Army Public Health Weekly Update, 12 March 2021

Date Published: 3/12/2021
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​The Army Public Health Update is a collection of articles taken from public sources to offer awareness of current health issues and the media coverage given to them. The articles do not necessarily represent U.S. Army Medical Command opinions, views, policy, or guidance, and should not be construed or interpreted as being endorsed by the U.S. Army Medical Command.

The Army Public Health Weekly Update does not analyze the information as to its strategic or tactical impact on the U.S. Army and is not a medical intelligence product. Medical intelligence is available from the National Center for Medical Intelligence External Link

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Table of Contents


    COVID-19 Vaccine Toolkit

    The Centers for Disease Control and Prevention believes it's likely that flu viruses and the virus that causes COVID-19 will both be active. Vaccine candidates are being offered through an Emergency Use Authorization by the Food and Drug Administration. We've developed this COVID-19 Vaccine Toolkit to give you messages and graphics you can use locally through various platforms. Use the materials provided in this toolkit to help educate the Military Health community about COVID-19 prevention and vaccination. External Link

    COVID-19 Townhall Template 

    Use this template and the associated Letter of Instruction to tailor a presentation for your installation's use and to meet the needs of your audience. COVID-19 Townhall Template External Link (CAC required. Sign-in to milSuite first before clicking this link or you'll have to sign-in and then return and click the link again) 


    All vets could be eligible for COVID vaccines at VA soon, but supply problems remain the biggest challenge

    9 March- Congress and Veterans Affairs leaders want to get as many veterans vaccinated against COVID-19 as possible in coming months. How quickly they can do that is still a big question, however. On Tuesday, House lawmakers approved new legislation that would allow VA health officials to offer vaccines to any veteran — including those living abroad — and most caregivers when supplies become available. Under current rules, only veterans who are eligible for VA health care and certain caregivers enrolled in the official VA assistance program can get the shots. Veterans living abroad who are enrolled in the Foreign Medical Program are also ineligible for coronavirus-related testing or treatments. "We don't have time to waste," House Veterans' Affairs Committee Chairman Mark Takano, D-Calif., said in a statement after the bill's passage. "We must get more shots in arms, our VA VACCINE Act makes sure that VA can." The measure passed without any objection and strong support from several prominent Republicans, including committee ranking member Mike Bost, R-Ill. It now heads to the Senate, where earlier this week the chairman and ranking member of the Senate Veterans' Affairs Committee offered a similar measure with a goal of increasing the number of vaccinated vets. "We need to vaccinate as many Americans as possible to get through this pandemic and get our economy back on track," said committee Chairman Sen. Jon Tester, D-Mont. "That starts by making sure that every veteran has access to a vaccine, regardless of whether they're enrolled in VA health care or not." Military Times External Link

    MHS GENESIS MassVax system rolling out with COVID19 vaccines

    9 March- MHS GENESIS, the Department of Defense's new electronic health record system, has recently created a large digital record of COVID-19 vaccinations administered to service members and their families. Referred to as 'MassVax,' the digital archive will more accurately track and ensure that the DOD's patient population has received COVID-19 vaccinations, considered essential to both a ready medical force and medically ready force. Air Force Col. (Dr.) Thomas Cantilina, chief health informatics officer for the Defense Health Agency, said the DOD partnered with Cerner Corp., the company that designed the still-evolving MHS GENESIS, to develop the new capability. "MassVax is designed to help us quickly record who gave what vaccine, as well as when and where it was given," said Cantilina. "Additionally, and more importantly, MHS GENESIS and its MassVax capability have enhanced safety and efficiency at our COVID-19 vaccine sites, through its ability to provide clinicians with patient data related to drug and allergy interactions - prior to vaccines being administered." There is plenty to keep track of. According to the Department of Defense, as of March 5, 84% of vaccines received by the DOD had been administered, accounting for nearly 1.3 million total doses given at 335 sites; additionally, 81,256 vaccinations at retail pharmacies were administered to MHS beneficiaries. And the newly approved single-shot Janssen COVID-19 vaccine (also known as Johnson & Johnson) was being prepared for immediate DOD roll-out. MassVax went live at Naval Hospital Twentynine Palms in California in September 2020, giving staff sufficient time to become proficient with the new system and recognize the powerful tool they had to administer vaccinations on a massive scale, touted Dave Marks, public affairs officer at NHTP. The facility supports the Marine Corps Air Ground Combat Center in the Mojave Desert, the largest Marine Corps base in the world. "Because an average Marine battalion is around 1,000 members strong, we needed something that was quick and efficient," said licensed vocational nurse Danielle Vasquez, the immunizations program manager who oversees the Twentynine Palms COVID-19 vaccine program. "We've had great success with our through-put. We can vaccinate up to 150 (service members) per hour, and that's not even using MassVax at its full capability." External Link


