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I've tested positive for COVID-19 and recovered. Can I go back to a mask-free life? – The Globe and Mail

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The question: I tested positive for COVID-19 a few weeks ago. I experienced some mild symptoms such as fever, cough and fatigue, but I seem to have fully recovered. Am I now immune to COVID-19, and can I go back to living a normal life – free of wearing a facemask, constant hand washing and physical distancing?

The answer: Don’t discard your facemask just yet. SARS-CoV-2, the novel coronavirus that causes COVID-19, is so new that medical experts are still trying to determine how long immunity might last following an infection.

In fact, troubling evidence suggests immunity might be very short-lived in some people.

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U.S. researchers recently published a case report of a Nevada man who was re-infected within six weeks of first testing positive for the virus. And for this 25-year-old patient, the second bout of the illness turned out to be worse than his original infection; he had to be hospitalized and given extra oxygen because of difficulty breathing.

Immunity lasting for only a few weeks is probably the exception rather than the rule, says Dr. Andrew Morris, medical director of the antimicrobial-stewardship program at Sinai Health and the University Health Network in Toronto. After all, he notes that more than 40 million people worldwide have contracted COVID-19 and, so far, only a handful of re-infections have been identified.

“I think we can comfortably say it is extremely unlikely that someone will be re-infected in the short term. What we don’t know is the long term,” says Morris.

Will immunity last several months or a few years? Researchers just don’t have enough information to make a reliable prediction.

What can be said with some certainty is that the body’s immune system usually produces specialized cells to guard against subsequent attacks from a microbial invader.

“Like an army, there are different types of immune cells that carry out specific jobs, and they all work better together,” says Rob Kozak, a scientist and clinical microbiologist at Sunnybrook Health Sciences Centre in Toronto.

For instance, antibodies will bind to the surface of a virus, marking it for elimination by other immune cells. And if the virus evades detection by the antibodies and actually enters a cell, so-called T-cells can destroy the infected cell to prevent the virus from replicating.

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After an infection is over, the immune system usually develops a type of memory of the foe so that the body’s defences are primed and ready for future attacks.

Blood tests can reveal if a patient has developed antibodies to a pathogen. But, in the case of COVID-19, researchers don’t know how many antibodies are needed to successfully fight off subsequent infections, says Kozak.

As a general rule, these protective antibodies tend to decline over time. We can also expect that the ability to beat back the virus will vary from person to person – depending on an individual’s genetics and overall health. Furthermore, a virus can mutate, essentially presenting as a brand-new threat.

So, immunity acquired through an infection isn’t a sure thing.

However, researchers are confident that they can create effective protection with a vaccine – several of which are currently under development.

“A vaccine can be formulated to enhance the immune response,” explains Kozak. He notes that adjuvants – or immunological stimulants – can be added to a vaccine so the immune system produces more antibodies and long-lasting protection.

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Even so, it will likely be some months before one of the vaccine candidates clears all the safety and effectiveness tests and is ready for the general public.

In the meantime, everybody – include those who have already recovered from a bout of COVID-19 – should do their best to protect themselves and others from infection, says Dr. Allison McGeer, an infectious-diseases physician at Sinai Health.

She readily acknowledges that some people who have already been infected may be tempted to forgo such precautions because they might assume they are immune. And, unfortunately, the medical community can’t provide them with an accurate estimate of their potential risk of re-infection.

“Until we have more data, it is really hard to say anything other than you just need to be careful for now,” says McGeer.

Now that it is recommended you wear a face covering in dense public settings like grocery stores and pharmacies, watch how to make the three masks recommended by the Centers for Disease Control and Prevention. Written instructions available at tgam.ca/masks The Globe and Mail

Paul Taylor is a Patient Navigation Adviser at Sunnybrook Health Sciences Centre. He is a former Health Editor of The Globe and Mail. Find him on Twitter @epaultaylor and online at Sunnybrook’s Your Health Matters.

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Alberta province halts AstraZeneca vaccine first shots due to supply issue

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Alberta has stopped administering first doses of the AstraZeneca COVID-19 vaccine because of limited supply, a government spokesman said on Tuesday.

Alberta Health spokesman Tom McMillan said the change was due to supply issues rather concerns about rare side-effects.

“This decision is based on the fact that we are receiving no known future shipments of AstraZeneca at this time but are receiving large quantities of mRNA vaccines,” McMillan said in an email, referring to messenger RNA vaccines from Moderna and Pfizer/BioNTech.

The shortage of AstraZeneca vaccines comes as the western oil-producing province of Alberta struggles with a surge in COVID-19 cases. Last week the provincial government introduced new restrictions to curb infections.

Alberta has administered approximately 255,000 first doses of the AstraZeneca vaccine. The remaining supply of about 8,400 doses will be used as second doses.

Last week, Alberta reported its first case of a patient dying from a blood clot condition after receiving the AstraZeneca vaccine. There have been three such deaths in Canada.

Despite the deaths linked to the AstraZeneca vaccine, Canada‘s health regulator has continued to support the use of the vaccine and highlighted its benefits.

