The pandemic has erased entire categories of friendship

‘Close relationships were long thought to be the essential component of humans’ social well-being, but Granovetter’s research led him to a conclusion that was at the time groundbreaking and is still, to many people, counterintuitive: Casual friends and acquaintances can be as important to well-being as family, romantic partners, and your closest friends...[this is the group of friends the pandemic has erased].

[At this point]...there’s cause for optimism. As more Americans are vaccinated in the coming months, more people will be able to return confidently to more types of interactions. If the best historical analogue for the coronavirus outbreak is the 1918 flu pandemic, the Roaring ’20s suggest we’ll indulge in some wild parties. In any case, Rawlins doubts that many of the moderate and weak ties people lost touch with in the past year will be hurt that they didn’t get many check-in texts. Mostly, he predicts, people will just be so happy to see one another again.

‘All of the researchers I spoke with were hopeful that this extended pause would give people a deeper understanding of just how vital friendships of all types are to our well-being, and how all the people around us contribute to our lives—even if they occupy positions that the country’s culture doesn’t respect very much, such as service workers or store clerks. “My hope is that people will realize that there’s more people in their social networks that matter and provide some kind of value than just those few people that you spend time with, and have probably managed to keep up with during the break,” Sandstrom said. America, even before the pandemic, was a lonely country. It doesn’t have to be. The end of our isolation could be the beginning of some beautiful friendships.’

Read here (The Atlantic, Jan 28, 2021)

Stories from a past pandemic: Readers write in about their ancestors’ experiences during the 1918 flu

‘A recent Scientific American feature explores how the catastrophic 1918 influenza pandemic seemed to quickly slip from public discourse. The event killed more than 50 million people worldwide, yet it takes up comparatively little space in society’s “collective memory.” The article considers, by analogy, how the current COVID-19 pandemic might be remembered by future generations. Scientific American accompanied the feature with a call for letters telling the stories of families affected by the 1918 crisis. Below are some examples of what we received.’

Read here (Scientific American, Jan 28, 2021)

Double masking for Covid-19 protection: A trend with a purpose

‘Layering your face is in -- but not as a fashion statement. It may just save a life. Public health officials are suggesting double masking as a way to increase the level of protection from the coronavirus and its multiple, more contagious variants. "If you have a physical covering with one layer, you put another layer on, it just makes common sense that it likely would be more effective, and that's the reason why you see people either double masking or doing a version of an N95," Dr. Anthony Fauci, now chief medical adviser to President Joe Biden, told NBC's Savannah Guthrie.

‘Biden and Vice President Kamala Harris have been doubling up for weeks -- in fact Biden was often seen with a surgical mask under his go-to black fabric covering before being sworn into office.’

Read here (CNN, Jan 28, 2021)

Pharmaniaga, Duopharma to supply 18.4m doses of vaccines

‘Malaysia has secured deals to acquire 18.4 million doses of Covid-19 vaccines through Pharmaniaga Bhd and Duopharma Biotech Bhd. In separate announcements, Pharmaniaga said it would be supplying 12 million doses of Covid-19 vaccines developed by China’s Sinovac Life Sciences Co Ltd, while Duopharma said it would supply 6.4 million doses of Sputnik V developed by Russia’s Gamaleya Research Institute to the government.

‘Both companies yesterday said they had entered into a term sheet agreements to supply the Covid-19 vaccines to the Health Ministry. Pharmaniaga said it would begin manufacturing Sinovac Covid-19 vaccines in February and will deliver the bottled vaccines to identified hospitals and other healthcare facilities nationwide by April 2021.

Read here (The Star, Jan 27, 2021) 

More than 50 long-term effects of Covid-19: A systematic review and meta-analysis

‘COVID-19, caused by SARS-CoV-2, can involve sequelae and other medical complications that last weeks to months after initial recovery, which has come to be called Long-COVID or COVID long-haulers. This systematic review and meta-analysis aims to identify studies assessing long-term effects of COVID-19 and estimates the prevalence of each symptom, sign, or laboratory parameter of patients at a post-COVID-19 stage. LitCOVID (PubMed and Medline) and Embase were searched by two independent researchers. All articles with original data for detecting long-term COVID-19 published before 1st of January 2021 and with a minimum of 100 patients were included. 

‘For effects reported in two or more studies, meta-analyses using a random-effects model were performed using the MetaXL software to estimate the pooled prevalence with 95% CI. Heterogeneity was assessed using I2 statistics. The Preferred Reporting Items for Systematic Reviewers and Meta-analysis (PRISMA) reporting guideline was followed. A total of 18,251 publications were identified, of which 15 met the inclusion criteria. 

‘The prevalence of 55 long-term effects was estimated, 21 meta-analyses were performed, and 47,910 patients were included. The follow-up time ranged from 15 to 110 days post-viral infection. The age of the study participants ranged between 17 and 87 years. It was estimated that 80% (95% CI 65-92) of the patients that were infected with SARS-CoV-2 developed one or more long-term symptoms. The five most common symptoms were fatigue (58%), headache (44%), attention disorder (27%), hair loss (25%), and dyspnea (24%). All meta-analyses showed medium (n=2) to high heterogeneity (n=13). In order to have a better understanding, future studies need to stratify by sex, age, previous comorbidities, severity of COVID-19 (ranging from asymptomatic to severe), and duration of each symptom. From the clinical perspective, multi-disciplinary teams are crucial to developing preventive measures, rehabilitation techniques, and clinical management strategies with whole-patient perspectives designed to address long COVID-19 care.’

Read/download PDF here (Medxiv, Jan 27, 2021)

The year global health went local: Bill & Melinda Gates

‘As hard as it is to imagine right now while so many people are still suffering from COVID-19, this pandemic will come to an end someday. When that moment comes, it will be a testament to the remarkable leaders who have emerged over the last year to steer us through this crisis.

‘When we say “leaders,” we don’t just mean the policymakers and elected officials who are in charge of the official government response. We’re also talking about the healthcare workers who are enduring unimaginable trauma on the frontlines. The teachers, parents, and caregivers who are going above and beyond to make sure kids don’t fall behind in school. The scientists and researchers who are working around the clock to stop this virus. Even the neighbors who are cooking extra meals to make sure no one in their community goes hungry.

‘Their leadership will get us through this pandemic, and we owe it to them to recover in a way that leaves us stronger and more prepared for the next challenge. Over the last year, a global threat touched nearly every person on the planet. By next year, we hope an equitable, effective COVID-19 response will have reached the whole world, too.’

Read here  (GatesNotes, Jan 27, 2021)

More than 85 poor countries will not have widespread access to coronavirus vaccines before 2023

• The rollout of vaccines against the coronavirus (Covid-19) has started in developed countries, but mass immunisation will take time. 
• Production represents the main hurdle, as many developed countries have pre-ordered more doses than they need. 
• The costs associated with mass immunisation programmes will be significant, especially for less-developed countries that have limited fiscal resources. 
• Vaccine diplomacy will play a role in determining which countries get access to a vaccine in the coming months. 
• Russia and China will use the rollout of their own coronavirus shots to advance their interests. 
• With priority groups vaccinated in rich economies by end-March, The EIU expects global economic prospects to brighten from mid-2021. 
• For most middle-income countries, including China and India, the vaccination timeline will stretch to late 2022. 
• In poorer economies, widespread vaccination coverage will not be achieved before 2023, if at all.

Read here (The Economist, Jan 27, 2021)

Resurgence of Covid-19 in Manaus, Brazil, despite high seroprevalence

‘A study published in The Lancet analyzed the increased SARS-CoV-2 transmission in Manaus, Brazil, a region that had previously shown high levels of seroprevalence among its community members. A study conducted in October 2020 detected SARS-CoV-2 antibodies in samples from 76% of blood donors, which suggested that the region may have reached the threshold to provide some level of community immunity (ie, herd immunity). Despite the high seroprevalence, Manaus exhibited a large surge in COVID-19 cases and hospitalizations in January 2021.

‘The researchers present 4 possible explanations for the surprising surge in cases. First, the previous study could have overestimated the seroprevalence, which could have put the community below the herd immunity threshold. Second, immunity to SARS-CoV-2 conferred by earlier infection could have waned, resulting in re-infections. Third, the new infectious could be a result of emerging variants, including the P.1 variant first reported in the area, that are less susceptible to antibodies from prior infections. And finally, new SARS-CoV-2 lineages could simply be exhibiting much higher transmissibility, which could allow widespread community transmission even in areas with high existing seroprevalence. The researchers note that these theories are not mutually exclusive, and further study is needed to better characterize the factors driving the current resurgence. In particular, it is critical to investigate the potential that emerging variants could evade antibodies developed from infection with other strains, which could inform response activities in communities around the world.’ 

Read here (The Lancet, Jan 27, 2021)

Covid-19: Five days that shaped the outbreak

‘A year ago, the Chinese government locked down the city of Wuhan. For weeks beforehand officials had maintained that the outbreak was under control - just a few dozen cases linked to a live animal market. But in fact the virus had been spreading throughout the city and around China. This is the story of five critical days early in the outbreak.’

Read here (BBC, Jan 26, 2021)

Wealth increase of 10 men during pandemic could buy vaccines for all: Oxfam

‘The combined wealth of the world's 10 richest men rose by $540bn (£400bn) during the pandemic, according to Oxfam. The charity claims this amount would be enough to prevent the world from falling into poverty because of the virus, and pay for vaccines for all. The organisation is urging governments to consider taxes on the super-rich. Oxfam's report comes as global leaders gather virtually for the World Economic Forum's "Davos Dialogue" meeting.’

