Slack / Private Message Drop — page 151

SLACK_000365 [Eddie Holmes] *Aleksei Chmura, PhD* _ Chief of Staff_ EcoHealth Alliance [Robert Garry] "Bob and I are now officially in the same 'Family' as the Grand Wizard of EgoHealth." This make me more than a "little bit nauseous," but so be it. I'm looking forward to the in-person meetings. [Kristian Andersen] Probably the most jarring COVID abstract I have read in a paper I just got for review for Nature Medicine: _"Here, from 273 COVID-19 patients, we identified six cases of reinfection based on clinical, phylogenic, virological, serological, and epidemiological data. During the secondary episode, we observed re-emergence of COVID-19 symptoms, new pulmonary lesions on CT images, increased viral load, and secondary humoral immune responses. More importantly, reinfection occurred not only in patients with inadequate or loss of immunity after the primary infection, but also in patients with measurable levels of neutralizing antibodies."_ I need to look more carefully tomorrow morning, but on first glance the paper looks solid... This would not be good to say the least. [Andrew Rambaut] Are the genomes different? Could these be chronic infections? [Andrew Rambaut] I guess they are different given '_phylogenic'._ [Kristian Andersen] Yup, different genomes so not relapse [Andrew Rambaut] How are the 273 patients selected. It seems implausible that in most parts of the world 6 out of 273 would even be exposed twice let alone infected. [Robert Garry] Yes - jarring if it holds up. Perhaps not surprising - SOME people get colds over and over again [repertoire holes?] and we know immunity to CoVs is rather short-lived at least in some people. I'd really want to see sequence data in both episodes for each patient. Too many people think they had COVID in November to January but really did not. Then there is the whole false-positive PCR thing - so a Ct in the high 30s or 40 might not be real per the NYT a few days ago. Yes - sequence confirmed in the first episode or may not be real. I'm also concerned about the mention of secondary" humoral responses. This is not evidence of reinfection. It seems to me that all of the humoral responses to SARS-CoV-2 appear to be secondary (likely due to previous seasonal exposures). In the COVID patients we've looked at IgG comes up at the same time as IgM and IgA, like a secondary response. Several other papers show the same thing. Also what are the neut titers? If they are low as seems typical they might well not be protective. Also I agree with Andrew - some weird selection bias? [Andrew Rambaut]