The Lambda Coronavirus Variant Has Arrived In Australia Here’s What We Know So Far

We’ve seen the Alpha, Kappa and Delta variants cross our borders, but it turns out another strain of the virus that causes COVID-19 has reached our shores.

The variant, named Lambda by the World Health Organization (WHO) last month, was detected in an overseas traveller who was in hotel quarantine in New South Wales in April, according to national genomics database AusTrakka.

Some reports suggest the new variant could be fast spreading and difficult to tackle with vaccines. So what sets this variant apart from others and should we be concerned?

Here’s what we know so far.

Where did it originate?

Previously known as C.37, Lambda was first detected in Peru in December 2020. Since then, it’s spread to 29 countries, seven of which are in South America.

In April and May this year, Lambda accounted for over 80 per cent of COVID-19 cases in Peru, with a high proportion of cases also in Chile, Argentina, and Ecuador.

On 14 June, Lambda was listed as a ‘variant of interest’ by the World Health Organization due to its vast spread in South America.

Variants of interest are listed as such because they have the potential to be more infectious and severe, but haven’t yet had the devastating impact of those listed as variants of concern.

On 23 June, Public Health England classified it as a ‘variant under investigation’, after six cases were detected in the UK to date, which were all linked to overseas travel.

What makes it different from other variants?

There are now 11 official SARS-CoV-2 variants listed by the WHO.

All SARS-CoV-2 variants are distinguished from one another by mutations in their spike proteins — the components of the virus that allow it to invade human cells.

For instance, the Delta variant first detected in India has two key spike protein mutations — T478K and L452R  — that allow it to infect cells more easily and evade the body’s immune response.

According to research published last week but yet to be peer reviewed,  Lambda has seven unique spike protein mutations.

A Chilean team of scientists analysed blood samples from health workers in Santiago who had received two doses of the CoronaVac vaccine developed by Sinovac Biotech in China.

They found  the Lambda variant has a mutation called L452Q, which is similar to the L452R mutation seen in the Delta and Epsilon variants.

As the L452R mutation is thought to make Delta and Epsilon more infectious and resilient against vaccination, the team concluded that Lambda’s L452Q mutation might also help it spread far and wide.

While it’s possible that Lambda is indeed more infectious than other variants, it’s too early to know for sure, said Kirsty Short, a virologist at the University of Queensland.

“It’s very preliminary,” said Dr Short, who was not involved in the study.

“It’s a good starting point, but I certainly wouldn’t infer anything from that into the clinic.”

Are vaccines still effective against the Lambda variant?

The study also found signs that Lambda’s unique spike mutations could help it slip past the body’s immune response.

The results of the study suggested that the CoronaVac vaccine produces fewer neutralising antibodies — proteins that defend cells against infections — in response to the Lambda variant.

But according to Paul Griffin, who specialises in infectious diseases and vaccines at the University of Queensland, it’s important to remember that these antibodies are just one aspect of immunity.

“We know that [neutralizing antibodies] only tell a part of the story,” said Dr Griffin, who was not involved in the study.

“If that further immunity remains intact, then even with a reduction in neutralizing antibodies, sometimes that protection can still be enough.”

It’s also worth remembering that different vaccines work in different ways to respond to the virus and its variants.

“You can’t really extrapolate from one vaccine,” Dr Short said.

CoronaVac uses inactive versions of SARS-CoV-2 to kick the immune system into gear.

On the other hand, Pfizer contains a single strand of the genetic code that builds the virus’s spike proteins, while AstraZeneca contains a double-strand.

Dr Griffin said that more traditional inactivated vaccines like CoronaVac have proven to be less effective overall than others.

“As a broad category, the inactivated ones have been a little bit underwhelming, particularly compared to others that have such high rates of efficacy,” said Dr Griffin, who was not involved in the study.

While not much is known about how effective the Pfizer and AstraZeneca vaccines are against Lambda, their response to the Delta variant can offer clues.

A recent study from the UK found that two doses of either Pfizer or AstraZeneca are over 90 per cent effective at preventing hospitalisation due to the Delta variant.

Should Australia be worried?

While there has only been one case of Lambda recorded in hotel quarantine in Australia so far, it’s worth keeping an eye on the emergence and spread of SARS-CoV-2 variants around the world, Dr Short said.

“There’s a reason why it’s a variant that we’re watching and looking into more, but it’s certainly not at a point of panic or anything like that.”

Dr Griffin added that Lambda would need to out-compete Delta to become a major concern. “That’s certainly not what we’re seeing,” he said.  But as more people get infected, the more chance the virus has to evolve into new variants, Dr Short said.

The best way to tackle this is to focus on getting more people vaccinated, not just in Australia, but globally. “What this should emphasise to everyone is that we need global effort in the vaccination campaign,” Dr Short said.

 By: ABC Health & Wellbeing Gemma Conroy

Source: The Lambda coronavirus variant has arrived in Australia. Here’s what we know so far – ABC News

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The COVID-19 Symptoms Doctors Are Seeing The Most Right Now

More than a year into the coronavirus pandemic, experts have unraveled so many mysteries about how to treat the virus and prevent it. But at the same time, SARS-CoV-2 is always changing as new variants emerge. And accordingly, the ways in which the virus affects people seem to be shifting as well.

Here’s a quick rundown of some of the most common COVID-19 symptoms doctors are seeing right now, and how vaccines and variants fit into this picture.

The most common symptoms — such as cough, fever, and loss of taste and smell — are all still pretty much the same.

Since the COVID-19 pandemic began, the most common symptoms of the virus included a cough (often dry), shortness of breath, a fever of 100 degrees or higher, and the sudden loss of taste and smell.

Those, however, are by no means the only frequent symptoms. People also report everything from headaches to diarrhea, all of which are listed on the Centers for Disease Control and Prevention’s rundown of common possible symptoms.

For the most part, that list of the most common symptoms hasn’t really changed. “The symptoms are really the same as before. It’s the headache, cough, fatigue, runny nose, fever — those kind of generalized flu-like symptoms,” said Jonathan Leizman, chief medical officer of Premise Health, a health care company headquartered in Tennessee.

The emergency warning signs of COVID-19 have also stayed pretty much the same. Those include issues like trouble breathing, persistent chest pain or pressure, and new mental confusion.

With the delta variant, some people’s symptoms might look more like a common cold.

The delta variant (B.1.617.2) is circulating widely around the globe and is now the main strain here in the United States; it’s hitting areas with high numbers of unvaccinated Americans particularly hard.

There is some initial evidence that the symptoms associated with delta might be a bit different than those with the original SARS-CoV-2 virus, though experts caution that it remains too early to say definitively.

“The information we’re getting from the U.K. and Europe and some initial surveys here in the United States is that the delta virus infection seems to be more likely to produce symptoms that are more typical of a common cold,” said William Powderly, co-director of the Division of Infectious Diseases at Washington University School of Medicine in St. Louis, which has recently seen a big uptick in COVID-19 cases and hospitalizations. “That’s a sore throat, mild cough and nasal congestion.”

“The symptoms we were seeing earlier on, which were much more like lower respiratory and fever, are less common,” Powderly added. “That isn’t to say they don’t happen. But there does seem to be a shift in the frequency and type of symptoms being reported.”

Experts don’t yet understand why the symptoms might be slightly different. It could be simply that there are now more infections in younger people, Powderly said. At the same time, researchers are exploring how variants classified as “of concern” and “of interest” — including delta but also lambda and others — might be different in terms of their ability to be transmitted or to make people more or less sick.

The newer coronavirus variants could be making people sicker.

While some people infected with the delta variant have symptoms that are in line with a common cold, there is also preliminary evidence suggesting that other people’s symptoms may be “more intensely felt” with delta, Leizman said.

“We have seen that hospitalization rates are seemingly increased in younger populations with the delta variant,” he offered as an example.

But at this point, there’s no scientific consensus on whether the delta variant is likely to make people sicker than the initial strain, simply because it (and other variants) are so new. The best we have at this point are one-off studies, surveys or even just anecdotal information from the field.

“There’s now data coming out of England and Scotland showing that the severity of the disease may be increased, and it may be leading to an increased risk of hospitalization,” said Carlos Malvestutto, an infectious disease specialist at Ohio State University’s Wexner Medical Center.

“People who are not vaccinated are particularly vulnerable because the new variants — and particularly the delta variant — transmits faster and may be causing more severe disease,” Malvestutto added.

