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This survivor may have had Covid-19 twice

(CNN)Covid-19 first struck Jordan Josey around St. Patrick's Day, right as social distancing guidelines were rolling out across the country.

The 29-year-old lawyer from Macon, Georgia, was sick through Easter, before eventually clearing the coronavirus, developing antibodies and gradually building up his stamina again by early May.

He donated convalescent plasma on May 18 and received a letter two weeks later confirming that he was positive for coronavirus antibodies. A swab test around that time came back negative for the virus itself.

Life felt like it was returning to normal. He started jogging again and by late June, he felt confident enough to visit his family in South Carolina, where they played tennis and ventured out on a lake in a boat.

But then inexplicably he came down with Covid-19 symptoms again just before the Fourth of July.

He tested positive again

Josey's second round of Covid-19 rendered him almost entirely inactive for four weeks.

He and his internist aren't sure whether the virus was never fully defeated or whether he may have gotten reinfected, perhaps during his weekend trip to see his folks.

His doctor declined to comment for this story, citing concerns about patient privacy.

Whatever the underlying cause, Covid-19 rocked his world again. The disease stole his lung stamina again, but it also presented with symptoms that differed from his first case. It caused fatigue so severe his doctors tested him for mononucleosis. He lost his appetite and dropped weight.

"I couldn't walk up a flight of stairs or go for a walk in my neighborhood," he said.

He spent six weeks in total lockdown quarantine, fearful of passing the virus to others. Fortunately, none of the 15 or 20 people he was exposed to in late June tested positive.

"I joked (to the doctors) when I tested positive round two. I was like, 'Do y'all want to do a case study on me now?' And they were like, 'Probably.'"

Jordan Josey still suffers from shortness of breath.

Josey continued working in his job practicing law, but only because he could accomplish tasks much of the time while lying down in bed using his laptop. He worried, however, how people waiting tables or landscaping yards might have fared in similar situations, working on their feet all day without access to short-term disability protections.

"I would have lost my job," he said.

But his own case grew more complicated. He tested positive for antinuclear antibodies, a marker often associated with lupus. His lymph nodes visibly swelled around his neck.

A CT scan of his lungs didn't show any scarring, but he was still having trouble taking a full breath.

"In July, I would have been worn out just by talking. I wouldn't have been able to make it through the length of this phone conversation," he said in an interview. "I'm still on steroid inhalers to help keep the shortness of breath at bay."

His various treatments and supplies, including nebulizers, inhalers, breathing medications and a spirometer, keep multiplying.

"I literally told my wife I'm bound to just create a box that's like 'Covid treatment kit' or something," he said. "Let's not get rid of the stuff because I may need to pull it out again for a third time."

Science still emerging around possible reinfections

The fevers, shortness of breath and aches of Josey's apparent second case of Covid-19 were similar to what he felt after he first tested positive and developed his original course of symptoms.

Cases like his are rare.

"People are beginning to question if indeed reinfection does happen not too long after infection," said Dr. Susan Kline, a professor of medicine in the division of infectious diseases and international medicine at the University of Minnesota Medical School. "These reports that have come out have us questioning how many others this has happened to."

It can be common for some families of viruses to go latent and then reactivate. For instance, the varicella-zoster virus can cause chickenpox in children, go dormant and then reactivate as herpes zoster, or shingles, which causes painful rashes in adults.

Previous coronaviruses, such as SARS, MERS and seasonal cold bugs, tended not to do that, however. And it seemed unlikely SARS-CoV-2 would reactivate in previously sick people, though the science is still emerging, Kline explained.

"I don't think we have good evidence for that, but we can't rule out that possibility," she said.

Antibodies may not last long

The US Centers for Disease Control and Prevention in August issued new guidance explaining that those who test positive for coronavirus do not need to quarantine or get retested for up to three months as long as they do not develop symptoms again. In many cases, it's unclear if someone actually got Covid-19 twice.

The recommendations are "based on the latest science about COVID-19 showing that people can continue to test positive for up to 3 months after diagnosis and not be infectious to others," CDC spokesperson said in August.

The CDC's guidance came after a number of scientific studies produced evidence that coronavirus immunity may not be long-lasting.

They make Josey question what's next in his life.

"If you operate under that three-month rule, do I have any immunity right now, if any, and how long can I expect that to last?" he wondered. "I know that my antibody time from round two is probably coming to a close."

Antibodies may begin to fade just 20 to 30 days after Covid-19 symptoms first appear, one study released in July showed.

Recently, a man in Hong Kong tested positive twice, becoming the world's first officially documented case of coronavirus reinfection after scientists sequenced the genomes of the viral strains that sickened him.

And scientists from the University of Nevada at Reno and the Nevada State Public Health Laboratory reported on August 28 in a pre-print study that a 25-year-old man had tested positive with two distinctly different coronavirus infections.

He became the first official US case of reinfection.

In order to prove that Josey's second case of Covid-19 is also a distinct reinfection, scientists would need to perform genetic sequencing of virus samples to see if his second Covid-19 case emerged from a different virus strain, Kline said.

