A Hong Kong man who recovered from COVID-19 more than four months ago has reportedly been reinfected with SARS-CoV-2, the virus that causes COVID-19. This time he didn’t have any symptoms.
This is not necessarily unexpected, because very few natural infections generate an immune response that completely prevents reinfection. Instead, what generally happens after an infection is that the body’s immune response gradually declines over months after the infection is cleared.
Specialised immune cells in the body are tasked with remembering each particular infection, so if you get infected again your body quickly starts producing the relevant antibodies and other immune cells (called T cells) in large numbers. This helps clear the new infection more rapidly and effectively. So you can still get reinfected, but you’re more likely to have fewer symptoms or be asymptomatic.
This is what seems to have happened to the 33-year-old Hong Kong man at the centre of the latest reports. The first infection caused symptoms, which he reportedly suffered from for some time. But the second time around he was asymptomatic, presumably because his body effectively repelled the disease.
The same phenomenon has previously been shown in monkeys, with one experimental study showing reinfection with SARS-CoV-2 is possible, but that reinfection did not result in the development of disease.
However, we have to be careful about over-interpreting what we know about this case. This is just one person. Is he the exception or the rule? We don’t know yet for sure, and we have to wait for further research. Also, his case was announced via a press release, so we have to wait for the paper to be officially published to be able to properly scrutinise the data.
There have been anecdotal reports of people being reinfected before, but many of these seem to be cases in which the initial infection simply persisted for a long time, or in which the person’s lungs were expelling dead virus.
But in this case, the virus isolated from the man’s two separate positive COVID-19 tests had slightly different genetic sequences. This suggests they had a different origin and are therefore different strains.
We must remember, however, it’s common for viruses to mutate. So it’s also possible we’ll need several different vaccines to account for multiple strains of the virus, like is often done with the flu vaccine.
The good news is this particular person’s immune system seems to have recognised the second infection, as shown by the fact his blood boosted antibodies against it. Despite the mutation, the man could still mount a good defence against the new strain.
Antibodies usually last in the blood for roughly 120 days following a stimulus such as natural infection with a virus or injection with a vaccine, though it varies depending on the disease. Both the B cells that produce antibodies, and the T cells that kill infected cells, also wane over time after the stimulus.
Vaccines can induce longer-lasting responses. But the key point is both natural infections and vaccines do generate memory B and T cells. So when the body comes in contact with the infection the second time, the memory cells respond rapidly and in high numbers. This can be so quick and strong that in some cases it can even result in “sterile protection”, effectively preventing the virus from infecting our cells. More commonly, there may be a small lag time for the immune system to respond fully, but in the end the virus is still unlikely to infect many cells.
At the moment it’s unclear if asymptomatic carriers can transmit infection. Indeed, there may be different types of asymptomatic carriers. Some asymptomatic people might transmit the virus, while others don’t. We don’t know why this is the case.
But based on our experience with other diseases, the higher the number of viral particles being spread from person to person, the higher the chance of infection. Therefore, asymptomatic carriers, who do not shed lots of virus through coughing or sneezing, should in theory have a lower risk of infecting others.
Herd immunity is still possible if we get a successful vaccine, because vaccines can be more powerful and protective than the immunity conferred by being naturally infected with the virus. Some epidemiologists suggest at least 70% of a population needs to be immunised to achieve herd immunity.
What’s more, becoming reinfected does not mean the virus will necessarily be transmitted — it depends on the viral dose and the susceptibility of people around the infected person. If they are all immunised with a vaccine, we generate a ring of fire that can contain spread of the virus.
It’s also possible SARS-CoV-2 becomes an endemic virus, like many viruses circulating in the population. But as long as there are diagnostics, vaccines and treatments, we could continue functioning normally just as we do with influenza present in the population. Ultimately it’s about what level of risk society is willing to accept. And we may need to use infection control methods like masks and hand hygiene for some time.
Vasso Apostolopoulos, Professor of Immunology and Pro Vice-Chancellor, Research Partnerships, Victoria University; Magdalena Plebanski, Professor of Immunology, RMIT University, and Maja Husaric, Lecturer; MD, Victoria University
The arrest this week of pro-democracy media tycoon Jimmy Lai in Hong Kong reveals the repressive reality of the city’s new made-in-China national security law.
It also sends a sharp signal to the remaining independent media in the territory: watch your step, or you could be next.
Lai, his two sons and four top executives of the Next Digital media group were all arrested under the new law. On the same day, police raided the offices of Next’s flagship publication, Apple Daily, deploying over 200 officers to search the premises for almost nine hours.