Symptoms tend to be mild in those who are fully vaccinated.

While the vast majority of new cases and hospitalizations occur in those who have not been vaccinated against COVID-19 (around 99% of new infections in some parts of the country), so-called “breakthrough cases” do occur among those who’ve received both shots of either of the Pfizer-BioNTech or Moderna vaccines or the Johnson & Johnson single-dose vaccine.

But the symptoms people experience in those instances tend to be relatively mild, according to the data that’s available at this point. About a third of people who got infected after being fully vaccinated were totally asymptomatic, for example.

The CDC now only tracks breakthrough cases that result in hospitalization or death, so there’s just not really robust data looking at how many people experience milder symptoms post-vaccine (or no symptoms at all), nor is there clarity about what variant those people may have caught. Still, there have been high-profile breakthrough infections in the news, like the New York Yankees cluster or entertainment reporter Catt Sadler, who recently said she had contracted COVID-19 after vaccination.

Ultimately, however, the goal of vaccination is not only to reduce transmission but to also drastically reduce hospitalizations and deaths — and the vaccines have done just that.

“The vast majority of individuals who are fully vaccinated do not have those severe consequences of disease, which makes us think the symptoms might be more mild in general for individuals who are fully vaccinated,” Leizman said.

Breakthrough cases also remain rare. As of mid-July, the CDC said that more than 157 million people in the United States had been fully vaccinated. There have been about 5,000 patients with COVID-19 vaccine breakthrough infections who were hospitalized or who died — though not all of those cases were directly attributed to COVID-19.

Which is why health experts are adamant that getting vaccinated is the best thing people can do to keep themselves and others safe — and to avoid developing any kind of symptoms at all.

“I’m in a state where we’re seeing a significant uptick in hospitalized patients … and they’re all people who have not been vaccinated, which is really hard and devastating, because these are completely preventable,” Powderly said.

Experts are still learning about COVID-19. The information in this story is what was known or available as of publication, but guidance can change as scientists discover more about the virus. Please check the Centers for Disease Control and Prevention for the most updated recommendations.

Source: The COVID-19 Symptoms Doctors Are Seeing The Most Right Now | HuffPost UK Wellness

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References :

The Delta SARS-CoV-2 variant first appeared in India in October 2020. This is the fastest-growing variant and is currently outpacing all other variants. This variant contains the “eek” mutation in the Spike protein, which helps the virus evade certain antibodies.  As a result, the Delta variant has shown significantly increased transmission.

This variant is responsible for the dramatic increase in COVID-19 cases in India over the past several months. Additionally, this variant has been identified in over 98 countries across the world as of July 2, 2021. Both the Pfizer/BioNTech (88%) and the AstraZeneca/Vaxzevria (67%) vaccine demonstrated protection was retained against severe disease caused by the Delta variant. Data is still limited relating to vaccine efficacy and the delta variant.

  1. Global Initiative on Sharing All Influenza Data (GISAID)
  2. Network for Genomics Surveillance in South Africa 
  3. Journal- Increased transmissibility and global spread of SARS-CoV-2 variants of concern as at June 2021
  4. Journal- Effectiveness of COVID-19 vaccines against hospital admission with the Delta (B.1.617.2) variant
  5. Sheikh A, McMenamin J, Taylor B, Robertson C. SARS-CoV-2 Delta VOC in Scotland: demographics, risk of hospital admission, and vaccine effectiveness. 

 

Will Covid Return When It Gets Colder?

In this week’s edition of the Covid Q&A, we look at what the cold weather might bring for the virus. In hopes of making this very confusing time just a little less so, each week Bloomberg Prognosis is picking one question sent in by readers and putting it to experts in the field. This week’s question comes to us from Rebecca in Albany, New York. She asks:

What will happen to infection rates in the U.S. when cold weather returns next fall?

While many parts of the world are still battling outbreaks of Covid-19, this summer in the U.S. it’s started to feel like the pandemic is over. Many states have completely done away with restrictions, and national case numbers are at their lowest levels since the pandemic began. But new, more contagious variants of the virus are on the rise, and there are regional pockets of vaccine holdouts that threaten to keep Covid in circulation.

All this suggests, unfortunately, is that it’s likely the U.S. isn’t done with the coronavirus just yet. “While it’s not purely a function of cooler temperature, Covid will rise again in the fall (if it doesn’t before),” says Andrew Noymer, a professor of public health at University of California, Irvine. “Covid’s future is as a seasonal disease in the fashion of influenza — and Covid’s future is now. Covid will be back in the fall or winter, or both.”

Without U.S. inoculation rates far higher than their current level, Noymer says, vaccines are unlikely to stop a cold-weather surge. “The vaccines will make the coming wave less severe than the one that crested in January 2021, but vaccination rates are currently not high enough to prevent another wave,” he says.

A resurgence was always likely, he says, but more contagious strains like the delta variant first identified in India may make the wave come sooner.  “Every major viral respiratory disease is seasonal with a winter dominance,” he says. “Influenza doesn’t vanish, and neither will Covid.”

Ali Mokdad, a professor of health metrics sciences at the University of Washington, said that projections by the school’s Institute for Health Metrics and Evaluation show a slow rise in cases in early September that will pick up with winter and peak in late January or early February. How bad it gets, he says, will depend on vaccination coverage, the variants in circulation and whether people return to habits like mask-wearing.

Still, several Covid vaccines appear to be far more efficacious than those for the seasonal flu. That means that while we may see a resurgence of the coronavirus, the worst is still most likely behind us.

Track the virus

One in Five Young Adults Not Working, Studying 

Almost one in five young adults in the U.S. was neither working nor studying in the first quarter as Black and Hispanic youth remain idle at disproportionate rates. The increase last quarter appears to be driven largely by joblessness, while school attendance rose moderately as campuses started to reopen, according to the study. Young adults are still experiencing double-digit unemployment rates.

Inactive youth is a worrying sign for the future of the economy, as they don’t gain critical job skills to help realize their future earnings potential.

People will be interacting more often indoors in places with poor ventilation, which will increase the risk of transmission, says Mauricio Santillana, a mathematician at Harvard Medical School in Boston, Massachusetts, who models disease spread.

But even if there is a small seasonal effect, the main driver of increased spread will be the vast number of people who are still susceptible to infection, says Rachel Baker, an epidemiologist at Princeton University in New Jersey. That means people in places that are going into summer shouldn’t be complacent either, say researchers.

“By far the biggest factor that will affect the size of an outbreak will be control measures such as social distancing and mask wearing,” says Baker.

By:

Critics:

Evidence so far

Seasonal trends in viral infection are driven by multiple factors, including people’s behaviour and the properties of the virus — some don’t like hot, humid conditions.

Laboratory experiments reveal that SARS-CoV-2 favours cold, dry conditions, particularly out of direct sunlight. For instance, artificial ultraviolet radiation can inactivate SARS-CoV-2 particles on surfaces1 and in aerosols2, especially in temperatures of around 40 °C. Infectious virus also degrades faster on surfaces in warmer and more humid environments3. In winter, people tend to heat their houses to around 20 °C, and the air is dry and not well ventilated, says Dylan Morris, a mathematical biologist at Princeton. “Indoor conditions in the winter are pretty favourable to viral stability.”

To assess whether infections with a particular virus rise and fall with the seasons, researchers typically study its spread in a specific location, multiple times a year, over many years. But without the benefit of time, they have tried to study the seasonal contribution to SARS-CoV-2 transmission by looking at infection rates in various places worldwide.

A study4 published on 13 October looked at the growth in SARS-CoV-2 infections in the first four months of the pandemic, before most countries introduced controls. It found that infections rose fastest in places with less UV light, and predicted that, without any interventions, cases would dip in summer and peak in winter. In winter, “the risk goes up, but you can still dramatically reduce your risk by good personal behaviour”, says Cory Merow, an ecologist at the University of Connecticut in Storrs, and a co-author of the study. “The weather is a small drop in the pan.”

But Francois Cohen, an environmental economist at the University of Barcelona in Spain, says that testing was also quite limited early in the pandemic, and continues to be unreliable, so it is impossible to determine the effect of weather on the spread of the virus so far.

Baker has tried to tease apart the effect of climate on the seasonal pattern of cases during the course of a pandemic, using data about the humidity sensitivity of another coronavirus. She and her colleagues modelled5 the rise and fall in infection rates over several years for New York City with and without a climate effect, and with different levels of control measures.

