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WUHAN: Doctors in China’s Wuhan, where the virus first emerged in December, say an increasing number of cases in which people recover from the virus, but continue to test positive without showing symptoms, is one of their biggest. challenges.
Dressed in a hazardous materials suit, two masks and a face mask, Du Mingjun knocked on the mahogany door of an apartment in a suburban district of Wuhan on a recent morning.
A man wearing a single mask opened the door slightly, and after Du introduced herself as a psychological counselor, she burst into tears.
“I really can’t take it anymore,” he said. Diagnosed with the new coronavirus in early February, the man, who appeared to be in his 50s, had been treated at two hospitals before being transferred to a quarantine center set up in a group of apartment blocks in an industrial part of Wuhan.
Why, he asked, did the evidence say he still had the virus more than two months after he first contracted it?
The answer to that question is a mystery that baffles doctors on the front lines of China’s battle against COVID-19, even though it has successfully slowed the spread of the coronavirus across the country.
All of the patients tested negative for the virus at some point after recovery, but then tested positive again, some up to 70 days later, the doctors said. Many have done it for 50-60 days.
The possibility of people remaining positive for the virus and therefore potentially infectious is a matter of international concern, as many countries seek to end blockades and resume economic activity as the spread of the virus slows . Currently, the globally recommended isolation period after exposure is 14 days.
So far, there have been no confirmations of recently positive patients infecting others, according to Chinese health officials.
China has not released precise figures on how many patients fall into this category. But Chinese hospital disclosures to Reuters, as well as other media reports, indicate that there are at least dozens of such cases.
In South Korea, about 1,000 people have tested positive for four weeks or more. In Italy, the first European country devastated by the pandemic, health officials noted that coronavirus patients could test positive for the virus for about a month.
Because there is limited knowledge about how infectious these patients are, doctors in Wuhan keep them isolated longer.
Zhang Dingyu, president of the Jinyintan Hospital, where the most serious cases of coronavirus were treated, said health officials acknowledged that the isolates may be excessive, especially if the patients proved not to be infectious. But, for now, it was better to do it to protect the public, he said.
He described the problem as one of the most pressing facing the hospital and said counselors like Du are being called on to help ease emotional tension.
“When patients have this pressure, it also weighs on society,” he said.
Dozens of cases
Wuhan’s plight of long-term patients underscores how much remains unknown about COVID-19 and why it seems to affect different people in so many ways, Chinese doctors say. So far, global infections have reached 2.5 million with more than 171,000 deaths.
As of April 21, 93% of 82,788 people with the virus in China had recovered and were discharged, according to official figures.
Yuan Yufeng, vice president of Zhongnan Hospital in Wuhan, told Reuters that he was aware of a case in which the patient had positive tests after being first diagnosed with the virus some 70 days earlier.
“We didn’t see anything like this during SARS,” he said, referring to the 2003 outbreak of severe acute respiratory syndrome that infected 8,098 people worldwide, primarily in China.
Patients in China are discharged after two negative nucleic acid tests, taken at least 24 hours apart, and if they no longer show symptoms. Some doctors want this requirement to rise to three tests or more.
The Chinese National Health Commission addressed Reuters to comments made at a briefing on Tuesday when asked for comment on how this category of patients was managed.
Wang Guiqiang, director of the infectious diseases department at Peking University First Hospital, said at the briefing that most of these patients showed no symptoms and very few had seen their conditions worsen.
“The new coronavirus is a new type of virus,” said Guo Yanhong, an official with the National Health Commission. “For this disease, the unknowns are even greater than the known ones.”
Reactivation
Experts and doctors struggle to explain why the virus behaves so differently in these people.
Some suggest that patients who retest as positive after previously negative were somehow reinfected with the virus. This would undermine hopes that people who contract COVID-19 will produce antibodies that prevent them from becoming ill from the virus again.
Zhao Yan, an emergency medicine physician at Zhongnan Hospital in Wuhan, said he was skeptical of the possibility of case-based reinfection at his facility, although he had no hard evidence.
“They are closely monitored in the hospital and are aware of the risks, so they remain in quarantine.” So I am sure they were not reinfected. “
Jeong Eun-kyeong, director of the Korea Centers for Disease Control and Prevention, said the virus may have been “reactivated” in 91 South Korean patients who tested positive after they were thought to have disappeared.
Other South Korean and Chinese experts have said the remnants of the virus may have remained in the patients’ systems but were not infectious or dangerous to the host or others.
Few details have been revealed about these patients, as to whether they have underlying health conditions.
Paul Hunter, a professor at the University of East Anglia Norwich School of Medicine, said that unusually slow clearance of other viruses such as norovirus or influenza had previously been seen in patients with weakened immune systems.
In 2015, South Korean authorities revealed that they had a patient with Middle Eastern Respiratory Syndrome affected by lymphoma who showed signs of the virus for 116 days. They said that his weakened immune system prevented his body from getting rid of the virus. The lymphoma eventually caused his death.
Yuan said that even if patients develop antibodies, it does not guarantee that they will become virus free.
He said some patients had high levels of antibodies, and still tested positive for nucleic acid.
“It means that the two sides are still fighting,” he said.
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