What does it mean to recover from coronavirus?

In a little more than a month, the novel coronavirus has spread throughout the D.C. region, infecting more than 13,000 people and killing 330 people.

As serious as the virus is, doctors have maintained from the beginning of the public health crisis, that most people infected with the virus will have mild to moderate symptoms and will eventually recover from the illness.

But what does it mean to be recovered from coronavirus and how many people in the D.C. area actually have?

How many patients in DC area have recovered

Every week it seems, we’re learning more about the spread of the coronavirus and how it has impacted the region. D.C., Maryland and Virginia release a plethora of data on the number of new coronavirus infections, the number of patients who have been hospitalized and several other key data points.

The data includes the number of coronavirus patients who have recovered — at least in D.C. and Maryland.

D.C., which listed more than 1,600 total cases as of Friday, reports more than 400 people have recovered from the virus.

Maryland, which reports nearly 7,000 total cases, says nearly 400 people have recovered, although the state officially uses the term “released from isolation” and not recovered.

What does ‘recovered’ mean?

Regardless of the term used, both D.C. and Maryland use the same general criteria from the Centers for Disease Control and Prevention to determine when a coronavirus infection has cleared up. These criteria are based on the symptoms that a COVID-19 patients experiences.

It may surprise you, but the CDC guidance doesn’t require patients to be retested to determine if they’ve recovered from a coronavirus infection.

While some doctors may opt to retest patients after their illness, that is “contingent on ample testing supplies,” the CDC says. Many areas, including in the D.C. region, still lack adequate testing supplies.

Instead, the determination of whether a patient has recovered can be made based on symptoms, alone, the CDC says.

The CDC guidelines are:

No fever for 72 hours without the use of fever-reducing medications;
Improvement in other symptoms, such as cough and shortness of breath;
At least seven days have passed since the symptoms first appeared.

Clinicians with D.C. Health carry out daily assessments to determine that a patient no longer needs to remain in isolation, D.C. Health spokeswoman Alison Reeves told WTOP in an email.

Even after patients fully recover, “everyone is advised to continue to practice preventive measures including social distancing, staying at home when you are sick, covering your cough with a tissue or your elbow and frequent hand washing,” Reeves said.

That’s important, because epidemiologists still aren’t entirely certain that once you’ve had coronavirus, you can’t get it again. And for another, all the good hygiene practices that help protect you from coronavirus also help protect against maladies, such as colds and the flu.

Another important note on the data about recoveries: It’s unclear to what extent the CDC guidance and DC and Maryland’s data capture cases where patients suffer serious illness.

Critically ill patients who go on ventilators often face a long, difficult road to recovery, even after their underlying illness has cleared up. That includes post-traumatic stress disorder, Alzheimer’s-like cognitive defects, depression, and problems with daily activities such as bathing and eating, according to a report this week in The Washington Post.

Virginia doesn’t report recoveries

Virginia does not report data on recoveries at a statewide level.

Virginia State Health Commissioner Dr. H. Norman Oliver told reporters at a news conference earlier that data on the number of recovered patients isn’t collected by local health departments and sent to state officials.

Oliver suggested that given the absence of massive amounts of testing, even the information the state does collect — such as the total number of positive COVID-19 cases and the number of deaths — is “almost definitely an underestimate of the actual spread of the disease,” because there is still no mass testing of the population for the virus.

“We have been talking for some time now about the fact that we have widespread transmission of the disease,” Oliver said.

“There are many people who have COVID-19, who are walking around in our community … and we don’t track those numbers either because we don’t have widespread testing.”

Even though Virginia doesn’t collect statewide figures, local health departments in Virginia have been following up with people who have tested positive for the virus in their communities to track their recovery.

In Loudoun County, where there have been 250 cases reported, health department spokesman Glen Barbour said the department investigates all positive cases and monitors them until they are no longer viewed as being a risk to others, based on the CDC guidance.

In Fairfax County, which has reported the highest number of cases in Virginia — 690 — the local health department had been following up with all patients “a couple of times during their illness,” said spokesman John Silcox, in addition to providing them information on when they are cleared to return to work.

“As the number of cases increases, we will not be following up with patients in the same manner,” Silcox told WTOP in an follow-up email. “We will continue to provide them information and guidance on when it is safe to return to work and other activities.”

Nationwide numbers hard to come by

Data on the number of patients nationwide who have recovered is even more fuzzy.

A global map of coronavirus cases maintained by Johns Hopkins University, which has become a go-to global resources, provides some data. But it says its figures for U.S. recoveries are estimates that are based, in part, on local media reports, since there is no uniform standard for reporting recoveries.

A recent review by WTOP of coronavirus data released by all 50 states’ health departments found that just 11 others states — in addition to Maryland and D.C. — release data on the number of patients who have recovered or have been released from isolation.

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