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Special thread discussing #COVID19 reinfection evidence in Iran. I felt it is time to compile it in a separate thread from my daily ones.
/start
/start
First of all, what we have is just simply anecdotal evidence that is not confirmed by PCR.
What is shocking to me, is the horde of experts flat out rejecting these reports, saying there is NO PROOF for reinfection yet.
/pre1
What is shocking to me, is the horde of experts flat out rejecting these reports, saying there is NO PROOF for reinfection yet.
/pre1
Bear in mind in a binary case (reinfection vs no chance of reinfection) with grossly asymmetric risk profiles, burden of proof is for the side with less risk (no reinfection). That is just basic risk management.
/pre2
/pre2
When you are about to enter a street with a homeless walking over to you saying "I saw a shooter!", you probably would not ask for a proof - you either do not enter or find enough evidence to believe it was a hoax.
/pre3
/pre3
This same simple Risk Management could have saved thousands of lives had WHO taken the risk of human-to-human infection seriously on Jan 5 and then 23 rather than playing it down.
/pre4
https://www.who.int/csr/don/05-january-2020-pneumonia-of-unkown-cause-china/en/
https://www.who.int/dg/speeches/detail/who-director-general-s-statement-on-the-advice-of-the-ihr-emergency-committee-on-novel-coronavirus
/pre4
https://www.who.int/csr/don/05-january-2020-pneumonia-of-unkown-cause-china/en/
https://www.who.int/dg/speeches/detail/who-director-general-s-statement-on-the-advice-of-the-ihr-emergency-committee-on-novel-coronavirus
With that in mind, I reported the first case of reinfection a month ago on June 21st: a nurse in Tehran. I asked but could not confirm that both episodes confirmed by PCR but likely they were since she was a medic. But we know one-off cases could occur /1 https://twitter.com/aliostad/status/1274762370552868865?s=20
Then 5 days ago, an official in Tehran reporting they are increasingly seeing more such cases /2 https://twitter.com/aliostad/status/1283840062002692097?s=20
Next day, similar report but this time from the province of Kurdistan which had a relativelt bad 1st wave and a worse 2nd wave. These were seen in medical staff and apparently confirmed reinfection cases. /3 https://twitter.com/aliostad/status/1284572934720323584?s=20
Then, health ministry strongly rejected these reports since it has not been proven [against the same thing, wrong burden of proof] and attributing it to long episode looking like reinfection. But they say can take 60 days while these were ~120 days. /4 https://twitter.com/aliostad/status/1284573977634115584?s=20
Currently a medical centre in Zanjan (431K) is tasked with a pilot to track reinfections, but they have not seen any yet. /5 https://www.isna.ir/news/99042921586/%D8%A7%D9%81%D8%AA%D8%AA%D8%A7%D8%AD-%DB%B2%DB%B0-%D8%AA%D8%AE%D8%AA-%D8%A2%DB%8C-%D8%B3%DB%8C-%DB%8C%D9%88-%D8%AF%D8%B1-%D8%B2%D9%86%D8%AC%D8%A7%D9%86
A well-known Infectious Disease specialist in Iran believes reinfection is rare and if it happens, the likelihood of getting a severe or mild case is the same. [I like his self confience in his statements!] /6 https://www.isna.ir/news/99042820810/%D8%A7%DB%8C%D8%B1%D8%A7%D9%86-%D8%AF%D8%B1-%D8%AD%D8%A7%D9%84-%D8%AD%D8%B1%DA%A9%D8%AA-%D8%A8%D9%87-%D8%B3%D9%85%D8%AA-%D8%A7%DB%8C%D9%85%D9%86%DB%8C-%D8%AC%D9%85%D8%B9%DB%8C-%DA%A9%D8%B1%D9%88%D9%86%D8%A7
