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First documented coronavirus reinfection reported in Hong Kong

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A 33-year-old man was infected a second time with the coronavirus more than four months after his first bout, the first documented case of so-called reinfection, researchers in Hong Kong reported Monday.

The finding was not unexpected, especially given the millions of people who have been infected worldwide, experts said. And the man had no symptoms the second time, suggesting that even though the prior exposure did not prevent the reinfection, his immune system kept the virus somewhat in check.

“The second infection was completely asymptomatic — his immune response prevented the disease from getting worse,” said Akiko Iwasaki, an immunologist at Yale University who was not involved with the work but reviewed the report at The New York Times’ request. “It’s kind of a textbook example of how immunity should work.”

People who do not have symptoms may still spread the virus to others, however, underscoring the importance of vaccines, Iwasaki said. In the man’s case, she added, “natural infection created immunity that prevented disease but not reinfection.”

“In order to provide herd immunity, a potent vaccine is needed to induce immunity that prevents both reinfection and disease,” Iwasaki said.

Doctors have reported several cases of presumed reinfection in the United States and elsewhere, but none of those cases have been confirmed with rigorous testing. Recovered people are known to carry viral fragments for weeks, which can lead to positive test results in the absence of live virus.

But the Hong Kong researchers sequenced the virus from both of the man’s infections and found significant differences, suggesting that the patient had been infected a second time.

“I believe this is the first reported case that is confirmed by genome sequencing,” said Dr. Kelvin Kai-Wang To, a clinical microbiologist at the University of Hong Kong.

The study is to be published in the journal Clinical Infectious Diseases. The Times obtained the manuscript from the university.

The man’s first case was diagnosed March 26, and he had only mild symptoms. In accordance with regulations in Hong Kong, he was hospitalized March 29 even though his symptoms had subsided and released April 14 only after he had tested negative for the virus twice.

He had no detectable antibodies after that first bout with the virus. He was positive again for the coronavirus on a saliva test Aug. 15 after a trip to Spain via the United Kingdom; the test was administered at the airport. The man had picked up a strain that was circulating in Europe in July and August, the researchers said.

His infections were clearly caused by different versions of the coronavirus, To said. “Our results prove that his second infection is caused by a new virus that he acquired recently, rather than prolonged viral shedding.”

Common cold coronaviruses are known to cause reinfections in less than a year, but experts had hoped that the new coronavirus might behave more like its cousins, severe acute respiratory syndrome and Middle East respiratory syndrome, which seemed to produce protection lasting a few years.

It is still unclear how common reinfection from the new coronavirus might be because few researchers have sequenced the virus from each infection.

“We’ve had, what, 23 million cases documented thus far, but the fact that one out of them at this point has been reinfected should not cause undue alarm as of yet,” said Jeffrey Shaman, an epidemiologist at Columbia University in New York.

“However, it remains very, very concerning — and this does nothing to dispel that — that we may be subject to repeat infection with this virus,” he said.

Iwasaki was more sanguine. She noted that the man had no antibodies after the first infection but produced them after the second exposure. Immunity is expected to build with each exposure to a pathogen exactly in this way, she noted.

“Again, it’s what the textbook says should happen,” she said. “When you have second exposure to the same pathogen, you should elevate the antibody, and that’s what’s happening.”

Most people who are infected with the coronavirus produce detectable antibodies that would be expected to protect against the virus. Even people who had only mild symptoms, including this man, may also have immune “memory” in the form of B and T cells that prevent symptoms on second exposure.

“The majority of patients likely have a cocktail of immune responses that activate on second exposure,” said Brian Wasik, a virologist at Cornell University. “This Hong Kong patient also seems to have been asymptomatic on second infection, perhaps due to some immune response.”

But the researchers said it’s also possible that in some people, a second exposure will prove more severe. “It cannot be generalized yet, because there’s still a possibility that the second infection can be worse,” To said.

Building immune memory is not unlike boosting memory of a person, said Dr. Michael Mina, an immunologist at the Harvard T.H. Chan School of Public Health.