Dozens of countries paused the use of the AstraZeneca vaccine this year after reports of rare, but serious, blood clots. Several of them have now resumed use either fully or with restrictions after health regulators said the benefits of the shot outweigh any risks.

The province is now receiving large and consistent shipments of Pfizer and Moderna vaccines, with more than 236,000 doses arriving this week.

(Reporting by Nia WilliamsEditing by Bill Berkrot and Nick Zieminski)

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BioNTech committed to deliver 1.8 billion doses of COVID-19 vaccine this year

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BioNTech SE said on Monday that its order backlog for delivery of COVID-19 vaccines this year together with partner Pfizer Inc had grown to 1.8 billion doses, underscoring its role as a major global supplier of immunization shots.

That was up from 1.4 billion doses announced in March.

Based on these delivery contracts, the company said it expects about 12.4 billion euros ($15.1 billion) in revenue from the vaccine this year, including sales, milestone payments from partners and a share of gross profit in the partners’ territories, up from a previous forecast of 9.8 billion euros.

More than 450 million doses of the two-shot vaccine known as Comirnaty were supplied globally as of May 6, 2021. By contrast, AstraZeneca, which has pledged to deliver up to 3 billion vaccine doses this year, said on April 30 it had supplied more than 300 million doses so far. That includes production from partners such as the Serum Institute of India.

BioNTech and Pfizer, which have been spared the type of production setbacks that have hobbled AstraZeneca and Johnson & Johnson , have repeatedly lifted projected delivery volumes amid a global scramble to speed vaccination campaigns.

Earlier on Monday, BioNTech unveiled plans to set up a new factory in Singapore to produce several hundred million doses of its mRNA vaccines per year from 2023.

BioNTech’s partner for China, Fosun Pharma , said on Sunday it would provide a factory with an annual capacity of up to 1 billion doses of the COVID-19 vaccine under a joint venture with BioNTech.

That followed a contract with the European Union for up to 1.8 billion doses of COVID-19 vaccines for 2021-2023, to cover booster shots, donations and reselling of doses.

BioNTech reported first-quarter total revenue of 2.05 billion euros, up from 27.7 million a year earlier, driven by vaccine sales, and including an estimated 1.75 billion euros from BioNTech’s share of gross profit from sales in Pfizer’s territories.

Quarterly net profit jumped to 1.13 billion euros, compared to a 53.4-million-euro loss in the year-earlier period.

The company said there was no evidence its current vaccine will need to be adapted to fight new virus variants, but added that it had developed strategies to address such variants should the need arise.

BioNTech reiterated that output capacity for the vaccine would reach 3 billion doses by the end of 2021, and more than 3 billion doses in 2022.

Pfizer last week said the pair was targeting production of as much as 4 billion doses of the shot next year, mostly for low- and middle-income countries.

($1 = 0.8222 euros)

(Reporting by Ludwig Burger; Editing by Thomas Escritt, Bernadette Baum and Bill Berkrot)

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Canada ready to discuss COVID-19 vaccine IP waiver, ‘not interfering or blocking’ -Trudeau

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Canada is ready to discuss an intellectual property rights (IP) waiver for COVID-19 vaccines and will not block one even though it stresses the importance of protecting patents, officials said on Friday.

U.S. President Joe Biden on Wednesday threw his support behind waiving IP rights for COVID-19 vaccines. Any such waiver would have to be negotiated through the World Trade Organization (WTO).

“We’ve been working with partners at the WTO to find a consensus-based solution and are ready to discuss proposals, in particular for COVID-19 vaccines,” Prime Minister Justin Trudeau told reporters.

Biden’s proposal angered pharmaceutical companies. Firms working on vaccines have reported sharp revenue and profit gains during the crisis.

Canadian International Trade Minister Mary Ng earlier said that Ottawa firmly believed in the importance of protecting IP.

“I can assure you Canada is not interfering or blocking. Canada is very much working to find a solution,” said Trudeau, who did not give details of the Canadian negotiating stance.

Ng said Ottawa recognized how much the pharmaceutical industry had done to innovate COVID-19 vaccines, adding that many barriers to access were unrelated to IP, such as supply-chain constraints.

Canada is trying to quell a third wave of the coronavirus pandemic that is pushing some healthcare systems to breaking points, particularly in the western provinces of Alberta and Manitoba.

Manitoba officials said they were postponing some non-urgent surgeries to open space for COVID-19 patients and planned to announce tougher public health restrictions as daily cases soared to a near-record high.

The U.S. state of Montana will offer vaccines to around 2,000 Alberta truckers who regularly cross the border, Alberta Premier Jason Kenney said.

Truckers will get vaccinated at a post being set up just south of the border, using Montana’s surplus Johnson & Johnson vaccines.

The scheme mirrors an agreement that Saskatchewan and Manitoba reached with North Dakota.

 

(Additional reporting by Nia Williams in Calgary and Rod Nickel in Winnipeg; Editing by David Goodman/Mark Heinrich, Grant McCool and Marguerita Choy)

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