By Chris Paul Otaigbe
At over one million confirmed cases with more than 60,000 deaths and no less than 200,000 recoveries, corona virus is violently asserting itself as the next plague to destroy humanity after the 1918 Spanish flu that killed over 53 million people on the planet.
In specific terms, covid-19 casualty figure stands at 1178544 cases, 64684 deaths, while 238,891 and counting, have recovered.
Without a doubt, the number of those who are ‘cleared’ to have recovered becomes even more worrying against the backdrop that they may recontract the virus and possibly re-infect others.
In other words, when you imagine how many more people 200, 000 recovered Patients can infect again or anew, you will understand that families, friends and other contacts of the covid-19 freed Patient may not be safe just as Lives within the immediate community and the country at large are in danger.
But then, so much has been said about the alarming cases of the confirmed and the frightening number of the dead.
However, not much attention has been given to the number of the recovered. Just before you begin to pop that chilled champagne in celebration of (half-baked) survivors or recoveries, the scientists have said those patients we believed survived the monster called covid-19 stand the risk of being reinfected and resuming the vicious cycle of reinfecting others.
As we proceed into this new zone of the plague, it suffices at this juncture to remind you that COVID-19 broke out with symptoms of its first index case on December 8, 2019, to status on February 20, 2020, in China. Over the course of the first two months after, more than 70, 000 cases were confirmed and many more suspected.
Before we proceed to interrogate the integrity of and reinfection probability of the covid-19 recovered, it will also help to know a bit more about the emergence and origin of the dreaded virus in China and how they handled it.
In an over 33-minute transcribed audio interview, titled: COVID-19 Update with NIAID’s Anthony Fauci, MD, published March 6, 2020, Fauci said the emergence of the Corona virus outbreak was prior to China’s annual Lunar New Year holiday.
It was an important factor the Chinese considered concerning reason behind the emergence and their response to the outbreak. Culturally, he said, the Lunar holiday is the largest and most important holiday of the year.
Like the Christmas/New Year festivities for Christians and majority of the human race, Lunar is a period the Chinese return home to their families. This is, often, the cause for the several billion person-trips made by residents and visitors during this time, mostly on crowded planes, trains, and buses.
According to him, knowing this meant each infected person could have numerous close contacts over a protracted time and across long distances. The government needed to act quickly. However, it was not only the speed of the government’s response, but also the magnitude of that response that were influenced by the impending holiday travel time.
“Knowing that specific treatment and prevention options, such as targeted antiviral drugs and vaccines, were not yet available for COVID-19, China focused on traditional public health outbreak response tactics—isolation, quarantine, social distancing, and community containment.
Identified case patients with COVID-19 were immediately isolated in designated wards in existing hospitals, and 2 new hospitals were rapidly built to isolate and care for the increasing numbers of cases in Wuhan and Hubei.
People who had been in contact with COVID-19 cases were asked to quarantine themselves at home or were taken to special quarantine facilities, where they could be monitored for onset of symptoms.” He said.
Enormous numbers of large gatherings were canceled, including all Lunar New Year celebrations, and traffic in Wuhan and in cities across Hubei was restricted and closely monitored. Virtually all transportation was subsequently restricted at a national level. All of these measures were instituted to achieve social distancing.
Additionally, an estimated 40-60 million residents of Wuhan and 15 other surrounding cities within Hubei Province were subjected to community containment measures. Although these types of traditional outbreak response actions have been successfully used in the past, they have never been executed on such a large scale.
Fauci reminded of the controversies the actions of the Chinese government caused as questions regarding the justification of its response, whether it was reasonable and proportional to the outbreak. According to him, some argued that a number of these approaches infringed on the civil liberties of citizens as some of the measures were referred to as “draconian.”
“However, it is not only individual rights that must be considered. The rights of those who are not infected, but at risk of infection, must be considered as well.
Whether these approaches have been effective (eg, in terms of reduced infections and deaths averted), and whether these potential benefits have outweighed the costs (eg, economic losses), will be debated for years.” He argued.
Another important point was the major goal of China’s outbreak response activity which was to help “buy time” for science to catch up before COVID-19 became too widespread. China, he affirmed, must now focus on adjusting tactics and strategies as new evidence becomes available.
“Much remains to be done and many questions remain unanswered. China is very grateful for the help it is receiving from the international scientific, health, and public health communities.” He said.
He further noted, in the report, that the global society is more interconnected than ever and emerging pathogens do not respect geopolitical boundaries. “Proactive investment in public health infrastructure and capacity is crucial to effectively respond to epidemics like COVID-19, and it is critical to continue to improve international surveillance, cooperation, coordination, and communication about this major outbreak and to be even better prepared to respond to future new public health threats.” Said Fauci.
As the world has discovered now, albeit the hard way, Fauci is right and spot on. The virus has crossed borders spreading discomfort and deaths across continents, while it is asserting the impact of its monstrosity and planting its scourge on the soul of humanity of the human race as all cultural, social and financial areas of people across the globe have been affected and disrupted.
Granted that this is the lot of the human race right now, at least for the infected and possibly the affected; how about the infected who is supposed to have been isolated, treated, cleared and declared recovered? Why can’t such jubilate for freedom from this vampire virus?
