fingernails as you wash. If you are outdoors and can’t wash your hands, use a hand sanitiser with at least 60% alcohol.

2. Avoid skin-to-skin contact

Avoid skin contact
You can pick up SARS-CoV-2 on your hands from surfaces you come into contact with. When you then touch your eyes, nose or mouth, lick your fingers or bite your fingernails, you risk transferring the virus into your body. The virus can spread through secondary contact with mucosa (found covering eyes, inside the nose and mouth)

3. Don’t share things

Keep your possessions to yourself and don’t borrow either. Don’t share food and drinks from the same plate, cup, glass or eating utensils with others. Similarly in the bathroom, don’t share towels, washcloths, toothbrushes or skin products with anyone else.

4. Keep your social distance

Anyone infected with SARS-CoV-2, whether they present symptoms or not, will carry a large amount of the virus in their saliva and can transmit the virus simply by talking to someone in close proximity. To be safe, make sure you keep a social distance of at least 2 metres from any other person. As we prepare for gradual resumption of activity following the end of circuit breaker period, it is important to ensure that we continue to maintain social distancing by avoiding group gatherings and dining out even for many months after.

5. Wear a cloth mask if you go out

Wear a mask
Where social distancing proves difficult, such as in the supermarket, everyone present should be wearing a mask. This reduces the risk of spreading the virus through breathing, talking, coughing or sneezing. When wearing your mask, avoid touching and fiddling with it, as you could transmit the virus from your hands to the mask. Wash both the mask and your hands after each use.

6. Insist on others wearing masks around you in public

SARS-CoV-2 is spread by air droplets when an infected person sneezes or coughs. These droplets can also land and stay on hard surfaces for up to 3 days. Insist that those around you cough or sneeze into their mask or a tissue, and that they wash their hands immediately afterwards.

7. Keep your home disinfected

Clean hard surfaces in your home, such as door handles, counter and table tops, furniture, electronic items and toys, with alcohol-based disinfectant a few times a day. Remember to also wipe surfaces on which you have placed items such as shopping bags brought into the home from outside.

8. Wash fresh groceries

Wash fresh grocery
Wash all fresh vegetables with vegetable antibacterial wash and dry them thoroughly before storing. Be sure to wash your hands before and after handling food.

With no treatment or vaccine yet for COVID-19, and not enough information to know whether people who recovered from COVID-19 develop long-term immunity from it, it is important to know the facts and take all the appropriate precautions for months or even years to come. Always follow the advice provided by your local health authority.

Seek medical attention if any of the following symptoms of COVID-19 develop:

  • difficulty breathing
  • pressure or pain in the chest
  • confusion
  • drowsiness or inability to be roused
  • blue-tinged lips or face

 

Following the end of the circuit breaker period, Mount Elizabeth Hospitals and our 24-hour A&E clinics will continue to deliver essential healthcare services to those in need. If you or your family members are experiencing urgent medical symptoms, seek medical help immediately.

Rest assured we have implemented measures to safeguard the health of our patients, visitors and staff. Learn more about how we keep our hospitals safe.

Let us remain COVID-safe and #BeatCOVIDwithME.

 

Article reviewed by Dr Leong Hoe Nam, infectious disease specialist at Mount Elizabeth Novena Hospital

Reference

Coronavirus (COVID-19) Prevention: 12 Tips and Strategies. Retrieved 14/4/2020 from https://www.healthline.com/health/coronavirus-prevention

Experts explain why coronavirus can reappear in discharged patients, raising questions about containment moves. Retrieved 14/4/2020 from https://www.straitstimes.com/asia/east-asia/experts-explain-why-coronavirus-could-reappear-in-discharged-patients-raising

Discharged coronavirus patients here no longer have viable virus and will not spread disease: NCID. Retrieved 14/4/2020 from https://www.straitstimes.com/singapore/health/discharged-coronavirus-patients-here-no-longer-have-viable-virus-and-will-not

How Long Does It Take To Recover From COVID-19?. Retrieved 14/4/2020 from https://www.npr.org/sections/health-shots/2020/04/13/833412729/how-long-does-it-take-to-recover-from-covid-19-and-how-long-are-you-infectious

Coronavirus disease 2019 (COVID-19) Situation Report – 73. Retrieved 26/5/2020 from https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200402-sitrep-73-covid-19.pdf?sfvrsn=5ae25bc7_2

26.MAY.2020
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Leong Hoe Nam
Infectious Disease Specialist
Mount Elizabeth Hospital

Dr Leong Hoe Nam is an infectious disease specialist practising at Mount Elizabeth Novena Hospital, Singapore. His clinical interest is in the treatment of complex infectious diseases such as tuberculosis, HIV and surgical complications, especially for transplant patients and patients with multi-drug resistant organisms.