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As a reporter who has covered the coronavirus since the first confirmed U.S. case landed in Seattle, where I live, I should have known what was to come, but there was a part of me that couldn’t really believe it . I had a breakthrough case of COVID-19 – despite my two injections of the Pfizer-BioNTech vaccine, the second in April.
I was just one more example of our country’s tug-of-war between the fantasies of a post-COVID summer and the realities of our still raging pandemic, in which even the vaccinated can get sick.
Not only was I sick, but I exposed my 67-year-old father and extended family on my first trip to the East Coast since the start of the pandemic. It was just the scenario I had tried to avoid for a year and a half.
Where did I get it? Who knows. Like so many Americans, I had slacked off on wearing masks all the time and physical distancing after being fully immunized. We had flown across the country, seen friends, stayed in a hotel, ate inside and, yes, even went to a long delayed wedding with other vaccinated people.
I ended up in quarantine with my father. Two rapid antigen tests (taken a day apart) came back negative, but I could tell I was starting to feel unwell. After my second negative test, the nurse leveled with me. “Don’t put your hat on it,” she said of the results. Sure enough, a few days later, the results of a PCR test for the coronavirus (this one sent to a lab) confirmed what had become evident at that time.
It was five miserable days. My legs and arms ached, my fever rose to 103, and every few hours of sleep left my sheets soaked in sweat. I fell to bed exhausted after a quick trip to the kitchen. To sum up, I would put my groundbreaking COVID case right there with my worst bouts of the flu. Even after my fever went down, I spent the next few weeks feeling weak.
Of course, I am very lucky. I did not face the virus with a naive immune system, as millions of Americans did before vaccines were widely available. And, in much of the world, vaccines are always a distant promise.
“You probably would have become much sicker if you hadn’t been vaccinated,” Dr. Francesca Torriani, an infectious disease physician at the University of California-San Diego, told me recently.
As I walked around my room to check for my fever, it was also reassuring to know that my chances of ending up in the hospital were slim, even with the delta variant. And now, about a month later, I have made a full recovery.
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The reality is that cases of rupture are more and more common. Here is what I wish I had known when these first symptoms brought me down.
1. Is it time to test reality on what vaccines can – and cannot do?
Vaccines are not a force field that keeps everything COVID away. They’ve been given the green light because they dramatically reduce your chances of getting seriously ill or dying.
But it was easy for me – and I’m not the only one – to grasp the idea that after so many months of trying not to catch COVID, the vaccine was, more or less, the finish line. And that made the illness of the virus maddening.
After all, there were reassuring findings earlier this year that the vaccine was remarkably effective in stopping any infection, however mild.
“There was so much initial euphoria over the effectiveness of these vaccines,” said Dr. Jeff Duchin, infectious disease physician and public health official for Seattle and King County. “I think we – in the public health community, in the medical community – have made it easy to feel that these vaccines are bulletproof.”
It’s hard to keep adjusting your risk calculations. So if you had hoped to avoid getting even mildly sick, maybe it’s time to do a “reset,” Duchin said. This is not to be alarmist but a reminder to dispel expectations that COVID is out of your life, and stay alert on common sense precautions.
2. What are my chances of getting a revolutionary case these days?
It used to be pretty rare, but the rise of the delta changed the odds.
“It’s a whole different ball game with this delta phase,” said Dr. Eric Topol, professor of molecular medicine and director of the Scripps Research Translational Institute in San Diego. “I think the risk of having a symptomatic infection has increased dramatically.”
But “quantifying that in the United States is very difficult” because our “data is so poor quality,” he said.
People who are vaccinated are still much less likely to be infected than those who are not protected in this way. Los Angeles County collected data over the summer as the delta variant began to increase: unvaccinated people were five times more likely to test positive than those who were vaccinated.
3. How careful do I have to be if I want to avoid a breakthrough?
Looking back, I would have liked to have taken more precautions.
And now my advice to friends and family is this: wear masks, stay away from large gatherings with unvaccinated people, and cut back on travel, at least until things calm down.
The United States averages over 150,000 coronavirus infections a day (about double what it was when I fell ill), hospitals are overwhelmed, and the White House has offered booster shots. Scientists continue to understand what is happening with revolutionary cases.
In many parts of the United States, we are all more likely to encounter the virus than in the spring. “Your risk will be different if you are in a highly vaccinated place, with a very low level of spread in the community,” said Dr. Preeti Malani, an infectious disease specialist at the University of Michigan. “The piece that is important is what is happening in your community. “
4. What does a “mild” case of COVID look like?
In my case, it was worse than I expected, but in public health jargon it was “light” meaning I didn’t end up in the hospital or needed oxygen.
This benign category is essentially a catch-all, said Dr. Robert Wachter, who chairs the Department of Medicine at the University of California-San Francisco. “Light” can range from “a day spent feeling miserable to lying completely in bed for a week, all of your bones are aching and your brain is not functioning well.”
There is no good data on the details of these mild infections, but so far it seems that “you do much better than those who are not vaccinated,” said Dr Sarang Yoon, a specialist. in occupational medicine at the University of Utah which was part of a national study conducted by the Centers for Disease Control and Prevention on breakthrough infections.
Yoon’s study, published in June with data collected before the delta surge, found that the presence of fever was halved and days in bed were reduced by 60% in people with infections. chronic, compared to unvaccinated people who got sick.
If you’re vaccinated, the risk of being hospitalized is 10 times lower than if you weren’t vaccinated, according to the latest CDC data. Those who become critically and critically ill with a breakthrough case tend to be older – in a study done before Delta, the median age was 80.5 years – with underlying medical conditions such as cardiovascular disease.
5. Can I pass it on to others and do I have to isolate myself?
Unfortunately, you still have COVID and need to act on it.
Even though my first two tests were negative, I began to wear a mask at home and keep my distance from vaccinated family members. I’m glad I did: no one else got sick.
The delta variant is more than twice as contagious as the original strain of the virus and can build up quickly in your upper respiratory tract, as was shown in a group of breakthrough infections linked to Provincetown, Massachusetts, during of summer.
“Even in asymptomatic and fully vaccinated individuals, they may have enough virus to transmit it,” said Dr. Robert Darnell, physician-researcher at Rockefeller University.
Science is not established on the likelihood of vaccinated people spreading the virus, and it appears that the amount of virus in the nose decreases more quickly in vaccinated people.
Still, wearing masks and staying isolated from others if you’re positive or showing symptoms is absolutely essential, Darnell said.
6. Could I have a long COVID after a breakthrough infection?
While there isn’t much data yet, research shows that breakthrough infections can lead to the type of lingering symptoms that characterize long-term COVID, including brain fog, fatigue, and headaches. “I hope that number is low. Hopefully it doesn’t last that long and is not as bad, but it’s just too early to know these things, ”Topol said.
Recent research in the UK suggests that people who are vaccinated are around 50% less likely to develop long-lasting COVID than those who are not vaccinated.
This story is from a reporting partnership that includes NPR and KHN.
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