Another confirmed case of reinfection has been reported in Isfahan (3.6M) again in a medical staff. Reported 3 days ago. /7 https://www.isna.ir/news/99042820679/%D9%86%DB%8C%D8%A7%D8%B2%DB%8C-%D8%A8%D9%87-%D8%A7%D9%81%D8%B2%D8%A7%DB%8C%D8%B4-%D8%AA%D8%AE%D8%AA-%D9%87%D8%A7%DB%8C-%D8%A8%DB%8C%D9%85%D8%A7%D8%B1%D8%B3%D8%AA%D8%A7%D9%86-%D8%A7%D9%85%DB%8C%D9%86-%D9%86%DB%8C%D8%B3%D8%AA
Another report today from Kashan (304K) which was involved during the 1st wave. This research centre says the likelihood of reinfection is higher due to a mutation. /8 https://www.tasnimnews.com/fa/news/1399/04/31/2311045/%D8%A7%D8%B2-%DA%AF%D9%88%D8%B4%D9%87-%D9%88-%DA%A9%D9%86%D8%A7%D8%B1-%DA%A9%D8%A7%D8%B4%D8%A7%D9%86-%D8%A7%D8%AD%D8%AA%D9%85%D8%A7%D9%84-%D8%A7%D8%A8%D8%AA%D9%84%D8%A7%DB%8C-%D9%85%D8%AC%D8%AF%D8%AF-%D8%A8%DB%8C%D9%85%D8%A7%D8%B1%D8%A7%D9%86-%D8%A8%D9%87%D8%A8%D9%88%D8%AF%DB%8C%D8%A7%D9%81%D8%AA%D9%87-%DA%A9%D8%B1%D9%88%D9%86%D8%A7%DB%8C%DB%8C-%D8%A7%D9%81%D8%B2%D8%A7%DB%8C%D8%B4-%DB%8C%D8%A7%D9%81%D8%AA%D9%87-%D8%A7%D8%B3%D8%AA
Now, looking at 4 provinces that had a severe 1st wave:
- Gilan
- Qom
- Mazandaran
- Golestan
In Gilan, antibody was present in up to 40% of population after the end of 1st wave. We also see this provided some protection and COVID is rising but not yet at the 1st wave level. /9
- Gilan
- Qom
- Mazandaran
- Golestan
In Gilan, antibody was present in up to 40% of population after the end of 1st wave. We also see this provided some protection and COVID is rising but not yet at the 1st wave level. /9
So after removing lockdown, immunity of these people kept R low although still above 1.
In Qom, it seems we are near the 1st wave level. In Mazandaran and Golestan, the situation is far worse than the 1st wave.
So reopening happened at the same time but different response? /10
In Qom, it seems we are near the 1st wave level. In Mazandaran and Golestan, the situation is far worse than the 1st wave.
So reopening happened at the same time but different response? /10
Different strain of virus could be one reason. Perhaps 1st wave and 2nd wave was due to a different strain. Or one strain results in shorter protection.
All of them good questions - but the answer will take some time to come. /11
All of them good questions - but the answer will take some time to come. /11
In the end:
- confirmed reinfections exist
- many more non-confirmed reinfection cases
- barely 4 months since the 1st wave peak, hence it might be clearer in a couple of months
- This is a question of risk management, not scientific proof
- virus strains to blame?
/summary
- confirmed reinfections exist
- many more non-confirmed reinfection cases
- barely 4 months since the 1st wave peak, hence it might be clearer in a couple of months
- This is a question of risk management, not scientific proof
- virus strains to blame?
/summary
Overall, Iran gives an early view to the rest of the world so use it.
Also do not look for PCR confirmation of reinfections in Iran, testing kits are scarce, most cases do not get tested even hospitalised cases.
/end
Also do not look for PCR confirmation of reinfections in Iran, testing kits are scarce, most cases do not get tested even hospitalised cases.
