Speaker 1: Welcome to Prognosis. I'm Laura Carlson. It's day one and
Speaker 1: ninety six since coronavirus was declared a global pandemic. Today's
Speaker 1: main story. We're now learning that having had COVID nineteen
Speaker 1: doesn't mean you can't get it again. We'll discuss what
Speaker 1: that means for stopping the outbreak spread and for the
Speaker 1: development of a vaccine. But first, here's what happened in
Speaker 1: virus news today. COVID nineteen could wipe out an estimated
Speaker 1: five hundred million jobs globally. That's a bigger hit to
Speaker 1: the labor market than economists anticipated. According to the International
Speaker 1: Labor Organization, the i l O also predicts a much
Speaker 1: slower recovery. At the end of this year. The i
Speaker 1: l O said that global working hours were seventeen percent
Speaker 1: lower than the end of equivalent to almost five hundred
Speaker 1: million jobs. That's up from four hundred million projected in June.
Speaker 1: Johnson and Johnson has begun dosing up to sixty thousand
Speaker 1: volunteers in a study of its COVID nineteen vaccine. It's
Speaker 1: the first big US trial of an inoculation that may
Speaker 1: only require one shot. J and J is the fourth
Speaker 1: vaccine maker to move its candidate into late stage human
Speaker 1: studies in the US. If enrollment goes as expected, the
Speaker 1: trial could yield results as soon as the end of
Speaker 1: the year, allowing the company to seek emergency authorization early
Speaker 1: next year if it proves effective. Finally, the Trump administration
Speaker 1: has shifted billions of dollars away from public health programs
Speaker 1: for testing and mask funds into its Operation Warp Speed
Speaker 1: vaccine effort. It's a sign the US government is increasing
Speaker 1: its focus on a medical solution to the pandemic. The transfers,
Speaker 1: disclosed in the government audit reported by Bloomberg News and
Speaker 1: described by Congressional Aids, have increased the budget of the
Speaker 1: Warp Speed program to as much as eighteen billion dollars,
Speaker 1: much larger than the ten billion dollar figure the administration
Speaker 1: has routinely cited in public and now for today's main story,
Speaker 1: scientists in Hong Kong were ar died last month. What
Speaker 1: many Headlong suspected could happen. Someone who had recovered from
Speaker 1: COVID nineteen caught the coronavirus again. Since then, about a
Speaker 1: dozen cases of reinfection have been reported worldwide. These cases
Speaker 1: demonstrate that a natural infection doesn't lead to lasting protection,
Speaker 1: and that the pandemic could persist in the human population.
Speaker 1: Bloomberg New Senior editor Jason Gale talked to health experts
Speaker 1: about what this means for our ability to stop the
Speaker 1: virus and to produce an effective immunization. Anecdotes of people
Speaker 1: being infected by the coronavirus twice have appeared in the
Speaker 1: media since at least February, but these cases went proven.
Speaker 1: To demonstrate reinfection, scientists have to isolate the microbial culprit
Speaker 1: at each time, check it's genetic, think a print, show
Speaker 1: that each infection was caused by a different virus. Scientists
Speaker 1: in Hong Kong reported the first confirmed reinfection almost a
Speaker 1: month ago. I asked an infectious diseases physician, he's worked
Speaker 1: on a lot of outbreaks, how we should interpret that finding.
Speaker 1: I'm Dr Tom friedan president and chief executive officer of
Speaker 1: Resolved Saved Lives and former director of both the Centers
Speaker 1: for Disease Control and Prevention and Commissioner of the New
Speaker 1: York City Health Department. Well, first, we're continuing to learn
Speaker 1: more every day, but it's clear now that reinfection can happen,
Speaker 1: how often it happens, and what the implications are for
Speaker 1: both natural infection and vaccine induced immunity really are still unclear.