Read here (BBC, Jan 26, 2021)

Is govt doing enough about Covid-19? – P Gunasegaram

‘The warning to manufacturers by the International Trade and Industry Ministry (Miti) reported over the weekend raises very serious questions on the handling of the Covid-19 pandemic. According to reports, Miti is involved in 99 of the more than 300 Covid-19 clusters in the country. This makes the manufacturing sector the main source of Covid-19 infections. Also, Miti indicated that there would be a shutdown/strict lockdown if Covid-19 numbers did not improve...

‘First, if indeed manufacturing is the main source of infections – it is no secret that cramped living quarters are the main source of Covid-19 – why is there no public information on this? Why is the matter only between manufacturers and the government?...

‘There are other questions, too. With the rising cases and contact tracing, it should have been obvious that the hospital system would reach full capacity and be strained. Why was there not enough serious effort put in to ease the strain on hospitals? When did we know that hospitals were going to be strained? Why wait so long before we announce it and formulate measures to take care of that? Why did contact tracing break down? What do we do now? What is the alternative?...

‘And then, there is the matter of the vaccine. Why was Khairy Jamaluddin, minister of science, technology and innovation, appointed to lead our search and procurement of suitable vaccines? It should have been led by health authorities. Let’s get this right, because the success of Covid-19 containment finally depends on it. Why the seeming delay in getting our vaccine rolled out? Why is our vaccine not yet ready? Singapore has got theirs, even Ecuador and Indonesia have theirs.

‘But where is ours? Why is it later than others? Are we prepared to roll out the vaccines in time, or will it take till next year, when enough of us are inoculated? And, have all the concerns about vaccination been sufficiently addressed?’

Read here (The Vibes, Jan 26, 2021)

Vaccines have been oversold as the pandemic exit strategy

‘Covid will be around for a long time — virus suppression is the right policy...

‘If regions with raging transmission do act as breeding grounds for resistant variants, then failing to control spread will prolong the pandemic. Prof de Oliveira stresses that Taiwan, China, Australia and New Zealand, which have chased elimination, are the role models to follow. “This should be a wake-up call for all of us to control transmission, not just in our own regions but globally. This virus will keep outsmarting us if we don’t take it very seriously,” he says.

‘That means not just vaccinating but fast testing, accurate and quick contact tracing, quarantine and isolation. In short, vaccination must go hand-in-hand with virus suppression, not become a substitute for it. A successful vaccine rollout will count for little if the country then becomes a crucible for resistant variants.’

Read here (Financial Times, Jan 26, 2021)

Efficacy of colchicine in non-hospitalized patients with Covid-19 (pre-print)

Background Evidence suggests the role of an inflammatory storm in COVID-19 complications. Colchicine is an orally administered, anti-inflammatory medication beneficial in gout, pericarditis and coronary disease.

Methods We performed a randomized, double-blind trial involving non-hospitalized patients with COVID-19 diagnosed by polymerase chain reaction (PCR) testing or clinical criteria. The patients were randomly assigned to receive colchicine (0.5 mg twice daily for 3 days and once daily thereafter) or placebo for 30 days. The primary efficacy endpoint was the composite of death or hospitalization for COVID-19.

Results A total of 4488 patients were enrolled. The primary endpoint occurred in 4.7% of the patients in the colchicine group and 5.8% of those in the placebo group (odds ratio, 0.79; 95.1% confidence interval (CI), 0.61 to 1.03; P=0.08). Among the 4159 patients with PCR-confirmed COVID-19, the primary endpoint occurred in 4.6% and 6.0% of patients in the colchicine and placebo groups, respectively (odds ratio, 0.75; 95% CI, 0.57 to 0.99; P=0.04). In these patients with PCR-confirmed COVID-19, the odds ratios were 0.75 (95% CI, 0.57 to 0.99) for hospitalization due to COVID-19, 0.50 (95% CI, 0.23 to 1.07) for mechanical ventilation, and 0.56 (95% CI, 0.19 to 1.66) for death. Serious adverse events were reported in 4.9% and 6.3% in the colchicine and placebo groups (P=0.05); pneumonia occurred in 2.9% and 4.1% of patients (P=0.02). Diarrhea was reported in 13.7% and 7.3% in the colchicine and placebo groups (P<0.0001).

Conclusion Among non-hospitalized patients with COVID-19, colchicine reduces the composite rate of death or hospitalization. (COLCORONA ClinicalTrials.gov number: NCT04322682)

Read here (Medrxiv, Jan 26, 2021)

Regeneron says monoclonal antibodies prevent Covid-19 in study

‘Regeneron said Tuesday that its monoclonal antibody cocktail prevented Covid-19 in a clinical trial. The news, issued via a press release, mirrored similar news from Eli Lilly last week that its monoclonal antibody prevented symptomatic Covid-19 infections in nursing homes.

‘The results represent the first 400 volunteers from the study, which is being run by the National Institute of Allergy and Infectious Diseases (NIAID), and is continuing to enroll patients. The volunteers were at high risk of infection because they lived in the same household as a Covid-19 patient. Half the patients received a placebo, and the other half received 1.2 grams of casirivimab and imdevimab, Regeneron’s antibodies.’

Read here (Stat News, Jan 26, 2021)

FLCCC Alliance issues open letter to UK researchers planning a new trial to test ivermectin for use in Covid-19

‘The Front Line COVID-19 Critical Care Alliance (FLCCC) has issued an open letter to researchers  in England at the University of Oxford who are planning to conduct a double-blind, Randomized Controlled Trial (RCT) of ivermectin for use in COVID-19.  The letter states, “Our manuscript, which reviewed both epidemiologic data and the existing clinical trials evidence base, concluded that ivermectin should be the standard of care in COVID-19.”

• ‘A meta-analysis of existing data of ivermectin as a therapeutic finds large, statistically significant reductions in time to clinical recovery, length of hospitalization, and death.
• ‘The Declaration of Helsinki – Ethical Principles for Medical Research involving Human Subjects” states that “when combining medical research with medical care, patients can only be studied...if the physician has good reason to believe that participation in the research study will not adversely affect the health of the patients who serve as research subjects.”

Read here (Newswire, Jan 25, 2021)

Download FLCCC Aliiance PDF here

Global life insurers impose restrictions, worried about long-term pandemic risks

‘Global life insurers are taking steps to curb payouts stemming from the coronavirus pandemic, including long-term health consequences that are not fully understood, industry sources told Reuters. Life insurers, including Prudential Financial Inc, and Aviva PLC, are now imposing waiting periods before COVID-19 patients, including those who have recovered, can apply for coverage, executives and spokespeople said. Some are also limiting coverage for certain age groups.

‘These changes come as some reinsurers demand new safeguards from life insurers they backstop, and as the industry struggles to ascertain the extent of problems caused by the novel coronavirus.’

Read here (Reuters,  Jan 25, 2021)

Politics, race, and religion: Pandemic misinformation courses through the Southeast Asian internet

‘From tales of allegedly dwindling food stockpiles in Singapore to Indonesian land supposedly being traded to China for precious supplies of vaccine, false narratives about COVID-19 have swirled around the Southeast Asian internet for months.

‘Disinformation in the region is not a new phenomenon. During  the 2014 Indonesian election, Islamist groups targeted current President Joko Widodo and falsely claimed he was a non-Muslim of Chinese lineage. Online troll armies notoriously helped propel Philippines President Rodrigo Duterte to victory in his 2016 campaign. Concerns about misinformation have led governments to implement highly controversial legislation in Thailand and Malaysia.

‘Now, the misinformation ecosystem in Southeast Asia continues to thrive in the ongoing coronavirus pandemic.’

Read here (Defend Democracy, Jan 25, 2021)

The worst of Malaysia's Covid-19 measures is yet to come: Sin Chew Daily columnist (Straits Times, Jan 25, 2021)

‘According to the government, this is to prevent a full-fledged impact the lockdown will have on the country's economy. Finance minister Tengku Zafrul has said the first MCO imposed nationwide last year cost the country RM2.4 billion (S$787 million) a day, but only RM600 million a day this time. While allowing key economic sectors to operate as usual could help arrest the daily economic loss, there is nevertheless a hefty public health price to pay...

‘To break the infection chain, we cannot afford to take things for granted. If the government eventually decides to extend the current MCO, it must tighten the SOPs, even to the extent of locking down all economic activities, or we will stand to lose even more if MCO is extended over and again. The situation now is indeed alarming.

‘From infection clusters mostly linked to migrant workers, factories, shopping malls, prisons and detention centres, we now have new clusters emerging in workplaces and even medical centres. All this highlights the fact that the virus has not only penetrated our communities but is fast expanding its reach, and may soon come to you or your family members, colleagues and friends.’

Read here (Straits Times, Jan 25, 2021)

Malaysia's worsening Covid-19 situation exposes serious economic, political fault lines

‘The darkening economic clouds for Malaysia will also have serious implications for the country's already troubled politics. Opposition politicians are keen to point out that Malaysians are starting to focus on the government's failures in dealing with the pandemic amid questions about Mr Muhyiddin's move to seek a declaration of a state of emergency.

"People and businesses need… a blanket moratorium on loans and perhaps a targeted movement control order. Certainly not the emergency," said Mr Ronnie Liu Tian Khiew, a senior politician from the opposition Democratic Action Party and elected assemblyman to the Selangor state government.

Read here (Straits Times, Jan 25, 2021)

Covid-19 pandemic could last 4 to 5 years: Lawrence Wong

‘It may take four to five years before the COVID-19 pandemic ends and the world can look to a "post-COVID normal", said Education Minister Lawrence Wong on Monday (Jan 25). "At some point in time the pandemic will pass, but it may take four to five years before we finally see the end of the pandemic and the start of a post-COVID normal. What will this new post-COVID world look like? No one can tell," he said. Mr Wong, who co-chairs the COVID-19 multi-ministry taskforce, was speaking at the Singapore Perspectives 2021 conference hosted by the Institute of Policy Studies (IPS).’

