Vaccination reduces risk of long Covid, even when people are infected, UK study indicates

‘People who are fully vaccinated against Covid-19 appear to have a much lower likelihood of developing long Covid than unvaccinated people even when they contract the coronavirus, a study published Wednesday indicated. The research is among the earliest evidence that immunization substantially decreases the risk of long Covid even when a breakthrough infection occurs. Already, researchers had said that by preventing many infections entirely, vaccines would reduce the number of cases of long Covid, but it wasn’t clear what the risk would be for people who still got infected after vaccination.’

Read here (STAT, Sept 1, 2021)

These charts show that Covid-19 vaccines are doing their job

‘While the vaccines don’t protect against infection as well as they do against severe disease, the shots are keeping people off ventilators and from dying, Kathryn Edwards, an infectious disease pediatrician at Vanderbilt University School of Medicine in Nashville, said August 26 in a news briefing sponsored by the Infectious Diseases Society of America. “We cannot lose the forest for the trees.”

Read here (ScienceNews, Aug 31, 2021)

How long does immunity last after Covid vaccination? Do we need booster shots? 2 immunology experts explain

‘As the rollout of COVID-19 vaccines continues, public attention is increasingly turning to booster shots, which aim to top up immunity if it wanes. But is a third dose needed? And if so, when? Let’s take a look at what the data tell us so far about how long immunity from COVID-19 vaccines might last.

• First, what about immunity following COVID-19 infection?
• How long does immunity from vaccines last?
• What about Delta?
• OK, so what now?

Read here (The Conversation, Aug 30, 2021)

Covid-19, post-Muhyiddin – P Gunasegaram

‘A curious thing happened after Tan Sri Muhyiddin Yassin resigned on August 16 and became the caretaker prime minister, during which period, he should not make any major decisions, but wait for the next prime minister to do so.

‘But that was not to be. He made a major decision to roll back movement controls, relaxing the standard operating procedures for those who have been fully vaccinated allowing them to dine in, and other associated measures. These were announced on August 19, to take effect the following day, when the palace announced that it had picked Datuk Seri Ismail Sabri Yaakob as the new prime minister.

‘What was the great hurry for Muhyiddin? Did he want to steal a little bit of thunder in his last days as prime minister? He should have let his successor make the decision, considering that his handling of Covid-19 was one of the reasons MPs lost confidence in his leadership.’

Read here (The Vibes, August 26, 2021)

The coronavirus could get worse

‘In the worst-case scenario, a variant could arise that would “make it like the vaccines did not exist,” Hanage [Bill Hanage, an epidemiologist at the Harvard School of Public Health] said. But at the moment, “there is no such variant like that.” And it would probably be extraordinarily difficult for one to manifest. Even the most evasive variants we know of—the ones that have stumped certain antibodies—aren’t fully duping vaccinated bodies, which harbor a slew of other immunological guards. Hanage also pointed out that many people’s immune systems have been trained on different triggers—distinct brands of vaccines, unique variants, or some combination thereof. A new version of SARS-CoV-2 would find skirting all of those blockades at once to be nearly impossible.

‘Viruses aren’t infinitely mutable; sometimes, to keep themselves in contention, they must make sacrifices. Several experts told me they’re hopeful that the coronavirus might struggle to max out both transmission and immune evasion at once, requiring some sort of trade-off between the two. Some of the most powerful anti-coronavirus antibodies target SARS-CoV-2’s spike protein, which the virus uses to unlock and enter our cells. If the virus altered the protein to sidestep those antibodies, it might make itself less recognizable to the immune system. But it could also hurt its ability to infect us at all.’

Read here (The Atlantic, Aug 25, 2021)

Ventilation for residential buildings: Critical assessment of standard requirements in the Covid-19 pandemic context

‘After the arrival of a new airborne virus to the world, science is aiming to develop solutions to withstand the spread and contagion of SARS-CoV-2. The most severe among the adopted measures is to remain in home isolation for a significant number of hours per day, to avoid the spreading of the infection in an uncontrolled way through public spaces. Recent literature showed that the primary route of transmission is via aerosols, especially produced in poorly ventilated inner spaces. Spain has reached very high levels concerning contagion rates, accumulated incidence, or number of hospitalizations due to COVID-19. Therefore, this article aims to develop a quantitative and qualitative analysis of the requirements established in Spain, with respect to the European framework in reference to ventilation parameters indoors. The different parameters that serve as calculation for the ventilation flow in homes are analyzed to this aim. Results show that the criteria established in the applicable regulations are insufficient to ensure health and avoid contagion by aerosols indoors.’

Read here (Frontiers in Built Environment, August 24, 2021)

Privatised health services worsen pandemic

‘Decades of public health cuts have quietly taken a huge human toll, now even more pronounced with the pandemic. Austerity programmes, by the International Monetary Fund (IMF) and World Bank, have forced countries to cut public spending, including health provisioning.’