They found that a small climate effect can result in substantial outbreaks when the seasons change if control measures are only just managing to contain the virus. “That could be a location where climate might nudge you over,” Baker says. The team posted its results on the preprint server medRxiv on 10 September; the authors suggest that stricter control measures might be needed during winter to reduce the risk of outbreaks.

In the future

If SARS-CoV-2 can survive better in cold conditions, it’s still difficult to disentangle that contribution from the effect of people’s behaviour, says Kathleen O’Reilly, a mathematical epidemiologist at the London School of Hygiene and Tropical Medicine. “Flu has been around for hundreds of years and the specific mechanism as to why you have peaks of flu in the winter is still poorly understood,” says O’Reilly.

And even if researchers had more reliable data for SARS-CoV-2, they would see only small or negligible seasonal effects so early in the pandemic, when much of the population is still susceptible, says Relman.

Over time, however, seasonal effects could play a more important part in driving infection trends, as more people build up immunity to the virus. This could take up to five years through natural infection, or less if people are vaccinated, says Baker.

But whether a seasonal pattern emerges at all, and what it will look like, will depend on many factors that are yet to be understood, including how long immunity lasts, how long recovery takes and how likely it is that people can be reinfected, says Colin Carlson, a biologist who studies emerging diseases at Georgetown University in Washington DC.

What you should read

Source: Will Covid Return When It Gets Colder? – Bloomberg

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The COVID-19 pandemic has resulted in misinformation and conspiracy theories about the scale of the pandemic and the origin, prevention, diagnosis, and treatment of the disease. False information, including intentional disinformation, has been spread through social media, text messaging,and mass media. Journalists have been arrested for allegedly spreading fake news about the pandemic. False information has also been propagated by celebrities, politicians, and other prominent public figures. The spread of COVID-19 misinformation by governments has also been significant.

Commercial scams have claimed to offer at-home tests, supposed preventives, and “miracle” cures. Several religious groups have claimed their faith will protect them from the virus. Without evidence, some people have claimed the virus is a bioweapon accidentally or deliberately leaked from a laboratory, a population control scheme, the result of a spy operation, or the side effect of 5G upgrades to cellular networks.

The World Health Organization (WHO) declared an “infodemic” of incorrect information about the virus that poses risks to global health.While belief in conspiracy theories is not a new phenomenon, in the context of the COVID-19 pandemic, this can lead to adverse health effects. Cognitive biases, such as jumping to conclusions and confirmation bias, may be linked to the occurrence of conspiracy beliefs.

See also

Delta Coronavirus Variant: Scientists Brace For Impact

When the first cases of the SARS-CoV-2 Delta variant were detected in the United Kingdom in mid-April, the nation was getting ready to open up. COVID-19 case numbers, hospitalizations and deaths were plummeting, thanks to months of lockdown and one of the world’s fastest vaccination programmes. Two months later, the variant, which was first detected in India, has catalysed a third UK wave and forced the government to delay the full reopening of society it had originally slated for 21 June.

After observing the startlingly swift rise of the Delta variant in the United Kingdom, other countries are bracing for the variant’s impact — if they aren’t feeling it already. Nations with ample access to vaccines, such as those in Europe and North America, are hopeful that the shots can dampen the inevitable rise of Delta. But in countries without large vaccine stocks, particularly in Africa, some scientists worry that the variant could be devastating.

“In my mind, it will be really hard to keep out this variant,” says Tom Wenseleers, an evolutionary biologist and biostatistician at the Catholic University of Leuven (KU Leuven) in Belgium. “It’s very likely it will take over altogether on a worldwide basis.”

Delta, also known as B.1.617.2, belongs to a viral lineage first identified in India during a ferocious wave of infections there in April and May. The lineage grew rapidly in some parts of the country, and showed signs of partial resistance to vaccines. But it was difficult for researchers to disentangle these intrinsic properties of the variant from other factors driving India’s confirmed cases past 400,000 per day, such as mass gatherings.

Delta data

The Delta variant has been linked to a resurgence of COVID-19 in Nepal, southeast Asia and elsewhere, but its UK spread has given scientists a clear picture of the threat it poses. Delta seems to be around 60% more transmissible than the already highly infectious Alpha variant (also called B.1.1.7) identified in the United Kingdom in late 2020.

Delta is moderately resistant to vaccines, particularly in people who have received just a single dose. A Public Health England study published on 22 May found that a single dose of either AstraZeneca’s or Pfizer’s vaccine reduced a person’s risk of developing COVID-19 symptoms caused by the Delta variant by 33%, compared to 50% for the Alpha variant. A second dose of the AstraZeneca vaccine boosted protection against Delta to 60% (compared to 66% against Alpha), while two doses of Pfizer’s jab were 88% effective (compared to 93% against Alpha).

Preliminary evidence from England and Scotland suggests that people infected with Delta are about twice as likely to end up in hospital, compared with those infected with Alpha.

“The data coming out of the UK is so good, that we have a really good idea about how the Delta variant is behaving,” says Mads Albertsen, a bioinformatician at Aalborg University in Denmark. “That’s been an eye-opener.”

Denmark, which, like the United Kingdom, is a world leader in genomic surveillance, has also seen a steady rise in cases caused by the Delta variant — although far fewer than most other European countries. It is only a matter of time before the variant becomes dominant in Denmark, says Albertsen, but the hope is that its expansion can be slowed through vaccination, surveillance and enhanced contact tracing. “It’s going to take over,” he says, but “hopefully in a few months and not too soon.”

Meanwhile, the Danish government is easing restrictions, not re-imposing them: restaurants and bars have been open for months to individuals who have been vaccinated or received a recent negative test, and, as of 14 June, masks are no longer required in most indoor settings. “It is looking good now in Denmark, and we are keeping a close eye on the Delta variant,” says Albertsen. “It can change quite fast, as it has done in the UK.”

Cases of the Delta variant in the United Kingdom are doubling roughly every 11 days. But countries with ample vaccine stocks should be reassured by the slower uptick in hospital admissions, says Wenseleers. A recent Public Health England study1 found that people who have had one vaccine dose are 75% less likely to be hospitalized, compared with unvaccinated individuals, and those who are fully protected are 94% less likely to be hospitalized.

US spread

Delta is also on the rise in the United States, particularly in the Midwest and southeast. The US Centers for Disease Control and Prevention declared it a variant of concern on 15 June. But patchy surveillance means the picture there is less clear. According to nationwide sampling conducted by the genomics company Helix in San Mateo, California, Delta is rising fast. Using a rapid genotyping test, the company has found that the proportion of cases caused by Alpha fell from more than 70% in late April to around 42% as of mid-June, with the rise of Delta driving much of the shift2.

Jeremy Kamil, a virologist at Louisiana State University Health in Shreveport, expects Delta to eventually become dominant in the United States, “but to be somewhat blunted by vaccination”. However, vast disparities in vaccination rates could lead to regional and local variation in cases and hospitalizations caused by Delta, says Jennifer Surtees, a biochemist at the University at Buffalo, New York, who is conducting regional surveillance.

She notes that 70% of eligible New Yorkers have received at least one dose of vaccine — a milestone that triggered the lifting of most COVID-19 restrictions last week — but that figure is below 40% in some parts of the state. Communities with high proportions of African American and Hispanic individuals, where vaccination rates tend to be low, could be especially hard hit by Delta. “These are populations that are really at risk of a localized outbreak from Delta, so I think it’s really important to still keep tracking and watch this as much as possible,” Surtees says.

Data from Helix2 on nearly 20,000 samples sequenced since April suggest that the Delta variant is spreading faster in US counties where less than 30% of residents have been fully vaccinated, compared to the counties with vaccination rates above that threshold.

Africa at risk

Delta poses the biggest risk, scientists say, to countries that have limited access to vaccines, particularly those in Africa, where most nations have vaccinated less than 5% of their populations. “The vaccines will never come in time,” says Wenseleers. “If these kinds of new variant arrive, it can be very devastating.”

Surveillance in African countries is extremely limited, but there are hints that the variant is already causing cases there to surge. Several sequences of the variant have been reported in the Democratic Republic of the Congo, where an outbreak in the capital city of Kinshasa has filled hospitals. The variant has also been detected in Malawi, Uganda and South Africa.

Countries that have close economic links to India, such as those in East Africa, are probably at the greatest risk of seeing a surge in cases caused by Delta, says Tulio de Oliveira, a bioinformatician and director of the KwaZulu-Natal Research and Innovation Sequencing Platform in Durban, South Africa. In his country, all of the Delta cases have been detected in shipping crews at commercial ports, with no signs yet of spread in the general community.