China imposed the national security law in June, bypassing the local legislature and breaching the principle of non-interference in the city’s governance.
The new law established a comprehensive PRC-style national security regime overriding aspects of Hong Kong’s common law legal system.
The national security law is designed to make dissent all but impossible in Hong Kong, including in the city’s once-freewheeling but gradually diminished independent media.
Lai and the others were arrested under article 29 of the new law, which criminalises collusion with a foreign country or external elements to endanger national security.
Banned acts include collaborating with a foreign entity to impose sanctions on Hong Kong or China, seriously disrupting the making of laws or policies, or provoking hatred of the government among Hong Kong residents.
Although Hong Kong’s pro-democracy movement is a grassroots, homegrown affair, Beijing has sought to portray it as the result of foreign meddling. Hong Kong’s last two leaders, Carrie Lam and CY Leung, both alleged foreign forces were behind the protests that took place during their terms.
Beijing has already signalled that collusion will be broadly interpreted under the law.
Police have not disclosed the specifics of Lai’s offences, but his July meeting with US Vice President Mike Pence and Secretary of State Mike Pompeo is likely to be under the microscope, as is an opinion piece he wrote for The New York Times in May.
Lai’s status as an influential media owner and prominent pro-democracy activist has positioned him in Beijing’s crosshairs. He has been the target of extraordinary vitriol from mainland state media and was arrested by Hong Kong police in February and April on charges of participating in an illegal assembly.
Lai’s case is undoubtedly intended to serve as a warning — “killing the chicken to scare the monkey,“ to borrow a Chinese saying — and an inducement for the city’s journalists to self-censor, lest they fall foul of the new law.
For instance, an editorial calling for Hong Kong’s constitutionally guaranteed autonomy to be preserved could be interpreted by a zealous prosecutor as inciting secession under articles 20 and 21 of the law.
Although self-censorship has long been a concern, Hong Kong has traditionally enjoyed a vibrant free press. In 2002, Reporters Without Borders ranked it 18th in its inaugural World Press Freedom Index.
However, by 2020, the city had plunged to 80th. (China, meanwhile, ranked 177th of 180 countries.) The application of the national security law in Hong Kong will no doubt see the territory’s ranking tumble even further.
Apple Daily’s days appear to be numbered. Similar fates could befall other outspoken independent media, like the crowd-funded Hong Kong Free Press, which launched in 2015 amid rising concerns over declining press freedoms in the city. This was around the same time the South China Morning Post, Hong Kong’s venerable English-language daily, was acquired by the mainland conglomerate Alibaba.
Over the years, much of Hong Kong’s media has been bought up by China-owned or -affiliated entities, some of which are ultimately controlled Beijing’s Liaison Office in Hong Kong. More than half of Hong Kong’s media owners are now members of political bodies on the mainland.
The public broadcaster Radio Television Hong Kong has remained editorially independent, but it is under review again, having recently fallen foul of the local regulator for criticising the police handling of pro-democracy protests in a manner that was
irresponsible, and could be regarded as a hate speech with the effect of inciting hatred against the police.
International media still operate in Hong Kong relatively unrestrained, but visa refusals for foreign journalists suggest this is changing.
In recent years, Financial Times editor Victor Mallet’s visa renewal was denied after he chaired a discussion with a pro-independence politician, and New York Times reporter Chris Buckley’s Hong Kong work permit was denied, without any specific reason, months after he was also kicked out of China.
The Times has moved some of its former China- and Hong Kong-based reporters to South Korea and Taiwan in response. However, foreign journalists who engage in critical reporting on China and Hong Kong could be in breach of the national security law regardless of where they are based, as the law applies extraterritorially and to non-Chinese citizens as well as nationals.
China’s constitution purports to preserve freedom of expression. It has never met the promise of its terms. In 2016, President Xi Jinping told the country’s press,
all news media run by the party must work to speak for the party’s will and its propositions and protect the party’s authority and unity.
The guarantees of free speech and a free press under Hong Kong’s Basic Law are now on the same trajectory.
It is unlikely the media in Hong Kong will be nationalised to the extent it is on the mainland. Instead, Beijing is deploying a combination of acquisition, co-optation and intimidation to obtain its compliant silence.
China and Hong Kong
In recent days, the prime ministers of the UK and Australia each declared they are working toward providing safe haven visas for Hong Kong residents. In the US, lawmakers passed a bill that would impose sanctions on businesses and individuals that support China’s efforts to restrict Hong Kong’s autonomy.
The prospect of a shift from rhetoric to action reveals just how dire the situation in China’s world city has become.