Read here (Channel News Asia, Jan 25, 2021)

The inequality virus: Bringing together a world torn apart by coronavirus through a fair, just and sustainable economy

‘The coronavirus pandemic has the potential to lead to an increase in inequality in almost every country at once, the first time this has happened since records began. The virus has exposed, fed off and increased existing inequalities of wealth, gender and race. Over two million people have died, and hundreds of millions of people are being forced into poverty while many of the richest – individuals and corporations – are thriving. Billionaire fortunes returned to their pre-pandemic highs in just nine months, while recovery for the world’s poorest people could take over a decade.

‘The crisis has exposed our collective frailty and the inability of our deeply unequal economy to work for all. Yet it has also shown us the vital importance of government action to protect our health and livelihoods. Transformative policies that seemed unthinkable before the crisis have suddenly been shown to be possible. There can be no return to where we were before. Instead, citizens and governments must act on the urgency to create a more equal and sustainable world.’ 

Download PDF here (Oxfam, Jan 25, 2021)

If it ain’t broke, don’t fix it — Musa Mohd Nordin

‘The data shows that the MOH is doing relatively well. The risk of a Covid-19 death per population n Malaysia is 1 per 50,000. This compares favorably against the Global average of 1 per 3,676.b It is worse in the UK and US, 1 per 700 and 781 respectively...

‘Despite the surging numbers of Covid-19 cases, the MOH infrastructure and services are holding up well and delivering good outcomes when compared to the US, UK and our southern neighbours. Therefore, if it ain’t broke, don’t fix it. It is in this context that the following suggestions are made:

1. The MOH should continue to operate with the 52 dedicated Covid Hospitals.
2. If these are inadequate to meet the current surge in Covid-19 cases, select private and government facilities can be transformed into dedicated Covid Hopsitals.
3. The concept and operations of Hybrid Hospitals should be avoided as much as possible. It compromises the Quality of Care, especially among the Category 4-5 patients, and the Safety of patients, HCW, other hospital staff and visitors, due to the real risk of nosocomial infection from this most transmissible coronaviruses.
4. The lay public is fast becoming very fearful of Covid and Hybrid hospitals and this has led to them shunning away from hospitals despite their need for regular hospital visits and review.
5. If they delay or miss their appointments, the management of Non-Covid illness eg NCD, Cancers, Immunization uptake, will be compromised.
6. The MOH has begun to decongest and create more empty General and ICU beds in Covid Hospitals by discharging Category 1&2 patients to Home Isolation with clear instructions on the use of Health Assessment Tools.’

Read here (Malay Mail, Jan 24, 2021) 

Oxford’s PRINCIPLE trial: Bringing ivermectin directly into the developed world in the battle against Covid-19

‘The University of Oxford soon kicks “the PRINCIPLE Trial” into a higher gear now, in what they consider a pathbreaking “high-quality trial” of Ivermectin, a generic drug already evidencing significant efficacy in over two dozen clinical trials around the world, according to some researchers. The UK government also backs this pivotal study via the Department of Health and Social Care. 

‘Searching for early-onset, home-based ambulatory treatments for COVID-19, the PRINCIPLE Trial seeks to meet a gap in research in the world’s richest nations to date. Nearly all of the taxpayer-financed research-based expenditures of governments in the US, UK and Europe, for example, have gone into vaccines, novel monoclonal antibodies, and novel therapeutics, with an emphasis on treating severely ill patients. 

‘Ivermectin, hailed as the “wonder drug” or “the People’s medicine” for COVID-19, gains growing attention worldwide made more widely available, frankly, partly due to TrialSite’s consistent chronicling of these trials around the world since the original University of Monash breakthrough.’

Read here (TrialSite News, Jan 23, 2021)

Key measures to reduce the Covid-19 raging fire ― Amar-Singh HSS

‘Many individuals and groups have voiced suggestions to manage our raging Covid-19 pandemic in Malaysia. However few appear to have been considered. Allow me to summarise five key measures we critically need to take to help put out the Covid-19 raging fire in our nation:

• Test extensively
• Restore contact tracing
• Support MoH staff
• Improve home quarantine
• Widen pick-up services

Read here (The Malay Mail, Jan 23, 2021)

‘Major breakthrough’ | Large study shows effectiveness of colchicine to treat Covid-19

‘A large study launched last March by the Montreal Heart Institute allows a “major breakthrough” in the treatment of COVID-19. Its results show that the anti-inflammatory drug colchicine is effective in treating the disease and preventing its complications. It is the first oral medicine proven to be effective in treating patients before they are admitted to hospital. “We have just provided the planet with hope, exclaims the D.r Jean-Claude Tardif, principal investigator of the COLCORONA study and director of the research center of the Montreal Heart Institute (ICM). We finally have a first treatment that can help patients with COVID before their hospitalization to prevent hospitalizations, prevent intubations and prevent death. ”

‘In 4,159 patients proven to be diagnosed with COVID-19 using a PCR test, colchicine resulted in a 25% decrease in hospitalizations, a 50% decrease in the use of ventilation and a decrease in deaths by 44%. “It’s a major breakthrough,” says Dr Tradif. Colchicine works to prevent the “major inflammatory storm” that affects the lungs and can send patients to hospital.’

Read here (The Canadian, Jan 23, 2021)

MCO 2.0 wipes off 90% of retail business volume

‘Malaysia’s second round of the Movement Control Order (MCO) has dimmed any hope of recovery for the local retail scene. Bumiputera Retailers Organisation president Datuk Wira Ameer Ali Mydin said retail businesses have dropped about 90% during the first week of MCO 2.0 compared to before it came into force on Jan 13.

“Although shopping complexes are allowed to open, the retail sector is taking a drastic hit. People are not coming out to shop despite strict standard operating procedures (SOPs) in place. Also, the number of Covid-19 cases which has been increasing tremendously day by day has affected consumers’ confidence,” he told The Malaysian Reserve (TMR).’

Read here (Malaysian Reserve, Jan 22, 2021)

Indonesia's Covid vaccination campaign prioritises workers

‘Indonesia has decided to prioritise vaccination for people aged 18-59, arguing the workforce needs to be protected first to boost the economy... The first two phases of Indonesia's vaccination campaign started on January 13 and are expected to run concurrently until April, according to the Health Ministry. The first shots will go to health workers and support staff. This will be followed by members of the public workforce, including public servants at ports and stations, electric companies, banks, water companies and any officials providing community services.’

Read here (DW, Jan 22, 2021)

Emerging coronavirus variants may pose challenges to vaccines

‘The mRNA technology on which the Pfizer and Moderna vaccines rely can be altered in a matter of weeks, and far more easily than the process used to produce flu vaccines. But it would be wise to prepare for this eventuality [a time when the current slew of vaccines become less effective] now and think through not just the technical aspects of updating the vaccines, but the testing, approval and rollout of those vaccines, experts said.

‘Still, the best path forward is to prevent the emergence of new mutations and variants altogether, they said. "Imagine having to do catch-up like this all the time - it's not something desirable," Dr Iwasaki said. "If we can just stop the spread as soon as possible, while the vaccine is very effective, that's the best way."

Read here (New York Times/Straits Times, Jan 22, 2021)

The prevalence of long Covid symptoms and Covid-19 complications (plus updated estimates)

‘The UK’s Office of National Statistics (ONS) published data regarding the prevalence of symptoms associated with “long COVID” in patients who recovered from acute SARS-CoV-2 infection. The data indicate that approximately 20% of infected individuals exhibit symptoms for 5 weeks or longer, and 10% report symptoms for 12 weeks or longer. This corresponds to an estimated 186,000 individuals in England with symptoms lasting between 5 and 12 weeks. The findings are based on responses to the UK’s COVID-19 Infection Survey, which utilizes a nationally representative sample from across the UK, and efforts are ongoing to gather additional data, including on symptoms that persist longer than 12 weeks. A more detailed look at the available data shows that prevalence of long COVID symptoms* tends to increase with age, peaking in the 35-49 years (26.8%) and 50-69 years (26.1%) age groups, compared to the 2-11 years (12.9%) and 12-16 years (14.5%) age groups. Additionally, there appears to be a statistically significant increase in prevalence among women (23.6%) compared to men (20.7%).’

Read here (Office for NationaL Statistics, UK, Dec 16, 2020)

Read here for update (Office for NationaL Statistics, UK, Jan 21, 2021)

Eli Lilly says its monoclonal antibody, bamlanivimab, prevented Covid-19 infections in clinical trial

‘Eli Lilly said Thursday that its monoclonal antibody prevented Covid-19 infections in nursing home residents and staff in a clinical trial, the first time such a treatment has been shown to prevent infection. Lilly released the results in a press release, although it said that it would publish the data in a research paper as quickly as possible.

‘In November, the antibody, bamlanivimab, was authorized for emergency use by the Food and Drug Administration in treating patients with Covid who are at risk of more severe disease. An antibody cocktail made by the biotechnology firm Regeneron has also been authorized... But Lilly believes its antibody could be an option not just to treat Covid-19 but to help prevent it in limited circumstances.’

Read here (STAT News, Jan 21, 2021)

Thailand: AstraZeneca vaccine approved, 50,000 doses due in February

‘The [Thai] Food and Drug Administration (FDA) has approved the emergency use of AstraZeneca Covid-19 vaccine and 50,000 doses of it will arrive in Thailand in February. FDA secretary-general Paisarn Dunkum said on Thursday that the FDA approved the registration of the vaccine, produced in Italy by AstraZeneca Co, on Wednesday after the firm had submitted nearly 10,000 pages of its documents for vaccine registration for emergency use on Dec 22 last year...

‘A total of 50,000 doses of the vaccine will arrive in Thailand in February. The import licence and vaccine registration will be valid for one year. A Reuters source said the approval applied only to doses manufactured overseas.’

Read here (Bangkok Post, Jan 21, 2021)

We're about to see a wave of long Covid. When will ministers take it seriously?

