 Hello and let's talk about the COVID-19 situation in India. The number of new cases in the country yesterday hit a high of 75,760 and this is the first time this number has crossed the 70,000 mark. In terms of the number of new cases in a single day, India was over 28,000 ahead of the second worst affected country, Brazil. And this is not a new phenomenon. India's new cases over the past few days have been in the 60,000s, even as other badly affected countries are in the 40,000s. And this is the total number of cases in the country stands at over 33 lakhs and the total number of deaths at close to 60,500. The number of active cases is around 7.25 lakhs. There's been of course no major announcement from the government regarding tackling the disease which is understandable considering that the government has been silent for quite some time on this issue. Maharashtra continues to be the state with the maximum number of cases and the highest number of new cases as well, recording close to 15,000 new cases yesterday. We talked in news clicks Mumbai correspondent Amit Rautkar on this issue. Thank you Amit for joining us. So Maharashtra yesterday saw over 14,800 cases. That's the single highest number of cases recorded in a day. And with this, the total number of cases has crossed of course 7 lakhs, it crossed it before itself. And this has been a consistent trend. So say unlike say a state like Andhra Pradesh, which is initially not recording so many cases but is now sold, Maharashtra has been the highest in terms of cases for a long time. So could you tell us what has been the pattern of the spread of the disease which are the main effected areas right now in what's happening? Hello Prasanta, you are right. Maharashtra has been the worrisome issue of COVID-19 for the entire country. The number of patients and number of deaths is also a serious issue for Maharashtra. Right now the problem, the challenge before Maharashtra government is not Mumbai. Mumbai is somehow getting controlled. But the problem for Maharashtra right now are four major districts. Pune, Solapur, Kulapur and Nagpur. But these four districts are witnessing the huge number of the spike in the number of COVID-19 patients. Right now, as you said, yesterday was highest, single day highest patients were found. Almost 14,888, close to 15,000. So we are that close to 15,000 right now. Comparatively, again, let me tell you, the comparison is the number with Maharashtra 15 days back. So two weeks back, the death rate was a little bit higher. But still, Maharashtra's death rate is higher than the entire country. So it is, this point need to be noted. And the spread of this COVID-19 across the four districts, which I mentioned earlier, Nagpur, Pune, Solapur and Kulapur is also a thing that need to, that Maharashtra government has to tackle it fast. One point, at this point of time, we should must raise the one issue. That is about the Pune. Pune has been the first patient of Maharashtra COVID-19 on 9th April. So, sorry, in March, month of March. So since then, Pune is not packet like Mumbai. The way Mumbai has been taken, the major, BMC has taken major, Pune kept behind, Pune lagged behind. And now we are seeing the Pune has become an AP center. It is shifting in last eight days. Now Pune is becoming an AP center of COVID-19. So that is most worrisome part. Unfortunately, this need to be said that, yes, Pune has been neglected compared to Mumbai and the MMR region. When we say the Mumbai and MMR region, MMR region is including Mumbai and eight municipalities, like Thane, Kallan, Dombuly, Ullas, Nagarpan, Vail, Bhivendi. So now this area is getting improved, but Pune is lagging behind. So this is the most important part right now. Maharashtra government is also under pressure because now the total number of COVID patients is almost seven lakhs, it has already crossed seven lakhs. Though the active patients is somewhere one lakh 72,000, but still it is much higher than any other state right now. So at this point of time, Maharashtra is again, unfortunately, the number one state in COVID-19 patients. Again in dates, dates are almost 23,000. Yesterday it did cross 23,000, so close to up now 25,000 and much higher, almost 42% compared to India out of India's total patients, 42% patients are from Maharashtra. So this is what the larger picture right now. So in this context, what steps is the government planning because there have been some meetings, I think yesterday was a cabinet meeting also. So in this context is the government planning out new fresh measures, intensification of existing steps, what is on the agenda right now? Maharashtra government is claiming or trying to say that they are trying to provide enough equipments, they are trying to upgrade the healthcare systems of various parts of state, so that people can fought well, the system can fought well against COVID-19. But situation is completely different from what Maharashtra government is right now claiming. Situations like that that the spread of COVID-19 is now almost all terminals of state, in Nashik, in Pune, in Kulapur, Sulapur, Nakhur, patients are more and more number of patients coming every day from this area. So the situation is like that, the Maharashtra government is trying to say various things but the number of patients, the infection is spreading widely. There are three reasons why the current situation has arrived in Maharashtra, despite of efforts of five months. For last five months Maharashtra is under lockdown, Maharashtra is fighting COVID-19, but still it is number one in the entire country. The number of deaths in Maharashtra have forced 23,000, which is again almost more than 40% to entire country. So why this is happening, the first and the important the reason is and that we need to mention time and again that the criminal negligence of healthcare accreditation over the last 20 years is now facing back people, all governments of all parties, we have seen in the last 20 years in Maharashtra but they neglected the healthcare system to agree it and the public healthcare system and now people are facing the problems. Second number issue is that people are getting tired to sit at home and that is very understandable situation for last four and a half months people are sitting at home, Maharashtra is in industrial state, still the people are trying to be at home but it is not possible because the financial complications, financial implications of the lockdown are more worrisome than the current COVID-19 situation and so people are now getting out. We have seen people claim to market in large number during the Ganesh festival these days, so this is another problem. Maharashtra government is trying to say that they are providing enough number of equipment, specially ventilators and ICU beds to ICU wards to various regions but the reports from local newspaper, reports from local media are saying something different. Also in Pune, also in Solapur, cases have come forward that the people have lost their lives because they couldn't get ICU beds or they couldn't get ventilators, so this is the one situation. The strategy of Maharashtra government was earlier that they were focusing entirely on Mumbai. Then they started focusing on MMR region as the COVID-19 spread in this MMR