/end
OK, I might have to update this as more news arrive:
Just news out that Dr. Seyyed Hossein Reza Azizi from Ardabil died in Tehran due to #COVID19 reinfection. https://www.isna.ir/news/99043123573/%D8%B3%D9%88%D9%85%DB%8C%D9%86-%D8%B4%D9%87%DB%8C%D8%AF-%D9%85%D8%AF%D8%A7%D9%81%D8%B9-%D8%B3%D9%84%D8%A7%D9%85%D8%AA-%D8%A7%D8%B1%D8%AF%D8%A8%DB%8C%D9%84-%D8%A8%D9%87-%DB%8C%D8%A7%D8%B1%D8%A7%D9%86-%D8%B4%D9%87%DB%8C%D8%AF%D8%B4-%D9%BE%DB%8C%D9%88%D8%B3%D8%AA
Just news out that Dr. Seyyed Hossein Reza Azizi from Ardabil died in Tehran due to #COVID19 reinfection. https://www.isna.ir/news/99043123573/%D8%B3%D9%88%D9%85%DB%8C%D9%86-%D8%B4%D9%87%DB%8C%D8%AF-%D9%85%D8%AF%D8%A7%D9%81%D8%B9-%D8%B3%D9%84%D8%A7%D9%85%D8%AA-%D8%A7%D8%B1%D8%AF%D8%A8%DB%8C%D9%84-%D8%A8%D9%87-%DB%8C%D8%A7%D8%B1%D8%A7%D9%86-%D8%B4%D9%87%DB%8C%D8%AF%D8%B4-%D9%BE%DB%8C%D9%88%D8%B3%D8%AA
Another report: 4 confirmed cases in Khuzestan where the patients between the two positive PCR result of each episode, had two negative results. (i.e. + - - +) https://www.isna.ir/news/99050100477/%DB%B9%DB%B0-%D8%AF%D8%B1%D8%B5%D8%AF-%D8%AC%D9%85%D8%B9%DB%8C%D8%AA-%D8%AE%D9%88%D8%B2%D8%B3%D8%AA%D8%A7%D9%86-%D8%AF%D8%B1-%D9%88%D8%B6%D8%B9%DB%8C%D8%AA-%D9%BE%D8%B1%D8%AE%D8%B7%D8%B1-%DA%A9%D8%B1%D9%88%D9%86%D8%A7
After Tehran and Kurdistan, we have now reports from Hormozgan province that several cases [does not say whether confirmed or not] of reinfection have been seen in this province. https://www.tasnimnews.com/fa/news/1399/05/04/2313471/%D8%A7%D9%85%DA%A9%D8%A7%D9%86-%D8%A7%D8%A8%D8%AA%D9%84%D8%A7%DB%8C-%D9%85%D8%AC%D8%AF%D8%AF-%D8%A8%D9%87-%DA%A9%D8%B1%D9%88%D9%86%D8%A7-%D8%AF%D8%B1-%D9%85%D9%86%D8%A7%D8%B7%D9%82-%DA%AF%D8%B1%D9%85%D8%B3%DB%8C%D8%B1%DB%8C
#BREAKING Dr. Minoo Mohraz, Iran's most prominent specialist in Infectious Diseases, just confirmed reinfection especially among the medical staff during the second wave. https://www.isna.ir/news/99050603830/%DA%A9%D8%B1%D9%88%D9%86%D8%A7%DB%8C%DB%8C-%D9%87%D8%A7%DB%8C-%D8%A8%D8%AF%D9%88%D9%86-%D8%B9%D9%84%D8%A7%D9%85%D8%AA-%DA%86%D9%86%D8%AF-%D8%B1%D9%88%D8%B2-%D8%A8%D8%A7%DB%8C%D8%AF-%D9%82%D8%B1%D9%86%D8%B7%DB%8C%D9%86%D9%87-%D8%A8%D9%85%D8%A7%D9%86%D9%86%D8%AF
Report of reinfections among 200 staff infection in Shohadaye-Tajrish hospital in north Tehran https://twitter.com/ilnanews/status/1287260954124857344?s=20
#BREAKING More PCR-confirmed #reinfection cases reported now from Isfahan - Iran's 2nd biggest city. Also:
- higher IgG if symptoms more severe
- mutation could also play a part https://www.irna.ir/news/83858915/%D9%BE%D8%B2%D8%B4%DA%A9-%D9%85%D8%AA%D8%AE%D8%B5%D8%B5-%D8%A7%DB%8C%D9%85%D9%86%DB%8C-%D8%A8%D9%87%D8%A8%D9%88%D8%AF-%DB%8C%D8%A7%D9%81%D8%AA%DA%AF%D8%A7%D9%86-%DA%A9%D8%B1%D9%88%D9%86%D8%A7-%D9%BE%D8%A7%DB%8C%D8%AF%D8%A7%D8%B1-%D9%86%DB%8C%D8%B3%D8%AA
- higher IgG if symptoms more severe
- mutation could also play a part https://www.irna.ir/news/83858915/%D9%BE%D8%B2%D8%B4%DA%A9-%D9%85%D8%AA%D8%AE%D8%B5%D8%B5-%D8%A7%DB%8C%D9%85%D9%86%DB%8C-%D8%A8%D9%87%D8%A8%D9%88%D8%AF-%DB%8C%D8%A7%D9%81%D8%AA%DA%AF%D8%A7%D9%86-%DA%A9%D8%B1%D9%88%D9%86%D8%A7-%D9%BE%D8%A7%DB%8C%D8%AF%D8%A7%D8%B1-%D9%86%DB%8C%D8%B3%D8%AA
#BREAKING as per report by ISNA, Ali Larijani, ex-head of the parliament has contracted #COVID19 for the 2nd time.
