Lead epidemiologist says reinfection still possible, however
NASSAU, BAHAMAS — There has been no clinical evidence to support a reinfection of COVID-19 in The Bahamas, according to Dr Nikkiah Forbes, director of the National HIV/AIDS and Infectious Disease Programme.
In an interview with Eyewitness News, Forbes was asked to confirm the number of local reinfection cases.
“What I want to say is that reinfections are not a common phenomenon based upon what has been reported globally by experts
“And there is stringent criteria about how you determine if someone is reinfected, including phylogenetic studies and that needs to be done.
“That is the gold standard.
“There are many centers of excellence that are looking at this and looking at their populations.
“The standard that is applied is phylogenetic studies to determine that someone with COVID symptoms, who has tested positive, does in fact have a reinfection, and a certain period of time has to go by. And I don’t believe that was met.
“So, I think we should use caution and there are standards for these things that haven’t been applied in these cases.”
In October, former Minister of Health Dr Duane Sands said there were at least two patients reinfected with the virus, noting the patients were tested after recovering with negative results, and following an intervening period of being asymptomatic, the patients subsequently tested positive.
Asked whether that meant there has yet to be a confirmed case of reinfection in The Bahamas, Forbes said: “Yes. I think when I read the article that it was clinically determined, but it cannot be clinically determined. That’s not how it is determined.”
But Forbes cautioned recovered cases from having a false sense of security.
“Reinfection is possible,” she said.
“There are a few cases that have been described in the international literature and reported on internationally.
“One must still be careful after getting COVID-19 because we’re determining and we’re still learning things with immunity with COVID-19.”
Although rare, cases of reinfections have been reported in other jurisdictions, as pointed out by Forbes.
Explaining what constitutes a reinfection, Andhra Medical College (AMC) Principal Dr PV Sudhakar said a case can be termed a reinfection only if the COVID-19 presence occurs a second time at least 90 to 120 days post-recovery from the first instance of contraction of the virus.
Further, the RT-PCR genome sequencing for the subsequent infection should be different from the first, according to Sudhakar.
While there have been several cases in India of patients complaining of the same COVID-19 symptoms a few weeks after an apparent recovery and requiring treatment, these cases were not declared reinfections as the patients had comorbidities and metabolic disorders, making it possible for the cases to have traces of the previous infection.
The Lancet Infectious Diseases medical journal also reported on a case in Reno, Nevada, that tested positive in April after showing mild symptoms, and got sick again in May with more severe symptoms.
Other isolated cases of reinfection have been reported in Asia and Europe.
A recent study of 20,000 patients of the Mount Sinai Health System found stable levels of antibodies in those with a mild case of the virus, and reinfection was unlikely for at least three months.
It remains unclear whether people who have been reinfected but remain asymptomatic can spread the virus to others.