‘Long Covid is shorthand for a range of conditions. Some scientists divide them into three broad categories, others into four. Of these, one seems to ring a bell. It’s a cluster of symptoms that bear a strong similarity to myalgic encephalomyelitis or chronic fatigue syndrome (ME/CFS). This is a devastating condition that affects roughly a quarter of a million people in the UK, and is often caused, like long Covid, by viral infection...

‘The NHS is now setting up specialist clinics to treat long Covid. But already, apparent mistakes are being made. Without the necessary caveats, the NHS recommends steadily increasing levels of exercise for people suffering from post-Covid fatigue. But as ME/CFS patients with post-exertional malaise know, this prescription, though it sounds intuitive, could be highly damaging.

‘We need massive research programmes into both long Covid and ME/CFS, coupled with better information for doctors. But above all, we need something that currently seems a long way off. A government that gives a damn.’

Read here (The Guardian, Jan 21, 2021)

Why kids might be key to reaching herd immunity

‘Vaccinating kids, however, is often not just about the direct and immediate benefits to them. It’s also meant to protect children against diseases that would otherwise become more dangerous for them as adults—measles, mumps, and chicken pox are three common examples—and dampen the overall spread of these diseases. In the short term, the primary reason to vaccinate children against COVID-19 may be that the U.S. will have a hard time reaching herd immunity otherwise.‘

Read here (The Atlantic, Jan 21, 2021)

NST editor under quarantine at MAEPS 2.0 shares 'humbling' experience

‘The ambience was quite festive with laughter and banter, not solemn, quiet and sedated as I had expected it to be. The residents — not patients — as I prefer to be called since I didn't feel any pain or discomfort, were either talking to each other at their beds or walking but not aimlessly. There were none within my sight seen lying on the bed covered by the thick white hospital blankets. But these were not the usual hospital beds, they were portable and foldable camp beds made of aluminium frames and canvas covers...

‘As I completed my first 24 hours at PKRC MAEPS 2.0, I had to admit that it was not too bad at all. The facilities were good — clean toilets/showers, two surau even though the spaces were quite small and food which was quite tasty though I wished for a bigger portion of vegetables. Truly, it was a most humbling experience. But my utmost appreciation went to the staff, everyone from the medical personnel to service staff and Rela personnel.’

Read here (News Straits Times, Jan 20, 2021)

Here's what Joe Biden can do about the Covid-19 pandemic starting on his first day as US president

‘If the pandemic unfolded in stages so too must it be contained that way. During the campaign, Biden promised swift action on such steps as testing, vaccine manufacture and distribution, and preventive measures like mask mandates. That, he’s said, will be followed by other steps like improving surveillance of emerging variants of SARS-CoV-2, extending unemployment benefits to people whose jobs were lost as a result of quarantining and lockdowns, extending the moratorium on evictions, and ensuring that people who contract COVID-19 and survive don’t face discrimination in insurance benefits. It would, the candidate promised, be nothing short of a stepwise, war-like mobilization...

‘If there’s a certainty in exactly how the Biden plan will unfold over the next 24 or 12 or even three months, it’s that there’s no certainty at all. Viruses are at once both mindless and clever—infecting and eluding, spreading and shape-shifting. It takes a set of policies that are equally adaptable, equally nimble to defeat them. The new president’s plan is an ambitious first step. A lot of sure-footed steps remain before the pandemic is defeated.’

Read here (Time magazine, Jan 20, 2021)

Europe’s growing mask ask: Ditch the cloth ones for medical-grade coverings

‘Faced with new, more contagious, strains of the coronavirus and a winter surge in cases, European nations have begun to tighten mask regulations in the hope that they can slow the spread of the virus. Germany on Tuesday night made it mandatory for people riding on public transport or in supermarkets to wear medical style masks: either N95s, the Chinese or European equivalent KN95 or FFP2s, or a surgical mask.

‘It follows a stricter regulation from the German state of Bavaria this week that required N95 equivalents in stores and on public transport. Austria will introduce the same measures from Monday.’

Read here (Washington Post, Jan 20, 2021)

WHO chief welcomes EU Council proposal for pandemic preparedness treaty

‘World Health Organization (WHO) Tedros Adhanom Ghebreyesus on Wednesday welcomed a proposal by the European Council to negotiate a global treaty on pandemic preparedness, noting it would be the second such treaty after a tobacco pact of 2003. Tedros, addressing the WHO’s Executive Board, referred to the proposal made by European Union Council President Charles Michel in December and said: “As you know we have the Tobacco Convention and if we can make this happen, this would be the second Convention or the second treaty and for a very important area, pandemic preparedness and response.

“All of us have seen how unprecedented this pandemic is, and we have to give it our best. And I think a treaty is the best thing that we can do that can that (bring) the political commitment of member states,” Tedros added.

Read here (Reuters, Jan 20, 2021)

The Biden-Harris plan to beat Covid-19

‘The American people deserve an urgent, robust, and professional response to the growing public health and economic crisis caused by the coronavirus (COVID-19) outbreak. President Biden believes that the federal government must act swiftly and aggressively to help protect and support our families, small businesses, first responders, and caregivers essential to help us face this challenge, those who are most vulnerable to health and economic impacts, and our broader communities – not to blame others or bail out corporations.

The Biden-Harris administration will always:

• Listen to science
• Ensure public health decisions are informed by public health professionals
• Promote trust, transparency, common purpose, and accountability in our government

President Biden and Vice President Harris have a seven-point plan to beat COVID-19:

1. Ensure all Americans have access to regular, reliable, and free testing.
2. Fix personal protective equipment (PPE) problems for good.
3. Provide clear, consistent, evidence-based guidance for how communities should navigate the pandemic – and the resources for schools, small businesses, and families to make it through.
4. Plan for the effective, equitable distribution of treatments and vaccines — because development isn’t enough if they aren’t effectively distributed.
5. Protect older Americans and others at high risk.
6. Rebuild and expand defenses to predict, prevent, and mitigate pandemic threats, including those coming from China.
7. Implement mask mandates nationwide by working with governors and mayors and by asking the American people to do what they do best: step up in a time of crisis.

Read here (White House, Jan 20, 2021) 

When will the pandemic end? (McKinsey & Co update, Jan 20, 2021)

‘This article updates our earlier perspectives on when the coronavirus pandemic will end. Transition toward normalcy in the United States remains most likely in the second quarter of 2021 and herd immunity in the third and fourth quarters, but the emergence of new strains and a slow start to vaccine rollout raise real risks to both timelines. We also add a perspective for the United Kingdom...

Transition toward normalcy

‘A transition toward normalcy will occur when COVID-19 mortality falls and the disease is de-exceptionalized in society. COVID-19 will not disappear during this transition, but will become a more normal part of the baseline disease burden in society (like flu, for example), rather than a special threat requiring exceptional societal response. During this transition, controlling the spread of SARS-CoV-2 will still require public-health measures (such as continued COVID-19 testing and mask use in many settings), but mortality will fall significantly, allowing greater normalization of business and social activities. This will be driven by a combination of early vaccine rollout (which, being directed first at those at greatest risk, should reduce deaths faster than cases), seasonality, increasing natural immunity, and stronger public-health response.’

Read here (McKinsey & Co update, Jan 20, 2021)

The effect of early treatment with ivermectin on viral load, symptoms and humoral response in patients with non-severe Covid-19: A pilot, double-blind, placebo-controlled, randomized clinical trial

Added value of this study: ‘This pilot, randomized, placebo-controlled, double blind trial failed to show a reduction in the proportion of PCR-positive patients seven days after ivermectin treatment; yet it shows a reduction in the self-reported anosmia/hyposmia and a (non-statistically significant) tendency to lower viral loads and lower IgG titers which presumably reflect milder disease.’

Implications of all the available evidence: ‘The positive signal found in this pilot together with emerging evidence from animal models and other clinical trials warrants the conduction of larger trials using ivermectin for the early treatment of COVID-19.’

Read here (EClinicalMedicine, The Lancet, Jan 19, 2021)

India to send Covaxin, Covishield to other nations as goodwill gesture

‘India has decided to export 8.1 lakh doses of Covaxin to Oman, Mongolia, Myanmar, Bahrain, Mauritius, the Philippines and the Maldives as a goodwill gesture, people in the know said. Government sources said Serum would supply a few lakh doses of Covishield to the Seychelles, Afghanistan, Bangladesh, Bhutan and Nepal.’

Read here (Economic Times, Jan 19, 2021)

Nothing to learn from East Asia?

‘Although most East Asian economies have successfully contained the pandemic without nationwide ‘stay in shelter lockdowns’, many governments have seen such measures as necessary. But lockdowns are blunt measures, with inevitable adverse consequences, especially for businesses and employment. 

‘Many countries have thus imposed lockdowns, citing China’s response in Wuhan. But as the first WHO fact-finding mission to China noted, “The majority of the response in China, in 30 provinces, was about case finding, contact tracing, and suspension of public gatherings—all common measures used anywhere in the world to manage [infectious] diseases.

‘Lockdowns were limited to a few cities where contagion went “out of control in the beginning”. The key lesson from China was “all about…speed. The faster you can find the cases, isolate the cases, and track their close contacts, the more successful you’re going to be.”

Read here (IPS News, Jan 19, 2021) 

Covid vaccine: WHO warns of ‘catastrophic moral failure’

‘The world faces a "catastrophic moral failure" because of unequal Covid vaccine policies, the head of the World Health Organization (WHO) has warned. Tedros Adhanom Ghebreyesus said it was not fair for younger, healthy people in richer nations to get injections before vulnerable people in poorer states. He said over 39 million vaccine doses had been given in 49 richer states - but one poor nation had only 25 doses. Meanwhile, both the WHO and China were criticised for their Covid response.’