    CDC releases highly anticipated guidance for people fully vaccinated against Covid-19

    8 March- New guidelines from the US Centers for Disease Control and Prevention say people fully vaccinated against Covid-19 can safely visit with other vaccinated people and small groups of unvaccinated people in some circumstances, but there are still important safety precautions needed. "Covid-19 continues to exert a tremendous toll on our nation. Like you, I want to be able to return to everyday activities and engage with our friends, families, and communities," CDC Director Dr. Rochelle Walensky said at the White House briefing Monday. "Science, and the protection of public health must guide us as we begin to resume these activities. Today's action represents an important first step. It is not our final destination." "As more people get vaccinated, levels of Covid-19 infection decline in communities, and as our understanding of Covid immunity improves, we look forward to updating these recommendations to the public." The CDC defines people who are fully vaccinated as those who are two weeks past their second dose of the Moderna and Pfizer Covid-19 vaccines or two weeks past a single dose of the Johnson & Johnson vaccine. There is growing evidence that people who are vaccinated don't spread Covid-19, but scientists are still trying to understand how long vaccine protection lasts. CNN External Link

    COVID-19 pill effective in preliminary testing may be 'holy grail' of pandemic, Dr. Marc Siegel says

    7 March- A new possible medication to treat coronavirus-positive patients could be enough to turn the pandemic on its head, Fox News medical contributor Dr. Marc Siegel revealed Sunday on "Fox & Friends Weekend." First-stage testing of the experimental COVID-19 pill called Molnupiravir, by Merck and Ridgeback Bio therapeutics, showed promising signs of effectiveness in reducing the virus in patients. "It may be the holy grail on this because it was just studied in phase two trials and it literally stopped the virus in its tracks," he explained. "And there wasn't any virus found in the patients that were studied." Fox News External Link

    Covid vaccines: How fast is progress around the world?

    8 March- More than 300 million doses of the coronavirus vaccines have been administered, in more than 100 countries worldwide. However, there are vast differences in the pace of progress in different parts of the world. Some countries have secured and delivered doses to a large proportion of their population - but many more are still waiting for their first shipments to arrive... With an aim to give doses to nearly every adult around the world, this is the largest-scale vaccination programme in history. The US and China have administered the highest number of doses, 90 million and 52 million respectively. The UK ranks third, with more than 23 million. But while nearly all of Europe and the Americas have begun vaccination campaigns, only a handful of African countries have. BBC News External Link

    COVID-19 vaccine shows new side effect as it may result in false positive on mammograms

    6 March- Medical experts just released the new side effect of the COVID-19 vaccine on women. It turns out that those who go for a mammogram may have a false-positive result. According to the report from Mayo Clinic, the COVID-19 vaccine can cause swollen lymph nodes under the arm where shots are normally given. The doctors at the Mayo Clinic stated that the swelling in the lymph nodes signifies that the person's body is positively responding to the vaccine and is creating a defense against COVID-19...A doctor at the MD Anderson Cancer Center in Houston, Texas, told KHOU in an interview that they had witnessed at least 10 false-positive results in mammograms this week alone. Dr. Jerome Schroeder, a breast imagining radiologist at SLC Health Breast Care Center, said that he had not seen it himself, but he has colleagues in his group that work throughout Texas and have seen at least two cases of false positives, but it has not been a massive issue so far. The MD Anderson Cancer Center is now warming patients that swelling could impact the results of mammograms for up to six weeks after the COVID-19 vaccination, so medical experts are urging patients to check on their schedule carefully. Dr. Schroeder and his colleague, Dr. Chelsea Gawryletz, urge their patients in Denver not to cancel or reschedule their mammograms even after getting a COVID-19 vaccine. Tech Times External Link

    Fully vaccinated people can reengage in certain activities 

    8 March- The US Centers for Disease Control and Prevention (CDC) issued announced Public Health Recommendations for Fully Vaccinated People on March 8, 2021. The CDC says fully vaccinated people can:

    - Visit with other fully vaccinated people indoors without wearing masks or physical distancing,

    - Visit with unvaccinated people from a single household who are at low risk for severe COVID-19 disease indoors without wearing masks or physical distancing,

    - Refrain from quarantine and testing following a known exposure if asymptomatic.