The initial bout with the new coronavirus is likely to result in “nonsterilizing immunity,” but the virus will elicit a stronger response with each exposure, he said: “It is often these second and third exposures that help to solidify the memory response for the long term.”

Overall, experts said, it is unclear how often people might become reinfected, and how soon, after a first bout with the virus.

“Those remain open questions, because one person exhibiting a mild reinfection, clearly documented as a distinct strain of the virus, does not provide enough evidence one way or another,” Shaman said.

Source: – The Japan Times

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Public health officials call for tighter restrictions, warn COVID-19 could spiral out of control – Yahoo News Canada

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Public health officials call for tighter restrictions, warn COVID-19 could spiral out of control

Infectious disease experts say Canadian health authorities must tighten restrictions again or hospitalizations and deaths from COVID-19 will increase exponentially in the coming weeks.

<p class="canvas-atom canvas-text Mb(1.0em) Mb(0)–sm Mt(0.8em)–sm" type="text" content="Echoing comments made Tuesday by Chief Public Health Officer Dr. Theresa Tam, who said Canada is at a crossroads in its pandemic battle, experts in public health are urging governments to take decisive action to prevent&nbsp;the current resurgence of the virus from spiralling out of control.” data-reactid=”33″>Echoing comments made Tuesday by Chief Public Health Officer Dr. Theresa Tam, who said Canada is at a crossroads in its pandemic battle, experts in public health are urging governments to take decisive action to prevent the current resurgence of the virus from spiralling out of control.

Canada reported 1,248 new cases Wednesday, and on Tuesday the country’s most populous province, Ontario, reported its highest number of new cases since early May. 

Tam outlined projections that show new cases could climb to 5,000 daily by October if we continue on the current course.

“To date, we’re not moving fast enough to get ahead of this,” said Dr. Michael Gardam, an infectious disease physician based at a Women’s College Hospital in Toronto. “I think we’re being lulled into a false sense of security because of the low numbers of hospitalizations and deaths [relative to earlier in the pandemic]. But they will come in the next six weeks or so.”

He said asking people nicely to tighten their social circles is not going to be enough.

Craig Chivers/CBCCraig Chivers/CBC

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“I think that appealing to people’s better natures — that, hey, you should be careful and you should make sure you limit your contacts — I don’t think that that’s going to work, to be perfectly frank.”

Gardam said Canadians grew fatigued with the restrictions imposed on their social circles earlier in the year and won’t be eager to return to them unless pressed.

“I think we’re going to have to be a lot more forceful,” he said. 

<p class="canvas-atom canvas-text Mb(1.0em) Mb(0)–sm Mt(0.8em)–sm" type="text" content="Adjusting bubbles” data-reactid=”61″>Adjusting bubbles

That means demanding Canadians tighten their social circles, and backing that up with enforcement.

“I would argue that we need to be very cautious, like we were back in March, in order to weather the storm from all the increased contacts that we’ve had.”

Right now, “people are playing fast and loose with bubbles all over the place,” said Gardam. 

If you increase the number of contacts that you have, this is going to go to hell real quick. – Michael Gardam, infectious disease physician, Women’s College Hospital

Instead, he says we need to rethink social bubbles now that school is in session again.

“We’re all going to have to pay the price because our kids are in school now. So what are we giving up?

“If you want to keep the restaurants open and bars, maybe you have to give up your private gatherings,” he said. “Because if you just increase in every dimension, if you increase the number of contacts that you have, this is going to go to hell real quick.”

The actions taken in the next two weeks could change the trajectory of the months to come, said Laura Rosella, an associate professor at the University of Toronto’s Dalla Lana School of Public Health,

“There’s a lot of things with this pandemic that we can’t control, but we might be able to control who we interact with, especially socially, and who’s in our bubble,” said Rosella, who holds a PhD in epidemiology.

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“I would encourage everyone to rethink what their bubbles are given the new situation, especially if something’s changed, if someone’s gone back to work, someone’s entering a school situation and especially if vulnerable people are in their bubbles.”

Rosella said her advice to Canadians is to “really think through what is absolutely necessary” when it comes to interactions with others.