Read here (BBC, Jan 19, 2021)

Independent Covid-19 review panel critical of China, WHO delays

‘An independent panel said on Monday (Jan 18) that Chinese officials could have applied public health measures more forcefully in January to curb the initial COVID-19 outbreak, and criticised the World Health Organization (WHO) for not declaring an international emergency until Jan 30.

‘The experts reviewing the global handling of the pandemic, led by former New Zealand Prime Minister Helen Clark and former Liberian President Ellen Johnson Sirleaf, called for reforms to the Geneva-based United Nations agency.’ 

Read here (Channel News Asia, Jan 19, 2021)

Norway moves to calm vaccine anxiety after elderly deaths

‘Health authorities in Norway sought to allay safety concerns raised by the death of some elderly patients after they were vaccinated against Covid-19, saying there’s no evidence of a direct link.

‘The initial reports from Norway raised alarm as the world looks for early signs of potential side effects from the vaccines. Although doctors say it’s possible that vaccine side-effects could aggravate underlying illnesses, they were expecting nursing-home residents to die shortly after being vaccinated because deaths are more common among the frailest and sickest elderly patients.

“Clearly, Covid-19 is far more dangerous to most patients than vaccination,” Steinar Madsen, medical director at the Norwegian Medicines Agency, said by phone on Monday, adding that a connection between the vaccine and the deaths is difficult to prove. “We are not alarmed.”

Read here (Bloomberg, Jan 18, 2021)

Chinese and Russian vaccines in high demand as world scrambles for doses

‘Sales represent coup for Beijing and Moscow, even as concerns over pharma standards linger... 

‘Chinese and Russian manufacturers are seeing growing appetite from foreign buyers for their Covid-19 vaccines as the international scramble for jabs intensifies, despite lingering concerns over incomplete trial data and the rigour of domestic approval processes.

‘Russia’s Gamaleya Research Institute of Epidemiology and Microbiology has agreed to sell its Sputnik V vaccine to countries including Algeria, Argentina, Saudi Arabia and Brazil, while the two leading Chinese manufacturers, Sinopharm and Sinovac Biotech, have signed deals with more than a dozen countries including Bahrain, United Arab Emirates, Egypt, Philippines, Indonesia and Hungary.’

Read here  (Financial Times, Jan 18, 2021) 

Vaccines need not completely stop Covid transmission to curb the pandemic

‘Influenza may provide the best blueprint of what to expect going forward. The most common flu vaccine—the inactivated virus—is not “truly sterilizing because it doesn’t generate local immune response in the respiratory tract,” Crowcroft says. This fact, coupled with low immunization rates (often shy of 50 percent among adults) and the influenza virus’s ability to infect and move between multiple species, enables it to constantly change in ways that make it hard for our immune system to recognize. Still, depending on the year, flu vaccines have been shown to reduce hospitalizations among older adults by an estimated 40 percent and intensive care admissions of all adults by as much as 82 percent.

‘Research on seasonal coronaviruses suggests that SARS-CoV-2 could similarly evolve to evade our immune systems and vaccination efforts, though probably at a slower pace. And data remain mixed on the relationship between symptoms, viral load and infectiousness. But ample precedent points to vaccines driving successful containment of infectious diseases even when they do not provide perfectly sterilizing immunity. “Measles, diphtheria, pertussis, polio, hepatitis B—these are all epidemic-prone diseases,” Crowcroft says. “They show that we don’t need 100 percent effectiveness at reducing transmission, or 100 percent coverage or 100 percent effectiveness against disease to triumph over infectious diseases.”

Read here (Scientific American, Jan 18, 2021)

Pandemic fatigue? How adherence to Covid-19 regulations has been misrepresented and why it matters

‘To the surprise of many, adherence to stringent behavioural regulations has remained extremely high (over 90%), even though many people are suffering considerably, both financially and psychologically. Equally, despite anecdotal observations about growing violations and polling which shows that people report low levels of adherence in other people, both self-reported data and systematic observations of behaviour in public places suggest that adherence stayed high during the second lockdown. Some 90% of people or more adhere to hygiene measures, to spatial distancing, and to mask wearing most of the time. Moreover, people generally support regulations and, if anything, believe that they should be more stringent and introduced earlier. This pattern has been repeated in the past few days, with 85% of the public endorsing the January lockdown and 77% thinking it should have happened sooner...

‘The problem, then, is that in psychologising and individualising the matter of adherence, one disregards the structural factors that underlie the spread of infection and the differential rates in different groups. One also avoids acknowledging the failures of government to provide the support necessary to follow the rules (most obviously in the case of self-isolation). Additionally, one overlooks the fact that some of the rules and the messaging around them may be the problem (such as encouragement to go out to the pub—doing one’s “patriotic best” according to the prime minister—and to return to work after the first lockdown). It is particularly misleading and unfair to ask people to do things and then blame them for doing so.’

Read here (BMJ, Jan 18, 2021)

One in eight ‘recovered’ Covid patients ‘die within 140 days’

‘The University of Leicester and the Office for National Statistics found that out of 47,780 people discharged from hospital in the first wave, 29.4% were back in hospital within 140 days and 12.3% died. Covid survivors were three and half times more likely to be readmitted to hospital and die compared to other conditions.’

Read here (Metro, UK, Jan 18, 2021)

Covid-19 vaccine — Frequently asked questions

Paul Sax, M.D., a Professor of Medicine at Harvard Medical School and an infectious disease specialist, provides concise and engaging answers to clinicians’ questions about Covid-19 vaccination and to the questions and concerns patients will raise.

Read here (New England Journal of Medicine, as at Jan 18, 2021)

A Covid genocide in the Americas?

‘Just as political leaders like Donald Trump and Jair Bolsonaro have forced a reckoning about the historical persistence of fascist politics, so have their disastrous responses to the COVID-19 pandemic renewed the relevance of the concept of genocide. How else are we to come to grips with so many culpably avoidable deaths?’

Read here (Project Syndicate, Jan 18, 2021)

Asia’s deadliest Covid country [Indonesia] to resist vaccination

‘A Saiful Mujani Research & Consulting survey last month found that only 37% of respondents were willing to take what might be the life-saving jab, with 40% uncertain and 17% saying they would refuse it, mostly because of concerns over safety and effectiveness. Health experts say even with a smooth rollout through hospitals and 10,000 first-level health clinics, it will be at least 15 months before the program reaches the percentage required for herd immunity among Indonesia’s 270 million-strong population. The government estimates it will need 427 million doses, factoring in a wastage of 15%, to vaccinate a targeted 181.5 million citizens, with Widodo saying he wants that done by mid-2022.’

Read here (Asia Times, Jan 18, 2021)

Three questions and the emerging answers about Covid-19 vaccine protection

‘As the COVID-19 vaccine rolls out, three big questions loom. First, can someone who has been vaccinated still spread the disease? Second, will the vaccine remain effective as the virus itself evolves? And third, how long will the vaccine's protection last?

‘Answers to these questions lie in our immune systems. And the answers aren't straightforward because our immune systems are both remarkably adept and remarkably challenging to predict.’

Read here (NPR, Jan 18, 2021)

World questions whether China’s Covid jab is safe

‘Although Turkish researchers found that the Sinovac vaccine was 91.25 percent effective in preventing the onset of the coronavirus, trials in the United Arab Emirates found it to be somewhat lesser, at 86 percent effective, while Indonesian trials found the drug was only 61 percent effective. The Turkish trials were conducted on only 29 subjects. Even worse news emerged from Brazil, where the Chinese vaccine was found to be effective in only 50.4 percent of cases in clinical trials numbering13,000 participants. Too many across Asia and elsewhere believe there wasn’t sufficient scientific rigor, the trials were too short and too rushed, and that, in the words of one observer who declined to be named, “poor Asians and others are being given a shoddy vaccine because Beijing wants to score political points with its crappy jab.”

‘Whether that is true or not, those countries going ahead with the Chinese vaccine, however, seem to be proceeding on the basis that, while it may only be 50 percent effective, it’s better than zero percent without a vaccine. Pfizer and Moderna vaccines have been found to be more than 90 percent effective, but it’s a question of availability and price. Although legions of common citizens from the Philippines to Indonesia to Turkey to Brazil are shying away from China’s vaccine, governments are sticking with it. Singapore has announced it will continue with the Chinese products, as will Thailand although authorities have also bought 26 million doses of the UK-based AstraZenica vaccine – which won’t arrive until June. It will still need to be approved by the Thai FDA.’

Read here (Asia Sentinel, Jan 17, 2021)

Concerned doctors' open letter to Muhyiddin gets a personal response (Full text included)

‘An open letter by a group of 46 doctors has elicited a personal response from Prime Minister Muhyiddin Yassin. The 46 doctors had, in an open letter on Jan 7, expressed worry at the "very bleak" state of the Covid-19 pandemic in the country.

‘Muhyiddin, in his response tonight, noted that several of their proposals have been implemented or are in the process of being rolled out. The prime minister said he will continue to put aside politics and focus on mobilising an all-of-society fight against Covid-19.’

Read here (Malaysiakini, Jan 17, 2021)

Correcting misleading information by Western media on Chinese vaccines responsible measure in global pandemic fight

‘Fair reporting of allergic events and side effects from both Chinese vaccines and Pfizer’s vaccines is of great significance. The biased reports by Western media outlets have made the Chinese vaccine like a boat sailing against the current in the international public opinion arena. It is not only unfair, but also harmful to the global fight against the pandemic. The Global Times has the obligation to correct the environment of public opinion created by misinformation from Western media and do our part to promote the fairness of public perceptions regarding different vaccines.’

Read here (Global Times, Jan 16, 2021)

Afriforum may take battle over Ivermectin to court

‘Afriforum insists that investigations regarding studies that have already been conducted globally on the use of Ivermectin be carried out as soon as possible to confirm if this drug can be used effectively in the prevention and treatment of the coronavirus. “A large range of studies in various countries show that Ivermectin can possibly be effective in the treatment of the virus,” Barend Uys, Afriforum’s head of research said.

