Top Line - September 02, 2020

First case of COVID-19 reinfection is reported in the United States

One of the bigger questions scientists have faced when dealing with COVID-19 has been whether or not a person who gets the virus once can get it again.

The answer appears to be yes. A newly released study reports that a 25-year-old man in Reno, Nevada, who had the virus in April contracted it again in late May. And his symptoms were worse the second time than the first. This is the first confirmed case of reinfection in the United States and the fourth confirmed case worldwide.  

These findings have implications for all aspects of combating the virus, including the drive to find a vaccine, the hope found in “herd immunity,” and whether this “new normal” is a temporary or long-lasting situation.

The Reno man had mild symptoms the first time he tested positive for the virus and those had resolved within 10 days. He then tested negative twice after that. But in May, the man developed more severe symptoms and was hospitalized and required oxygen.

Researchers found differences in some of the genomes from the first and second infections, indicating the man was infected with two different strains of the virus rather than simply having never completely recovered from the first infection. Those findings indicate that being exposed to the virus the first time did not provide complete immunity, that it is possible to catch the virus more than once, and that the severity is unpredictable.

However, researchers also pointed out that this is a singular incidence and likely represents a rare event.

"After one recovers from COVID-19, we still do not know how much immunity is built up, how long it may last, or how well antibodies play a role in protection against a reinfection," Mark Pandori, the director of the Nevada State Public Health Laboratory and a co-author of the study, said. "If reinfection is possible on such a short timeline, there may be implications for the efficacy of vaccines developed to fight the disease. It may also have implications for herd immunity.”

Another study released last week had reported that a 33-year-old man in Hong Kong who had previously been infected was reinfected almost five months later. The man had a severe case of the virus in April and was diagnosed again in August with a different strain of the virus. However, he was asymptomatic the second time. His was the first documented case of reinfection. There were reports of two people in Europe who also had contracted the virus twice, but with milder or no symptoms the second time.

Question to Consider:

If we are indeed in this for the long term, what steps do we take now to be proactive in making ourselves and our businesses safer and more secure? 

COVID-19: THE HIGHLIGHTS

The world and the United States both have reached grim milestones in the coronavirus pandemic. The number of cases worldwide topped 25 million Sunday. And the United States, which had reached 5 million cases just three weeks ago, went over the 6 million mark Monday.  The United States had 1 million cases at the end of April. There have been more than 846,000 deaths worldwide due to the virus and more than 183,000 in the United States, which means this country, which accounts for about 4 percent of the world’s population, has 21 percent of the virus-related fatalities.

India reported a one-day record of 78,761 new cases on Monday, the worst one-day rise yet recorded. The  country of 1.3 billion people ranks behind only the United States and Brazil in the number of reported cases. The spike in cases is attributed in part to more testing and in part to the reopening of the economy.

A second wave of the virus is hitting Europe. The number of cases has risen rapidly in France and parts of Eastern Europe, but the highest toll has come in Spain, which reported 53,000 new cases last week. Spain had been able to slow the virus earlier thanks to a stringent lockdown, but has seen cases surge as it followed that lockdown with a very quick reopening.

Meanwhile, according to the World Health Organization, there are 173 candidate vaccines for COVID-19, 31 in clinical evaluation and 142 in pre-clinical evaluation. The U.S. Food and Drug Administration said it could allow “emergency use authorization” for vaccines before they complete Phase Three clinical trials if that authorization is “appropriate.” Such authorization would most likely be allowed for high-risk populations, according to public health experts. While some of the candidate vaccines already are in Phase Three testing, results of those tests are not expected until October at the earliest. Officials have said that approval for wide-ranging use of a vaccine in the general population would most likely not come before the first half of 2021.

BEYOND THE NOISE: The ‘New Normal’

The Centers for Disease Control and Prevention has updated its guidance on limiting workplace violence associated with COVID-19.  The update comes amid a growing number of reports of violence against workers from angry customers. Among the recommendations:  don’t engage with customers who refuse to adhere to regulations to help prevent the spread of the virus. Workers are advised to employ nonviolent responses, including remaining calm, giving a person space, making sure other people are in the area, not touching the person or trying to forcibly remove them, maintaining non-threatening eye contact, using supportive body language, and avoiding threatening gestures, such as finger pointing or crossed-arms. If staffing permits, two workers should work as a team to encourage prevention policies be followed. And, a safe area should be identified for employees to go to if they feel they are in danger, such as a room that locks from the inside, has a second exit route, and has a phone or silent alarm.

Meanwhile, as families gear up for Labor Day weekend, public health experts are warning that, while people are generally cognizant of potential problems arising from large gatherings, they need to be wise about small gatherings with family and friends outside the household, as well, especially because there are so many of those events and because they add up.

While it’s difficult to gather statistics for infections from small gatherings, researchers say the sheer number of such get-togethers are a cause for concern, and that they may be the source of a greater number of COVID-19 cases than is commonly believed.

Health experts are encouraging anyone attending a gathering on Labor Day weekend to wear masks and practice social distancing and to keep gatherings small enough that the host could ask about symptoms before the event.

Unfortunately, Labor Day is small potatoes compared to the holidays coming up later in the year. Health officials say Thanksgiving and Christmas get-togethers could turn out to be responsible for a huge amount of transmission of the virus. Compounding the problem on these holidays is the fact that guests often travel from great distances and, because of colder weather, most activities are held indoors.

TRUSTED RESOURCES: for numbers & guidance

Johns Hopkins University – Coronavirus Resource Center

World Health Organization – COVID-19 Pandemic

Centers for Disease Control – Coronavirus (COVID-19)