De Oliveira expects it to stay this way. South Africa is in the middle of a third wave of infections caused by the Beta variant (also known as B.1.351) identified there last year. This, combined with a lack travel from countries affected by Delta, should make it harder for a new variant to take hold.

Similar factors could be keeping Delta at bay in Brazil, which is battling another immune-evading variant called P.1, or Gamma, says Gonzalo Bello, a virologist at the Oswaldo Cruz Institute in Rio de Janeiro, who is part of a team conducting national surveillance. So far, Brazil has sequenced just four cases of the Delta variant in the country.

While countries gird themselves against the Delta variant — or hope that it passes them by — researchers say we need to watch for even greater threats. “What most people are concerned about are the next variants — if we start to see variants that can really challenge the vaccines,” says Albertsen.

By: Ewen Callaway

Source: Delta coronavirus variant: scientists brace for impact

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Critics:

Delta variant, also known as lineage B.1.617.2, is a variant of lineage B.1.617 of SARS-CoV-2, the virus that causes COVID-19. It was first detected in India in late 2020. The World Health Organization (WHO) named it the Delta variant on 31 May 2021.

It has mutations in the gene encoding the SARS-CoV-2 spike protein causing the substitutions T478K, P681R and L452R, which are known to affect transmissibility of the virus as well as whether it can be neutralised by antibodies for previously circulating variants of the COVID-19 virus. Public Health England (PHE) in May 2021 observed secondary attack rates to be 51–67% higher than the alpha variant.

On 7 May 2021, PHE changed their classification of lineage B.1.617.2 from a variant under investigation (VUI) to a variant of concern (VOC) based on an assessment of transmissibility being at least equivalent to B.1.1.7 (Alpha variant), first identified in the UK (as the Kent variant). Subsequently on 11 May 2021, the WHO also classified this lineage VOC, and said that it showed evidence of higher transmissibility and reduced neutralisation. The variant is thought to be partly responsible for India’s second wave of the pandemic beginning in February 2021.

See also

Sage Modelling Warns of Risk of ‘Substantial’ Covid Third Wave

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New modelling for the government’s Sage committee of experts has highlighted the risk of a “substantial third wave” of infections and hospitalizations, casting doubt on whether the next stage of Boris Johnson’s Covid roadmap can go ahead as planned on 21 June.

Government sources suggested the outlook was now more pessimistic but stressed that a decision would be taken after assessing a few more days’ worth of data on the effect that rising infections are having on hospitalizations.

The prime minister is due to announce on Monday whether the lifting of the remaining restrictions – nicknamed “freedom day” by anti-lockdown Tory MPs – will have to be delayed.

Johnson is understood to be personally frustrated at the prospect of delaying the reopening, but a No 10 source said there were now clearly signs for concern in the data.

Key ministers and officials are expected to discuss a range of options on Sunday, when Johnson will still be hosting the G7, including a two- to four-week delay, as well as the possibility of a watered-down reopening that keeps some rules in place.

A Whitehall source said it was “broadly correct” that the outlook was now more pessimistic. “Cases are obviously higher and they are growing quickly,” the source said.

Prof Neil Ferguson, of Imperial College London, said modelling updated this week suggested there was a risk of a surge in infections and hospitalizations that could rival the second wave in January.

Johnson sounded markedly less confident than in recent days when he was asked about the case for a delay as he visited a wind farm in Cornwall on Wednesday as part of the buildup to the G7 summit.

“What everyone can see very clearly is that cases are going up and in some cases hospitalizations are going up,” he said. “I think what we need to assess is the extent to which the vaccine rollout, which has been phenomenal, has built up enough protection in the population in order for us to go ahead to the next stage.

“And so that’s what we’ll be looking at. And there are arguments being made one way or the other, but that will be driven by the data. We’ll be looking at that and we’ll be setting it out on Monday.”

The prime minister had previously repeatedly said he had seen nothing in the data to justify a delay.

Ferguson said the cases of the Delta variant were now doubling in less than a week, close to what was seen before Christmas when the Alpha variant took hold and sent infections soaring in January to a daily peak of 68,000. What is unclear is how long the doubling will continue with so many adults vaccinated, and what proportion of new cases will turn into hospitalizations and deaths.

“There is a risk of a substantial third wave,” Ferguson said. “It could be substantially lower than the second wave or it could be of the same order of magnitude, and that critically depends on how effective the vaccines are at protecting people against hospitalization and death.”

He suggested there may be a case for postponing the reopening to get more shots into arms and reduce the size of any summer surge. “Clearly you have to be more cautious if you want measures to be irreversibly changed and relaxed,” he said. “Having a delay does make a difference. It allows more people to get second doses.”

Ministers have been encouraged by the enthusiasm with which younger people are taking up the opportunity to get their jab. The NHS announced that 1 million people had booked appointments through its website on Tuesday as eligibility was extended to 25- to 29-year-olds.

The next two to three weeks will be crucial for scientists on Sage to work out what the rise in hospitalizations – and potentially deaths – might look like in the months ahead.

Ferguson said: “One of the key things we want to resolve in the next few weeks is do we see an uptick in hospitalizations – we are seeing it in some areas – matching the cases, and what is the ratio between the two, because vaccination has substantially changed that.”

Evidence is firming up around the Delta variant being 60% more transmissible than the Alpha variant, with estimates ranging from 40% and 80%. The variant is somewhat resistant to vaccines, particularly after one dose.

While Ferguson believes we may see fewer deaths in the third wave compared with in January, the latest modelling does not rule out what he called a “disastrous” third wave if transmission and vaccine resistance are at the higher end of the best estimates.

The latest official data showed 7,540 new confirmed cases of the virus in England. Hospitalizations are not yet rising sharply nationwide, though they are surging in hotspot areas including Greater Manchester.

Chris Hopson, the chief executive of NHS Providers, said trusts in hard-hit areas were confirming that the vaccines provide good protection against the virus.

“There is a growing sense that thanks to the vaccine, the chain seen in previous waves between rising infections and high rates of hospital admissions and deaths has been broken. That feels very significant,” he wrote in a blogpost for the British Medical Journal.

But Hopson warned that the NHS was already “running hot” in many areas, and an increase in Covid admissions would set back efforts to tackle the long backlog of treatment for other health problems that has been caused by the crisis.

By:, and

Source: Sage modelling warns of risk of ‘substantial’ Covid third wave | Health policy | The Guardian

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Critics:

Recommended preventive measures include social distancing, wearing face masks in public, ventilation and air-filtering, hand washing, covering one’s mouth when sneezing or coughing, disinfecting surfaces, and monitoring and self-isolation for people exposed or symptomatic. Several vaccines have been developed and widely distributed since December 2020.

Current treatments focus on addressing symptoms, but work is underway to develop medications that inhibit the virus. Authorities worldwide have responded by implementing travel restrictions, lockdowns and quarantines, workplace hazard controls, and business closures. Numerous jurisdictions have also worked to increase testing capacity and trace contacts of the infected.

The pandemic has resulted in significant global social and economic disruption, including the largest global recession since the Great Depression of the 1930s. It has led to widespread supply shortages exacerbated by panic buying, agricultural disruption, and food shortages. However, there have also been decreased emissions of pollutants and greenhouse gases.

Numerous educational institutions and public areas have been partially or fully closed, and many events have been cancelled or postponed. Misinformation has circulated through social media and mass media, and political tensions have been exacerbated. The pandemic has raised issues of racial and geographic discrimination, health equity, and the balance between public health imperatives and individual rights.

The COVID-19 pandemic has resulted in misinformation and conspiracy theories about the scale of the pandemic and the origin, prevention, diagnosis, and treatment of the disease. False information, including intentional disinformation, has been spread through social media, text messaging, and mass media. Journalists have been arrested for allegedly spreading fake news about the pandemic. False information has also been propagated by celebrities, politicians, and other prominent public figures. The spread of COVID-19 misinformation by governments has also been significant.

Commercial scams have claimed to offer at-home tests, supposed preventives, and “miracle” cures. Several religious groups have claimed their faith will protect them from the virus. Without evidence, some people have claimed the virus is a bioweapon accidentally or deliberately leaked from a laboratory, a population control scheme, the result of a spy operation, or the side effect of 5G upgrades to cellular networks.

