First known patient reinfected with South Africa COVID-19 variant is in critical condition

Paris: A man in France is critically ill with the coronavirus variant first identified in South Africa four months after he was previously infected with the virus – the first recorded reinfection case involving the contagious mutation, according to his doctors.

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After experiencing a mild infection in September, the 58-year-old man with a history of asthma was hospitalised in January and remains in critical condition, according to a paper shared Friday by the journal Clinical Infectious Diseases. The authors wrote that cases of reinfection like this “remain rare albeit probably underestimated,” urging further investigation into cross-immunity between variants and the effectiveness of vaccines against them.

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The news comes as reports of the variant, called B. 1.351, have escalated globally, including 13 cases in five states, according to the U.S. Centers for Disease Control and Prevention. With the increased prevalence of the mutation, scientists have expressed concern that the variant, and two others first identified in the United Kingdom and Brazil, may become a predominant source of infection and elude coronavirus vaccines developed before the variants were detected.

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Lowered effectiveness

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Studies of the vaccines produced by Moderna, Pfizer-BioNTech and Novavax – drugmakers supported by the U.S. federal government’s Operation Warp Speed – appeared to show that the vaccines work against the B. 1.351 variant but have a lowered effectiveness.

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Maryland biotech company Novavax said “data suggest that prior infection with COVID-19 may not completely protect against subsequent infection by the South Africa escape variant,” but that its vaccine “provided significant protection.”

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Despite fears that the variants could prolong the effort to reach herd immunity, experts have cautioned that such reports of reinfection cases like the one in France are not common, indicating that immunity is possible for many. Studies have shown that the body’s virus-fighting cells are able to remember the pathogen from a previous illness and attack, either killing the infection or staving off more severe symptoms.

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“I worry especially that some of these premature sweeping conclusions being made could rob people of hope,” Angela Rasmussen, a virologist at Georgetown University’s Center for Global Health Science and Security, previously told The Washington Post. “I worry the message they may receive is that we’re never going to be rid of this. When in fact that’s not what the data suggests.”

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Given the limited surveillance of variants, it is difficult to assess how common reinfections can be, or confirm the French researchers’ assertion that the case is the first of its kind.

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No elaboration

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On Friday, the World Health Organisation warned that it had received preliminary reports from South Africa about people being reinfected with a new variant of the virus. In a news briefing, WHO Chief Scientist Soumya Swaminathan did not elaborate further about those cases but said the review of reinfections is one of the “areas of active research.”

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Swaminathan added that vaccine clinical trials have had promising results, highlighting that inoculation can protect against severe illness and death.

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Swaminathan did not mention the case in France.

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French researchers wrote that the man had a mild fever and difficulty breathing the first time he was infected. After his recovery, the man tested negative twice in December. They wrote that the length of time between the infections ruled out viral shedding causing a second positive test.

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The researchers are not sure what variant of the virus the man was previously infected with. When he was admitted to the hospital, viral genome sequencing identified the three mutations representative of the B. 1.351 variant in the spike region.

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Seven days after he was hospitalized, the man was intubated and put on a ventilator, doctors wrote.

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There is no evidence that the variant discovered in South Africa is more lethal.

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Risk of hospitalisation and death

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On the other hand, the variant identified in the United Kingdom is “likely” linked to an increased risk of hospitalisation and death, British government scientists wrote in a paper released Friday. British officials had previously indicated that the variant “may be associated with a higher degree of mortality.”

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The unknowns about the variants – and the possibility that the virus can continue to mutate – has alarmed officials, who advise people to maintain distancing to limit the spread of the contagious variant.

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More cases of the mutation have been identified in the United States, Anthony S. Fauci, the nation’s highest-ranking infectious-diseases doctor, told CNN’s Wolf Blitzer, meaning the variant could become a main source of infection in the country.

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“If it becomes dominant, the experience of our colleagues in South Africa indicates that even if you’ve been infected with the original virus, that there is a very high rate of reinfection to the point where previous infection does not seem to protect you against reinfection,” he said. “That gets to the point that we’ve said over and over again, vaccination is very important.”

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