‘According to him, it was irrational to approve the use of a vaccine that had been developed within months while at the same time banning the use of a drug that had been proven safe and been in use for four decades. “Farmers have been using Ivermectin as a livestock product for many years and it is immediately available in their medicine cabinets,” said Uys.’

Read here (IOL, Jan 16, 2021)

'Miracle' drug ivermectin unproven against Covid, scientists warn

‘Scientists have warned against taking an anti-parasite drug as a treatment for Covid-19 despite headlines that have touted it as a cure. Facebook posts and articles endorsing ivermectin have proliferated in Brazil, France, South Africa and South Korea as governments around the world scramble to roll out vaccination programmes.

‘But health agencies say that there is not enough evidence to promote the drug as a remedy for coronavirus -- and that research into the question has often been unsound. Ivermectin has long been used to treat parasites such as head lice and has been widely distributed in sub-Saharan Africa since the 1990s to treat river blindness.’

Read here (France 24/AFP, Jan 15, 2021)

Association of American Physicians and Surgeons (AAPS) applauds NIH revised stance on Ivermectin for Covid-19

‘The National Institutes (NIH) has issued a new statement on the use of the anti-parasitic drug ivermectin for the treatment of COVID-19. Previously, it recommended against this treatment, but now states that its Panel “has determined that there are insufficient data to recommend either for or against the use of ivermectin for the treatment of COVID-19.”

‘The Association of American Physicians and Surgeons (AAPS) notes that there are now 49 ivermectin studies summarized on c19study.com, 100 percent of which show favorable results. In contrast, there are very few studies of the antibody cocktails now being used under an Emergency Use Authorization.

‘NIH concludes from its current analysis that “results from adequately powered, well-designed, and well-conducted clinical trials are needed to provide further guidance on the role of ivermectin in the treatment of COVID-19.” The NIH may be responding to requests related to the testimony strongly favoring ivermectin in a Dec 8 Senate hearing before the Committee on Homeland Security and Governmental Affairs.’

Read here (Globe Newswire, Jan 15, 2021)

The coronavirus is evolving before our eyes

‘Even if we cannot contain this particular variant, we’re learning from its spread. Preventing more virulent strains from becoming dominant—when they inevitably do arise—may be possible if we can track genomic patterns more widely, so that we have the context needed to determine whether a strain is indeed uniquely dangerous. If we can take steps to contain a new threat early enough, it may never become widespread. If we miss these opportunities, we risk repeating the kind of mistake that allowed the original SARS-CoV-2 strain to escape China in the first place.

‘Last week, Eddie Holmes reflected on the fateful moment when he tweeted the virus’s original genetic code. It was a moment of triumph for collaborative science, but the work was just beginning. The triumph must be repeated daily. “What worries me most of all is if politics gets in the way of data sharing and science,” he told Medscape. “Step one has to be immediate, rapid, open data sharing. Speed is of the essence in a pandemic. Any barrier to working together makes this a much less safe world. That should be the lesson of this outbreak.”

Read here (The Atlantic, Jan 15, 2021) 

Chinese health experts call to suspend Pfizer's mRNA vaccine for elderly after Norwegian deaths

‘Chinese health experts called on Norway and other countries to suspend the use of mRNA-based COVID-19 vaccines produced by companies such as Pfizer, especially among elderly people, due to the vaccines' safety uncertainties following the deaths of 23 elderly Norwegian people who received the vaccine. 

‘The new mRNA vaccine was developed in haste and had never been used on a large scale for the prevention of infectious disease, and its safety had not been confirmed for large-scale use in humans, a Chinese immunologist said. The death incidents in Norway also proved that the mRNA COVID-19 vaccines' efficacy was not as good as expected, experts said. 

‘As of Thursday, Norway has reported 23 deaths in connection with vaccination."So far, 13 of these have been assessed. Common side effects may have contributed to a severe course in frail elderly people," the Norwegian Medicines Agency said on its website. All the deaths have occurred in frail, elderly patients in nursing homes. All are over 80 years old and some of them over 90, Norwegian media NRK reported.’

Read here (Global Times, Jan 15, 2021)

Moderna CEO: World will have to live with COVID-19 ‘forever’

‘As new, more infectious variants of COVID-19 continue to pop up in the U.S. and other parts of the world, Stephane Bancel, CEO of Moderna, which is the maker of one of two coronavirus vaccines approved for use by the Food and Drug Administration, believes the virus could be around “forever.”

‘Speaking during a panel discussion at the annual JPMorgan Healthcare Conference, Bancel said he agrees with emerging data suggesting that “SARS-CoV-2 is not going away. We are going to live with this virus, we think, forever,” he said, according to a CNBC report.’

Read here (Christian Post, Jan 15, 2021)

EU looks at vaccine certificates to help summer tourism

‘The European Union is looking at a common vaccine certificate to help get travelers to their vacation destinations and prevent tourism from suffering another disastrous year due to the coronavirus pandemic.

‘European Commission President Ursula von der Leyen said the certificates for individuals who have been vaccinated could be combined with COVID-19 tests for those awaiting shots to allow as many people as possible to travel during the summer, which is vital for warm weather Mediterranean destinations like Greece, Italy and Spain.’

Read here (AP, Jan 15, 2021)

Emergency ordinance gives Muhyiddin carte blanche – P Gunasegaram

‘The Emergency (Essential Powers) Ordinance, already in effect from January 11, gives unfettered powers to Prime Minister Tan Sri Muhyiddin Yassin in the name of the king, going far beyond what is required to control the Covid-19 pandemic.

‘It provides numerous avenues for a substantial abuse of power, without any checks and balances whatsoever, including the power to appoint a committee that could potentially extend the life of the emergency, and the power to temporarily seize land, building and movable property, and unilaterally decide the compensation for this.’

Read here (The Vibes, Jan 15, 2021)

FTTISI:The bedrock of Covid-19 infection control — Dr Musa Mohd Nordin and Dr Mohammad Farhan bin Rusli

‘The key element in the blueprint of action to mitigate this Covid-19 national emergency, must surely be a well executed Find, Test, Trace, Isolate and Support (FTTIS) system recommended by the WHO, which has fallen terribly short in national implementation.

‘The FTTIS system Finds and Tests hotspots of Covid-19 outbreaks. Rapid Isolation of cases and quarantine of close contacts through Tracing is extremely critical. Isolation will only work if the rakyat, especially the B40, receive Support during the MCO period with food security and financial Support.

‘The government through its relevant ministries and agencies must provide this social security net and support to this new policy of home isolation to ensure its success. Otherwise, the rakyat will fail to comply with home isolation, in order to search for and put food on the table and scour for basic home essentials. The government already has in place Low Risk Isolation Centres for households who are unable to effectively isolate at home.

‘Clinical support is also vital for monitoring the health of cases and contacts who are undergoing home isolation in the community.’

Read here (Malay Mail, Jan 15, 2021)

Ivermectin is now a therapeutic option for doctors & prescribers

‘One week after Dr. Paul Marik and Dr. Pierre Kory – founding members of the Front Line Covid-19 Critical Care Alliance (FLCCC) – along with Dr. Andrew Hill, researcher and consultant to the World Health Organization (WHO), presented their data before the NIH Treatment Guidelines Panel, the NIH has upgraded their recommen­da­tion and now considers Ivermectin an option for use in COVID-19.

‘Their recommendation has now been upgraded to the same level as those for widely used monoclonal antibodies & convalescent plasma, which is a “neither for nor against” recommen­da­tion. The significance of this change is that the NIH has decided to no longer recommend against the use of ivermectin in the treatment of COVID-19 by the nation’s health care providers. A consequence of this change is that ivermectin has now been made a clear therapeutic option for patients.’

Read here and press release here (FLCCC Alliance, Jan 15, 2021)

As system buckles, MOH cuts down testing of close contacts

‘With the healthcare system at breaking point due to the surge in the number of Covid-19 patients, the Ministry of Health is trying several new approaches to ease the burden. Yesterday, the ministry issued a new circular containing changes in contact tracing and priority for swab tests.

‘According to Health Ministry sources, they would no longer test every individual identified as close contacts to Covid-19 positive patients and instead only test those with symptoms. "All close contacts must be identified, ordered to undergo isolation and monitoring at home. However, Covid-19 screening test would be done only on close contacts who are symptomatic," said the notice sighted by Malaysiakini.’

Read here (Malaysiakini, Jan 14, 2020)

Why use emergency when we freely offered help? Asks medical group

‘Galen Centre for Health and Social Policy CEO Azrul Mohd Khalib said the proclamation of an emergency appeared to involve harnessing the resources of the private sector, based on Prime Minister Muhyiddin Yassin’s speech on Tuesday. He said this could mean some private hospitals and medical facilities being requisitioned to increase the public health sector’s capacity for intensive care, beds and specialised personnel.

‘However, he told FMT that private healthcare stakeholders, particularly hospitals, had been trying to get some form of a public-private operational framework for Covid-19 and non-Covid-19 cooperation and funding since early 2020. “However, there has been limited movement on this issue. The latest decision must come as a shock, as the government seems to want to use emergency legislation to get what was willingly offered,” he said.’

Read here (Free Malaysia Today, Jan 14, 2021)

Khairy: If you’re a healthy Malaysian under 60 and not a frontliner, expect to be vaccinated only by Q3 2021 or even later

‘Malaysians who are not active frontliners, below the age of 60 and in relatively good health can expect to receive their dose of Covid-19 vaccinations only by the third-quarter of this year or later, the science, technology and innovation minister revealed today. Khairy Jamaluddin, also the Special Committee on Ensuring Access to Covid-19 Vaccine Supply (JKJAV) co-chair, said this is because the first batch of vaccines to arrive will be prioritised to inoculate those within vulnerable groups. 

