What to do if you’re exposed to COVID-19 after being fully vaccinated, according to experts

Californians at farmers market without masks
People make their way down the aisle at the Farmers Market in Irvine Regional Park on Tuesday, June 15, 2021 in Irvine, CA. Restrictions are lifted at most businesses, and Californians fully vaccinated for COVID-19 can go without masks in most settings.

  • If you’re vaccinated and exposed to COVID-19, most of the experts Insider spoke to said you don’t need to worry unless you have symptoms.
  • You should get tested if you’re symptomatic, but some experts say to get tested after any exposure.
  • If you’re sick, stay away from others – even if it’s not COVID.
  • See more stories on Insider’s business page.

So your roommate has a cold.

You both got vaccinated months ago, yet every time you hear a cough from the next room, you can’t help but wonder if you should get tested for COVID.

Most public health experts would say you’re in the clear – probably not sick and probably not infectious – unless you start to feel symptoms. (Your ailing roommate, however, should get tested.)

Although the COVID-19 vaccines are highly effective at preventing severe illness, “breakthrough” infections are occurring in fully vaccinated people. It might feel like a bad cold, or carry no symptoms at all.

The Delta variant has increased the odds of such an infection, but there are plenty of other viruses going around, Amesh Adalja, senior scholar at Johns Hopkins Center for Health Security, told Insider.

The only way to know for sure is to get tested. But if your roommate’s test comes back positive for COVID-19, what do you do?

Get tested if you develop cold-like symptoms

If you develop a cough, congestion, or a loss of taste and smell after a known exposure, you should get tested regardless of your vaccination status.

Start with a rapid antigen test. In studies, rapid tests were about 72% effective at identifying COVID-19 in symptomatic people and correctly ruled out COVID for about 99.5% of people who had symptoms for other reasons.

You can also take a rapid test at home. They’re more accurate if you get tested every few days, so if you’re initially negative, you might want to test again to be sure. You could also follow up with a PCR test that looks for other viruses as well, Adalja added.

“You also have to remember that now that many people are socially interacting, other viruses have come back – things like rhinovirus and seasonal coronaviruses – so there are other causes of cold-like symptoms,” Adalja said.

If you don’t have symptoms, many experts say you’re probably in the clear

The CDC recommend vaccinated people get tested or quarantine only if they have symptoms of COVID-19.

If you’re symptom-free for more than a week after an exposure, you can relax, according to Paul Offit, director of the Vaccine Education Center at Children’s Hospital of Philadelphia.

“The only time you should get tested if you’re fully vaccinated is if you’re symptomatic, no matter what the exposure,” Adalja said.

Charity Dean, a former top-tier official at the California Department of Public Health, told Insider she was “very disappointed” the CDC is not seriously tracking mild or asymptomatic infections in fully vaccinated people. Without that information, we risk missing a more dangerous “escape variant,” Dean told Insider’s Hilary Brueck.

So if you’re making your decision with public health in mind, you may want to get tested even if you don’t have symptoms.

Quarantine if you feel sick or test positive for COVID

COVID-19 or seasonal virus symptoms indicate that you could be infectious to others.

“If the virus reproduces itself well enough in you to cause symptoms, I think that means that you’re likely to be contagious,” Offit told Insider.

Vaccinated people who get COVID may be less contagious than unvaccinated infected people, if their reduced viral loads are any indication.

However, other experts recommend using common sense before deferring to CDC guidelines, which “lack nuance,” emergency physician Leana Wen told CNN.

“I don’t want someone coming into work, who then tells me that they just spent the entire night caring for their spouse who’s ill from COVID,” Wen told CNN. “Should that person really be in a crowded conference room with a whole bunch of other people? Does that sound right? It doesn’t meet the common sense test.”

One thing experts generally agree on: stay away from people if you’re not feeling well.

The norms of the pandemic – mask-wearing, quarantining – still apply if you’re sick and it’s not COVID-19. But if you’re vaccinated and feeling fine, there’s no need to worry, Offit said.

“I think we’re going to drive ourselves crazy if we’re expecting this vaccine to prevent asymptomatic or mildly symptomatic disease,” Offit said. “Just use common sense. If you develop respiratory symptoms, I think it’s probably a good idea to wear a mask.”