Speaker 1: Reinfections have now been confirmed in Asia, Europe, and North
Speaker 1: and South America. That all up, these cases probably number
Speaker 1: less than a dozen, which is reassuring. Right, globally we
Speaker 1: certainly had more than a hundred million infections. Now if
Speaker 1: we haven't seen a lot of reinfection, it must be rare,
Speaker 1: or you can say, you know, we're really not looking
Speaker 1: and until we look, we're not going to find. I
Speaker 1: think most of us believe that there is some level
Speaker 1: of immunity for some period of time in some people,
Speaker 1: but those are very vague qualifiers is some ten percent
Speaker 1: or eighty percent, and really until we get better dead
Speaker 1: and we won't know. This first case reported by doctors
Speaker 1: at the University of Hong Kong occurred in at thirty
Speaker 1: three year old nine t worker who had a mild
Speaker 1: case of COVID nineteen in March last month. He was
Speaker 1: screened for the coronavirus at the airport after we return
Speaker 1: from a works trip to Europe. The man didn't have
Speaker 1: any symptoms, so it was no doubt a surprise when
Speaker 1: the test came down't positive. The fact that he was
Speaker 1: infected without symptoms suggested to some scientists that his memory
Speaker 1: immune response prevented any symptomatic disease. In other words, that
Speaker 1: natural infection protected him from getting the cough soil throughout
Speaker 1: favor and headache he experienced four and a half months earlier,
Speaker 1: but it didn't prevent him being infected again. I asked Tom,
Speaker 1: is this what we might expect from a subsequent infection
Speaker 1: with the Sasko et virus. Well, one theory is that
Speaker 1: you're not likely to get severe disease twice. There is
Speaker 1: a reported case of someone who had mild disease the
Speaker 1: first time and then moderately severe disease the second time,
Speaker 1: and someone else who had moderately severe disease the first
Speaker 1: time and mild disease the second time. And the theory
Speaker 1: here is that it's the more severe disease that's more
Speaker 1: likely to result in protective antibodies. We know that there
Speaker 1: are some people who have very mild disease who don't
Speaker 1: seem to mount an antibody response, and that may correlate
Speaker 1: with being able to get infected again. It also seems
Speaker 1: antibodies don't always stick around that long. Last Thursday, researches
Speaker 1: at the Vanderbilt University Medical Center published a study in
Speaker 1: which they found more than half of the health care
Speaker 1: workers who have been infected with sansko vie too and
Speaker 1: had detectable antibodies in early April didn't have detectable antibodies
Speaker 1: two months later. The researchers said they didn't know whether
Speaker 1: the decline and antibodies increases risk of reinfection and disease.
Speaker 1: It's at least helping us understand what the limitations of
Speaker 1: immunity against COVID nineteen might be. I think it's unlikely
Speaker 1: that immunity to COVID is going to be as dramatically
Speaker 1: effective as to say, immunity to measles is. If you
Speaker 1: get measles naturally once in your life, you will in
Speaker 1: all likelihood never get it again. In contrast, if you
Speaker 1: get influenza or malaria or lots of other conditions, you
Speaker 1: may get them again, but perhaps less Seriously, we really
Speaker 1: don't know at this point enough about COVID. But what
Speaker 1: has emerged is that um certain antibodies known as neutralizing antibodies,
Speaker 1: do appear that they may be protective and that's why
Speaker 1: we're hopeful that vaccination may be possible, But until that's proven,
Speaker 1: that's just the theory. There's a possibility that immune protection
Speaker 1: against the coronavirus might be cumulative. The more times are
Speaker 1: immune system says the virus, the better and faster it
Speaker 1: could be in awarding it. Tom says, we don't know
Speaker 1: that for sure, though. Well, there's something called an anamnastic response,
Speaker 1: where when someone is exposed again and again to a
Speaker 1: pathogen it strengthens their immune system. That's one theory, but
Speaker 1: we really don't know what the reality is with COVID.
Speaker 1: What we do know is that there's a wide variety
Speaker 1: of illness. Some people get infected and it's quite mild.
Speaker 1: Other people will get infected and they can get severely
Speaker 1: ill or died, and we're not sure what the difference is.
Speaker 1: One of the key questions around reinfection is whether someone
Speaker 1: who has called the virus again is capable of transmitting it.
