(Bloomberg) — The first study to investigate the case of a person in the U.S. who contracted Covid-19 twice found reinfection can occur swiftly and the second bout of illness can be more severe.
The research, published in the Lancet medical journal, examined the case of a 25-year-old man living in Nevada who became infected with two different genetic variants of the SARS-CoV-2 virus in less than two months. He tested negative twice in between, meaning he’s unlikely to have suffered a single prolonged infection.
The findings come as U.S. President Donald Trump says he’s immune to the virus after a single encounter. Any new findings on resistance can also have implications for a vaccine as drugmakers race toward the finish line.
The degree of protective immunity after a Covid-19 infection is one of the pandemic’s great unknowns.
So far a handful of reinfection cases have been recorded since the start of the outbreak late last year. One patient in Ecuador also suffered a worse bout of illness the second time around and an elderly woman in the Netherlands died after testing positive a second time. It’s also possible people with no symptoms could be infected multiple times without knowing it.
The Nevada man first tested positive for the virus mid-April after experiencing a headache, coughing, nausea and diarrhea. He had no underlying conditions that could’ve worsened his illness. He isolated and got better by the end of the month.
At the end of May, though, the man consulted at an urgent care center with fever and dizziness in addition to the symptoms he’d experienced the prior month. Five days later he was hospitalized with shortness of breath and given oxygen before testing positive for Covid-19 once more.
Scientists sequenced the genomes of the patient’s virus samples and found significant differences, suggesting the man was infected by two distinct versions of the coronavirus.
The researchers said they couldn’t be sure why the second infection was worse. It’s possible the patient was exposed to a higher dose of virus the second time, that the version he encountered was more virulent or even that the presence of antibodies from the first infection was to blame in a twist observed with another coronavirus. It’s even possible — but unlikely — that there was a continuous infection with some sort of deactivation-reactivation dynamic, they wrote.
“There are still many unknowns,” said Mark Pandori, director of the Nevada State Public Health Laboratory and lead author of the study. “Our findings signal that a previous SARS-CoV-2 infection may not necessarily protect against future infection. The possibility of reinfections could have significant implications for our understanding of Covid-19 immunity, especially in the absence of an effective vaccine.”
(Updates with Dutch woman’s death in fifth paragraph)
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People with dementia among hardest hit by COVID-19 health restrictions – CBC.ca
Before COVID-19, Lyne Gauthier did her best to keep her husband’s mind from slipping away by organizing activities they had enjoyed together before he was diagnosed with early-onset Alzheimer’s disease.
She would visit the long term facility where Yves Dessureault, 66, has lived for three years and take him on simple outings.
“We’d go grocery shopping, go out for an ice cream cone,” said Gauthier. Sometimes they would just “listen to music and dance.”
But then the coronavirus hit, and there were no more outings.
There were also no more services like pet therapy or music therapy within the facility due to the pandemic.
Gauthier says she has watched her husband deteriorate dramatically in the past six months. He’s now considered to be in the late stages of Alzheimer’s.
“I think COVID has really fast-tracked the progression of his symptoms,” she said.
Gauthier feels the health rules that curtailed their outings and deprived Dessureault of face-to-face contact robbed him of precious time as a husband, father and grandfather.
At his care home, there is little mingling these days and many residents eat their meals in their rooms.
The social isolation has left him more fragile, both physically and emotionally, said Gauthier.
Since the spring, she says, Dessureault appears more upset and anxious. His balance has gotten worse and even the simplest words have lost their meaning.
“If I want to show him where we’d like to sit, I need to tap the seat and do more gestures,” said Gauthier.
“There is a lot he can’t do anymore.”
Worsening symptoms linked to lockdowns
During the pandemic, many residents in long-term care experienced rapid cognitive decline, increased depression and more behavioural symptoms such as wandering and agitation, said Dr. Isabelle Vedel, a public health physician and associate professor in McGill University’s Department of Family Medicine.
There is some preliminary research from the United States and the U.K. suggesting people with dementia were hit the hardest by the virus.
Not only were they at an increased risk of being infected and of dying from COVID-19, but there were thousands of so-called excess deaths — meaning many more people died than the average for the same period in previous years.
Vedel fears the same will be true in Canada.
“People living in long-term care were extremely affected by the pandemic,” said Vedel. “Eighty per cent of the deaths happened in long-term care in Canada, and we know that approximately 80 per cent of people in long-term care have dementia.”
With funding from the Canadian Institutes for Health Research, Vedel is leading a research project in collaboration with Alzheimer’s societies across Canada that will measure the deaths of people with dementia during the pandemic.
It will also examine what impact the disruption of services and access to health care may have had on their lives.
For instance, during the first wave of the pandemic, Quebec feared hospitals would be overrun, so long-term care facilities were asked not to send people to the ER, said Vedel.
“It’s very probable that even though they had acute illnesses, they were not sent to the emergency department, so they didn’t receive the appropriate care they needed.”
Lessons for the 2nd wave
Maintaining services as much as possible during subsequent waves of the virus is paramount, Vedel said.