The World Health Organization (WHO) declared an “infodemic” of incorrect information about the virus that poses risks to global health. While belief in conspiracy theories is not a new phenomenon, in the context of the COVID-19 pandemic, this can lead to adverse health effects. Cognitive biases, such as jumping to conclusions and confirmation bias, may be linked to the occurrence of conspiracy beliefs.

See also

References

Hot Tub Health Kick: Why a Long Bath is Almost As Good For You As a Long Run

A soak in a hot tub could be just the thing to relax you after a long day. The warm, bubbly water also eases aches and pains from conditions like arthritis, low back pain, and fibromyalgia.

But hot tubs might not be safe for some people, including pregnant women and those with heart disease. And when they aren’t cleaned well, they pose risks to even healthy people.

Before you buy a hot tub for your backyard or step into those warm waters at the spa or gym, make sure you know a bit about their safety.

Health Benefits

Warm water soothes your body for a few reasons. The heat widens blood vessels, which sends nutrient-rich blood throughout your body. Warm water also brings down swelling and loosens tight muscles. And the water’s buoyancy takes weight off painful joints.

A dip in the hot tub might also help your mental state. Research shows they can promote relaxation and ease stress.

Hot Tub Risks

These warm water whirlpools can pose some risks if you’re not careful.

Infections

Between 2000 and 2014, outbreaks from treated pools and hot tubs were linked to more than 27,000 infections and eight deaths in the United States. When hot tubs aren’t cleaned well, their moist environment is the perfect breeding ground for bacteria.

Pseudomonas, one type of bacteria that thrives in hot tubs, causes infections of the hair follicles and skin. Symptoms include red, itchy bumps on the belly and areas covered by your bathing suit. These bumps can pop up anywhere from a few hours to a few days after you take a dip. The same bacteria cause an infection known as swimmer’s ear.

Other germs that live in hot tubs can also make you sick. Cryptosporidium causes GI infections with diarrhea. Legionella causes a severe type of pneumonia, or lung disease.

Hot Tub Use in Pregnancy

Hot tubs might not be safe for pregnant women because they increase body temperature. Research finds that pregnant women who use a hot tub more than once or for long periods of time are more likely to have babies with neural tube birth defects like spina bifida or anencephaly.

Avoid hot tubs if you can during those 9 months. If you do use a hot tub, turn down the temperature and limit your time in the water to less than 10 minutes.

Heart Risks

Be cautious when using a hot tub if you have heart disease. When you soak in hot water, your body can’t sweat. Your blood vessels instead need to widen to cool you off. This makes your blood pressure drop. In response to falling blood pressure, your heart rate speeds up.

This isn’t a problem for healthy people, but if you have heart disease, it can strain your heart.

Hot Tub Safety Tips

To stay safe, follow these tips:

Ask your doctor. If you’re pregnant or you have a health condition like heart disease, ask your doctor if it’s safe for you to get into a hot tub.

Check the cleanliness. Ask the hotel or gym how often they clean their hot tub, and whether they keep the pH and chlorine concentrations at levels the CDC recommends (a pH of 7.2-7.8, and a free chlorine concentration of at least 3 parts per million). If the water looks murky or slimy, don’t get in.

Avoid crowds. Stay away when a hot tub is full. More people equals more germs. About half of people say they don’t shower before they swim.

Turn down the heat. A temperature of 100 F should be safe for healthy adults. Anything over 104 could be dangerous. Turn it down another couple of degrees if you have a medical condition.

Limit your time. Don’t stay in the hot tub for longer than 10 minutes. If you feel dizzy, overheated, or unwell, get out right away.

Watch where you sit. Don’t sit too close to the heat source. Keep your head, arms, and upper chest out of the water to avoid overheating, especially if you’re pregnant.

Stay hydrated. Drink water while in the hot tub to cool off your body. Avoid alcohol, which can dehydrate you.

Don’t go from hot to cold. Don’t jump straight from the hot tub into the pool to cool off. The cold water could shock your system and spike your blood pressure.

Wash off afterward. Take off your bathing suit and shower with warm water and soap as soon as you finish.

By  Carol DerSarkissian, MD

Source:https://www.webmd.com

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Safety

Sitting in water above normal body temperatures can cause drowsiness which may lead to unconsciousness and subsequently result in drowning. The U.S. Consumer Product Safety Commission (CPSC) recommends that water temperatures never exceed 40 degrees Celsius. A temperature of 37 degrees is considered safe for a healthy adult. Soaking in water above 39 degrees Celsius can cause fetal damage during the first three months of pregnancy.

It is also recommended to install residual-current devices for protection against electrocution. The greater danger associated with electrical shock in the water is that the person may be rendered immobile and unable to rescue themselves or to call for help and then drown.

Hot tubs and spas are equipped with drains that can create powerful suction and between 1980 and 1996, the CPSC had reports of more than 700 deaths in spas and hot tubs, about one-third of which were drownings to children under age five. In the same period 18 incidents were reported to the CPSC involving body part entrapment.

To reduce the risk of entrapment, US safety standards require that each spa have two drains for each pump, reducing the amount of suction. From 1999 to 2007 there were 26 reports to the CPSC concerning circulation entrapments hot tubs and spas, including three deaths.

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References

 

Silicon Valley Tech Leaders Organize Relief For India’s Covid-19 Crisis

Virus Outbreak

As India faces a deadly second wave of Covid-19 that has killed more than 250,000 people and badly strained hospitals’ ability to house and care for the sick, a number of Silicon Valley venture capital and technology executives have rallied resources to help address the crisis.

“This is a huge crisis,” says Navin Chaddha, managing director at Mayfield venture capital, who says he has lost college friends to the virus. “As venture industry and entrepreneurs, we need to get more than money, we need to give our time.” Starting in May, Mayfield’s philanthropic offshoot raised around a million dollars and delivered 1000 oxygen concentrators to India, he says. The organization has partnered with local organizations such as Oxygen for India to ensure supplies reach places where the need is greatest.

To date, India’s health ministry has reported a total of 23 million cases with 262,317 deaths. About 4,000 deaths were reported in the past 24 hours. Hospitals are running short on basic life-saving medical devices such as oxygen cylinders and concentrators.

A new local strain, B 1.617, potentially more infectious than the original one and a lax public health response contributed to the surge, health experts say. “There were just so many political gatherings, religious gatherings, social gatherings,” Anant Bhan, a public health and bioethics researcher in Bhopal, told Forbes.

Social media is flooded with images of crematoriums overflowing with bodies of Covid-19 patients. “Many people didn’t even have money to go get the bodies, unfortunately, from the hospitals, or to get them to the cremation ground,” says Chaddha.Last month, billionaire and venture capitalist Vinod Khosla said on Twitter he would work to fund hospitals in India and solicit others in the tech industry to help.

“I will be coordinating grants and sourcing thru @GiveIndia @atulsatija. Please make your requests to them directly and please contribute to their efforts too. The needs are large,” Khosla said an April 24 tweet. In addition, the Khosla family made a combined donation of $10 million to the non-profit GiveIndia.

Salesforce, a cloud software company co-founded by Marc Benioff, sent a Boeing 787 to India earlier last month with over 2,000 oxygen concentrators and 10,000 pulse oximeters. The company plans to send another plane this month with more oxygen concentrators, says Ryan Aytay, its chief business officer. Meanwhile, Twitter and Square CEO Jack Dorsey announced a donation of $15 million to India-based non-governmental organizations.

Even with added supplies reaching India from these and other sources, there are concerns about whether they are reaching regions where the need is the highest and whether hospitals have adequate beds for patients in dire need of oxygen. At another venture capital firm, Foundation Capital, general partner Ashu Garg started an initiative called One More Breath to address what he calls a ‘the last mile’ problem. “Airports are overflowing with oxygen concentrators. Everyone is bringing stuff in, but there is still no clarity over which hospitals need the supply,” says Garg.

His team has partnered with local humanitarian groups that are examining how to make room for new beds in existing hospitals. Garg says they will have at least 500 new beds with oxygen supply ready by the end of May. One More Breath hopes to raise $2 million to set up 1,400 beds by mid-June. (Complicating matters, a recent law passed in India limits foreign donations.) 

Much more help will likely be needed, as several Indian states suspended vaccinations for people in the 18-44 age group due to shortages. So far, less than 2% of the country’s 1.3 billion population has been fully vaccinated. “It is just heartbreaking,” says Garg.

Follow me on Twitter or LinkedIn. Send me a secure tip.