<p class="canvas-atom canvas-text Mb(1.0em) Mb(0)–sm Mt(0.8em)–sm" type="text" content="More than a blip” data-reactid=”98″>More than a blip

Rosella said Canadians can’t afford to ignore the changes happening with COVID-19.

“We’re not in the August situation anymore. There’s clearly an uptick of cases,” said Rosella, “The fact that we’re already on that trajectory tells me that the likelihood of this being just a small blip, that we’re not going to notice and we can carry on, is pretty low.”

“We are going to experience a significant increase that we’re going to have to manage and react to. It could be worse if we do nothing. And if we act, we could minimize the impact of it.” 

Dr. Samir Gupta, a clinician-scientist at St. Michael’s Hospital and an assistant professor in the department of medicine at the University of Toronto, said getting a handle on this COVID-19 surge means returning to restrictions implemented earlier in the pandemic.

Craig Chivers/CBCCraig Chivers/CBC

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<p class="canvas-atom canvas-text Mb(1.0em) Mb(0)–sm Mt(0.8em)–sm" type="text" content="Speaking with Heather Hiscox on CBC&nbsp;Morning Live&nbsp;Wednesday, Gupta said Canadians "need to start making similar sacrifices to the ones we made the first time around," which was successful with flattening the curve in the spring.” data-reactid=”123″>Speaking with Heather Hiscox on CBC Morning Live Wednesday, Gupta said Canadians “need to start making similar sacrifices to the ones we made the first time around,” which was successful with flattening the curve in the spring.

Without enforcement, “we risk overwhelming our health-care system capacity … [and getting] into real trouble,” he said.

“We don’t want to have to turn people away and not be able to take care of people who are sick with this virus. And that’s the biggest risk we face.”

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Ottawa reports 82 new coronavirus cases: provincial data – Global News

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Ottawa’s surge in coronavirus infections continues Thursday with 82 new COVID-19 cases reported via the provincial database.

The latest daily increase is Ottawa’s second-largest spike in cases so far in the pandemic, surpassed only by the 93 cases reported on Tuesday.

No new deaths related to the novel coronavirus were reported in Ottawa on Thursday, according to the Ministry of Health’s COVID-19 dashboard.

Read more:
Ontario reports 409 new coronavirus cases with most in Toronto-area, Ottawa

Ottawa Public Health’s (OPH) latest weekly epidemiology report shows the second wave of the virus in the nation’s capital was already setting grim records before this week’s spiking case figures.

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The local public health unit’s report shows the week of Sept. 14 to 20 had the highest number of new cases reported since the pandemic began, with 385 people testing positive for the virus.

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That’s up from 244 cases the week previous and surpasses the previous high of 331 cases set in the week of April 20.

OPH will release its more fulsome daily report on the novel coronavirus later Thursday afternoon.

The OPH report will sometimes revise case numbers provided earlier in the day via the provincial database due to lags in reporting.






10:38
Ottawa mayor: We are losing $1 million a day as a result of the COVID-19 pandemic


Ottawa mayor: We are losing $1 million a day as a result of the COVID-19 pandemic

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Sampling-site bottlenecks continue to impede Manitoba COVID-19 testing efforts – CBC.ca

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When Bronagh Nazarko took one of her kids to get a COVID-19 test in Winnipeg, she ended up waiting four hours in line and missing a day of work.

When her husband took their other two kids to get tested several days later, he too waited four hours and also missed a day in the home office.

The experience left her wondering how other parents are supposed to juggle child-care and work responsibilities while they wait for a COVID-19 swab, which Manitoba’s government has spent six months promoting as a central facet of its pandemic response.

“We’re very lucky that we have fairly flexible office jobs and that we can work from home, but for a lot of people, I just can’t see that this is sustainable to do this,” Nazarko said Wednesday in an interview.

“I can see that this would deter people from getting tested, and I’m concerned that that means cases will get missed because people don’t want to wait.”

Winnipeg still undergoing surge in demand for swabs

For weeks, there have been long lines outside Winnipeg’s sole drive-through COVID-19 sampling site in the North End on Main Street and heavy traffic at its three other sampling sites.

