[Q&A] "51 Cases of Re-diagnosis After Full Recovery, Emphasis on Reactivation... Antiparasitic Drug Treatment Not Verified"

Jung Eun-kyung, Head of the Central Disaster and Safety Countermeasure Headquarters for COVID-19
[Photo by Yonhap News]

[Asia Economy Reporter Kim Heung-soon] It has been identified that there are about 50 cases nationwide where patients confirmed with the novel coronavirus infection (COVID-19), after being declared recovered and released from quarantine, were diagnosed positive again. The quarantine authorities are placing more weight on viral reactivation rather than reinfection through contact with other confirmed cases.

Jung Eun-kyung, head of the COVID-19 Central Disaster and Safety Countermeasures Headquarters, stated at a regular briefing on the afternoon of the 6th, "So far, there have been 51 cases confirmed as re-positive after being released from quarantine." Among these, seven individuals from the Pureun Nursing Home in Bonghwa-gun, Gyeongbuk Province, who were confirmed positive and then released from quarantine, tested positive again in subsequent diagnostic tests. The 18 cases of re-confirmation in the Daegu area are also included.

Head Jung said, "Since the re-positivity was confirmed within a very short period after release from quarantine, we are considering it as reactivation rather than reinfection," and added, "The epidemiological investigation team will go on-site to conduct epidemiological investigations on the cases confirmed as re-positive."

Below is the Q&A with Head Jung Eun-kyung regarding cases of re-confirmation after recovery

- Regarding cases of re-confirmation after recovery, which is given more weight: reinfection or reactivation?

▲ To determine whether it is reinfection or reactivation, an epidemiological investigation will be conducted. Along with specimen testing, we plan to investigate whether live virus can be isolated and cultured to assess actual infectivity, and to check antibody formation through blood tests. Currently, since re-positivity is confirmed within a very short time after release from quarantine, we consider it reactivation rather than reinfection. Also, during the patient's hospitalization and isolation, PCR (real-time polymerase chain reaction) tests are periodically conducted, and there are many cases where the test turns negative and then positive again. Therefore, while placing more weight on reactivation, we will conduct comprehensive tests on the infectivity of PCR-positive cases after release from quarantine.

- Regarding re-confirmation cases, do you think there is no need to introduce guidelines like mandatory two-week self-quarantine after discharge, as in China?

▲ Current guidelines include thorough personal hygiene practices for about two weeks after release from quarantine and health education to report symptoms if they appear. Since secondary infection caused by re-confirmed patients has not yet been confirmed, we will review the investigation results to determine the extent to which management should be strengthened.

Photo by YouTube screen capture

- Among recent confirmed cases, 5-10% are cases with unknown infection routes.

▲ In the past two weeks, about 46% of new patients were infected overseas, and 5% were cases where family or acquaintances related to overseas inflow developed the disease, making overseas-related cases about 51%. Cases occurring in hospitals and nursing hospitals account for 28%. This includes infections in nursing hospitals and psychiatric hospitals in the Daegu and Gyeongbuk regions, as well as cases at Uijeongbu St. Mary's Hospital in Gyeonggi Province. Community cluster outbreaks account for 7%, including transmission through churches, spas, or bathhouses recently reported. About 7% were confirmed positive while in self-quarantine as contacts of prior confirmed cases. The remaining approximately 5% have uncertain infection routes, which vary slightly daily depending on case occurrences. Excluding cases imported from overseas, epidemiological investigations are thorough for cluster outbreaks within the community, but it is difficult to identify the infection route of the initial patient. Therefore, a significant number of cluster outbreak cases recently occurring domestically have unknown infection routes.

- Politicians are shaking fists with voters who are bare-handed while wearing gloves during election campaigns. Is there a possibility of virus transmission through gloves?

▲ Since social distancing is in place, we ask that a 2-meter distance be maintained whenever possible. Handshakes are the riskiest because hands touch directly, but even with fist bumps, if the virus is on the hand, there is some possibility of transmission. It is safest to greet with eye contact or maintain social distancing during campaigns rather than fist bumps.

- Australian researchers have announced that the antiparasitic drug ivermectin is effective against COVID-19.

▲ The antiparasitic drug ivermectin was not administered to patients or people but tested at the cellular level, suggesting the possibility of effectiveness. This does not mean it is immediately applicable for treating COVID-19 patients. Also, since the exact dosage, side effects, safety, and efficacy have not been sufficiently verified, applying this to clinical treatment is very difficult and limited. It is merely a research-stage suggestion for a potentially effective drug, not a clinically verified result. Therefore, the Central Disaster and Safety Countermeasures Headquarters' position is that safety and efficacy have not yet been proven.