Alarmist elements in the news media are going in overdrive about a semi-credible report from Hong Kong (based on a leaked draft manuscript by one Dr. Kelvin Kai-Wang To) that somebody who was previously cured from COVID19 now got infected again. OMG! We’ll never have a vaccine! And no herd immunity either! ZOMG we’re all gonna die! DJ Lethal Bring It On!
Not so fast, says Dr. Campbell — and rightly so.
First of all, even if this were kosher, we’re talking about an isolated case — with a little effort, you can turn up one or two cases in history where somebody was bitten to death by a Jack Russell Terrier. He mentions two additional case reports, one in the Netherlands and another in Belgium. (De Standaard reports, in Dutch, that the Belgian case was only alluded to by Leuven virologist Marc van Ranst and that there is no confirmation in the literature.)
Second, what are the specifics of the case? In brief: a 33year old man, healthy, not immunocompromised, got the virus back in March, had fever for several days and was hospitalized, then eventually discharged. Interestingly enough, he never tested positive for antibodies — but Dr. Campbell explains that about 8% of COVID19 cases do not “seroconvert”. (Nobody was testing for T-cells back then — I don’t know who, outside of the Karolinska Institute in Sweden, has a workable testing setup.)
After a vacation in Spain (also stopping over in the UK) our friend was tested upon entry at Hong Kong airport and tested positive. He was hospitalized, but remained asymptomatic, with normal temperature, 98% oxygen saturation, … CRP (C-reactive protein, an inflammation marker) was elevated, indicating some sort of inflammatory response. Viral titer kept dropping, and eventually he did “seroconvert”.
Hong Kong is a pretty high-tech medical setting, so (unusually) full genome sequencing of the virus was done for the same patient in first and second infection. This appears to indicate he got two different variants of the virus. The first strain is genetically closely related to the strains circulating in England and the USA in March, the second more closely to strains from July. The leaked draft speaks (in apparently garbled language) of a deletion of 58 amino acids in the spike protein.
Here is Dr. Campbell being interviewed about the matter on Deutsche Welle (German Wave, the German counterpart of VOA). I’m glad they decided to interview somebody a bit clear-headed, even though I don’t always agree with the good doctor.
Dr. Maria van Kerkhove of the WHO (one of the actual professionals, unlike the political hack and CCP turtle-boy at the top) calls for calm, pointing out that it’s a single report and that not even a preprint is available for people to read.
(2) Miscellaneous updates
- (H/t: Laura R.) As discussed here earlier, ACE inhibitors and ARBs (angiotensin receptor blockers), two commonly used types of blood pressure medication, appear to significantly reduce the risk of death and severe disease in older people. (Maybe also in younger, but hypertension is a common malady as we grow ‘younger’, so there just is a bigger data set for older people.)
- Israel’s coronavirus czar, Prof. Roni Gamzu, wants to avoid at all costs a second lockdown (unlike most of his colleagues, he’s an economist as well as a medical doctor). In this Hebrew video, he vents his frustration about the lack of compliance of the public with social distancing (including what in some other societies would be called “politely respecting others’ personal space”). At the end he says, “if I have no authority to do anything, then I don’t need to do this job”. [He’s on leave of absence as the CEO of the country’s largest hospital.]
- (H/t: Keith Clinton). An interesting read from the Center for Evidence-Based Medicine about the reliability of COVID19 testing.
- (H/t: Erik Wingren) A paper advocating early outpatient treatment of COVID19. https://doi.org/10.1016/j.amjmed.2020.07.003 (Popular discussion here.) This decision flowchart as an appetizer:
Update: Dr. Seheult weighs in on the matter, and via him Dr. Mina. Neither of them are particularly perturbed by this report. https://youtu.be/J9BOs_dR_bI
Update 2: Interesting video by Wendover Productions on how the epidemic has disrupted the airlines’ computer-modeled pricing system and how they are willy-nilly falling back on human intuition https://youtu.be/H_akzwzghWQ