region. Now they have to focus on this, especially Pune, Solapur, Kulapur, Nasi because the numbers of patients are coming from these districts are higher than in Mumbai. So now they are trying to focus on all corners of state and so that is where Maharashtra government and the entire healthcare system is tired. Our next story is about the report of a case of a COVID-19 reinfection in Hong Kong. This is the first such confirmed case of its kind and news clicks, Purbio Purkayasai and immunology, Dr. Satyajit Rat talk about its implications. Satyajit will start with the first proven case where we know a reinfection is taking place. Hong Kong person who was infected earlier has again shown to be infected. This time we know it's a reinfection because it's a different genetic sequence that we are able to see. Can you tell us a little more about what this really means in terms of how we identified it and what it really means for all of us? Okay, so let's start with what we didn't know which we have come to know with the Hong Kong case. And that is we've had a lot of anecdotes floating around saying so and so was virus positive. Then they became virus negative. Then when they were retested they were again virus positive. And people said, oh, is this reinfection? And the trouble with that sequence being interpreted as a reinfection is that the negative test may have been wrong because test... We discussed that earlier that we don't know because you're not sure of the negative test in the middle. Well, tests always have some finite probability of being wrong. So the negative test may be wrong. And if that was the case then these people may simply have a prolonged viral infection rather than a reinfection. This had not been ruled out definitely so far as I have heard before the Hong Kong case. In the Hong Kong case, both the earlier positive test virus and the later positive test virus have had their entire genetic code sequenced. And the code is sufficiently different for us to say with certainty that these are two independent infections that this individual has had in a span of a few months. And in that sense, this is a true instance of reinfection. Let's look at it in simple terms. Out of a hundred people who are infected with SARS-CoV-2, how many get symptoms less than half? So the chances of any person getting infected and developing symptoms are actually a minority. So the fact that this reinfection in this particular individual was not symptomatic is not necessarily because he had an immunity from the previous infection. Okay. So what you're saying is unless we have 50 such cases, we will not be able to conclusively say whether it is the immunity, residual immunity, or whether it's a simple statistical chance that the person did not develop the symptoms. So on behalf of my statistician friends, it is astonishing that I have those. Let me modify the usual statement. There are lies, there are damned lies, and both are dealt with by statistics. Quite often created by statistics also. So this is so absolutely. So that this person was asymptomatic is not necessarily evidence that it was asymptomatic because of pre-existing immunity. Okay. Just as the fact that this person had a reinfection is not evidence that this second virus infection was materially different from the first virus infection. None of these speculations are supported by any evidence so far. At the moment. But what we could also think of that after only one person has been reinfected that we know of, there may be more, but there is not hell of a lot of more people. Otherwise, you would have got more cases. I am not so sure because remember that this reinfection was discovered accidentally, simply because this person was traveling and therefore in a situation where he got sampled regardless of anything. Yeah, that's true. Because most people are still getting tested only when they have symptoms or they are in contact with the person who has had symptoms. So it's only a very small subset of people who get tested. So we really to test the person who has been reinfected is anyway statistically is a very small number. So an interesting issue would be if everybody who came up as virus positive began to be tested that day for antibodies, especially for IgG antibodies. Then we would begin to have at least a rough idea. It's quite possible that the IgG antibodies may be because of that infection. But the antibodies you have to spell out a little more. As you know, it's complicated. Well, it takes a few days for us to develop IgG antibodies. So if today I'm virus infected and also have high levels of IgG antibodies, then there is at least some reason for thinking that this may be a reinfection. So there's all sorts of correlations that I suspect the field is going to begin to look very actively for in order to provide statistical heft for the phenomenon of reinfection. But at least now we know that there is possibility of reinfection and we are back on the vaccine issue which we have discussed earlier that we will get some protection, maybe 100%, maybe 70% if it lasts for six months, if it lasts for two years, it may even last for a lifetime. We don't know at this point. That's where we still are. And what this shows that it is a possibility that after some time, we may get a second infection as you have argued earlier that vaccination may give you a stronger immune protection that an infection gives you. So again, we are back to the issue that it is really complicated, right? So let me add two issues. Connecting this reinfection case with the prospects of vaccination. Number one, people are using the reinfection case to say that if reinfection like this is possible, vaccines may not work. And as you pointed out, we've discussed earlier the fact that vaccination is triggering the same immune response through somewhat different contexts and pathways than the natural infection does, or at least not necessarily through the same pathways. And therefore the magnitude of a response through an infection and the magnitude of a response through vaccination are not necessarily the same. But the second point that's being made with the reinfection case is that, oh, the virus has changed. It has mutated and therefore there is no protection any longer. At the moment, looking at the mutations of the second virus strain in this individual, there is no evidence to think that a standard vaccine response that would be generated by any of the leading vaccine candidates would not protect equally against both the first and the second. So I don't think that the mutations or the variations in the virus sequence so far have raised any immediate and imminent red flags about the durability of utility of vaccines. That's why I had said 22 changes in the genome sequence out of 29,000, 30,000. So therefore it's a very small change we're talking about and it doesn't appear to be or probably not, again, probably not an argument that it has changed significantly. Well, let me underline that. None of those changes appear to be in regions of the virus critical for vaccine protection so far. So in that sense, this is no immediate red flag for worry. That's all we have time for today. We'll be back tomorrow with major news developments from the country. Until then, keep watching NewsClick.