Speaker 1: Some pointed to one example that indicated someone could be
Speaker 1: infectious and another example that suggested they might not be.
Speaker 1: At this point, um there are theories but no proof.
Speaker 1: For example, someone who has had a mild infection before
Speaker 1: has very little immunity may behave just the same as
Speaker 1: someone who is infected for the first time. In contrast,
Speaker 1: someone who was very ill and has a high level
Speaker 1: of neutralizing antibody may indeed reduce their viral load and
Speaker 1: be less infectious. It's something that we need to figure out.
Speaker 1: So what do these reinfections mean for our ability to
Speaker 1: reach herd immunity where the virus is potential to spread
Speaker 1: is mitigated by a high level of immune protection in
Speaker 1: the community, all bets are off still um the likelihood
Speaker 1: is that herd immunity is going to involve well over
Speaker 1: half of the population getting infected, but there's still many unknowns,
Speaker 1: And one thing that's important to keep in mind is
Speaker 1: that herd immunity is not a dichotomy. It's not her
Speaker 1: immunity on off. The more people who are immune in
Speaker 1: a community to slower the virus spreads. What is certainly
Speaker 1: the case is that in all likelihood, getting to herd
Speaker 1: immunity for COVID in the US would require an infection
Speaker 1: rate of something like currently we're at about we have
Speaker 1: two d thousand deaths, So in all likelihood, getting to
Speaker 1: herd immunity in the US would involve another six hundred
Speaker 1: thousand deaths. We're talking about more than almost any war
Speaker 1: in US history. When does all this slave vaccine for COVID?
Speaker 1: Dr Chip School, the professor in the Division of Infectious
Speaker 1: Diseases that you see San Diego School of Medicine, says,
Speaker 1: we have to be careful about going down the AIDS
Speaker 1: vaccine hole. As you remember, we're gonna have an age
Speaker 1: vaccine and we never got one. But we've done pretty
Speaker 1: well with ADS, and we did it with drugs, and
Speaker 1: we did it with behavioral changes, and we may be
Speaker 1: in the same boat with Yeah. I mean, these reinfections
Speaker 1: have to give you pause about thinking that you can
Speaker 1: do better with a vaccine and you can do with
Speaker 1: natural infection. Chip says previous research with vaccines suggests that
Speaker 1: the immunity isn't long and it may not be the
Speaker 1: silver bullet many of us being included, hoping it will be.
Speaker 1: That's why I think it's important to try to UM
Speaker 1: optimize non vaccine interventions UM and get back to business.
Speaker 1: I think we really have to get on with it
Speaker 1: about how to operate in the in the colvid era
Speaker 1: where the virus is kind of gonna be looking over
Speaker 1: our shoulder for a wild to come. There's so much
Speaker 1: we don't know about the coronavirus, including our ability to
Speaker 1: produce a safe, effective and durable immune response with the vaccine,
Speaker 1: But there are things we do know we can do
Speaker 1: to stop the pandemic. While we push ahead with developing vaccines,
Speaker 1: we also have to develop better treatments and keep practicing
Speaker 1: physical distancing, hand washing, mask wearing, and everything else we
Speaker 1: can to prevent infections. That was Jason Gale, and that's
Speaker 1: it for our show today. For coverage of the outbreak
Speaker 1: from one beers around the world, visit Bloomberg dot com
Speaker 1: slash coronavirus and if you like the show, please leave
Speaker 1: us a review and a rating on Apple Podcasts or Spotify.
Speaker 1: It's the best way to help more listeners find our
Speaker 1: global reporting. The Prognosis Daily edition is produced by Toph
Speaker 1: for foreheads Jordan Gaspoure, Magnus Henrickson, and me Laura Carlson.
Speaker 1: Today's main story was reported by Jason Gale. Original music
Speaker 1: by Leo Sedrin. Our editors are Rick Shine and Francesco Levi.
Speaker 1: Francesco Levi is Bloomberg's head of Podcasts. Thanks for listening.