July 1 is usually associated with Hong Kong’s annual pro-democracy march. This year, it saw around 370 arrests as protesters clashed with police under the shadow of a brand new national security law.
Hong Kong police have been cracking down hard on demonstrators for over a year – with Beijing’s blessing – and most of this week’s arrests were possible simply because police had banned the gathering.
But ten arrests were made under the national security law for conduct including the possession of banners advocating Hong Kong independence.
The national security law had been unveiled just hours earlier, its details kept secret until this week. It was imposed on Hong Kong in unprecedented circumstances when Chief Executive Carrie Lam, Beijing’s appointed leader in the city, bypassed the local legislature and promulgated it directly.
The law creates four main offences: secession, subversion, terrorism and collusion with foreign forces to endanger national security.
Hong Kong law already contains some offences of this sort, including treason, a disused colonial relic, and terrorism, tightly defined by statute. The new national security offences are different beasts – procedurally unique and alarmingly broad.
Secession, for example, includes the acts of inciting, assisting, supporting, planning, organising or participating in the separation or change of status of any part of China, not necessarily by force. This is calculated to prevent even the discussion of independence or self-determination for Hong Kong.
Collusion includes making requests of or receiving instructions from foreign countries, institutions or organisations to disrupt laws or policies in or impose sanctions against Hong Kong or China.
This is aimed at barring Hong Kongers from lobbying foreign governments or making representations at the United Nations, which many protesters have done in the past year.
The law contains severe penalties: for serious cases, between ten years and life imprisonment. It also overrides other Hong Kong laws. The presumption in favour of bail, for instance, will not apply in national security cases, facilitating indefinite detention of accused persons.
Defendants can be tried in Hong Kong courts, but in a major departure from the city’s long-cherished judicial independence, the chief executive will personally appoint the judges for national security cases.
The chief executive also decides if a trial involves state secrets – a concept defined very broadly in China. In these cases, open justice is abandoned and trials will take place behind closed doors with no jury.
While Hong Kong courts can apply the new national security law, the power to interpret it lies with Beijing alone. And in the most serious cases, mainland Chinese courts can assume jurisdiction.
This raises the prospect of political prisoners being swallowed up by China’s legal system, which features no presumption of innocence and nominal human rights guarantees. China also leads the world in executions.
Much of the national security law’s content contradicts fundamental principles of Hong Kong’s common law legal system and the terms of its mini-constitution, the Basic Law.
Even the territory’s justice minister – another unelected political appointee – has admitted the systems are incompatible.
In the typical style of mainland Chinese laws, the national security law is drafted in vague and general terms. This is designed to give maximum flexibility to law enforcement and prosecutors, while provoking maximum fear and compliance among the population.
A Beijing spokesman has said the charge of collusion to “provoke hatred” against the Hong Kong government could be used against people who spread rumours that police beat protesters to death in a notorious subway station clash last year, echoing the infamous mainland Chinese law against “picking quarrels and provoking trouble”.
The law does not appear to be retroactive, but fears that it could be interpreted that way have caused a flurry of online activity as people have deleted social media accounts and posts associating them with past protests.
This is unsurprising given the Hong Kong government’s record of trawling through old social media posts for reasons to bar non-establishment candidates from standing at elections.
Despite the promise of autonomy for Hong Kong, enshrined in a pre-handover treaty with the UK that China claims is now irrelevant, the national security law has escalated the project to “harmonise” the upstart region by coercive means, rather than addressing the root causes of dissatisfaction.
Under the auspices of the new law, the Chinese government will openly establish a security agency, with agents unaccountable under local law, in Hong Kong for the first time. It has also authorised itself in the new law to extend its tendrils further into civil society, with mandates to manage the media, the internet, NGOs and school curricula.
Under the weight of this authoritarian agenda, dissent in any form becomes an extremely hazardous prospect. It is no doubt Beijing’s intention that it will one day be impossible – or better yet, something Hong Kongers would not even contemplate.
The aim of silencing all opposing voices – including those overseas – is clear from the purported extraterritorial operation of the law.
The international community has condemned Beijing’s actions, but its members have a responsibility to follow words with actions. The least that democratic countries like the US, UK, Australia and others can do is offer a realistic path to safety for the civic-minded Hong Kongers who have stood up to the world’s premier authoritarian power at grave personal risk.
Some 23 years after China achieved its long-held ambition of regaining Hong Kong, it has failed to win hearts and minds and has brought out the big stick. Its promises may have been hollow, but its threats are not.
Beijing’s recent announcement it would authorise the Standing Committee of the National People’s Congress – China’s rubber-stamp parliament – to draft a national security law for Hong Kong caught most off guard.
