A doctor's fight for survival in ICU

‘On Dec 27, 2020, after 23 days in the hospital, I was finally allowed to return home. I was told that my blood parameters and X-ray would only return to normal after many months. All this would not have been possible if not for the prayers and love of my wife, family, friends and God. I was grateful for a strong social support group...

‘It's been a month since I was discharged from the hospital, but my joints still hurt, I suffer from fatigue and shortness of breath when walking far or fast. There is also social stigma as many people won't come near me because I'm a former Covid-19 patient. A friend even declined my small change claiming that the virus would be on it.’

Read here (Malaysiakini, Feb 1, 2021)

Efficacy of the AstraZeneca-Oxford University vaccine: A preprint for The Lancet

‘A study (preprint for The Lancet) of data from the Phase 3 clinical trials of the AstraZeneca-Oxford University vaccine evaluated vaccine efficacy after a single dose and for alternate timing for the booster dose. Notably, the UK adapted the timing for the booster dose from 4 weeks after the first dose—which is how the vaccine was designed to be administered and the timing used for clinical trials—to 12 weeks in an effort to provide the first dose to as many people as possible. This study assessed the vaccine’s efficacy in participants who received the 2 doses between 4 and 12 weeks apart.

‘The researchers found that the efficacy after the first dose did not wane in the first 12 weeks. A single dose of the vaccine was 76% efficacious in preventing symptomatic COVID-19 disease in the first 90 days after vaccination, although it was associated with a substantial decrease in efficacy with respect to preventing asymptomatic infection. Notably, however, the additional asymptomatic infections could potentially be among participants who would have otherwise developed COVID-19 symptoms. Additionally, the efficacy in preventing symptomatic disease was higher in participants who received the booster dose later than in those who received it earlier. Vaccine efficacy was 82.4% among participants who received their booster dose 12 weeks or longer after the first dose, compared to 54.9% in those who received their 2 doses less than 6 weeks apart. These results provide support for vaccination plans that delay the booster dose beyond the intended 4 weeks, considering that the immunity conferred after the first dose appears to be relatively stable over the first several months and the overall protection appears to increase with an increased time between the prime and booster doses.

‘The researchers also found that vaccination was associated with an overall reduced risk of infection—54.9% efficacy for 2 doses and 67% efficacy for 1 dose—which provides evidence that the vaccine could also provide protection against SARS-CoV-2 transmission. The role of SARS-CoV-2 vaccines in mitigating transmission risk remains uncertain, but these findings provide a promising indication that vaccination could reduce community spread of the virus, which would be a major tool to bring the pandemic under control.’

**The above summary was contained in an update of Feb 5, 2021, on the COVID-19 pandemic from the Johns Hopkins Center for Health Security 

• Single dose administration, and the influence of the timing of the booster dose on immunogenicity and efficacy of ChAdOx1 nCoV-19 (AZD1222) vaccine

Read here (The Lancet, Feb 1, 2021)

Coronavirus: After Wuhan, it’s time for global response reset, says Covid-19 probe chief

‘Covid-19 has exposed global deficiencies in the response to dangerous infectious diseases and the international system will need to be strengthened to raise alerts and deal with future outbreaks, according to Helen Clark, co-head of an international panel investigating the pandemic.

‘Despite the novel coronavirus emerging in a world with rapid communication services, it was notable how slow the global response to the outbreak was after it was first detected in China, said Clark, a former prime minister of New Zealand and one-time head of the United Nations Development Programme.

“Every day counts if you are trying to stop an infectious disease of unknown origin,” she said in an interview with the South China Morning Post. “There just doesn’t seem to be enough happening quickly enough, from the time of first awareness of the cluster onwards, and here we are.

“The WHO didn’t have all the information it needed, and – let’s be fair here, we are still discovering things about Covid-19 every day, we are on a very steep learning curve – but all the more reason, I would think, for applying a precautionary principle. If it smells bad, it may well be bad,” she said, referring to the early days of the pandemic.’

Read here (South China Morning Post, Feb 1, 2021)

How Singapore picked its Covid-19 vaccines

‘Last June, Singapore sealed its first deal to buy Covid-19 vaccines - before any of the more than 200 vaccine candidates had even started their phase three clinical trials. It decided not to wait for the trials, and even paid a premium on the price, in order to secure some early stock of vaccines for people here at high risk, such as healthcare workers and the elderly. That was for the Moderna mRNA vaccine, which has yet to be approved for use here.