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Amazon has received FDA authorization for a COVID-19 test that can be carried out at home using nasal swabs

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The company plans to use the test among its employees.

  • Amazon received FDA approval for a COVID-19 test, which is made by its subsidiary STS Lab Holdco.
  • The test can be conducted with or without supervision from a healthcare professional.
  • The company plans to use the test to boost its COVID-19 preparedness and response program.

Amazon has received approval from the Food and Drug Administration (FDA) for a COVID-19 test, developed by its subsidiary STS Lab Holdco, according to an FDA filing.

Individuals will be able to carry out the nasal-swab test alone at home or with help from a professional.

The company plans to use the test among its employees as part of its effort to bolster its COVID-19 preparedness and response program, according to a different FDA document.

Amazon staff may be timetabled for an onsite test or have the option to receive an at-home kit to conduct the test at home, the document states.

The authorization also mentions Amazon’s employee screening program, in which some staff will be automatically scheduled for a test approximately every 14 days, upon employee discretion. Previously, staff could only sign up to get tested through an internal system.

The letter of approval is addressed to Cem Sibay, the vice president of Amazon Labs. Last year, Amazon tapped Cem Sibay, a 15-year company veteran, to lead its efforts to build an in-house COVID-19 testing lab, Insider previously reported.

Insider has approached Amazon for comment.

Over the past year, Amazon has ramped up its COVID-19 testing capabilities for its workforce. Last January, the company announced it was selling an FDA-approved at-home saliva COVID-19 test for $110, curated by DxTerity, a genomics company. All employees have to do is provide a small amount of saliva in an empty tube bottle, and then mail it to a Los Angeles-based lab.

Figures show the US has 30.8 million COVID-19 cases. This means tests are in great demand. Last October, Amazon reported that nearly 20,000 employees contracted the virus between March 1 and September 19.

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A new coronavirus variant found in France can hide from COVID-19 nasal-swab tests

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Waitress Josephine Madinier waits for take-away orders at Miss Banh-Mi restaurant in Paris on February 1, 2021.

  • France’s health ministry has identified a new coronavirus variant that can evade some tests.
  • So far, that variant doesn’t seem to be deadlier or more infectious than other strains.
  • The variant shares some mutations with another variant first found in California.
  • See more stories on Insider’s business page.

A region of France has been beset by a version of the coronavirus that can hide from standard tests.

The French ministry of health and social affairs announced Monday that among a cluster of 79 COVID-19 cases in Brittany, eight patients were infected with the new variant, but several of them tested negative.

Despite those negative tests, the patients showed typical COVID-19 symptoms.

The new variant does not yet have a alphanumeric designation. But it’s not the first variant that appears able to evade testing. Finnish researchers announced last month that they had identified a strain named Fin-796H with a mutation that made it difficult to detect with some nasal-swab tests, too.

An inability to accurately diagnose infected people could make it harder to curtail the virus’s spread at a time when cases across Europe are already spiking.

Confirming infections with the new variant is tricky

coronavirus test nasal swab
A nurse swabs a patient at a testing site for COVID-19 in Paris, France.

The standard molecular lab tests – known as reverse transcription polymerase chain reaction (RT-PCR) tests – hunt for an infection in a swab from a patient’s nose, looking for the coronavirus’s genetic code.

But according to the French Health Directorate, genetic sequencing revealed that the variant found in Brittany has several mutations on its spike protein that help it evade detection by these diagnostic tests.

Health officials in Brittany eventually confirmed some of the cases caused by the new variant by either testing the patients’ blood for antibodies or collecting samples of phlegm the patients coughed up from inside their lungs and running those through a RT-PCR test.

But neither of those methods are the typical COVID-19 tests, which suggests the new variant could be circulating undetected in France and possibly beyond.

However, one European diagnostics company, the Novacyt Group, announced Thursday that its PCR tests can successfully detect the new variant.

The variant doesn’t appear to be deadlier or more infectious

France COVID vaccines
A woman is carried on a stretcher to the COVID-19 vaccination center at the South Ile-de-France Hospital Group in Paris on February 8, 2021.