    For this new CDC guidance, people are considered fully vaccinated for COVID-19 ≥2 weeks after receiving the second dose of the Pfizer-BioNTech or Moderna vaccines or ≥2 weeks after they have received a single-dose vaccine Johnson and Johnson - Janssen COVID-19 vaccine. The CDC stated it would continue to evaluate and update public health recommendations for vaccinated people as more information, including new virus variants, becomes available. Further information on evidence and considerations related to these recommendations is available in the new Science Brief. Rochelle Walensky, the CDC's new director, stated, “There are some activities that fully vaccinated people can begin to resume now in the privacy of their own homes. Everyone, even those who are vaccinated, should continue with all mitigation strategies when in public settings," reported NPR. Precision Vaccinations External Link

    Intellectual disability, obesity tied to COVID-19 hospitalization, death

    8 March- Intellectual disability is second only to old age as a risk factor for COVID-19 death, and obesity is linked to coronavirus-related hospitalization and death, two new studies find.  The first study, led by researchers from Jefferson Health in Philadelphia and published late last week as a commentary in the New England Journal of Medicine Catalyst, involved analyzing the medical records of 558,672 US COVID-19 patients from January 2019 to November 2020. Patients with intellectual disabilities had higher rates of coronavirus infection than those without those limitations (3.1% vs 0.9%). In unadjusted analysis, compared with the 431,669 patients without intellectual disabilities, the 127,003 patients with intellectual disabilities were more susceptible to hospitalization (63.1% vs. 29.1%), intensive care unit (ICU) admission (14.5% vs. 6.3%), and death (8.2% vs. 3.8%). Intellectual impairments were the strongest predictor of death other than older age. "The chances of dying from COVID-19 are higher for those with intellectual disability than they are for people with congestive heart failure, kidney disease or lung disease," lead study author Jonathan Gleason, MD, said in a Thomas Jefferson University news release. COVID-19 patients with intellectual disabilities were more likely to be established patients of the health system where they sought care; 22% were new patients, compared with 44% of those without intellectual disabilities. They were also more likely to be younger than those without these limitations, with only 1% older than 80 years and 18% aged 60 to 80, versus 5% and 25%, respectively. Forty-four percent of patients with intellectual disabilities had insurance coverage associated with low incomes, versus 28% in other patients. They also had higher rates of all underlying medical conditions except cancer. "The risks to patients with intellectual disabilities incorporate not only risks associated with intellectual disability itself, but also the risks associated with these comorbidities that were overrepresented among those with intellectual disabilities," the authors wrote. CIDRAPExternal Link

    Will the U.S. have Covid vaccine doses for everyone by the end of May? Probably

    8 March- President Biden confidently declared last week that there would be enough Covid-19 vaccine delivered to the U.S. government by the end of May to vaccinate every American. But predictions about vaccine availability have repeatedly been proven wrong. How confident should Americans be this time? The short answer: somewhat. There is no doubt that the U.S. is moving from a time of vaccine scarcity, when there is not enough vaccine to go around, to one of vaccine surplus, when it will be far easier for people who want a Covid vaccine to receive one. By early summer, barring a manufacturing catastrophe, there should be enough vaccine for every American. But the math behind Biden's pledge that the U.S. will have enough supply to vaccinate roughly 260 million by the end of May depends a great deal on new, more aggressive timelines from Johnson & Johnson. A closer look at administration and industry statements also suggests officials know this. Even if J&J misses the goals stated by it and the administration, it is likely the supply would hit this 260 million figure. The March 2 announcement was based not only on current expectations of supplies from vaccine manufacturers Moderna and the partnership of Pfizer and BioNTech, but on expectations that the U.S. will have 100 million doses of the newly authorized vaccine from Johnson & Johnson by the end of May. STAT News External Link