I am a New York based health and science reporter and a graduate from Columbia’s School of Journalism with a master’s in science and health reporting. I write on infectious diseases, global health, gene editing tools, intersection of public health and global warming. Previously, I worked as a health reporter in Mumbai, India, with the Hindustan Times, a daily newspaper where I extensively reported on drug resistant infections such as tuberculosis, leprosy and HIV. I also reported stories on medical malpractice, latest medical innovations and public health policies.

I have a master’s in biochemistry and a bachelor’s  degree in zoology. My experience of working in a molecular and a cell biology laboratory helped me see science from researcher’s eye. In 2018 I won the EurekAlert! Fellowships for International Science Reporters. My Twitter account @aayushipratap

Source: Silicon Valley Tech Leaders Organize Relief For India’s Covid-19 Crisis

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More Critics:

India’s coronavirus crisis is the worst since the pandemic began, and it will probably worsen before it gets better.

Hospitals are full, oxygen supplies are dwindling, and sick people are dying as they wait to see doctors. As workers leave locked-down cities for their home villages, experts fear that the exodus could accelerate the spread of the virus in rural areas, as a similar one did last year.

Official estimates of the nationwide infection toll — well above 300,000 a day — are probably undercounted, epidemiologists say. The reported figure will mostly likely rise to 500,000 cases a day by August, they say, leaving as many as one million of India’s 1.4 billion people dead from Covid-19.

Charities, volunteers and businesses in India and beyond are trying to help the country’s Covid victims and frontline workers.

(Before giving money to an organization, make sure you feel comfortable with it. In the United States, sites like Guidestar and Charity Navigator grade nonprofits on their effectiveness and financial health.)

Here are a few ways to help.

  • United Nations agencies, including UNICEF and the World Health Organization, are delivering personal protective equipment kits, oxygen concentrators, diagnostic testing systems and other supplies to India’s frontline health care workers.

  • PATH, a global health nonprofit based in Seattle, says it has a team of more than 200 people working in India to procure oxygen supplies and accelerate Covid-19 testing and surveillance.

  • The International Medical Corps, which works in conflict areas around the world, is raising money for a campaign to help provide medical equipment, P.P.E., isolation facilities and other essential supplies in India.

  • Care India says it has supplied hospitals and frontline workers in India with more than 39,000 P.P.E. kits, along with masks and other supplies.

  • The Association for India’s Development, a Maryland-based charity that partners with nonprofits in India, says it has volunteers distributing food and protective equipment in most of India’s 29 states.

  • Project HOPE, also in Maryland, is a nonprofit providing medical training, health education and humanitarian assistance around the world. The group says it has given Covid-related assistance in 150 countries during the pandemic, including India.

  • GIVE.asia, a fund-raising platform in Singapore for causes across the Asia-Pacific region, says it is working with the Singapore Red Cross to send ventilators, oxygen concentrators and oxygen generators to India. The platform also hosts fund-raising campaigns by individuals.

  • Americares, a nongovernmental organization based in Connecticut that specializes in emergency medical response work, says it is working in several Indian states to deliver P.P.E., ventilators and other medical equipment, as well as to educate people on how to prevent the spread of the virus.

  • Vibha, an aid group in California, has partnered with the New York-based celebrity chef Vikas Khanna to raise money to buy oxygen concentrators, P.P.E. kits and other supplies. Last year, Mr. Khanna ran a relief effort for poor Indians who were suffering under coronavirus lockdowns.

  • The Indian Red Cross Society has staff and volunteers running blood drives, delivering aid and medical supplies, along with providing other essential services across the country.

  • Youth Feed India and Helping Hands Charitable Trust are delivering ration kits to vulnerable residents of Mumbai. Each kit includes staples like rice and dal, and feeds a family of four for 15 days. Donate here in a variety of ways, including through Google Pay.

  • Ketto, a fund-raising platform in Mumbai, a hot spot of the country’s latest Covid outbreak, is shepherding a campaign by hundreds of entrepreneurs to purchase 3,000 oxygen concentrators. (The organizers are tweeting live updates.)

  • OxygenForIndia delivers medical oxygen for free to patients in seven Indian cities. The group was founded by Ramanan Laxminarayan, an economist and epidemiologist who directs the Center for Disease Dynamics, Economics & Policy, a research outfit based in Washington and New Delhi.

In Washington, hundreds take part in pro-Palestinian protests

WHO Finally Admits Coronavirus Is Airborne. It’s Too Late

Medical mask with world map.

 

Over a year since declaring Covid-19 a pandemic, the World Health Organization has finally admitted that Coronavirus is airborne. Aerosol researchers started warning that “the world should face the reality” of airborne transmission in April 2020. Then in June, some claimed that it was “the dominant route for the spread of COVID-19”.

In July, 239 scientists signed an open letter appealing to the medical community and governing bodies to recognize the potential risk of airborne transmission. That same month (by coincidence, not as a result of the letter), WHO released a new scientific brief on transmission of SARS-CoV-2 that stated:

“Short-range aerosol transmission, particularly in specific indoor locations, such as crowded and inadequately ventilated spaces over a prolonged period of time with infected persons cannot be ruled out.”

Epidemiologist Bill Hanage interpreted WHO’s statement to mean: “While it is reasonable to think it can happen, there’s not consistent evidence that it is happening often.” In other words, WHO believed that spread via aerosols was rare.

Research

As Hanage told The New York Times, WHO staff were looking for proof that would falsify their existing beliefs: “They are still challenged by the absence of evidence, and the difficulty of proving a negative.”

Virologist Julian Tang added that “WHO is being overly cautious and shortsighted unnecessarily” and criticized its approach to avoiding hazards: “By recognizing aerosol transmission of SARS-CoV-2 and recommending improved ventilation facilities to be upgraded or installed, you can improve the health of people.”

According to primary healthcare expert Trish Greenhalgh, there was another problem — members of WHO’s scientific committee didn’t agree on how to interpret the data: “The push-pull of that committee is palpable. As everyone knows, if you ask a committee to design a horse, you get a camel.”

WHO’s scientific briefs aren’t official guidance, and so its reluctance to recognize that Coronavirus is airborne created a bigger issue: a lack of health advice.

The importance of providing information for the public is highlighted by a search for ‘Coronavirus transmission’ because the top result is a Q&A section on WHO’s website — which until recently didn’t acknowledge the contribution of aerosols.

On 30 April 2021, almost 10 months after WHO said it would review the research on airborne transmission, it updated its Q&A page with the following statement:

“Current evidence suggests that the virus spreads mainly between people who are in close contact with each other, typically within 1 metre (short-range). A person can be infected when aerosols or droplets containing the virus are inhaled or come directly into contact with the eyes, nose, or mouth. The virus can also spread in poorly ventilated and/or crowded indoor settings, where people tend to spend longer periods of time. This is because aerosols remain suspended in the air or travel farther than 1 metre (long-range).” WHO’s statement is too little, too late.

Reasons

Why has the World Health Organization been so slow to publish public health guidance?

As I explained in my article ‘4 Reasons Why WHO Won’t Admit Coronavirus Is Airborne’, there are four (not mutually exclusive) explanations for its reluctant response.

For historical reasons, WHO’s staff assume that virus-laden droplets must spread over short distances, for instance, which (as Hanage pointed out) then leads to a need for scientific evidence to disprove that assumption.

WHO is also hampered by sociopolitical factors and how its decisions might be perceived by the public or its various stakeholders — including the countries that fund its activities.

But the most likely explanation for WHO’s slow progress is simply bureaucracy. The organization decided that its own staff should review all the evidence for airborne transmission. According to Soumya Swaminathan, WHO’s chief scientist, they were carefully reviewing 500 studies every day.

WHO made a rod for its own back. A cynic would say that its scientists created busy-work to justify their jobs, as they could have instead consulted some of the 239 researchers who had signed the letter on airborne transmission. Why did WHO’s scientists believe they understood more about aerosols than aerosol experts?

Regardless of the reason, WHO positioned itself as the sole authority that could judge the research. In doing so, it put its personal beliefs on what constitutes scientific rigor over the need for health guidance when speed was of the essence.

Since mid-2020, about 2.7 million people have died of Covid. While it’s unfair to pin that figure on WHO, we should consider how many deaths could have been prevented if it had listened to researchers who are specialists in their field.

WHO failed to consider that practical advice — to recommend the public use caution and wear face masks to block airborne droplets — has no major downsides compared to the alternative, which is to potentially allow people to spread Covid. To quote an English idiom: It’s better to be safe than sorry.