“Frontline workers from the healthcare and security sectors will go first. Then senior citizens and people with chronic illnesses. Only then we will move on to the general population in order to get to a meaningful herd immunity threshold.’

Read here (The Malay Mail, Jan 14, 2021)

Covid’s toll on smell and taste: What scientists do and don’t know

‘Early in the COVID-19 pandemic, it emerged that many people infected with the SARS-CoV-2 virus were losing their sense of smell — even without displaying other symptoms. Researchers also discovered that infected people could lose their sense of taste and their ability to detect chemically triggered sensations such as spiciness, called chemesthesis.

‘Almost a year later, some still haven’t recovered these senses, and for a proportion of people who have, odours are now warped: unpleasant scents have taken the place of normally delightful ones. Nature surveys the science behind this potentially long-lasting and debilitating phenomenon:

• How many people with COVID-19 lose their sense of smell?
• Why do people with COVID-19 lose their sensitivity to smells?
• How quickly do the impaired senses return?
• How does permanently losing the chemical senses affect a person?
• Are treatments available for restoring these senses?

Read here (Nature, Jan 14, 2021)

Past Covid-19 infection may provide 'months of immunity'

‘Most people who have had Covid-19 are protected from catching it again for at least five months, a study led by Public Health England shows. Past infection was linked to around a 83% lower risk of getting the virus, compared with those who had never had Covid-19, scientists found.

‘But experts warn some people do catch Covid-19 again - and can infect others. And officials stress people should follow the stay-at-home rules - whether or not they have had the virus.’

Read here (BBC, Jan 14, 2021) 

Cracks in the vial of China’s vaccine diplomacy

‘Clouds are gathering over Indonesia’s Covid-19 inoculation rollout plan after Brazilian scientists reported this week that the efficacy of China’s CoronaVac vaccine was just barely over 50%. The readout was well below the 78% mark the same Brazilian researchers asserted last week and considerably lower than trials on the Sinovac-produced vaccine conducted in other countries.

‘Indonesia, which has the highest number of Covid-19 cases in Southeast Asia at 850,000, has already ordered 125.5 million CoronaVac doses. Its president, Joko Widodo, received a shot of the same vaccine on Wednesday morning in a symbolic start to Indonesia’s national vaccination program. Two days earlier, Indonesia’s food and drug agency became the first regulator in the world to approve use of the Sinovac vaccine, after its own local trials found 65.3% efficacy, above the World Health Organization’s 50% threshold for advised use.’

Read here (Asia Times, Jan 14, 2021)

After months of bashing Russia’s Sputnik V vaccine, Western journalists in Moscow line up to be inoculated against Covid-19

‘Since Russian President Vladimir Putin announced the registration of Sputnik V, the world's first vaccine against Covid-19, sections of the Western media have taken aim at a formula they’ve dubbed both dangerous and ineffective. However, in recent weeks, Moscow-based representatives of the very same outlets have lined up to receive the much-maligned Sputnik V. Living in Russia, it is no surprise that the correspondents have a much more realistic view of the country than their New York and London-based superiors.

‘On Friday, the New York Times’ Andrew Kramer revealed he had received his first dose of Sputnik V, praising the “bona fide accomplishment for Russian scientists continuing a long and storied practice of vaccine development,” even noting that Moscow has avoided some of the logistical problems seen in the West.’

Read here (RT, Jan 14, 2021)

Covid: WHO team probing origin of virus arrives in China

‘A World Health Organization (WHO) team has arrived in the Chinese city of Wuhan to start its investigation into the origins of the Covid-19 pandemic. The long-awaited probe comes after months of negotiations between the WHO and Beijing. A group of 10 scientists is set to interview people from research institutes, hospitals and the seafood market linked to the initial outbreak.’

Read here (BBC, Jan 14, 2021) 

Emergency: Minister says govt benefits from more power to manage Covid-19

‘Defence Minister Ismail Sabri Yaakob has defended the government’s use of the national emergency, saying it allows Putrajaya additional powers it can use to better manage the Covid-19 pandemic. Such powers include fining private hospitals up to RM5 million for refusing government requests.

‘Provided the Yang di-Pertuan Agong assents to the relevant ordinances, Ismail said the state of emergency also accords the army “the same powers” as the police. “Like now, the army can arrest undocumented workers. They can take direct action by arresting them and putting them in a lock-up.’

Read here (Malaysiakini, Jan 14, 2021)

Military gets emergency power to detain MCO offenders

‘Officers and personnel of the Malaysian armed forces now have the power to detain and take action against those found violating the movement control order, senior minister for security Ismail Sabri Yaakob said today. He said that the Emergency Ordinance provides similar authority to the police and military, which would help efforts to manage the Covid-19 crisis better.

“If previously the armed forces could only take action if there was border intrusion, now they can detain suspects for further action without the presence of police,” he said at his daily media briefing.’

Read here (Free Malaysia Today, Jan 14, 2021) 

Khairy explains Malaysia's vaccine procurement process, delivery schedule (full text)

‘As two of Malaysia's closest neighbours, Singapore and Indonesia, kicked off their vaccination programmes, Science, Technology and Innovation Minister Khairy Jamaluddin wrote a blog post to give an update on what Malaysia's vaccine procurement process is like — why it is not slow in getting its vaccines — and the delivery schedule that Malaysians can expect. Khairy is also the co-chair of the Special Committee on Ensuring Access To Covid-19 Vaccine Supply.’

Read here (The Edge, Jan 14, 2021)

Brazil trial finds efficacy of Sinovac vaccine at 50.4 percent

‘A coronavirus vaccine developed by China’s Sinovac Biotech was found to be just 50.4 percent effective at preventing symptomatic infections of COVID-19 in a Brazilian trial, researchers said on Tuesday, barely enough for regulatory approval and well below the rate announced last week.

‘The latest results are a substantial disappointment for Brazil, as the Chinese vaccine is one of two that the federal government has lined up to begin immunisation during the second wave of the world’s second-deadliest COVID-19 outbreak.’

Read here (Aljazeera, Jan 13, 2021)

We can't afford to wait for Covid-19 vaccines to be rolled out. Here’s what we can do to curb the virus now (The US situation)

• First, we need to get every American a high-filtration mask
• Second, schools and workplaces need to be made safer
• Third, we must protect our essential workers
• Fourth, we need to urgently build a functioning nationwide “test, trace, isolate, support” (TTIS) system
• Fifth, the US needs a “circuit breaker” to break the chains of transmission

Read here (Time magazine, Jan 13, 2021)

Sinovac releases vaccine data in Brazil: 100% effective in preventing severe cases, could reduce hospitalizations by 80%

‘Sinovac's COVID-19 vaccine is 100 percent effective in preventing severe and moderate infections, 77.96 percent effective in preventing mild cases, and has an overall efficacy of 50.4 percent in Brazil's final-stage trials. Experts say the result is good enough considering almost all participants in Brazil are high-risk medical workers, and the 77.96 efficacy for mild-case protection means the vaccine can reduce 78 percent of people from needing hospitalization. 

‘We have today one of the best vaccines in the world, Dimas Covas, director of the Butantan Institute in Brazil, said during a news conference on Tuesday.’

Read here (Global Times, Jan 13, 2021)

I spoke to 99 big thinkers about what our world after coronavirus might look like: This is what I learned

‘For me, it was truly a season of learning. Among other things, it helped me understand why COVID-19 is not a storm that we can just wait out. Our pre-pandemic world was anything but normal, and our post-pandemic world will not be like going back to normal at all. Here are four reasons why:

• Disruption will accelerate
• Politics will become more turbulent
• Pandemic habits will persist
• Crisis will create opportunities

Read here (Fast Company, Jan 13, 2021)

Covid-19: Thank you, Agong, for declaring national state of Emergency — Malaysian Medical Association

‘The Malaysian Medical Association (MMA) wishes to thank His Majesty Yang di-Pertuan Agong Al-Sultan Abdullah Ri’ayatuddin Al-Mustafa Billah Shah for declaring a national state of Emergency to bring the Covid-19 situation in the country under control.

‘We also support the government’s decision to implement the second MCO in six states — most affected by the surge in cases of Covid-19, the CMCO in six other states and the RMCO in Perlis and Sarawak. MMA will provide support in any way it can to assist the Health Ministry and the government manage the Covid-19 situation in the country. We urge the public to give their full support by fully adhering to the MCO’s SOPs that will be announced this evening.

‘A second MCO is indeed necessary as cases of Covid-19 have been consistently on the rise with no sign of improvement. There is also spread in the community and the infection rate has not come down from the current RO of between 1.1 and 1.2. There is also concern over the B117 Covid-19 strain known as the UK strain that has been detected in the country...’

Read here (Malay Mail, Jan 12, 2021)

Taiwan’s coronavirus success, job opportunities lure foreigners to talent-thirsty island

‘Taiwan is becoming increasingly attractive for expats, with the number of foreigners obtaining residency permits and entrepreneur visas climbing in recent years. The island is tempting international professionals with its successful handling of the pandemic, its media freedoms and ‘gold card’ scheme for skilled workers.’

Read here (South China Morning Post, Jan 12, 2021)

Vaccines were a chance to redeem failures in the US coronavirus response. What went wrong?

‘The delayed and disjointed vaccine rollout is the product of poor coordination between the federal government and the 50 states and additional jurisdictions tasked with carrying out the most ambitious immunization campaign in history, likened by officials to the effort to turn back the Nazis in 1944.

‘With these problems thwarting the rollout, it is clear the United States has not learned from its fractured pandemic response and risks repeating some of the same errors.

“My peers in infectious-disease medicine and public health are all looking around saying, ‘How are you all handling these issues? What happens when we get airdropped vaccines? Who gets it first? How do we do it equitably?’ ” said David Aronoff, director of the division of infectious diseases at Vanderbilt University Medical Center.’