Beijing’s decision to bypass the Hong Kong’s legislature and directly impose a national security law is widely seen as a violation of the joint treaty signed between China and the UK when Hong Kong was handed over in 1997.
It could jeopardise the rule of law and civil liberties currently enjoyed in the city, and ultimately, be the death knell for the “one country, two systems” framework that Beijing has touted to integrate Hong Kong into the mainland and compel Taiwan to move towards unification.
Now that Beijing has made its play, it’s up to the US and its allies to decide how to respond. And the situation could have more serious geopolitical consequences if neither side backs down.
The Basic Law, Hong Kong’s mini-constitution that came into effect in 1997, calls for the local government to enact a national security law. But legislation to do this has been suspended since 2003 when a half million people took to the streets in protest.
The law, if formally adopted this week, would prohibit treason, secession, sedition, subversion and the theft of state secrets. And it would legitimise the presence of China’s state security apparatus in the city.
The timing of the move by the Chinese government appears to be opportunistic. It comes as the year-long pro-democracy protests in Hong Kong have waned due to the COVID-19 pandemic. Western countries, the traditional supporters of Hong Kong’s push for freedom, have been distracted by their own responses to the pandemic.
For Beijing, the move kills two birds with one stone. In the short term, it should help quell – through intimidation – the civil unrest that has been raging in the city for over a year.
More profoundly, in the longer term, it could be the decisive blow for rule of law in Hong Kong – and the city’s autonomy.
What should be noted here is the significance of Beijing’s top-down, unilateral approach. This is, indeed, an audacious move considering the potential costs down the road.
The announcement will certainly fuel a new wave of protests in Hong Kong, this time with much higher stakes. Though some in the pro-democracy movement have expressed feelings of hopelessness recently, thousands still took to the streets on Sunday, leading to clashes with police.
China risks a severe backlash in the international arena. The UK, Canada and Australia have issued a joint statement saying they were “deeply concerned” about the proposed legislation.
The United States has reacted more forcefully by “condemning” the move and urging “Beijing to reconsider its disastrous proposal”. President Donald Trump has threatened to respond “very strongly” if Beijing follows through with the new law.
One option for the US is to invoke the Hong Kong Human Rights and Democracy Act, which was passed by Congress last year amid the continuing Hong Kong protests.
This, however, would represent the “nuclear option” for the US. Under the act, the US could revoke Hong Kong’s preferential trading status if the city’s autonomous status within China is compromised. This means the same tariffs and export controls the US now imposes on China would extend to Hong Kong, putting at risk some US$67 billion in annual trade.
There is growing support in the US to apply sanctions to mainland Chinese officials behind the proposed security law.
The aim of this kind of response would be to hurt China by hurting Hong Kong. This comes at a time when Beijing needs Hong Kong, an international finance hub, to attract foreign investment as it deals with the ongoing trade war with the US and its post-pandemic economic recovery.
Beijing’s credibility could be severely damaged if it fails to honour its treaty obligations with regards to Hong Kong. This runs contrary to the image Beijing has been painstakingly building in recent years of a responsible great power and an emerging leader of the world.
Given the potential costs, it is all the more extraordinary that Beijing is taking this approach. What, then, could have driven such a move?
For Beijing, this is a public acknowledgement of its inability to resolve the political unrest in Hong Kong without resorting to violence, and that the ongoing protests could ultimately undermine its own national security.
It is a sign that Beijing has lost patience with the “one country, two systems” approach to slowly incorporate Hong Kong into the fold and provide a road map for Taiwan’s eventual unification with the mainland.
As Taiwan has drifted further away from Beijing’s overtures in recent years, the Chinese government has felt less obliged to keep up the “one-country, two systems” window dressing in Hong Kong.
The strategy is no longer to win hearts and minds, but to impose fear.
Beijing is counting on Washington and its allies to come to the realisation that hurting Hong Kong would not be in their own economic interests and eventually back away from their threats to take action.
If anything, this is a dual crisis in the making. It is a constitutional crisis for Hong Kong that could irrevocably redefine the nature of its autonomy and rule of law in the city moving forward.
It also has the potential to become a diplomatic crisis. There’s a chance Beijing may have miscalculated the situation and the US and its allies will retaliate with economic or other punishments.
The Chinese leadership is unlikely to back down and be seen as giving in to external pressures.
This puts China even more firmly on a collision course with the US and suggests the Chinese leadership is as determined as ever to fight a new cold war with its western adversaries.
And Hong Kong is in the middle, poised to become, as pro-democracy activist Joshua Wong, put it, “the new Berlin”.