Remaining hopeful

To connect with others, he joined Survivor Corps, an online community for coronavirus survivors with now over 100,000 members sharing their experiences.

He is almost entirely back to normal now, but being rocked by illness is seared in his memory.

"When I look back on the year, like I'll be extremely thankful because I do have my life and I've got my health. I've still got a job, and I still have a place to live," Josey said. "A lot of people have been impacted by this and lost everything or lost a loved one."

Exasperated by the twists and turns of his journey, and unable to sleep one night in July, he posted in the Survivor Corps group. Responses poured in with other survivors offering encouragement and retelling what they were going through.

He felt buoyed.

"I try to stay patient and be grateful. They keep me grounded," he said. "I haven't felt isolated or alone."

State-backed group invests in battery-metals firm after Trump recently signed rare-earths executive order

The U.S. government is ramping up efforts to secure minerals critical to modern technology but whose supply is dominated by China—a stranglehold that miners warn could take years to break.

In recent years, the U.S. and other Western nations have invested in projects and approved licenses to mine these resources—essential for the production of electric vehicles, cellphones and wind turbines—an effort these countries are now accelerating given how far they still trail China.

Last week President Trump signed an executive order declaring a national emergency and authorizing the use of the Defense Production Act to speed the development of mines. The law was used earlier this year to speed production of medical supplies amid the pandemic.

On Monday, Ireland-based TechMet Ltd. said the U.S. International Development Finance Corporation, a state-funded lender and investor, had made a $25 million investment in its projects that produce and recycle resources like battery metals nickel and cobalt.

Miners and analysts have welcomed the moves, but caution it takes around 10 years to set up a mine and that the West also needs to develop the capability to process these resources into the materials used in final products.

“To dislodge China’s overwhelming dominance of rare earth, in particular, is a multi, multiyear process,” said TechMet Chief Executive Brian Menell. “There are no quick fixes.”

Rare-earth elements, used in batteries and electronics, are one of the 35 types of minerals that the U.S. government has deemed critical to economic and national security. The U.S. says it imports 80% of its rare-earth elements from China, with further supply coming indirectly from the country. For 14 of the 35 critical types of minerals, the U.S. has no domestic production.

That includes gallium, an element used in light-emitting diodes and semiconductors for cellphones. Critical minerals are also used in less high-tech sectors. China supplies half of the U.S.’s barite, which is used in the hydraulic fracturing that revolutionized American oil production.

China has built its dominant position in many of these minerals because of their abundance there, the country’s more lax environmental laws make it easier to mine them and through subsidizing their production and processing.

Up until the 1980s, the U.S. was the world’s biggest producer of rare earths and created the technology to process them, but today it has only one producing mine, the Mountain Pass mine in California, and no processing plants.

David Henderson, founder of consulting firm Rittenhouse International Resources LLC, says the U.S. now lacks technical expertise in the sector and will need to collaborate with allies like Australia and Canada to catch up.

Even if you can mine the minerals, China dominates the entire supply chain, says Jack Lifton, another consultant who has worked for the U.S. government. To make magnets, for example, rare earths have to be mined, extracted from their ores and then separated into individual elements. They are then turned into magnet metals, which are made into magnets. Chinese companies can do every stage of this process, sometimes within the same firm, he says, while only one company outside of the country can—Canada’s Neo Performance Materials ULC.

Mr. Trump’s executive order called for an assessment of U.S. dependence on China for critical minerals, and said the government could provide grants and loans to kick-start production and processing. It also said it could impose tariffs and quotas on imports from China.

The U.S. government, though, has for almost two decades voiced concern about China’s dominance and the need to catch up, with little progress.

In 2012, the Obama administration filed a complaint with the World Trade Organization asking China to loosen its restrictions on exports of rare earths. And in 2017, the Trump administration issued an order calling for a strategy to reduce U.S. susceptibility to critical mineral-supply disruptions. Since then, the government has funded some projects.

The Defense Department is part-funding the development of a processing facility at a mine in California, and also supporting a separation plant in Texas. This year, the U.S. Geological Survey has invested about $30 million in critical minerals research.

Other countries are also stepping up their efforts.

Last month, the European Union published an action plan to increase domestic sourcing and diversify its supply of 30 raw materials. Canada recently funded a rare-earth processing facility in Saskatchewan, while Australia is offering loans to develop its domestic industry in these minerals.

Miners say they think Mr. Trump’s executive order could encourage a stronger U.S. industry in critical minerals, not least because investors are more likely to back companies they believe the government supports. Shares in companies that mine or want to mine critical materials rose on the news of the order.

“The U.S. has been moving very slowly,” said Pini Althaus, chief executive of USA Rare Earth, which hopes to be mining these minerals within three years in Texas. “This gives it a boot up the rear end to get it happening quicker.”

Consumers are exhibiting more empathy this year, supporting businesses that support retail employees.

Reports have found that consumers beginning holiday shopping even earlier this year, and that may be a good thing as consumer behavior continues to shift drastically to favor online shopping and at-home delivery.