    Women report worse side effects after a Covid-19 vaccine

    9 March- In a study published last month, researchers from the Centers for Disease Control and Prevention analyzed safety data from the first 13.7 million Covid-19 vaccine doses given to Americans. Among the side effects reported to the agency, 79.1 percent came from women, even though only 61.2 percent of the vaccines had been administered to women. Nearly all of the rare anaphylactic reactions to Covid-19 vaccines have occurred among women, too. Anaphylaxis is a severe allergic reaction, and C.D.C. researchers reported that all 19 of the individuals who had experienced such a reaction to the Moderna vaccine had been female. Women made up 44 of the 47 who had anaphylactic reactions to the Pfizer vaccine, they wrote. "I am not at all surprised," said Sabra Klein, a microbiologist and immunologist at the Johns Hopkins Bloomberg School of Public Health. "This sex difference is completely consistent with past reports of other vaccines." In a 2013 study, scientists with the C.D.C. and other institutions found that four times as many women as men ages 20 to 59 reported allergic reactions after receiving the 2009 pandemic flu vaccine, even though more men than women got those shots. The news isn't all bad for women, though. Side effects are usually mild and short-lived. And the physical reactions are a sign that a vaccine is working — that "you are mounting a very robust immune response, and you will likely be protected as a result," Dr. Klein said. The New York Times External Link


    WHO-Influenza Update

    01 March 2021, based on data up to 14 February 2021:

    - The current influenza surveillance data should be interpreted with caution as the ongoing COVID-19 pandemic has influenced to varying extents health seeking behaviors, staffing/routines in sentinel sites, as well as testing priorities and capacities in Member States. The various hygiene and physical distancing measures implemented by Member States to reduce SARS-CoV-2 virus transmission have likely played a role in reducing influenza virus transmission.

    - Globally, despite continued or even increased testing for influenza in some countries, influenza activity remained at lower levels than expected for this time of the year.

    - In the temperate zone of the northern hemisphere, influenza activity remained below baseline, though sporadic detections of influenza A and B viruses continued to be reported in some countries.

    - In the temperate zone of the southern hemisphere, influenza activity was reported at inter-seasonal level.

    - In the Caribbean and Central American countries, sporadic influenza detections were reported. Severe acute respiratory infection (SARI) activity was low in most reporting countries.

    - In tropical South America, sporadic detections were reported in Colombia.

    - In tropical Africa, influenza activity was reported in some reporting countries in Western, Middle and Eastern Africa in recent weeks.

    - In Southern Asia, sporadic influenza detections were reported in India.

    - In South East Asia, influenza A(H3N2) detections continued to be reported in most reporting countries.

    - Worldwide, influenza B detections accounted for the majority of the very low numbers of detections reported. WHO External Link


    Salmonella test prompts recall of sesame oil; expiration date unknown

    8 March- Sesame oil packed in August 2020 is now under recall because of positive Salmonella test results. The product labels do not have expiration dates. Mediterranean Food Inc. of Warren, MI, is recalling its 2-pound plastic jars of “Alqosh Sesame Oil” after receiving notice of the problem found during routine testing by the Michigan Department of Agriculture and Rural Development (MDARD). The department collected the test sample from one of the retailers that received the implicated sesame oil. The recalled sesame oil was distributed in Michigan retail stores and distributors via the company’s staff, according to a recall notice from Mediterranean Food Inc. that was posted by the Food and Drug Administration.  “The Product was distributed in the period from 11/06/2020 to 12/10/2020,” according to the company notice. “The product comes in a 2Lb, clear plastic jar marked with lot # 16082020 on the side of the jar and with a Production date of 08/16/2020 stamped on the side. “Production of the product has been suspended while FDA and the company continue their investigation as to the source of the problem.” As of the posting of the recall notice no confirmed illnesses had been reported in relation to the recalled product. Consumers who have purchased Alqosh Sesame Oil “Tahin” 2Lb plastic jar with lot # 16082020 should not consume the product and are urged to return it to the place of purchase for a full refund. Consumers with questions may contact the company at 586-777-3460. Food Safety News External Link