All eight of the French patients infected with the new variant died of the virus, according to local outlet LaDepeche, but local health officials said that doesn’t necessarily mean it’s more deadly than other strains.

There is no evidence yet that the strain is more transmissible than other versions of the virus. More studies are still needed to figure out whether it can evade vaccines or antibodies from prior coronavirus infections, the French health ministry said in a release.

The variant’s genetic profile shows it doesn’t share any key mutations with B.1.351 and P.1 – the variants first found in South Africa and Brazil, respectively – which are more contagious and can partially evade vaccines.

The variant from Brittany is in the same group of strains as a variant first spotted in Southern California, however. Variants in that group, named Clade 20C, are expected to make up one-fifth of the world’s coronavirus infections by April, according to Nextstrain, a genetic repository that tracks the coronavirus’s evolution over time.

coronavirus test
A medical worker performs a PCR test for COVID-19 on August 31, 2020 in Montreuil, France.

News of the variant in Brittany came amid France’s third peak of infections.

The average number of daily coronavirus cases there has doubled since mid-December, jumping from less than 15,000 to a near record-high of more than 38,000 on Wednesday. The increase prompted Prime Minister Jean Castex to announce new lockdowns for Paris and the surrounding Ile-de-France region on Thursday.

France has been under a nationwide curfew between 6 p.m. and 6 a.m. for the last two months.

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The 4 things the US is doing wrong in the fight against COVID-19, and what we should be doing instead

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Chris Duncan, whose 75 year old mother Constance died from COVID on her birthday, photographs a COVID Memorial Project installation of 20,000 American flags on the National Mall as the United States counted 200,000 lives lost in the COVID-19 pandemic, September 22, 2020 in Washington, DC.

  • We’ve been living pandemic life for a year now.
  • Insider has identified 4 ways we could be living with COVID-19 better, right now.
  • Safer travel, savvier surveillance, and well-regulated masks are all areas we can improve, and the results could be huge.
  • See more stories on Insider’s business page.

After a year of pandemic life, better days appear to be on the horizon.

“By July the 4th, there’s a good chance you, your families, and friends will be able to get together in your backyard or in your neighborhood and have a cookout and a BBQ and celebrate Independence Day,” President Biden said Thursday, on the one year anniversary of World Health Organization’s pandemic declaration.

Biden’s projection lines up well with what other experts have said: by this summer, things won’t be perfect, but we will be living life again, reconnecting with family and friends.

Yet the virus will still be with us well beyond then for many, many months to come. Even as tens of millions of vaccines have started to take effect, the relief they provide is muffled by the fact that there are still no great treatments for this coronavirus yet.

“This is not the last pandemic we’re all gonna face, and we will need to do much, much better next time around,” Brown University dean of public health Ashish Jha told reporters on the pandemic’s anniversary this week.

“We just can’t repeat this performance again, it has been so awful,” he said.

Knowing that, here are the four things we could clearly be doing better to live alongside the virus more safely and more tolerably, right now.

1. Forget abstinence. We should be encouraging the right kinds of travel.

disney world pandemic

There’s no reason that grandparents can’t fly around the country to see their grandkids this summer, with some level of continued vigilance. 

“I don’t believe it’s unsafe,” Jha said. 

Read Insider’s report on how we can travel without spreading COVID-19

2. Everyone should have cheap and easy at-home COVID-19 test kits.

Color COVID 19 test site
More COVID-19 tests should be available for use at home.

There is truly no good reason why we don’t.

“We have more than enough technology and ability to have widespread antigen testing available for the American people at probably $3, 4 bucks a pop,” Jha said. “Cheap, easy.”

Let’s make it happen. 

Read Insider’s report on how testing could be improved.

3. We should stop wasting time contact tracing for COVID-19.

Contact tracing

Contact tracing the coronavirus is a waste of precious resources. Instead, we should focus more on variant surveillance. 

Dr. Anthony Fauci calls this a “somewhat inexcusable deficiency.”

Read Insider’s report on how the US should step up its genetic sequencing game — fast — and let the contact tracers of the country do other vitally important work.

4. We should hack-a-thon our way to better masks.

covid masks
Sandra Martínez sews a face mask at her atelier.

