Wait, did WWE’s Kayla Braxton really get COVID-19 TWICE?

Is that even possible? Virologist Jim Duehr returns to examine.

June 29, 2020

The enormous surge of new coronavirus cases in Florida has, unavoidably, affected WWE, which has been running all shows for the last several months from their performance center in Orlando. It’s been reported that perhaps dozens of talents, both off- and on-air, have tested positive within the last week.

While the most notable name revealed is host and backstage personality Renee Young (who wasn’t even tested by WWE; she had it done on her own), the most curious case may be that of interviewer Kayla Braxton, who claims to have just tested positive for COVID a second time.

Was keeping it quiet but since everyone else is sharing, I feel like it is my responsibility to share this PSA: YOU CAN GET COVID-19 MORE THAN ONCE! I had it back in early March and then thought I was invincible after I recovered. Not true. Dont be dumb like me.

Sadly, she was bullied right off Twitter shortly thereafter, but was any of it really warranted? Can you get COVID more than once? Is there no immunity?

AIPT Science reached out to virologist and contributor Jim Duehr to see where the state of our knowledge on this crucial question really is.

Wait, did WWE's Kayla Braxton really get COVID-19 TWICE?

Unfortunately, I have to start this answer with a very broad caveat — there’s a lot we still don’t know about this virus. “Can you ever get re-infected?” is probably one of the biggest question marks.

So instead of waxing philosophical and loading you with lots of useless info, I’m going to just give you the facts and then try to make some best guesses out of those facts.

Here’s what we know so far

There were a series of cases (150+) in March and April in South Korea where someone tested positive, had symptoms, got better, and then later tested positive again. Scientists are pretty sure those weren’t actually “new” virus (see the next section).
Scientists have determined people actually do make antibodies against the virus.

A few studies have shown that people even make neutralizing antibodies ⁠— the kind you need to be truly “immune” (but most of these focused on the very ill & hospitalized).
One study found that 40% of people who don’t show symptoms lose neutralizing antibodies after two months, while only 13% of people with symptoms do. Almost everyone in both groups (80% and 62%) had a big drop in the amount of neutralizing antibodies.
In America, WWE has tested a lot of people, and one announcer (Kayla Braxton) has said she has tested positive for the second time, with the first being in March. It’s unclear whether or not she has/had symptoms for either of these times.

There are basically three possibilities for someone who tests (+) for COVID after recovering

It’s real! They really did get infected again. There are two reasons why this could be:
1. Their immunity went away (via loss of neutralizing antibodies)
2. They never became immune at all. Immunosuppression is the most likely reason.¹ But these people would also likely get very sick with COVID.

It’s not real! Test was a false positive. This is way less likely if they always repeat a (+) test.²
It’s really COVID, but it’s not a second infection. It’s still the first. In other words, the virus was “latent.” This is likely what happened in South Korea, and we’ve seen it in the U.S., too. Often it isn’t actually virus still in the body, being spread outward from your mouth and infecting other people, but instead just the genetic code that makes the virus (its RNA).

Of those possibilities, #3 is more likely than #1, and #1 is much, much more likely than #2.

#2 is unlikely given WWE’s repeat testing (although it is unknown exactly how much of this is going on). #3 is only more likely because we’ve seen lots of people test (+) again after recovering, and they mostly don’t spread actual virus to the people around them.

If Braxton has truly been re-infected, it would certainly be novel.

So they’re probably not re-infected, but instead latently infected. Sixty days is on the longer end of what we would expect in other viruses (like Ebola or Zika). If Braxton has truly been re-infected, it would certainly be novel.

That notwithstanding, if Braxton was asymptomatic the first time around, this is exactly when we would expect re-infection to be a distinct possibility. Unfortunately, it’s extremely difficult (if not impossible) to determine if any specific person with a second (+) test has actually been re-infected or not. We’d need to compare the genomic sequences of the virus from the first infection and the current disease. This kind of full virus sequencing isn’t done for every patient.³

^{1. Immunosuppression has lots of different causes, including genetic mutations, other viruses like HIV/AIDS, or acquired temporary conditions like chemotherapy or pregnancy.}

^{2. Out of 1,000 tests, you might expect 30 false positives ⁠— not a ton, but also not zero. With repeat testing of every (+), it’s more like 9 out of 100,000. Extremely unlikely.}

^{3. Very few people have their full virus sequenced. And it typically happens only at a few hospitals attached to universities. It just isn’t necessary to confirm it’s SARS-CoV-2. When they test you with a nasal swab, they’re looking for just a few of the letters in the virus, not all of them. Only enough to know that it’s SARS-CoV-2 and not a different disease.}