According to Accenture’s 14th annual holiday shopping survey, most U.S. shoppers are supportive of retailers closing on Thanksgiving Day wanting to protect the health, safety and livelihood not only of themselves but of store employees. In fact, the company’s survey revealed that 61 percent of consumers plan to minimize in-store shopping with the expressed intent of reducing health risks to essential workers. The same number reported they would be “inspired to shop with retailers that demonstrate visibly high commitments to health, safety and hygiene practices.

“It’s not so much that you could get [sick] by shopping, it’s actually that you don’t want to give something to [retail employees] which I thought that was really amazing, really a big deal,” said Jill Standish, a senior managing director at Accenture. “One of the things that are coming through is how transparent things are today because we’re sitting in front of media most of the day and it’s really easy for news to spread. What you do with your employees and what you do with your policies and procedures is just well known.”

In fact, 57 percent of respondents told Accenture they “really want to shop with a retailer that supports their workers.” Further, 41 percent said they will not shop with a retailer that has laid off staff or reduced benefits because of the pandemic.

Concurrently, consumers are planning to show support for minority-owned businesses. While 40 percent of respondents said they will support and shop at minority-owned businesses, 39 percent said they will shop at retailers that support the Black Lives Matter movement.

Surprisingly, Accenture’s survey found that only 11 percent of consumers were willing to use methods of buying online and picking up in-store. According to Standish, this may be partially due to “curbside pickup” or buy online, pick up in-store meaning different things across retailers. It may make consumers question if they will need to enter a store for pickup or simply wait for an employee to deliver products to their cars.

At the same time, consumers have become adjusted to free online shipping which is ultimately the most convenient option. Still, to be considered, findings showed that consumers’ patience is fleeting and if a retailer does not deliver on expectations for a seamless experience, they will not shop with the retailer again.

“This is really tricky for a retailer because it is more expensive if you think about it to ship too long,” said Standish. “You’ve got to pick up the tab for the packaging and everything else.”

One method of getting consumers back in stores is through appointment-based shopping. Accenture’s report saw 62 percent of consumers are open to booking times to shop in person at a department store, consumer electronics retailer, or a homeware retailer.

Accenture’s report found that while 44 percent of consumers plan to spend the same amount on holiday shopping this year compared to last year, 41 percent said they expect to spend less. Only 15 percent said they plan to spend more.

Notably, recent reports by WWD have revealed similar findings reflecting consumers’ sentiments amid difficult economic times.

With the acceleration of online shipping and a clear preference for at-home delivery in mind, Standish says retailers will be up against some difficulties with delivery capabilities which may create a “bottleneck.” But with consumers starting holiday shopping early, retailers may have the opportunity to plan accordingly.

“In terms of some strategies we’re seeing it’s starting early,” said Standish. “It is flattening the curve. Instead of having pent-up demand right to the very end and needing everything to be expedited, we can start early and get our act together to make it a little bit easier for the retailer.”

In part, Standish explained, the consumer has been motivated to shop early after experiencing more frequent out-of-stocks during the pandemic. “We’re seeing this across all categories,” she said. “Both online and in-store. If you do know what you want, and you see it’s available the consumer is saying buying now, versus waiting.”

Accenture’s survey found 30 percent of consumers plan to start holiday shopping earlier this year out of fear of not getting items on their list if they wait until after Thanksgiving. However, this early holiday shopping may give retailers an opportunity to collect data on holiday purchasing trends that will mirror shopping later in the season.

“If you knew that consumers are starting to buy certain products together, that you didn’t think would be complimentary but all of a sudden you’re seeing that demand, can you put them in the same warehouse and alleviate split shipments and put it in one box?” said Standish. “Can you start to see demand hiking in certain areas by watching what’s trending on social? Can you move inventory closer to that demand or at least understand what the cost would be to do that? Those kinds of strategies can only be done if you really have a view of what’s going on, locally, and how to do that it’s really a testament to data play.”

Further, with this data, retailers will be able to consider how much in-store shopping consumers will partake in and determine how much product is needed in-store.

“Cost to serve just went up,” said Standish. “How can you start to get smart and surgical about how you fulfill demand but also how do you eliminate the extra cost. That to me is kind of the game that this holiday is going to show and I think it’s for the long run it’s not just for holidays, it’s going to be like this for a while.”

Kosmos Energy has closed a Gulf of Mexico facility with Beal Bank USA and Trafigura Trading LLC (“Trafigura”).Kosmos has restructured its previously announced Gulf of Mexico prepayment facility into a five-year $200 million term-loan facility secured against the Company’s U.S. Gulf of Mexico assets. The $50 million advanced under the prepayment agreement with Trafigura announced in June has been rolled into the new facility, structured by CSG Investments, Inc., with the remaining $150 million provided by Beal Bank. The facility, which has an interest rate of approximately 6%, increases the company’s borrowing capacity by $50 million from the initial prepayment agreement, extends the tenor to five years and includes an accordion feature allowing the facility to be expanded up to $300 million.