“You have basically an unregulated bunch of products, nobody really knows how they perform,” University of Wisconsin mechanical engineering professor David Rothamer said.

Crowdsourcing creative solutions to such tough design issues is something the federal government has done before. Just ask NASA. 

Read Insider’s report on how we could have much comfier, safer (and perhaps more stylish) masks.

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America’s COVID-19 testing strategy isn’t working. Let’s test more people at random, and be more precise about when to get tested.

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  • Coronavirus tests will be important infection prevention tools, with us for years to come.
  • Using more rapid tests at schools, offices, and before boarding airplanes could become the norm.
  • Experts stress we need to develop better testing systems, and understand what test results mean.
  • This article is one in a four-part series on the simple ways to fix the America’s biggest COVID-19 mistakes. Click here to read more.
  • See more stories on Insider’s business page.

A year into the pandemic, one might think we’d all be COVID testing pros by now, with little home testing kits as simple to use and easy to get as a urine wand pregnancy test.

Nope.

Although many of us have grown used to braving the near brain-tickle of a nose swab, some fundamental misunderstandings about when, why, and how to get tested remain.

The coronavirus testing that is supposed to be free to anyone who needs it in the US isn’t always widely available, or used well either.

We’re still using negative test results for all the wrong reasons, while not being conscientious enough about what those test results really mean, and how to best make use of our supply.

“Obviously, vaccinations are awesome, and we need to vaccinate people [but] we cannot give up on testing,” Dr. Ashish Jha, dean of the Brown University School of Public Health told reporters Thursday, on the one year anniversary of the World Health Organization’s pandemic declaration.

“I think testing will remain an important part of this pandemic response, of this disease response, for years,” he added. “And I mean for years, I don’t just mean for the next couple of months.”

We need to be smarter about when we get tested

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A health worker conducts a COVID-19 test at a health center in San Jose, Costa Rica, June 26, 2020.

Amidst constantly changing advisories about when to get tested, most people haven’t gotten the proper timing down.

Experts recommend waiting five to seven days after any known coronavirus exposure to get a COVID test. During that waiting period, you should self-isolate to be sure that you’re not exposing others to the virus if you are sick (or potentially getting infected yourself).

The coronavirus’s incubation period is between two and 14 days, so it’s best to keep away from others while you wait for your results. Some experts even suggest getting a second test if your first one is negative, just in case the virus was still incubating when you first got tested.

Experts also stress that in the next phase of the pandemic, a different kind of widespread, surveillance-style testing will become more and more important.

“We’ve got to be able to run both testing sites and vaccination sites, and cannot be trading off one for the other,” Jha said.

Kids in primary schools won’t be vaccinated this summer, so it’ll be important to have rapid tests available when schools reopen, and at other large indoor gatherings where it’s unclear who’s vaccinated and who’s not: indoor concerts, plays, weddings, offices, and college campuses could all benefit from more rapid tests, which are not perfect, but do often help screen out the most infectious among us.

“Testing will add a really important level of safety in making those things possible,” Jha said.

A negative test result should still be treated with caution

mask shield airport
A couple wear protective face shields and masks as they walk to their flight at Newark International Airport on November 25, 2020.

Even if you do everything right before getting a COVID-19 test, your results still only reflect a moment in time, and are never 100% accurate. That means a negative test result is not an “immunity passport” or permission to live as if you’re COVID-free. You could be incubating the virus today, and become infectious to others tomorrow.

Getting tested for COVID-19 is not pointless, but be thoughtful about when and why you’re seeking out that swab.

If you’re getting tested so you can visit with a high-risk family member, for example, you should plan to get a test five days after your most recent potential exposure (which might be the plane/train ride there, if you’re taking a trip). After waiting out the incubation period and potentially getting a second test, the first place you go should be grandma’s house – not a restaurant or your friend’s apartment where others could be getting you sick.

Ultimately, a negative test is going to be just one in a slew of COVID-19 prevention measures that will be with us for a while: wearing a mask in public, social distancing, and traveling less. Doing that, what some health experts have dubbed the “swiss cheese” model of infection prevention, and including a negative test in the mix, leaves very little room for the virus to spread, especially if the more vulnerable members of your party have already been vaccinated.