This story is well argued and contains several relevant and informative links under the following subheadings:

• ‘Government is the problem’
• Neoliberal reforms worse
• Unhealthy reforms
• Austerity kills
• Government not main problem

Read here (IPS News, Aug 24, 2021) 

Prioritising profits reversed health progress

‘Instead of a health system striving to provide universal healthcare, a fragmented, profit-driven market ‘non-system’ has emerged. The 1980s’ neo-liberal counter-revolution against the historic 1978 Alma-Ata Declaration is responsible.’

This story is well argued and contains several relevant and informative links under the following subheadings:

• Alma-Ata a big step forward
• Primary healthcare
• Lalonde Report turning point
• Neo-liberal ascendance
• Healthcare financing key
• Philanthropy rules

Read here (IPS News, Aug 24, 2021)

When will the Covid-19 pandemic end? McKinsey & Co update August 2021

‘This article updates our perspectives on when the coronavirus pandemic will end to reflect the latest information on vaccine rollout, variants of concern, and disease progression. Among high-income countries, cases caused by the Delta variant reversed the transition toward normalcy first in the United Kingdom, during June and July of 2021, and subsequently in the United States and elsewhere. Our own analysis supports the view of others that the Delta variant has effectively moved overall herd immunity out of reach in most countries for the time being. The United Kingdom’s experience nevertheless suggests that once a country has weathered a wave of Delta-driven cases, it may be able to resume the transition toward normalcy. Beyond that, a more realistic epidemiological endpoint might arrive not when herd immunity is achieved but when COVID-19 can be managed as an endemic disease. The biggest overall risk would likely then be the emergence of a significant new variant.’

Read here (McKinsey & Co, August 23, 2021)

Singapore SARS survivors yield hope for Covid super vaccine

‘Survivors who lived through the SARS crisis in Singapore nearly two decades ago may yield hope for the development of a super vaccine to combat potent Covid-19 variants and even other coronaviruses, new research shows.

‘Scientists from the city-state’s Duke-NUS Medical School and National Centre for Infectious Diseases (NCID) have found “highly potent functional antibodies” in people who had severe acute respiratory syndrome and were vaccinated with Pfizer-BioNTech’s shots for Covid-19.’

Read here (Free Malaysia Today, August 21, 2021)

Highly vaccinated Israel is seeing a dramatic surge in new Covid Cases. Here's why

‘Israel was the first country on Earth to fully vaccinate a majority of its citizens against COVID-19. Now it has one of the world's highest daily infection rates — an average of nearly 7,500 confirmed cases a day, double what it was two weeks ago. Nearly one in every 150 people in Israel today has the virus.

‘What happened, and what can be learned about the vaccine's impact on a highly vaccinated country? Here are six lessons learned — and one looming question for the future of the pandemic.’

1. Immunity from the vaccine dips over time.
2. The delta variant broke through the vaccine's waning protection.
3. If you get infected, being vaccinated helps.
4. Israel's high vaccination rate isn't high enough.
5. Vaccinations are key, but they are not enough.
6. Booster shots offer more protection — if you are one of the world's lucky few to get them.

Looming question: Will we need COVID-19 vaccines every several months? We don't know.

Read here (NPR, August 20, 2021)

Delta has changed the pandemic risk calculus

‘Vaccination was a reprieve from this calculus of personal danger, at least for a while—get vaccinated, get your family and friends vaccinated, get back to a far more normal version of life. To a certain extent, that logic holds: The vaccines are still doing a fantastic job preventing hospitalization and death from the coronavirus’s far-more-transmissible Delta variant. But as COVID-19 cases and hospitalizations have roared back, concerns about breakthrough cases among the vaccinated and increased transmissibility among kids have muddied a lot of people’s ability to gauge their own day-to-day risk, just as they’d begun to venture back out into the world and hug, eat, and laugh in the same airspace together again. In some ways, pandemic life is more confusing than ever.’

Read here (The Atlantic, August 19, 2021)

Covid-19: What is coming our way? — Dr Amar-Singh HSS

‘We have all been occupied by the political situation in the country, but the Covid-19 virus is not. It is continuing its relentless march forward, whether we are focused on it or not. While an efficient government that deals with the pandemic decisively is crucial for the country, Malaysians need to be prepared for what is coming our way. I would like to share with you some possible scenarios for the coming weeks and months, and some thoughts and opinions based on current data.

• Continued recovery in the Greater Klang Valley
• Worsening crisis outside the Klang Valley
• Infections in children the next wave?
• Resolving Sinovac vaccine efficacy issues
• The myth of herd immunity and a resurgence of Delta as immunity wanes?

