Can you get COVID-19 twice? A veteran at the Holyoke Soldiers’ Home who had seemingly recovered from virus tests positive

Active positive case identified at hard-hit home for first time in weeks

The Soldiers' Home in Holyoke.Blake Nissen for the Boston Globe/file

State officials have temporarily cut off visitation at the Holyoke Soldiers’ Home after a resident who seemed to have recovered from the novel coronavirus tested positive again, signaling a possible reemergence of COVID-19 at a facility that had endured one of the nation’s most notorious outbreaks.

The resident began showing symptoms Monday and was transferred to a local hospital, where he tested positive, a state official said Tuesday.

It was the first time in weeks that an active positive case had been identified at the Soldiers’ Home, now under interim leadership after at least 76 elderly residents died of the virus and dozens more fell ill amid shocking conditions earlier this year.

Asked whether state officials believe the man had become infected a second time, Brooke Karanovich, a spokeswoman for the state’s Executive Office of Health and Human Services, said, “We don’t know the answer to that. That’s one of the things about the pandemic — that it’s new. We don’t know exactly what this is.”

Experts said that it’s possible, but uncommon, for people to get infected and sick with the coronavirus more than once.

Reinfection is “not the rule, it’s the exception,” said Dr. Michael Mina, an epidemiologist at the Harvard T. H. Chan School of Public Health.

Mina likened the immune system to memory. Some people need to study a fact more than once before they can retain it — and some need to confront a virus multiple times before they develop a strong immune response. That’s why many vaccines require booster doses to be effective.

Likewise, he said, both immunity and memory decline with age. Just as an older person may forget someone’s name, his immune system may fail to recognize a virus that it has encountered before. This happens with many infections, not just the coronavirus.

Another possible explanation for the veteran’s illness, Mina said, is that the original virus lay dormant in his body for a time and then resurfaced. It’s also possible that he came down with an unrelated illness, and his COVID-19 test came back positive because virus fragments from the first infection remained harmlessly in his body.

No one has solid documentation of someone coming down with COVID-19 more than once, said Marc Lipsitch, director of the Center for Communicable Disease Dynamics at Harvard’s public health school.

Korean health authorities reviewed more than 100 cases of people who tested positive, then negative, then positive again. “All could be explained as false negatives or the virus beginning to replicate heavily again after being at a lower level,” Lipsitch said.

It’s possible the Holyoke veteran’s illness is a case of reinfection, but that doesn’t mean that COVID-19 fails to confer immunity, Lipsitch cautioned. “That would be like saying, if one plane crashes then no plane is safe,” he said.

“It’s very likely that people will be immune to COVID after infection, and that immunity will be imperfect — it won’t last forever and will be protective but not perfectly protective in some people,” he said.

The Soldiers’ Home resident tested positive “early on” in the pandemic, Karanovich said, declining to be more specific. He survived the infection and had been among 21 residents living on a unit for those who had clinically recovered from COVID-19. Karanovich said all residents on that unit are now quarantined.

She had no information on whether the man had ever tested negative. When he became ill on Monday, she said, his symptoms were “comparable to COVID.”

Officials are testing all residents and staff members who consent before deciding whether to resume visitation.

“We’re pushing to get expedited testing results,” Karanovich said, “in the hopes that we can decide whether or not it’s safe to resume.”

The Soldiers’ Home suspended visiting for Tuesday and Wednesday. Previously, it had been allowing two visitors at a time to meet with residents — masked and 6 feet apart — in an outside location, by appointment Tuesday through Saturday.

The home is under interim leadership as it struggles to recover from last spring’s outbreak. A state-commissioned report released last month found that former leaders at the home had made “utterly baffling” mistakes, including failing to plan or execute basic measures to stem the spread of the virus.

That included the decision to merge two locked dementia units in late March, creating what the report called “deplorable” conditions for 40 veterans crowded into a space designed to hold 25. A recreational therapist who was instructed to help with the move told investigators she felt like she was “walking [the veterans] to their death,” the report said.

But since June 18, state officials have reported that all residents there had recovered, and in near daily updates, the last of which was sent Friday, zero positive cases were reported at either the facility or Holyoke Medical Center, where about two dozens veterans had been staying at a dedicated skilled nursing unit as of last week.

There has been other fallout. Bennett Walsh, then the facility’s superintendent, has since been fired, but is fighting his termination.

The family of a late Korean War veteran has sued him, the state’s former veterans’ secretary, and three others, charging in a $176 million lawsuit that scores of residents unnecessarily died at the facility because the officials showed a “deliberate indifference” to their care.