COVID-19 tops 23 million cases as evidence builds for reinfection

COVID-19 rapid testing
COVID-19 rapid testing

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Today, the global COVID-19 total passed 23 million cases, as India, at more than 3 million cases, reported the biggest surge, and Hong Kong researchers detailed new evidence of reinfection in a patient.

Today, the pandemic total is at 23,519,827, according to the Johns Hopkins online dashboard. The pandemic death toll has now topped 800,000 and is at 810,051.

Man's infections were 142 days apart

In a press release today, a team from Hong Kong University's microbiology department described the first evidence of reinfection based on genetic sequencing of SARS-CoV-2, the virus that causes COVID-19, which showed that the virus strain in the patient's first infection is different than the one that triggered the second infection 142 days later. They noted that the full details of their investigation will be published in Clinical Infectious Diseases.

A key question about the virus is how strong immunity is and how long it lasts after the first infection, World Health Organization (WHO) experts have said. And though there have been sporadic reports of suspected reinfection, positive tests were attributed to persistent viral RNA in respiratory secretions.

The patient in the new report is a 33-year-old man from Hong Kong who was hospitalized with a lab-confirmed infection in late March. His second infection was detected during airport screening in Hong Kong on Aug 15 after he flew back from Spain via the United Kingdom. He was hospitalized but remained asymptomatic.

Genetic analysis on respiratory samples collected in March and August revealed different SARS-CoV-2 clades, suggesting that the second episode supported reinfection rather than prolonged viral shedding. Tests during his most recent hospitalization showed a high viral load that gradually declined and evidence of seroconversion during the second infection, suggesting that the second infection was real.

Researchers said that SARS-CoV-2 might persist in the human population, similar to human coronaviruses that cause common colds, and that immunity may be short lived, which would mean that vaccination, along with distancing measures and masking, should be considered for those who have already been sick with COVID-19.

Deadline nears for COVAX enrollment

At a WHO briefing today, Director-General Tedros Adhanom Ghebreyesus, PhD, said the group recently sent a letter urging countries to join the COVAX Global Vaccines Facility, a mechanism to pool the risk of supporting vaccine development, with an eye toward securing vaccine doses in an equitable manner at reasonable prices.

So far, 172 countries have engaged with COVAX, and nine vaccines are in the portfolio, the largest and most diverse in the world, Tedros said, adding that discussions are under way with four more producers.

Tedros said a coordinated vaccine plan with much of the world participating offers a way out of the pandemic, but to secure enough doses, the next step is for countries to make binding commitments to COVAX, which aims to deliver at least 2 billion doses by the end of 2021. "While we're grateful for the funds already committed towards the COVAX Facility, more is urgently needed to continue to move the portfolio forward," he said.

In a related development, the Coalition for Epidemic Preparedness and Innovations (CEPI) said in a statement today that seven of the nine vaccines in the COVAX portfolio are in clinical trials and that so far, governments, companies, and individuals have contributed committed $1.4 billion for development, but another $1 billion is urgently needed to push the portfolio forward.

India cases top 3 million

Cases continue to surge in a handful of hot spot countries that have large populations, such as the United States, Brazil, and India. India is currently reporting the highest daily totals, with 61,408 illnesses reported yesterday, putting it past the 3-million case mark. If India's COVID-19 activity continues at its current level, it will soon overtake Brazil as the world's second hardest-hit country.

India has reported more than 60,000 cases for six straight days, and the country is moving forward with reopening the economy. Yesterday, the government issued guidance for reopening media production, including the movie industry.

For comparison, the United States yesterday reported 34,567 cases, and Brazil reported 23,431, according to Johns Hopkins.

In another hot spot development, a raid on a crowded nightclub gathering that violated COVID-19 rules in Lima, Peru, resulted in a stampede that killed 13 young people in their 20s and 30s, Reuters reported. Several of the people who died tested positive for COVID-19, as did a number of those detained by the police.

Peru is Latin America's second worst-hit country, and bars and nightclubs have been closed since March.

Korea flare-up continues

South Korea yesterday reported 397 new cases, marking more than a week of cases in the triple digits, Reuters reported. Many of the country's new cases are linked to a church cluster in Seoul, but activity has extended to other parts of the country, with clusters reported at workplaces and other facilities.

The government ordered social distancing measures to be stepped up in locations outside the capital, and health officials warned that if cases continue to rise, schools and businesses might be closed. In Seoul, in-person classes have been suspended at about 2,000 schools.

Cases down Down Under

In New Zealand, a country that reported a recent flare-up after going 102 days without a local case, the country's president today extended the lockdown for Auckland by 4 more days and ordered masks to be worn on public transport in the entire country, according to Reuters.

So far, about 150 cases have been  linked to a family cluster, and new cases slowed to the single digits over the past 3 days.

Likewise in Australia, where the country is battling a resurgence in Victoria state, the number of new cases decreased to 121 yesterday, the lowest 1-day number since Jul 5.

In other global developments:

  • Some European countries continue to report continuing spikes in cases, such as France, which reported 4,879 cases yesterday, the most in a day since the lockdown ended 2 months ago, and Germany reported 2,034, its largest daily total since late April.

  • Finland has reported a recent rise in cases, though slower than the rest of Europe, and today officials tightened restrictions on gatherings, which are now limited to 50, down from 500 in August.

  • Children 12 years and older should wear masks like adults, the WHO and UNICEF said in new guidance released on Aug 21. They also said children 5 and younger shouldn't be required to wear them based on safety and ability to use them with minimal assistance and that decisions to require them for kids 6 through 11 years should be based on a number of factors, including local transmission and the availability of adequate adult supervision.

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