    Proper nutrition impacts overall health & readiness

    4 March- Nutrition is one the eight Total Force Fitness domains, and having safe, high-quality foods available to members of the military goes a long way toward sustaining and optimizing physical and cognitive performance, as well as health, well-being, and readiness. With March serving as National Nutrition Month, Military Health System providers emphasize the importance and impact of maintaining proper nutrition throughout the year. "The implications of nutritional fitness are far-reaching because being truly nutritionally fit will impact all the other TFF domains: medical, behavioral, psychological, environmental, physical, social, and spiritual," said Patricia Deuster, executive director of the Uniformed Services University (USU) Consortium for Health and Military Performance (CHAMP) in Bethesda, Maryland. "Nutritional choices and habits affect every aspect of life: sleep, mood, physical and cognitive performance, sense of purpose, health, and more," Deuster said. "Nutrition is intricately woven into the fabric of each TFF domain. So by choosing a healthy diet, limiting alcohol and tobacco, and engaging in regular physical activity, this will empower service members, their families and retirees to live healthy and fulfilling lives. But we must also provide an environment so that the healthy choice is the easiest and default choice." Army Maj. Joetta Khan, deputy director and chief of education and research, Nutrition Services Department, Walter Reed National Military Medical Center (WRNMMC) in Bethesda, Maryland explained, "We are no longer focused on the old model of treating illness but have transitioned to a more preventive approach" that incorporates proper nutrition as a linchpin of TFF. "If we can coach, teach and mentor the soldier at multiple points within his or her career, from basic training until retirement, there could be a significant cost savings for the soldier. These could be in the form of fewer injuries and chronic diseases, more healthy work days, and increased resiliency," said Khan. "For the soldier's family, this could translate into the soldier bringing the concepts home, and more healthy days at home," added Khan. "Finally, this continuous training in TFF could translate into fewer sick/injured days and lower medical care costs associated with treating long-term conditions." External Link


    Ebola outbreaks in Africa: Death toll rises to 13

    7 March- The number of Ebola Virus Disease (EVD) cases and deaths have risen to 29 cases and 13 deaths as of Saturday, according to the World Health Organization. On 6 February 2021, the DR Congo Ministry of Health (MoH) confirmed an outbreak of EVD in Butembo. In North Kivu province, Democratic Republic of Congo (DR Congo), the cumulative number of confirmed cases now stands at 11, including four deaths in four health zones: Biena (5; 3), Butembo (3; 0), Katwa (2; 1) and Musienene (1; 0). Nearly one thousand people have been vaccinated to date. On 14 February 2021, the Guinea Ministry of Health (MoH) confirmed an outbreak of EVD in N’Zérékoré prefecture. In Nzérékoré, Guinea, 18 total EVD cases have been reported (14 confirmed and 4 probable) and nine deaths. 1600 people have been vaccinated. Outbreak News Today External Link


    Pakistan: 1st Crimean-Congo hemorrhagic fever case reported in Karachi

    7 March- A patient in Karachi has been diagnosed with Crimean-Congo hemorrhagic fever (CCHF), according to a report in The Nation. “A patient infected with CCHF has been admitted at the Jinnah Hospital,” Dr. Seemi Jamali said. It is the first patient of the Congo virus reported this year. “The patient has been a cowherd and resident of Bilawal Chowrangi in Karachi,” Dr. Jamali said. After confirmation, an alert was issued by the KMC to hospitals, directing them to adopt special precautions for a Congo affected patient. It had further asked hospitals to establish special wards for Congo patients, and run awareness campaigns about the virus. Crimean-Congo hemorrhagic fever is a widespread disease caused by a tick-borne virus (Nairovirus) of the Bunyaviridae family. The CCHF virus causes severe viral hemorrhagic fever outbreaks, with a case fatality rate of 10–40%. Animals become infected by the bite of infected ticks and the virus remains in their bloodstream for about one week after infection, allowing the tick-animal-tick cycle to continue when another tick bites. Although a number of tick genera are capable of becoming infected with CCHF virus, ticks of the genus Hyalomma are the principal vector. The CCHF virus is transmitted to people either by tick bites or through contact with infected animal blood or tissues during and immediately after slaughter. The majority of cases have occurred in people involved in the livestock industry, such as agricultural workers, slaughterhouse workers and veterinarians. Human-to-human transmission is possible. Outbreak News Today External Link


    Norway reports salmonella outbreak, 10 people hospitalized

    8 March- The Norwegian Institute of Public Health (NIPH) is reporting a Salmonella outbreak which is geographically spread over large parts of country. Twenty cases have been reported–12 confirmed and 8 suspected cases. The same genetic profile have been detected in all 12 confirmed cases. Preliminary analyzes of samples from the 8 suspected cases indicate that these also carry the outbreak strain. Those affected are aged from 11 to 91 years, median age is 59 years. 60% are women. The infected live in Viken (9), Oslo (3), Innlandet (2), Vestfold and Telemark (1), Agder (1), Rogaland (1), Vestland (1), Møre og Romsdal (1) and Nordland (1). 10 of the cases have been hospitalized. “The infected live in many different counties. Therefore, we believe that they are infected through a food that is widely distributed”, says doctor Hilde Marie Lund at the department of infection control and emergency preparedness. “Investigation work can be complicated and time consuming, and in many cases it will not be possible to find the source of the infection or to clarify whether it is a common source. It is too early to say whether this is a limited outbreak or whether it will increase in scope. We follow the situation closely”, says doctor Hilde Marie Lund. “The high proportion of patients admitted in this outbreak may be related to the relatively high age of the cases (median 59 years), but this is being investigated further”. Outbreak News Today External Link