Reform

On 14 April 2020,  Donald Trump announced his intent to withdraw US membership — and funding — from the World Health Organization. Many people think Trump was trying to shift blame for his poor handling of the pandemic to a scapegoat, criticizing WHO for “severely mismanaging and covering up” the spread of Covid-19 and mistakes that “pushed China’s misinformation.”

Others believe that blaming WHO is not scapegoating because there’s some merit to Trump’s criticism. I hold that opinion. No organization is perfect, and large ones especially have room for improvement — I’m not suggesting that we should defund WHO, but the organization could do with a little restructuring.

WHO has a relatively small annual budget of $2.5 billion. It needs to shift its financial resources toward areas that need money the most, such as protecting people from global health emergencies, and away from communicating for health — an area where a bureaucratic body will be slow to react to rapidly-changing scientific evidence.

The world needs somebody (like Trump, but not Trump) who has the power to put pressure on WHO to reform its approach to communication.

WHO’s scientists should also stop giving press conferences that prioritize technically-correct but confusing jargon (like ‘presymptomatic’) over media-friendly language that the public can understand. That might, for instance, involve using professional science communicators to provide clear messages.

While indispensable in its role supervising the international fight against disease, WHO is ineffectual at giving guidance.

I’m a science communicator specialising in public engagement and outreach through entertainment, focusing on popular culture. I have a PhD in evolutionary biology and spent several years at BBC Science Focus magazine, running the features section and writing about everything from gay genes and internet memes to the science of death and origin of life. I’ve also contributed to Scientific American and Men’s Health. My latest book is ’50 Biology Ideas You Really Need to Know’.

Source: WHO Finally Admits Coronavirus Is Airborne. It’s Too Late

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Related Contents:

World Health Organization. Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19) 16-24 February 2020 [Internet]. Geneva: World Health Organization; 2020 Available from: https://www.who.int/docs/default- source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf

Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19). Intensive Care Medicine DOI: 10.1007/s00134-020-06022-5 https://www.sccm.org/SurvivingSepsisCampaign/Guidelines/COVID-19 

Interim guidelines for the clinical management of COVID-19 in adults Australasian Society for Infectious Diseases Limited (ASID)  https://www.asid.net.au/documents/item/1873

Coronavirus disease (COVID-19): For health professionals. https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/health-professionals.html

Guidance on infection prevention and control for COVID-19 https://www.gov.uk/government/publications/wuhan-novel-coronavirus-infection-prevention-and-control

Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings. https://www.cdc.gov/coronavirus/2019-ncov/infection-control/control-recommendations.html 

Infection prevention and control for COVID-19 in healthcare settings https://www.ecdc.europa.eu/en/publications-data/infection-prevention-and-control-covid-19-healthcare-settings 

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Can the Covid Vaccine Protect Me Against Virus Variants?

Vaccines do a good job of protecting us from coronavirus, but fear and confusion about the rise of variants have muddled the message. Here are answers to common questions.

The news about coronavirus variants can sound like a horror movie, with references to a “double-mutant” virus, “vaccine-evading” variants and even an “Eek” mutation. One headline warned ominously: “The devil is already here.”

While it’s true that the virus variants are a significant public health concern, the unrelenting focus on each new variant has created undue alarm and a false impression that vaccines don’t protect us against the various variants that continue to emerge.

“I use the term ‘scariants,’” said Dr. Eric Topol, professor of molecular medicine at Scripps Research in La Jolla, Calif., referring to much of the media coverage of the variants. “Even my wife was saying, ‘What about this double mutant?’ It drives me nuts. People are scared unnecessarily. If you’re fully vaccinated, two weeks post dose, you shouldn’t have to worry about variants at all.”

Viruses are constantly changing, and new variants have been emerging and circulating around the world throughout the pandemic. Some mutations don’t matter, but others can make things much worse by creating a variant that spreads faster or makes people sicker. While the rise of more infectious variants has caused cases of Covid-19 to surge around the world, the risk is primarily to the unvaccinated, for whom there is great concern. While vaccination efforts are well underway in the United States and many other developed countries, huge swaths of the world’s population remain vulnerable, with some countries yet to report having administered a single dose.

But for the vaccinated, the outlook is much more hopeful. While it’s true that the vaccines have different success rates against different variants, the perception that they don’t work against variants at all is incorrect. In fact, the available vaccines have worked remarkably well so far, not just at preventing infection but, most important, at preventing serious illness and hospitalization, even as new variants circulate around the globe.

The variants are “all the more reason to get vaccinated,” said Dr. Anthony S. Fauci, the nation’s top infectious disease specialist. “The bottom line is the vaccines we are using very well protect against the most dominant variant we have right now, and to varying degrees protect against serious disease among several of the other variants.”

Part of the confusion stems from what vaccine efficacy really means and the use of terms like “vaccine evasion,” which sounds a lot scarier than it is. In addition, the fact that two vaccines have achieved about 95 percent efficacy has created unrealistic expectations about what it takes for a vaccine to perform well.

Here are answers to common questions about the variants and the vaccines being used to stop Covid-19.

The variant called B.1.1.7, which was first identified in Britain, is now the most common source of new infections in the United States. This highly contagious variant is also fueling the spread of the virus in Europe and has been found in 114 countries. A mutation allows this version of the virus to more effectively attach to cells. Carriers may also shed much higher levels of virus and stay infectious longer.

The main concern about B.1.1.7 is that it is highly infectious and spreads quickly among the unvaccinated, potentially overwhelming hospitals in areas where cases are surging.

All of the major vaccines in use — Pfizer-BioNTech, Moderna, Johnson & Johnson, AstraZeneca, Sputnik and Novavax — have been shown to be effective against B.1.1.7. We know this from a variety of studies and indicators. First, scientists have used the blood of vaccinated patients to study how well vaccine antibodies bind to a variant in a test tube. The vaccines have all performed relatively well against B.1.1.7.

There’s also clinical trial data, particularly from Johnson & Johnson and AstraZeneca (which is the most widely used vaccine around the world), that shows they are highly effective against both preventing infection and serious illness in areas where B.1.1.7 is circulating. And in Israel, for instance, where 80 percent of the eligible population is vaccinated (all with the Pfizer shot), case counts are plummeting, even as schools, restaurants and workplaces open up, suggesting that vaccines are tamping down new infections, including those caused by variants.

No vaccine is foolproof, and even though the Covid vaccines are highly protective, sometimes vaccinated people still get infected. But breakthrough cases of vaccinated people are very rare, even as variants are fueling a surge in case counts. And the vaccines prevent severe illness and hospitalization in the vast majority of the vaccinated patients who do get infected.

So what’s the risk of getting infected after vaccination? Nobody knows for sure, but we have some clues. During the Moderna trial, for instance, only 11 patients out of 15,210 who were vaccinated got infected. Both Pfizer and Moderna now are doing more detailed studies of breakthrough cases among vaccinated trial participants, and should be releasing that data soon.

Two real-world studies of vaccinated health care workers, who have a much higher risk of virus exposure than the rest of us, offer hopeful signs. One study found that just four out of 8,121 fully vaccinated employees at the University of Texas Southwestern Medical Center in Dallas became infected. The other found that only seven out of 14,990 workers at UC San Diego Health and the David Geffen School of Medicine at the University of California, Los Angeles, tested positive two or more weeks after receiving a second dose of either the Pfizer-BioNTech or Moderna vaccines.

Both reports were published in the New England Journal of Medicine, and are a sign that even as cases were surging in the United States, breakthrough cases were uncommon, even among individuals who were often exposed to sick patients. Most important, patients who were infected after vaccination had mild symptoms. Some people had no symptoms at all, and were discovered only through testing in studies or as part of their unrelated medical care.

A recent C.D.C. report found that after 75 million people had been fully vaccinated, there were 5,814 documented cases of breakthrough infections, including 74 deaths. More details about those patients weren’t available, although at least nine of them died of causes other than Covid-19.

Researchers are still studying whether the variants eventually might increase the number of breakthrough cases or if vaccine antibodies begin to wane over time. So far, data from Moderna show the vaccine still remains 90 percent effective after at least six months. Pfizer has reported similar results.

For now, the variants don’t appear to be increasing the rate of infection in vaccinated people, but that could change as more data are collected. Read more about breakthrough cases here.