Read here (Washington Post, Jan 12, 2021)

Covid-19 herd immunity unlikely in 2021 despite vaccines: UN

‘The World Health Organization’s chief scientist warned that even as numerous countries start rolling out vaccination programs to stop COVID-19, herd immunity is highly unlikely this year.

‘At a media briefing on Monday (Jan 11), Dr Soumya Swaminathan said it was critical countries and their populations maintain strict social distancing and other outbreak control measures for the foreseeable future. In recent weeks, Britain, the US, France, Canada, Germany, Israel, the Netherlands and others have begun vaccinating millions of their citizens against the coronavirus.’

Read here (Channel News Asia, Jan 12, 2021)

Scientists call for pause on AstraZeneca vaccine rollout

‘The Australian and New Zealand Society for Immunology says the federal government should immediately pause the planned rollout of the AstraZeneca vaccine because it may not be effective enough to generate herd immunity.

‘Phase three clinical trials of the vaccine, which is the centrepiece of Australia's vaccination strategy, show it is only 62 per cent effective in preventing COVID-19 when given in the recommended dose. Trials suggest vaccines from Pfizer and Moderna are about 95 per cent effective.’

Read here (Sydney Morning Herald, Jan 12, 2021)

Post-Covid world discourse: Four fault lines

‘There is a plethora of published views, opinions and emerging evidence available on what the post-COVID world might look like. A broad consensus seems to exist regarding how things won’t – or can’t – go back to the way they were before. A ‘new normal’ will emerge resulting in a significant refashioning of the status quo, for economic agents as well as governance structures globally.

‘But a review of the opinions and outlooks out there so far suggests that there are a number of vital gaps that need to be brought forth if we are to ‘build back better’ and in an inclusive and sustainable way. These include:

1. Southern voices and local contexts are missing
2. Limited focus on long-term implications
3. Over-generalised perceptions about anticipated changes
4. Absent national level analysis of global trends’

Read here (On think tanks, Jan 11, 2021)

Travel body rejects compulsory COVID-19 shots as experts say herd immunity not close

‘Some policymakers have proposed immunisation should be compulsory for air travel as the world steps up the battle to curb the spread of Covid-19, and Australia's Qantas Airways has said it plans to introduce such a requirement. But Ms Gloria Guevara, chief executive of the World Travel and Tourism Council, said such moves would be similar to workplace discrimination.

"We should never require the vaccination to get a job or to travel," Ms Guevara, whose organisation represents a sector that has been badly hit by the pandemic and accounts for as much as 10 per cent of global employment, told a panel at Reuters Next.’

Read here (Reuters, Jan 11, 2021)

Vitamin D and Covid-19: Why the controversy?

‘The issue of vitamin D supplementation has been extensively debated, with strong arguments in favour and against. The COVID-19 pandemic has further escalated the discussion. It has long been clear that groups that traditionally exhibit vitamin D deficiency or insufficiency, such as older adults and nursing home residents, and Black, Asian, and minority ethnic populations, are the same groups that have also been disproportionately impacted by COVID-19. Additionally, increased time spent indoors due to strict lockdowns and shielding triggered concerns that some people might not obtain the necessary physiological levels of vitamin D from sunlight...

‘On Dec 17, 2020, the National Institute for Health and Care Excellence (NICE), in collaboration with Public Health England and the Scientific Advisory Committee on Nutrition, published an updated rapid review of recent studies on vitamin D and COVID-19. Their recommendations support the current government advice, revised in April, 2020, during the first lockdown in the UK, for everyone to take vitamin D supplements to maintain bone and muscle health during the autumn and winter months... However, the rapid review concluded that sufficient evidence to support vitamin D supplementation with the aim of preventing or treating COVID-19 was still lacking and that the topic should be further investigated. Experts studying vitamin D welcomed the call for more research, but the lack of specific recommendations in the context of COVID-19 was also met with disappointment by many in the scientific community who have argued that vitamin D supplementation is generally safe and that any potential low toxicity would likely be strongly outweighed by any potential benefits in relation to protection from COVID-19.

‘NICE should continue to monitor new evidence as it is peer-reviewed and published, including results from several clinical trials on vitamin D and COVID-19 outcomes that are currently underway. However, particularly in countries where the pandemic situation continues to worsen (and will continue to do so during the winter months before the effects of vaccinations become perceptible), additional evidence could come in just too late. In an ideal world, all health decisions would be made based on overwhelming evidence, but a time of crisis may call for a slightly different set of rules.’ [blog editor’s emphasis]

Read here (The Lancet, Jan 11, 2021)

Indian nasal Covid vaccine can be potential gamechanger: Experts

 Indian nasal Covid vaccine can be potential gamechanger: Experts

‘Public health experts believe that intranasal vaccines for coronavirus, administered through nose rather than muscles, can be a potential gamechanger in Indias fight against the coronavirus pandemic. The nasal vaccine is different from two intramuscular vaccines which recently got approval, as it is non-invasive, needle-free, doesn't require trained healthcare workers, eliminates needle-associated risks, suits children and adults and has scalable manufacturing.

‘Several studies have proved that the clinical efficacy of intranasal vaccine is superior to that of injectable vaccine. In India, Hyderabad-based Bharat Biotech has sought Drugs Controller General of India's (DCGI) approval to conduct clinical trials of its nasal vaccine for coronavirus.’

Read here (Khaleej Tinmes, Jan 10, 2021)

Coronavirus: Chinese study finds most patients still show signs of ‘long Covid’ six months later

‘Most patients who received hospital treatment for Covid-19 developed long-term health problems, according to a large-scale study from China. Researchers found that 76 per cent of those discharged from one hospital in Wuhan, the city at the centre of the outbreak, still showed at least one symptom associated with the disease six months later.

“Fatigue and sleep difficulties, which occurred in 63 per cent and 26 per cent of the patients respectively, were the most common problems. To the surprise of the researchers, over a third of the patients showed signs of kidney malfunction, which led to problems such as an increase in bodily waste in the blood and increased the risk of sexual dysfunction.’

Read here (South China Morning Post, Jan 10, 2021)

Noor Hisham’s cry for help answered? – P. Gunasegaram

‘Our top Covid-19 fighter needs to be given leeway to do this. After all, before the ill-fated Sabah election, he was doing a great job of containing the virus, earning not only the gratitude and adulation of the whole country, but also gaining international recognition for successfully keeping the disease at bay in Malaysia. We were justifiably proud of him then, but the politicians have spoiled it, as they have done with so many things over so many years.

‘It is rather peculiar that the PM’s special adviser on public health, Tan Sri Dr Jemilah Mahmood, takes a directly opposite stance to Dr Noor Hisham’s on the preparedness of the health service.

‘When asked what the government should be doing, she told BFM radio yesterday: “My advice is that we have to have a very clear game plan. Right? That means I don’t agree that the health system is at a breaking point – it is  easy to throw these words around. If you look at the situation in the UK, Italy, the US and all that, people, the health professionals, the health system, will find ways to cope.”

‘Surely Dr Noor Hisham, as health director-general, knows much more about the preparedness of the service that he oversees than Dr Jemilah, even if she is special adviser to the PM. And does Dr Jemilah want us to go the way of the UK, Italy and the US? Surely not.’

Read here (The Vibes, Jan 9, 2021)

Prevalence and risk factors for delirium in critically ill patients with Covid-19: A multicentre cohort study

‘In this large, international cohort study of more than 2000 patients with severe COVID-19, acute brain dysfunction (coma or delirium) was more common and more prolonged than observed in other studies of patients with acute respiratory failure without COVID-19. Patients with COVID-19 also received treatment with sedatives for a prolonged duration: two-thirds of patients were given benzodiazepines and propofol for a median of 7 days. 

‘As a result of the COVID-19 pandemic, many ICUs were operating in resource-constrained environments, and despite demonstrated efficacy in previous studies, evidenced-based strategies, such as light sedation techniques, spontaneous awakening and breathing trials, avoiding benzodiazepines, early mobility, and family visitation, all occurred on fewer than 1 in every 3 days among patients with severe COVID-19. We found that risk of delirium among patients with severe COVID-19 was lower when benzodiazepine sedative infusions were avoided and family was present, whereas greater severity of illness and greater respiratory support was associated with a higher risk of delirium.’

Read here (The Lancet, Jan 8, 2021)

Thailand, Indonesia and Philippines to roll out Chinese vaccines

‘Three Southeast Asian countries – Indonesia, the Philippines and Thailand – are poised to roll out COVID-19 vaccines produced by the Chinese pharmaceutical company Sinovac.’

Read here (CGTN, Jan 8, 2021) 

How Gamaleya’s vaccine (Sputnik V) works

‘The Gamaleya Research Institute, part of Russia’s Ministry of Health, developed a coronavirus vaccine known as Sputnik V or Gam-Covid-Vac. Gamaleya announced in December that the vaccine had an efficacy of 91.4 percent. Russia is using it in a mass vaccination campaign, and it is now being distributed in Argentina, Belarus and other countries.’ This story tells you in graphic form how it works...

Read here (New York Times, Jan 8, 2021)

A second Chinese coronavirus vaccine is said to be effective

‘Brazilian officials said Thursday that a coronavirus vaccine made by a Chinese company was effective, bolstering the chances of approval for a second Chinese inoculation that could be rolled out in much of the developing world. Officials in the state of São Paulo, where a prominent medical research institute carried out a large study of the vaccine made by the Beijing-based Sinovac, said the inoculation had an efficacy rate of 78 percent.

‘The vaccine prevented all participants from developing serious and mild complications from the virus, officials said, calling it a highly effective preventive tool. Sinovac Biotech has sold more than 300 million doses to the developing world, filling a gap left by Western countries.’

Read here (New York Times, Jan 7, 2021)