More people should be getting tested regularly

snl kate mckinnon
Kate McKinnon, and her fellow Saturday Night Live cast members, all get tested regularly. It’s something that’s quickly become standard protocol in the film and TV industry.

The US has had plenty of time to scale up its testing capabilities, but still, tests are not always available when we need them most. Yet a few places have managed to get testing down right on their own.

In Massachusetts, elementary schools are saving on testing supplies by pooling many students’ samples together, helping to ensure entire classrooms are virus-free for learning.

Harvard epidemiologist Dr. Michael Mina is teaming up with Citibank to get the company’s employees to use rapid, at home tests three times a week, and measure whether that cuts down on disease spread in the workplace.

“These types of tests are (remarkably) not FDA authorized for frequent use at home,” Mina tweeted on Thursday as his new study was announced.

“I’m committed to helping us (society) not find ourselves having to distance from our loved ones for a year ever again,” he added. “And I’ll keep working to identify creative avenues that prevent another year like the one we are emerging from.”

Read the original article on Business Insider

India’s sudden drop in coronavirus cases has puzzled disease experts. Strict public-health measures and difficulty recording rural cases may have factored in.

india school coronavirus
A student gets her body temperature taken in Hyderabad, India on February 1, 2021.

  • India’s daily coronavirus cases have plummeted since September.
  • The nation is now reporting just 8 daily cases per one million people, among the lowest per-capita rates in the world.
  • Experts say the decline is puzzling. The difficulty of recording rural cases, combined with strict public-health measures, may offer some explanation.
  • Visit Business Insider’s homepage for more stories.

At the start of the pandemic, few countries were more ripe for a major coronavirus outbreak than India.

Not only is India the world’s second most populous country, it’s also one of the densest, with around 1,200 people per square mile. Cases there climbed steadily from April through September, reaching a peak of nearly 100,000 daily cases on September 16.

Then something unexpected happened: India’s daily cases plummeted from mid-September until February, with average weekly cases dropping by roughly a third each month. The nation is now reporting fewer than 11,300 daily cases, on average – around 8 per 1 million people, among the lowest per-capita rates in the world.

India’s health ministry has attributed this success to a few factors, including a robust testing and contact-tracing effort. But infectious-disease experts say the quick turnaround is puzzling.

India only began administering coronavirus vaccines in mid-January, so it’s probably too soon for vaccinations to affect transmission. Some public-health experts say India’s strict mask mandates may have helped lower cases, but masks have been required there since April, so that don’t fully explain why cases dwindled so dramatically in the fall.

“There are a lot of questions and lessons to be learned, and I think that we need to do a deeper dive into what they’ve done well,” Dr. Krutika Kuppalli, an assistant professor at the Medical University of South Carolina, told Insider.

Kuppalli’s previous research focused on barriers to medical care among women with HIV in southern India.

“I know from having worked and lived in India that they have a lot of challenges in terms of dealing with large populations that are in close quarters, infection control issues, hygiene issues, ventilation issues – all the things that we are concerned about in terms of how this disease spreads,” she said.

Kuppalli added that it’s worth studying whether India’s population may have unique genetic or demographic characteristics that make people less susceptible to symptomatic COVID-19 infection. It’s also possible, she added, that coronavirus cases are simply hard to record in rural areas.

Penalties for not wearing masks 

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Students wearing face masks attend class in Hyderabad, India on February 1, 2021.

Widespread adherence to public-health measures may partly explain why India has gotten its outbreak under control. Several large cities and states there began requiring masks in public places in April, two months before the World Health Organization recommended face coverings for the general public.

Since then, the nation’s largest city, Mumbai, has levied fines against those who violate the rule. By October, Mumbai had collected a total of more than $70,000 in fines from more than 14,000 people who’d failed to wear masks in public. By early December, Delhi had also issued around 500,000 mask fines, The Wall Street Journal reported

For the most part, Indians have been supportive of mask requirements: In an October survey from social media platform LocalCircles (which included more than 15,000 responses across roughly 200 districts in India), nearly 90% of respondents said they were in favor of a mask mandate. About 40% said they would support increased penalties for those who didn’t comply.