Winnipeg is now the epicentre of the province’s COVID-19 outbreak, with the city possessing 335 of Manitoba’s 418 active cases.

(Jacques Marcoux/CBC)

The province has responded by warning more restrictions could be placed on the Winnipeg health region if residents and visitors don’t become more diligent about gathering in small groups, washing their hands, keeping a safe distance away from each other and wearing masks when they cannot.

On Tuesday, the province also pledged to open another sampling site by Sept. 28 under the management of private health-care company Dynacare. It is supposed to collect up to 1,400 samples a day, at first, with the eventual potential to administer 2,600 swabs.

“The new specimen-collection sites announced [Tuesday] will help address waits for sample collection that are due to increased volumes,” Manitoba Public Health said in a statement.

Manitoba’s Official Opposition contends this promise is not good enough for Manitobans right now.

“I think people are upset today, waiting hours in line,” NDP Leader Wab Kinew said.

“This is something that the government has seen coming for six months or more. And again, we all made tremendous sacrifices, whether on a personal or social level to try and flatten the curve, to buy the government more time.”

Testing inspires confidences, premier suggested

At the height of Manitoba’s economically stifling lockdown, the premier suggested widespread testing and contact tracing would be the key to allowing the province to get back to business.

“We know that through increased testing there is an increased possibility that we’ll be able to build confidence — not only in the general public, but in the health officials whose guidance we must listen to — that we are not opening the door to a resurgence in COVID infections in our province,” Premier Brian Pallister said on April 16.

Twelve days later, he pledged to increase lab-testing capacity to 3,000 tests per day with the help of a new Dynacare lab in Winnipeg. That lab was completed by the end of July and Manitoba can now complete as many as 2,800 tests per day, between the work conducted at the Dynacare lab and Cadham Provincial Lab.

In recent weeks, the province has been completing fewer than 1,500 tests per day, on average, and Winnipeggers began to complain about long lines.

(Jacques Marcoux/CBC)

Unlike in April, when health-care workers left idle due to restrictions on hospital and clinic operations presented an easily accessible pool of skilled labour, health administrators found themselves unable to find the staff to extend hours at sampling sites, Chief Provincial Public Health Officer Dr. Brent Roussin said last week.

Health Minister Cameron Friesen’s office said the province is facing unprecedented challenges.

“We empathize with Manitobans’ frustrations surrounding COVID-19, and work to alleviate these stressors as we have done throughout the entire pandemic,” Friesen’s office said in a statement.

The Winnipeg Regional Health Authority is recruiting volunteers to help direct traffic at sampling sites, spokesperson Paul Turenne said.

The Dynacare site will also help, Friesen’s office said. The precise date it will open has not been determined, said Mark Bernhardt, Dynacare’s communications manager based in Brampton, Ont.

Kinew accused the province of relying too heavily on the private firm.

“It seems as though the government is just abdicating [its] responsibility to provide what I think is the most important public health measure right now: figuring out whether or not you have COVID during the COVID pandemic,” he said. 

“The government’s declared a state of emergency, and yet they basically created a vacuum of leadership and just said, ‘OK, Dynacare … you go handle everything for us.'”

Workplace testing available for private clients

Kinew also expressed concern that Dynacare provides workplace COVID-19 testing for companies willing to pay extra to test their workers.

“If someone has more money and they have a registered business, all of a sudden they can skip the line. To me, that’s not fair and it violates the public health interest that we all have in fighting the pandemic,” he said.

Bernhardt confirmed Dynacare provides mobile workplace testing for COVID-19 as well as blood tests for other illnesses. All samples collected from private clients are processed at a lab in Brampton, he said, and do not compete for lab time with public samples in Winnipeg.

Nazarko, who spent hours in the testing queue with her kids, said she is concerned about will happen in Winnipeg during the winter, when waiting for hours outside won’t be possible.

“I would personally really like to see them switch to an appointment-based system where we could wait at home and my husband and I could work until our appointment time comes,” she said.

Roussin said earlier this month the province is pondering what to do with sampling sites during the winter.

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