Sonoma County infectious disease specialist answers more of readers’ COVID-19 questions

Can you get coronavirus twice? Is it common for symptoms to linger after you’ve recovered?

Evolving research and even misinformation makes it easy to become overwhelmed during the pandemic.

We reached out once again to a local infectious disease specialist to answer readers’ questions. Dr. Gary Green is the medical director of infection control at Sutter Santa Rosa Regional Hospital and the medical director of quality for Sutter Medical Group of the Redwoods.

Here’s what Green had to say about everything from coronavirus antibodies to what researchers still don’t know about the virus.

This story was updated on Sept. 12, 2020.

Can you get COVID-19 more than once?

The short answer is that researchers still are collecting information to answer this question.

“Some may not develop a strong enough immune response (called ’natural immunity’) to protect and prevent a second infection,“ Green wrote in an email. ”Overall, we think that, from a few case reports early on from China, repeat infection is rare. Each day we are learning more about this novel virus, how it behaves and how our immune systems respond to it individually and in specific populations. “

If you have antibodies to COVID-19, can you spread the virus to others?

Antibodies are proteins that our immune systems develop in response to any type of infection, Green explained. Our bodies make many types of antibodies — some which are helpful to our immune systems and some that aren’t.

“We use these antibodies to detect exposure [to] the virus, which we call serology,” he wrote. “Just because a patient makes an antibody response does not mean that response is protective. With COVID-19, we currently believe that by the time a patient makes antibodies, they are usually no longer contagious.”

If you are hospitalized with COVID-19, what treatment methods are there? What medicines are commonly used right now?

The medication remdesivir, convalescent plasma and anticoagulants, which help prevent blood clots, all are being used to help treat the virus, according to Green.

The treatment methods used across the Sutter network are based on scientific data from international studies and collaborations, he wrote. In early March, the hospital participated in compassionate use study of remdesivir. A National Institute of Health study later showed that the medication reduced patients’ recovery time from 15 to 11 days.

“Additionally, we are a part of a national research study with the Mayo Clinic to study COVID-19 specific plasma treatment,” he wrote.

Will any vitamins or supplements taken to boost my immune system prevent me from getting COVID-19?

There are ongoing studies worldwide that are researching whether vitamins and supplements can treat or prevent this virus, Green wrote. To ensure a treatment is ethical, safe and effective, it first should undergo a study called a randomized control trial. This study should be approved by an Institutional Review Board with oversight from the Food and Drug Administration.

Vitamin D is being studied extensively worldwide, Vitamin A is being studied at UCLA and Vitamin C is being studied in Canada. “Some vitamins and supplements can be dangerous if taken in large quantities and should only be used for COVID-19 in a research setting to ensure patient safety,” Green wrote.

If I am going for a run or a bike ride, should I wear a mask the entire time?

If you’re exercising outside near others, you should cover your nose and mouth with a face mask or other covering, Green wrote. This isn’t as important when you’re alone, but you should carry a face covering with you in case you enter an area with other people.

Is it normal to experience lingering symptoms after recovering from COVID-19?

“Symptoms like cough, fatigue and breathlessness can linger based on what we currently know,” Green wrote. “We are learning that after moderate or severe COVID-19 illness, the recovery time can last for weeks, and sometimes months, before we get back to our baseline health.”

Some people also are experiencing lingering neurological symptoms and say they’re feeling foggy. It’s unclear whether that’s part of the fatigue of a major illness or if COVID-19 affects the brain, Green explained.

Why is hydroxychloroquine unsafe to take for COVID-19?

Every medication has risk, and hydroxychloroquine can alter the heart’s conduction system, Green wrote.

“In early July, the FDA published a review of safety issues regarding the use of the drug to treat hospitalized patients with COVID-19,” Green wrote. “In addition, the World Health Organization (WHO) has recommended that most research studies of this medication be stopped for safety reasons.”

The FDA also has warned that the medication could interact with remdesivir, he added.

Does blood type affect whether you get the virus or how your body responds to it?

The medical studies on this topic have had contradictory results so far, according to Green. But as research continues, more information likely will be released in the coming months.

“A few previous studies have noted differences in COVID-19 severity with blood types A and O, but a recent large Harvard study did not show a difference in COVID-19 severity and outcomes with blood types,” Green wrote.

What are some of the biggest unknowns about the virus right now?

“There are many important questions about this virus that we have yet to understand,” Green wrote. “Some are very basic, like why are the elderly at such risk of severe disease. Another important area of research is why children have a less severe course overall, but then a handful of children have a very critical illness well after the acute viral disease.”

How similar is COVID-19 to the coronavirus that causes the common cold?

Human coronaviruses and COVID-19 are all part of the same virus family, Green explained. But it’s uncommon for other coronaviruses to cause anything more than a head cold.

“This new virus, COVID-19, attaches to cells in the upper and lower respiratory tract, which may lead to pneumonia or other complications in some people,” he wrote. “This makes this virus more dangerous than the common cold.”

If I work around people all day, what are some of the best ways to protect myself and my family?

Wearing a mask, social distancing and not touching your face are important protective measures, Green wrote. So is washing your hands frequently, especially when touching surfaces such as doorknobs, counter tops and shopping carts.

“Remember, people appear to be most infectious with COVID-19 early in the course of illness when symptoms are so mild that people think they might not be ill at all,” Green wrote.

Is there more than one strain of this virus and has it mutated?

COVID-19 is an RNA virus similar to influenza, Green explained. Like influenza, it’s likely that COVID-19 will mutate, but that doesn’t mean it will become more harmful.

“In general, most of the mutations of viruses result in a virus that is no longer able to survive, and very few mutations make viruses more contagious or more dangerous,” Green wrote.

Many laboratories are participating in an international effort to follow virus strains or subtypes called “clades.” “Research shows there is one new clade of COVID-19 called “G614” that may be more easily transmissible but does not seem to be any more dangerous,“ he added. ”This was the major strain/clade in Italy, France, Spain and New York that may have contributed to the high incidence of cases in those regions.“

What is the best kind of mask?

“Cloth masks or scarves will help stop the spread of COVID-19 if a person is infected with the virus,” he wrote. “Masks with an open hole or ’vent’ will not offer much protection and are not recommended by the CDC.

“Surgical masks are a little more protective than homemade cloth masks, and we use them in medical settings. The N95 masks are more accurately classified as respirators and offer one of the best protections to someone in close contact with a COVID-19 patient. We wear these masks in the hospital setting when caring for suspected or confirmed COVID-19 patients.”

Does a flu shot help prevent COVID-19?

Although a flu shot doesn’t protect you from COVID-19, it helps prevent contracting both viruses at the same time, according to Green. A study based in Brazil shows that patients who received the flu shot had improved chances of surviving COVID-19, likely because they were less susceptible to both viruses.