The US, by contrast, has struggled to convince large segments of the public that masks are an effective tool. 

“The United States very much failed from a lack of national leadership, miscommunication, and a lack of community engagement. I think we can really boil it down to those three things,” Kuppalli said, adding, “we still have people who don’t believe the pandemic is real in this country.”

A focus on ‘test, trace, isolate’

india contact tracing
A member of the internal medical team at the Ahmedabad One Mall checks a staffer’s Aarogya Setu app, India’s virus contact-tracing app, on June 7, 2020.

Epidemiologists typically rely on a three-step strategy to contain a virus: test, trace, isolate.

Though India’s testing got off to a slow start, it has ramped up considerably since the summer. By August, the nation had nearly 1,600 testing labs, up from just 14 in February 2020. India is administering nearly 486,000 daily tests. Only two other countries, the UK and the US, are testing more.

India’s large population also worked to its advantage when it came to enlisting contact tracers.

From March through April, tens of thousands of health workers traced the contacts of more than 435,000 infected people across two southern states, Andhra Pradesh and Tamil Nadu. The workers reached more than 3 million contacts, around 575,000 of whom had available COVID-19 test results.

These efforts were made easier by a longstanding disease surveillance network that began monitoring COVID-19 cases in late January 2020.

As of April, Indian residents could download the nation’s contact tracing app, Aarogya Setu, to find out if they had been been within 6 feet of an infected person. Indian residents are asked to download the app if isolating due to a positive COVID-19 test and report any symptoms to a local surveillance officer.

Possible immunity to new pathogens

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A healthcare worker collects a swab sample from a resident during a coronavirus screening at a civic clinic in Mumbai on October 12, 2020.

India has indeed seen fewer COVID-19 deaths per million than many developed nations. As of Wednesday, 113 out of every million people in India had died of COVID-19, compared to nearly 1,500 out of every million in the US and 1,755 per million in the UK.

India is now recording fewer than one daily death per million people.

Kuppalli said India’s rapidly falling cases raises another important question: “Are there things about this particular population, this ethnicity, that puts them at decreased risk?” 

An August study suggested that populations with a higher exposure to diverse types of bacteria – predominantly due to poor sanitation – might see fewer COVID-19 deaths per million, perhaps because of an acquired or innate immunity to new pathogens. This line of thinking isn’t new: A 2006 study found that developing countries may have a different “immunological experience” with tuberculosis than the US and Europe.

“Look at the average Indian: He or she has probably had malaria at some point in his life or typhoid or dengue,” Sayli Udas-Mankikar, an urban policy expert at the Observer Research Foundation in Mumbai, recently told NPR. “You end up with basic immunity toward grave diseases.”

The idea remains a theory for now, however.

Rural populations are harder to surveil 

rural india coronavirus
Chhayarani Sahu, an Indian farmer, plucks vegetables at in Bhadrak on September 14, 2020.

The coronavirus spreads best in dense, crowded environments. That means countries like the US, where more than 80% of residents live in urban areas, face an uphill battle to contain the virus’ spread.

India, on the other hand, is less urbanized: Around 65% of Indian residents live in rural areas. 

Though the virus has undoubtedly reached India’s rural population, the nation’s cities have been particularly hard-hit. By May, nearly 80% of India’s total COVID-19 cases hailed from just 30 cities. A January survey found that 56% out 28,000 people sampled in Delhi tested positive for coronavirus antibodies.

But Kuppalli said health trends among India’s rural population are difficult to track.

For one thing, rural areas are larger and more spread out. Many Indians living in these communities also lack internet access, which prevents them from plugging into the nation’s surveillance network.

Kuppalli also noted that it’s difficult for patients who are sick in rural places to get to large urban hospitals because of transportation or financial issues. A 2018 report found that only one state-run hospital is available for every 90,000 people in India’s rural communities. That could mean that India simply isn’t recording as many rural cases.

That too, is just a possibility, though. For now, Kuppalli said, “it’s great that they’ve had this turnaround.”

“It’s an opportunity for us to study this population,” she added. “There are lots of things to think about and try to understand.”

This article was originally published on February 3. It has been updated to reflect the latest data on India’s coronavirus cases.

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