    African swine fever: New strains found in China, milder but highly transmissible

    7 March- A new study published in the journal, Science China Life Sciences, Chinese researchers with the Harbin Veterinary Research Institute in Heilongjiang report the discovery of new strains of African swine fever that are milder but highly transmissible. According to a statement from Harbin Veterinary Research Institute (computer translated): In 2020, the National African Swine Fever Specialty Laboratory of Harbin Institute of Veterinary Medicine of the Chinese Academy of Agricultural Sciences found that African swine fever genotype II with low fatality rate appeared in some provinces and regions of my country during the epidemiological surveillance and etiology research of African swine fever. Variant epidemic strains. The related research paper “Emergence and prevalence of naturally occurring lower virulent African swine fever viruses in domestic pigs in China in 2020” was published online in “SCIENCE CHINA Life Sciences” on February 26, 2021. At present, at least 24 genotypes of African swine fever virus have been identified worldwide. Among them, genotype II is the main prevalent in Asia. Currently, there is no commercial vaccine or effective treatment for African swine fever. Early diagnosis and culling of infected pigs are the main strategies for prevention and control. Therefore, carrying out epidemiological surveillance and research on the genome variation, biological phenotype and pathogenicity of epidemic strains is of key guiding significance for the prevention and control of African swine fever. Outbreak News Today External Link


    U.S.: Houston- U.K. COVID-19 variant virus (B.1.1.7) detected at most wastewater treatment plants

    9 March- City of Houston health officials reported this week that the more contagious variant of the COVID-19 virus, the UK variant B.1.1.7, was detected widespread in Houston's wastewater. Samples collected on February 22 detected the U.K. variant at 31 of the city's 39 wastewater treatment plants. That's an increase from February 8 when it was detected at 21 of the treatment plants. "The prevalence of the U.K. variant in our wastewater shows it's actively spreading in our city," said Dr. David Persse, chief medical officer for the City of Houston. "This is another clear indication that we must continue to mask up, practice social distancing, wash our hands, get tested and, get vaccinated when possible." "I am concerned about this new data on the U.K. strain of the virus in Houston, especially at a time when the State of Texas is easing mandates on measures proven to reduce transmission and ultimately save lives," said Mayor Sylvester Turner. "Despite the mixed messaging, this is a clear indication that it is too soon to stop requiring masks in public places. I urge all Houstonians to continue masking up to protect their families and community." Wastewater sample results for other highly transmissible variants, including the South Africa, Brazil, and California variants, are pending. Outbreak News Today External Link


    Panama reports 1st case of COVID-19 reinfection

    8 March- Last month, officials with the Gorgas Institute in Panama identified the first person with COVID-19 reinfection. “We have already reported the first case of reinfection confirmed at the molecular level, in a 36-year-old subject who presented a mild picture of COVID-19 in June and later in December presented another picture much milder than the first. Luckily we were able to keep both samples in good condition and the genetic analysis was carried out, the two complete viruses were sequenced and a reasonable difference between the two was observed to classify it as a reinfection ”according to Dr. Juan Miguel Pascale. Dr. Alexander Martínez explained that in order to confirm that it is a reinfection, it must be ensured that the virus with which the person was infected for the first time has a difference from the second virus with which it was infected, that is, changes enough in your genome. It was observed in this subject that between the first virus and the second, there are more than 20 nucleotide changes, 10 of them are found in the surface protein, thus achieving confirmation of the case of reinfection. Dr. Sandra López assured that with this second virus that is already under analysis, it will be possible to determine how it behaves, that is, if it infects cells better, if it replicates faster or if it escapes the antibody response when people they are infected with the other viruses that are already circulating in the country. Dr. Pascale states that there are currently around 20 probable cases of reinfection. These cases appear to meet the requirements to be considered as reinfection but are still being analyzed. Regarding whether people who have been infected should be vaccinated: “Definitely people who have had COVID-19 should be vaccinated to guarantee a more complete protection for the future and avoid reinfections, since it has been proven that people who have been infected and the vaccine is given, they develop a more robust immune response, ”said Dr. Pascale. Outbreak News Today External Link