People with dementia rely on home care, community services, family physicians and caregivers. If there are obstacles to getting these services, people with dementia will decline and fall between the cracks, she said.
“We have to make an extra effort for them and make sure that they can be well cared for during the pandemic,” said Vedel.
She expects the research group will have statistics and recommendations in the spring.
Disruptions, reimposed restrictions
With parts of Canada now firmly in a second wave of the pandemic, all the changing health precautions and disruption can be especially distressing for people with dementia.
In Quebec, for instance, more and more regions are in red zones, where visits are once again limited in long-term care homes and private seniors’ residences. The partial lockdown also means many programs are suspended.
The goal is to limit contacts and keep the virus from sweeping through those facilities as it did in the first wave.
The directive to wear masks or face coverings to slow the spread poses a problem for these patients because it’s harder to read facial expressions, which they rely on to communicate and interact.
Overmedication is another problem: As patients get more agitated, more medication is being prescribed, including anti-psychotic drugs to calm them down, said Nouha Ben Gaied, the director of research and development for the Federation of Quebec Alzheimer Societies.
These drugs, “are inappropriate to use for people with dementia and they can cause more harm than benefits” said Ben Gaied.
Ben Gaied hopes Quebec’s health ministry has learned lessons from the first wave.
A spokesperson for the ministry said it has introduced measures to better protect this population and reduce the number of excess deaths.
That includes better access to a family doctor and improving the transition between primary care and specialized services, said Marie-Louise Harvey.
The government has also recruited nearly 10,000 new patient attendants, about 7,000 of whom are already working in the system. The rest are still in training.
The province has asked long-term care homes to limit the movement of employees between long-term care homes as much as possible.
Infection control and prevention is also being closely watched.
Even so, since September, some of the new outbreaks in long-term care homes or private seniors’ residences in Quebec have been in units for people with a cognitive impairment like Alzheimer’s or dementia.
‘He deserves better’
Gauthier’s greatest fear is her husband getting COVID.
She’s concerned about the high number of cases in Quebec, and what will happen to her husband if the partial lockdown is extended beyond the end of the month.
She’s doing everything she can to help her husband connect, though now that his care home is in a red zone, all she can offer are video chats with family, walks on the grounds or jaunts in the car to listen to music.
One of the activities that still makes Dessureault light up, she says, is a visit with his grandchildren — even if it is through a window or on FaceTime. Dessureault loves children, she says, and seeing them brings out his goofy, playful side.
“I find my husband for a few more seconds, a minute. It’s as if my husband is back,” said Gauthier, fighting to hold back tears. “The emotions are there. They connect. It’s just simple.”
She says she knows he’s still there, underneath the disease, but his quality of life has spiralled downward during the pandemic.
“He deserves better,” said Gauthier, who sometimes finds it hard to keep her spirits up.
“As a society, we can do better.”
At least 49 cases of COVID-19 linked to wedding in Calgary: Alberta Health – CityNews Edmonton
CALGARY – Alberta Health said 49 active COVID-19 cases have been linked to a wedding in Calgary earlier this month.
The health agency said the wedding had a large number of Albertans from different households.
Alberta Health spokesman Tom McMillan said aggressive contact tracing is underway to identify anyone who may have been exposed to make sure they are isolating and getting tested.
He did not say how many people attended the wedding and said specifics about individual cases cannot be disclosed because of patient confidentiality.
COVID-19 restrictions implemented by the province state a maximum of 100 people can attend outdoor and indoor seated events, such as
wedding ceremonies, funeral services, movie theatres, indoor arts and culture performances.
McMillan says the city of Calgary has recently seen several outbreaks linked to social gatherings.
WATCH: Recent rise in numbers due to large social events
Active COVID-19 cases in Calgary zone exceed 1,000 – Calgary Herald
Article content continued
Sixteen of the 70 ICU beds allocated for COVID-19 patients are currently in use in Alberta, which marks 23 per cent of available space.
Due to the rise in case numbers, delayed wait times for test results and an increase in flu and cold symptoms, the province has placed more restrictions on asymptomatic testing.
“We must take further action,” said Hinshaw. “Effective immediately, we will be pressing pause on all asymptomatic testing in those who have no known exposure. This is an important and necessary step to help us reduce testing wait times, get results to Albertans and limit the spread.”
Asymptomatic testing was only available for priority groups before Tuesday’s announcement.
Alberta’s top doctor said Alberta has seen a handful of examples of gatherings gone wrong in recent weeks, adding to the provincial COVID-19 case count.
She noted a Calgary “superspreader” wedding linked to at least 49 cases, a workplace gathering connected to nine cases, and a party where one-third of the attendees have tested positive.
“COVID-19 really does love parties and we need to keep this in mind while planning or attending social events,” said Hinshaw, reminding Albertans to keep gatherings small while following all public health guidance.
There are no immediate plans for the government to implement additional measures to curb the spread of COVID-19 as cases grow, unlike other provinces such as Ontario that have rolled back relaxed directives.
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