The C.D.C. is tracking more than a dozen variants, but only a few qualify as “variants of concern,” which is a public health designation to identify variants that could be more transmissible or have other qualities that make them more of a risk. The main additional variants everyone is talking about right now are the B.1.351, which was first detected in South Africa, and the P.1, which was first identified in Brazil.

While there are other variants (including two “California” variants, B.1.427 and B.1.429, and a New York variant, B.1.526), for now, it seems that the South Africa and Brazil variants (which as of late March together accounted for about 2 percent of cases in the United States) are causing the most concern. While a new variant can emerge at any time, existing variants also compete with each other for dominance. One interesting new development: In countries like the United States where B.1.1.7 is dominant, some of the other variants seem to be getting crowded out, making them less of a worry.

There is a concern that the B.1.351 and the P.1 are better at dodging vaccine antibodies than other variants. But that doesn’t mean the vaccines don’t work at all. It just means the level of protection you get from the vaccines against these variants could be lower than when the shots were studied against early forms of the virus. Among the variants, the B.1.351 may pose the biggest challenge so far. It has a key mutation — called E484K, and often shortened to “Eek” — that can help the virus evade some, but probably not all, antibodies.

A recent study of 149 people in Israel who became infected after vaccination with the Pfizer vaccine suggested that B.1.351 (the variant first identified in South Africa) was more likely to cause breakthrough infections. However, those eight infections occurred between days seven and 13 following the second dose.

“We didn’t see any South Africa variant 14 days after the second dose,” said Adi Stern, the study’s senior author, a professor at the Shmunis School of Biomedicine and Cancer Research, Tel Aviv University. “It was a small sample size, but it’s very possible that two weeks after the second dose, maybe the protection level goes up and that blocks the South Africa variant completely. It gives us more room for optimism.”

Remember that there’s a lot of “cushion” provided by this current crop of vaccines, so even if a vaccine is less effective against a variant, it appears that it’s still going to do a good job of protecting you from serious illness.

We don’t yet have precise estimates of vaccine effectiveness against B.1.351, which may be the most challenging variant so far. But studies show that the various vaccines still lower overall risk for infection and help prevent severe disease. A large study of Johnson & Johnson’s one-dose vaccine in South Africa found it was about 85 percent effective at preventing severe disease, and lowered risk for mild to moderate disease by 64 percent.

(Distribution of the Johnson & Johnson vaccine has been paused as health officials investigate safety concerns.) The AstraZeneca vaccine did not do much to protect against mild illness caused by B.1.351, but scientists said they believed the vaccine might protect against more severe cases, based on the immune responses detected in blood samples from people who were given it.

There’s less definitive research for the Pfizer and Moderna vaccines against the variant, but it’s believed that these two-dose vaccines could reduce risk of infection against the variant by about 60 percent to 70 percent and still are highly effective at preventing severe disease and hospitalization.“From everything we know today, there is still protection from the vaccines against the South Africa variant,” said Dr. Stern.

Part of the problem is that we misinterpret what efficacy really means. When someone hears the term “70 percent efficacy,” for instance, they might wrongly conclude that it means 30 percent of vaccinated people would get sick. That’s not the case. Even if a vaccine loses some ground to a variant, a large portion of people are still protected, and only a fraction of vaccinated people will get infected. Here’s why.

To understand efficacy, consider the data from the Pfizer clinical trials. In the unvaccinated group of 21,728, a total of 162 people got infected. But in the vaccinated group of 21,720, only eight people became infected. That’s what is referred to as 95 percent efficacy. It doesn’t mean that 5 percent of the participants (or 1,086 of them) got sick. It means 95 percent fewer vaccinated people had confirmed infections compared to the unvaccinated group.

Now imagine a hypothetical scenario with a vaccine that is 70 percent effective against a more challenging variant. Under the same conditions of the clinical trial, vaccination would still protect 21,672 people in the group, and just 48 vaccinated people — less than one percent — would become infected, compared to 162 in the unvaccinated group. Even though overall efficacy was lower, only a fraction of vaccinated people in this scenario would get sick, most likely with only mild illness.

While far more research is needed to fully understand how variants might dodge some (but not all) vaccine antibodies, public health experts note that an estimate of 50 percent to 70 percent efficacy against a challenging variant would still be considered an adequate level of protection.

“Seventy percent is extremely high,” said Dr. Stern. “Basically what this means is that it’s even more important to get vaccinated. If you have 95 percent efficacy, you can create some form of herd immunity with less people. With 70 percent efficacy, it’s even more important to get vaccinated to protect others.”

Vaccine makers already are working on developing booster shots that will target the variants, but it’s not clear how soon they might be needed. “In time, you’re going to see a recommendation for a booster,” said Dr. Peter J. Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston. “That booster will elevate everybody’s antibodies and increase durability. The booster will probably be configured to target the South African and Brazil variants.”

Even amid the rise of variants, vaccines will significantly lower your risk for infection and will protect you from serious illness and hospitalization. People who are vaccinated can socialize, unmasked, with other vaccinated people. While vaccinated people still need to follow local health guidelines about wearing a mask and gathering in groups to protect the unvaccinated, vaccinated people can travel, get their hair and nails done, or go to work without worrying. And vaccinated grandparents can hug their unvaccinated grandchildren. Because there are still some outstanding questions about the risk of vaccinated people carrying the virus, a vaccinated person is still advised to wear a mask in public to protect the unvaccinated — although those guidelines may be updated soon.

“The vaccines protect you, so go get vaccinated — that’s the message,” said Dr. Fauci. “If you’re around other vaccinated people, you shouldn’t worry about it at all. Zero.”

Tara Parker-Pope

 

By: Tara Parker-Pope

 

Source: Can the Covid Vaccine Protect Me Against Virus Variants?

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Regeneron Says Antibody Therapy Prevents COVID-19 Infections

Regeneron Pharmaceuticals is planning to ask the Food and Drug Administration (FDA) to allow its antibody cocktail to be used as a preventive treatment for COVID-19, the company said Monday.

New results from a clinical trial conducted with the National Institute of Allergy and Infectious Diseases found the drug reduced the risk of symptomatic infection by 81 percent in people who were not infected at the start of the trial, Regeneron said.

The company has already received emergency use authorization from the FDA to use its antibody drugs to treat adults with mild to moderate COVID-19 and pediatric patients at least 12 years old who have tested positive for the virus and are at high risk of severe disease but are not yet hospitalized.

The trial enrolled 1,505 people who were not infected with the virus but lived in the same household as someone who recently tested positive. The patients were randomized to receive either one dose of the antibody therapy or a placebo administered as injections.

After 29 days, 11 people out of the 753 who received a single 1,200 mg dose of the treatment developed symptomatic COVID-19; 59 people who received a placebo out of 752 participants developed symptomatic COVID-19.

The drug provided 72 percent protection against symptomatic infections in the first week and 93 percent protection in subsequent weeks, Regeneron said. The data has not yet been peer reviewed or published.

Regeneron also said the trial found individuals treated with the therapy who experienced a symptomatic infection resolved their symptoms in one week, compared to three weeks with placebo. Infected individuals also cleared the virus faster with the therapy, the company said.

Adverse events occurred in 20 percent of patients who received the antibody drug and 29 percent of those who received a placebo, Regeneron said, but nobody withdrew from the trial because of them.

None of the participants who received the therapy were hospitalized or went to the ER because of COVID-19 over the course of 29 days; four in the placebo group did so. There were four deaths in the trial — two in the therapy group and two in the placebo group — but none were reported due to COVID-19 or the drug.

“With more than 60,000 Americans continuing to be diagnosed with COVID-19 every day, the REGEN-COV antibody cocktail may help provide immediate protection to unvaccinated people who are exposed to the virus, and we are also working to understand its potential to provide ongoing protection for immunocompromised patients who may not respond well to vaccines,” George Yancopoulos, president and chief scientific officer at Regeneron, said in a statement.

The trial tested the antibody treatment for use as a “passive vaccine,” which involves directly injecting antibodies into the body. Traditional vaccines rely on a person’s immune system to activate and develop its own antibodies.

That means the treatment may provide immediate benefits, in contrast to active vaccines, which take weeks to provide protection. In addition, using injections rather than an infusion could make administering it more convenient than the currently authorized use for antibody drugs.

While much of the attention has been focused on vaccines, experts say therapeutic treatments are just as important to ending the pandemic, which has killed more than 562,000 Americans.

Source: Regeneron says antibody therapy prevents COVID-19 infections | TheHill

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