Here are the likely reasons…
A report titled Can People Who Recover from COVID-19 Become Reinfected? published on March 15, 2020 sheds some light on the confusion and controversies covid-19 may have thrown into the camp of those who should know and inadvertently guide us.
According to the report, Medical professionals believe positive coronavirus retests are more likely the result of errors in testing rather than reinfection.
As the world contended with the coronavirus pandemic in early 2020, people around the globe began to consider the dread possibility that COVID-19 might not only be more infectious and have a much higher mortality rate than the seasonal flu, but that at least some persons who survived it might become reinfected rather than developing an immunity to it.
The report showcased two cases that concluded that the possibility of existing error in medical judgement may be freeing hundreds that may return to the society to re-infect ignorantly jubilant friends, and families who will, in turn, re-spread the virus on a much larger scale than before.
Citing the example of the Chinese experience, the report spoke about the account of Mr. Wang, a resident of Xuzhou, in Jiangsu province, who appeared to have emerged victorious from a month-long battle with the illness.
Three days later, according to the report, Wang was said to have tested positive for the coronavirus again. He was, then, re-hospitalized, while his neighbors were locked down for the second time. His current condition could not be ascertained.
Although his full name was not disclosed for privacy reasons, Wang is one of over 100 reported cases of Chinese patients released from hospitals as survivors of the new coronavirus only to test positive, one more time, in the puzzling mathematics of this mysterious illness.
At this stage, however, it is difficult to ascertain whether Patients who were cleared as fully recovered for the virus, were truly reinfected. Could their condition have deteriorated or were they not fully recovered from their first experience of the pandemic?
The report posited that the diagnostic testing method may explain why the victims retested positive for the virus after they were supposed to have been cleared as recovered.
These cases clearly create the ground to query the credibility of the diagnostic tests, the probability of reinfection and if the Patients were falsely confirmed as “recovered” and released too early from hospitals.
Scientists, in and outside China, are all on the same page concerning the likelihood of reinfection as the valid explanation for Patients who are declared positive.
In the report, the Experts submitted that testing errors most likely account for either false negatives that resulted in patients being discharged too early, or false positives when they retested leading to their return to the hospital.
Those errors, the report concluded, could be credited to “contaminated test samples, human error while taking wipes, or an oversensitive nucleic acid test that detects strands of virus.
Also, in the report, Dr. Keiji Fukuda, director of Hong Kong University’s School of Public Health in a 2020 edition of the Los Angeles Times said COVID-19 reinfection was unlikely and that false positives in testing procedures were a more likely possibility.
“If you get an infection, your immune system is revved up against that virus,” he said. “To get reinfected again when you’re in that situation would be quite unusual unless your immune system was not functioning right.” He said.
Another probable cause would be the fact that those declared as recovered and released from hospital are still harboring dormant fragments of the non-infectious part of the virus in their system. Those harmless components of the virus look exactly the same as the actual disease, when taken through nucleic acid test.
According to Dr. Fukuda, the test may seem positive without the presence of any infectious element in the detected virus from the supposedly recovered Patient.
Philip M. Tierno, Clinical Professor of Microbiology and Pathology at at New York University agreed with Fukuda, regarding this part of the story when he posited that a coronavirus infection’s going into a “dormant” stage and then re-emerging was another possibility for explaining the appearance of reinfection.
“Once you have the infection, it could remain dormant with minimal symptoms. And then you can get an exacerbation if it finds its way into the lungs.” Said Philip.
Similarly, according to another Expert, Dr. Clifford Lane, deputy director for Clinical Research and Special Projects at the National Institute of Allergy and Infectious Diseases (NIAIDs), who was quoted in the report, the real question has to do with inexactitudes in testing patients who had not fully recovered rather than with reinfection.
According to him, another likelihood of these inaccuracies could be that the level of virus fell below the threshold that tests could access but which end up reemerging.
“It looked like some patients cleared the virus and then the virus came back. But they never really cleared it and they had a more prolonged course of infection.” Lane said.
Lane, who was one of only two United States experts in a World Health Organization delegation that visited China in February, said Chinese experts told the visitors that there were no examples of people who became “reinfected.”
A different argument which was advanced by the Associated Press (AP) is the possibility that mutations in the virus might conceivably make it different enough to re-infect persons who had acquired immunity to an earlier version.
According to the AP story, Scientists at the at the Fred Hutchinson Cancer Research Center in Seattle submitted that the 30,000-letter genetic code of the virus changes by one letter every 15 days. However, the Scientist cautioned that the changes, that would be needed for the virus to seem different enough to the immune system of someone who had a previous version of it for it to cause a fresh infection, cannot be ascertained.
Dr. Anthony S. Fauci, the NIAID’s Director who has now become a household name and face in America due to his constant televised briefings on developments on the covid-19 pandemic with President Donald Trump of the US informed the US Congress that he felt it was unlikely anyone could become reinfected by the virus.
“We haven’t formally proved it, but … if this acts like any other virus, once you recover, you won’t get reinfected.” He said.
In the end, the fundamental focus should dwell on restricting the outbreak with methods that make sure persons who are not diagnosed and who are symptomatic do not expose themselves to also avoid and avert the risk of infecting others.