Read here (Code Blue, August 19, 2021)

The origins of SARS-CoV-2: A critical review

Since the first reports of a novel severe acute respiratory syndrome (SARS)-like coronavirus in December 2019 in Wuhan, China, there has been intense interest in understanding how severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in the human population. Recent debate has coalesced around two competing ideas: a “laboratory escape” scenario and zoonotic emergence. Here, we critically review the current scientific evidence that may help clarify the origin of SARS-CoV-2.

We contend that although the animal reservoir for SARS-CoV-2 has not been identified and the key species may not have been tested, in contrast to other scenarios there is substantial body of scientific evidence supporting a zoonotic origin. Although the possibility of a laboratory accident cannot be entirely dismissed, and may be near impossible to falsify, this conduit for emergence is highly unlikely relative to the numerous and repeated human-animal contacts that occur routinely in the wildlife trade. Failure to comprehensively investigate the zoonotic origin through collaborative and carefully coordinated studies would leave the world vulnerable to future pandemics arising from the same human activities that have repeatedly put us on a collision course with novel viruses.

Read here (Cell, Aug 18, 2021). Download PDF here

If you’re going to mandate Covid vaccination at your workplace, here’s how to do it ethically

‘Maintaining and promoting trust is important when it comes to vaccine mandates. It matters to people subject to mandates and it matters to the public more broadly because mutual trust is a cornerstone of effective public health engagement. People should feel supported in their health decision making and they should trust and feel respected by their employers. We’re seeing increasing politicisation about COVID public health measures, in Australia and internationally. This is a social harm we should avoid.’

Read here (The Conversation, August 18, 2021)

How the pandemic now ends: Ed Yong

‘Pandemics end. But this one is not yet over, and especially not globally. Just 16 percent of the world’s population is fully vaccinated. Many countries, where barely 1 percent of people have received a single dose, are “in for a tough year of either lockdowns or catastrophic epidemics,” Adam Kucharski, the infectious-disease modeler, told me. The U.S. and the U.K. are further along the path to endemicity, “but they’re not there yet, and that last slog is often the toughest,” he added. “I have limited sympathy for people who are arguing over small measures in rich countries when we have uncontrolled epidemics in large parts of the world.”

‘Eventually, humanity will enter into a tenuous peace with the coronavirus. COVID-19 outbreaks will be rarer and smaller, but could still occur once enough immunologically naive babies are born. Adults might need boosters once immunity wanes substantially, but based on current data, that won’t happen for at least two years. And even then, “I have a lot of faith in the immune system,” Marion Pepper, the immunologist, said. “People may get colds, but we’ll have enough redundancies that we’ll still be largely protected against severe disease.” The bigger concern is that new variants might evolve that can escape our current immune defenses—an event that becomes more likely the more the coronavirus is allowed to spread. “That’s what keeps me up at night,” Georgetown’s Shweta Bansal told me.

‘To guard against that possibility, the world needs to stay alert. Regular testing of healthy people can tell us where the virus might be surging back.’

Read here (The Atlantic, August 12, 2021)

Delta variant: Everything you need to know -- Tomas Pueyo

‘Delta is a deadly variant. It spreads like wildfire and kills efficiently. We need to be careful.

If you’re an individual

‘If you’re vaccinated, you’re mostly safe, especially with mRNA vaccines. Keep your guard up for now, avoid events that might become super-spreaders, but you don’t need to worry much more than that. If you’re not vaccinated though, this is a much more dangerous time than March 2020. The transmission rate is higher than it used to be, and if you catch Delta, you’re much more likely to die—or get Long COVID. You should be extra careful, only hang out with other vaccinated people, and avoid dangerous events.’

If you’re a community leader

‘If you’re in charge of a community, you have two goals:

1. ‘Vaccinate, vaccinate, vaccinate. The lives of your community depend on it. Any vaccine that works is better than none. If people are opting out, try to lure them in. Most are not anti-vaxxers, but rather they’re on the fence, or simply don’t see the benefit worth the cost. So change their calculation. Create lotteries. The Ohio one, among the first, probably didn’t work, but the cost is paltry compared to the cost of deaths and closing the economy this Fall.
2. ‘Keep Delta at bay as much as you can while vaccinations proceed. An elimination strategy will be best. Good border fences and test-trace-isolate programs are your best tools. Super-spreader events should still be avoided. Masks indoors and in crowds should be mandatory. Great ventilation is a must. 

‘However, if you have vaccinated everybody that wants to be vaccinated, and the rest simply doesn’t want to get vaccinated, then the calculation changes drastically. If your location values the freedom of its people to make the wrong decisions (as long as they don’t impact others), then you might consider opening up the economy. Delta will tear through those unvaccinated, but that’s their prerogative. Maybe the reality will hit better then.