He got it once during the 1st wave and was hospitalised for a long time. [I think he lives in Qom, @qomnews can you confirm?] https://twitter.com/isna_farsi/status/1288539172064681984?s=20
He got it once during the 1st wave and was hospitalised for a long time. [I think he lives in Qom, @qomnews can you confirm?] https://twitter.com/isna_farsi/status/1288539172064681984?s=20
[Off-Topic since I just report on COVID in Iran]
ICYMI, this paper released 2 weeks ago by a Canadian blood bank suggesting disappearance of antibodies only after 2-3 months. I guess many have already seen this.
https://www.biorxiv.org/content/biorxiv/early/2020/07/17/2020.07.16.206847.full.pdf
ICYMI, this paper released 2 weeks ago by a Canadian blood bank suggesting disappearance of antibodies only after 2-3 months. I guess many have already seen this.
https://www.biorxiv.org/content/biorxiv/early/2020/07/17/2020.07.16.206847.full.pdf
A health official in Fasa (111K), Fars, reported a [PCR-confirmed] 'reinfected' patient has died from a more severe episode: one out of total 14 COVID casualties in this town.
[Due to testing kit shortages confirmed COVID deaths are grossly underreported] https://www.irna.ir/news/83891302/%D9%85%D8%B9%D8%A7%D9%88%D9%86-%D8%AF%D8%A7%D9%86%D8%B4%DA%AF%D8%A7%D9%87-%D8%B9%D9%84%D9%88%D9%85-%D9%BE%D8%B2%D8%B4%DA%A9%DB%8C-%D9%81%D8%B3%D8%A7-%D8%A7%D8%A8%D8%AA%D9%84%D8%A7-%D8%A8%D9%87-%DA%A9%D8%B1%D9%88%D9%86%D8%A7-%D8%A7%DB%8C%D9%85%D9%86%DB%8C-%D8%A7%DB%8C%D8%AC%D8%A7%D8%AF-%D9%86%D9%85%DB%8C-%DA%A9%D9%86%D8%AF
[Due to testing kit shortages confirmed COVID deaths are grossly underreported] https://www.irna.ir/news/83891302/%D9%85%D8%B9%D8%A7%D9%88%D9%86-%D8%AF%D8%A7%D9%86%D8%B4%DA%AF%D8%A7%D9%87-%D8%B9%D9%84%D9%88%D9%85-%D9%BE%D8%B2%D8%B4%DA%A9%DB%8C-%D9%81%D8%B3%D8%A7-%D8%A7%D8%A8%D8%AA%D9%84%D8%A7-%D8%A8%D9%87-%DA%A9%D8%B1%D9%88%D9%86%D8%A7-%D8%A7%DB%8C%D9%85%D9%86%DB%8C-%D8%A7%DB%8C%D8%AC%D8%A7%D8%AF-%D9%86%D9%85%DB%8C-%DA%A9%D9%86%D8%AF
