FORT WORTH, Texas - Meredith McKee rushed to the hospital in June after taking her blood pressure at a CVS pharmacy and seeing it was dangerously high. The emergency room staff at Texas Health Presbyterian Hospital admitted her but insisted on testing for COVID-19.
"I laughed at the team and said I had already had it," said McKee, a 45-year-old Dallas resident. "There's no way I could have COVID again."
But the test proved her wrong.
"I didn't have any symptoms other than high blood pressure," she said. "If it wasn't for the second test, I would have never known."
McKee was first diagnosed with COVID-19 early this year after experiencing mild symptoms. She recovered after a few weeks and later tested positive for antibodies. She stayed in her home since then, only going outside if it was essential. But in late May, she felt it was safe to attend a couple of outdoor social events and a close friend's birthday party.
"It was before the mask mandate, so no one was wearing masks," McKee said. "If I would have known there was a possibility for reinfection I would have never gone."
Confirmed reinfection cases are extremely rare worldwide, and new research suggests immunity to the coronavirus could last years, so why are health experts sounding the alarm that there's not enough data to know how effective antibodies are at fighting COVID-19?
Testing of reinfected patients is limited because the second time around symptoms could be minor, nonexistent or completely different from the first infection.
The current threshold for confirmed reinfection cases must show the second virus was different from the first contracted virus, excluding a countless number of patients who did not have an initial test.
As of this week, more than 66,000 people had recovered from COVID-19 in Tarrant County. Armed with new antibodies, these patients might think they no longer have to take the same precautions or worry about reinfection, but that's not the case, according to Mark Pandori, director of the Nevada Public Health Laboratory, who warns that there's not enough data to know how effective antibodies are at fighting this novel coronavirus.
"There's no invulnerability or immunity passport that comes with having been infected with this," Pandori said. "You can't assume you're in the clear just because you've had it because your own natural immunity may not last very long to this virus; we don't know that yet."
Pandori was part of a team researching the case of a 25-year-old man from Reno who tested positive for COVID-19 in mid-April, recovered but got sick again in late May with more severe symptoms, according to a study published in the Social Science Research Network.
This was the first confirmed reinfected patient in the U.S. and one of only three confirmed cases in the U.S. and 26 worldwide, according to an unofficial COVID-19 reinfection tracker published by BNO News. The tracker, which bases its finding on case studies and news reports, showed an additional 599 suspected cases, including 28 in South Dakota and 100 in Washington state as of Nov. 21.
In comparison there were 59.9 million COVID-19 cases worldwide as of midweek, according to data from the Johns Hopkins University School of Medicine.
Until late August when the first confirmed reinfection case was reported in Hong Kong, most reinfection cases were considered anecdotal, according to the World Health Organization.
In order to count as a reinfection, a patient must have had a positive test twice with at least 23 symptom free days in between, according to Russel Hopkins, director of emergency preparedness at the Northeast Texas Public Health District, also known as NET Health.
One of the first cases NET Health started tracking as a possible reinfection was of a health care worker who recovered from COVID-19 but continued to shed the virus for months, Hopkins said.
He said this patient and many others in North Texas will test positive after a second COVID-19 test because the patient has a residue from the original infection in their respiratory tract or they could have suppressed the virus but never fully recovered.
"That's more common than reinfection or at least there's more documentation," Hopkins said.
Early in the pandemic, NET Health developed a system to help identify duplicate cases. As of this week, this was the only tool it had available to help identify reinfections but there is a major flaw, Hopkins said. Testing.
"Why would someone go get tested four months after they've recovered, especially if they are not showing any symptoms," Hopkins said. "We're not calling people in, and I don't know anybody else that may be doing this."
Since McKee checked out of the Texas Health Presbyterian Hospital in Dallas, no one has called to inquire about her possible reinfection other than a few journalists from local media outlets. Earlier this week, she told the Star-Telegram she is still not certain if the virus was simply dormant or if she caught a different strain the second time she tested positive.
In an emailed statement, the Texas Department of State Health Services said it is developing the guidance for identifying potential reinfections. Once the criteria are finalized, the department will be able to review suspected cases of reinfection. The department anticipates finalizing the guidance next month, according to the statement.
The U.S. Centers for Disease Control and Prevention is also "actively working to learn more about reinfection to inform public health action," according to its reinfection with COVID-19 page last updated on Oct. 27. The page recommends wearing masks, social distancing, hand washing and avoiding crowds and confined spaces, "whether you have had COVID-19 or not."
"It is surprising to me that they are still not tracking or following up with patients that could be reinfected," McKee said.
She said she worries about the people who recovered from COVID-19 and think it's OK to go to Thanksgiving dinner with the family because they can't catch the virus or spread it anymore.
"Well, I'm here to tell you, 'You're absolutely not immune even if you've had it,'" McKee said.