‘But it really depends on each society. Opening up without full vaccination would infect some of those vaccinated, about 10% of them would get long COVID7, and about 0.3% of them would die8.

‘So here each society needs to decide. Say 40% don’t want to vaccinate. Is the freedom of 40% to not vaccinate worth the deaths and Long COVID of those vaccinated? Otherwise, are you willing to force people to vaccinate? Are you going to keep the country closed until there’s a booster vaccine? Will you be able to get your fences and test-trace-isolate programs to work?’

If you’re in charge of vaccine policy

‘An R0 of 8 is bad news for herd immunity. It puts its threshold at ~90% of people protected, which is impossible to reach if vaccines are only 65% protective of infection. Booster shots are necessary. Let’s accelerate their testing, approval, release, and deployment.

‘Also, support vaccine mix-and-match. In most countries, today, if you need a boost you are forced to take the same vaccine. But mixing types likely protects you better and is as safe as using the same type.’

If you’re in a developing country

‘We don’t pay enough attention to developing countries. Most of the science and media focuses where the money is, in developed economies. But Delta is very hard in developing countries, especially in dense urban areas where the poor are forced to work but live in close quarters with many others. India, Argentina, Tunisia, South Africa, and Indonesia are very sad examples of this. 

‘Unfortunately, there’s not many special tricks that poor countries can pull. They tend to have a younger population, which helps. The one thing they have going on for them is that they tend to be warmer and more humid, which helps against COVID. Also, thanks to a warmer weather, they can have more events outdoors. This is the one thing they can leverage: have as many of your gatherings outside, while you do everything you can to vaccinate your population, and delay as much as you can the arrival of Delta with strong fences. 

‘Let’s hope vaccine production keeps growing and people the world over can get vaccinated before the fall.’

Read here (Uncharted Waters, Aug 11, 2021)

Covid FAQ Summer 2021, Part 1: Tomas Pueyo

‘You shared the last article about the Delta Variant so much that nearly 400,000 people read it. Thanks for spreading the word on something so important. You also asked so many good questions that I have tried to answer as many as I could in this article. It’s so long that I split it in two pieces. This 1st piece covers these questions:

1. What’s the update on the Delta variant and cases worldwide?
2. Am I safe if I’m vaccinated? What activities can I go to? Why are there still cases in very vaccinated countries?
3. I’m vaxxed. Can I go to an indoor event if I get masked?
4. When will we leave this behind? when we’re all vaccinated?
5. Can vaccines stop the pandemic?
6. Do we know more about vaccine effectiveness?
7. Should vaccines be fractionalized?
8. Should I get a booster shot?
9. Should I mix-and-match?

Read here (Uncharted Territories, Aug 11, 2021)

Note: Part 2 is only premier, paid subscribers

China takes the lead at international forum tackling Covid-19 vaccine inequality

‘Foreign Minister Wang Yi pledges more technology transfers and production agreements to get vaccines to developing countries. The UN estimates 11 billion more doses are needed to vaccinate 70 per cent of the world’s population against the disease.’

Read here (South China Morning Post, August 6, 2021)

Long Covid in adults discharged from UK hospitals after Covid-19: A prospective, multicentre cohort study using the ISARIC WHO Clinical Characterisation Protocol

‘Survivors of Covid-19 experienced long-term symptoms, new disability, increased breathlessness, and reduced quality of life. These findings were present in young, previously healthy working age adults, and were most common in younger females.’

Findings

‘55% of participants reported not feeling fully recovered. 93% reported persistent symptoms, with fatigue the most common (83%), followed by breathlessness (54%). 47% reported an increase in MRC dyspnoea scale of at least one grade. New or worse disability was reported by 24% of participants. The EQ5D-5L summary index was significantly worse following acute illness (median difference 0.1 points on a scale of 0 to 1, IQR: -0.2 to 0.0). Females under the age of 50 years were five times less likely to report feeling recovered (adjusted OR 5.09, 95% CI 1.64 to 15.74), were more likely to have greater disability (adjusted OR 4.22, 95% CI 1.12 to 15.94), twice as likely to report worse fatigue (adjusted OR 2.06, 95% CI 0.81 to 3.31) and seven times more likely to become more breathless (adjusted OR 7.15, 95% CI 2.24 to 22.83) than men of the same age.’

Read here (The Lancet, August 5, 2021)

Central banks must address pandemic challenges

‘Hopes for an inclusive global economic recovery are fast fading. As rich countries have done little to ensure poor countries’ access to vaccines and fiscal resources, North-South “fault lines” will certainly widen.’

This story is well argued and contains several relevant and informative links under the following subheadings:

• Enhancing relief, recovery, transformation
• Macroeconomic policy coordination
• Central banks’ developmental role
• Supporting transformation
• Bolder actions needed

Read here (IPS News, Aug 3, 2021)