‘Singapore signed two more purchase agreements in August - with Sinovac which produces a traditional vaccine, and Pfizer-BioNTech which also uses mRNA. These purchases should provide sufficient vaccines for the entire adult population. But Singapore is buying more. Dr Benjamin Seet, who chaired the panel that picked the vaccines for Singapore, said several late-stage discussions are still ongoing with a handful of other companies - as part of a contingency plan should there be disruptions in the supply of purchased vaccines, delays in the delivery, or even the need for further booster shots.’

Read here (Straits Times, Feb 1, 2021) 

The mystery of India's plummeting Covid-19 cases

‘Last September, India was confirming nearly 100,000 new coronavirus cases a day. It was on track to overtake the United States to become the country with the highest reported COVID-19 caseload in the world. Hospitals were full. The Indian economy nosedived into an unprecedented recession.

‘But four months later, India's coronavirus numbers have plummeted. Late last month, on Jan. 26, the country's Health Ministry confirmed a record low of about 9,100 new daily cases — in a country of nearly 1.4 billion people. It was India's lowest daily tally in eight months. On Monday, India confirmed about 11,000 cases.

"It's not that India is testing less or things are going underreported," says Jishnu Das, a health economist at Georgetown University. "It's been rising, rising — and now suddenly, it's vanished! I mean, hospital ICU utilization has gone down. Every indicator says the numbers are down." Scientists say it's a mystery. They're probing why India's coronavirus numbers have declined so dramatically — and so suddenly, in September and October, months before any vaccinations began.

‘They're trying to figure out what Indians may be doing right and how to mimic that in other countries that are still suffering.’

Read here (NPR, Feb 1, 2021)

Is Noor Hisham a bystander in the Covid-19 crisis? Frankie de Cruz

‘Some claim the director-general of health, who wasn’t fazed by whatever was thrown at him in the early days of the crisis, is in a political straitjacket. Could it be that his views have narrowed the political and economic choices of those in power to relatively tight parameters?

‘If that is true, it needs fixing. In the meantime, the people expect professionalism and strong leadership at a time when Covid-19 infections and deaths are rising. That means Noor Hisham has to be firm and shoot straight to give Malaysians the confidence that the war is being fought with confidence.’

Read here (Free Malaysia Today, Jan 31, 2021)

Private practitioners welcome govt roping in GPs to monitor Covid-19, call for guidance

‘The Federation of Private Medical Practitioners’ Association (FPMPAM) has welcomed the government’s upcoming move to task private general practitioners (GPs) with monitoring some Covid-19 patients. However, it called for more guidance for the GPs. 

‘Health Minister Dr Adham Baba said yesterday that the cabinet had agreed to amend the Emergency (Essential Powers) Ordinance 2021 to empower private GPs to issue home quarantine orders.

‘The Malay Mail quoted him as saying such orders can be issued without the need of a positive test result if a patient displays Covid-19 symptoms or is suspected to have the virus. GPs will also be equipped with an unspecified device that can help identify Covid-19 patients, he added.’

Read here (Malaysiakini, Jan 31, 2021)

Vaccine wars: The global battle for a precious resource

‘Armed guards are patrolling the perimeter fence of a sleek factory. Software experts are fending off hackers. Border officials are checking trucks and ferries, not for weapons or illegal immigrants, but for a mysterious biochemical soup, while spies and spin doctors are feeding social media with scare stories flaming one national champion or another. Welcome to the first great geopolitical battle of the 21st century. It may sound like something ripped from the pages of a dystopian sci-fi novel, but in truth we’re seeing the opening salvos in the vaccine wars.

‘Rather than co-operating with one another to roll out a global vaccination campaign to rid the world of Covid-19, the major powers of the world are instead descending into a fierce, increasingly nationalistic competition. The EU is threatening to hold back supplies from Britain, the Americans are scooping up supplies wherever they can, and the Russians and the Chinese are engaged in a form of ‘vial diplomacy’ reminiscent of the Cold War. It is all starting to turn very, very nasty. We are seeing how quickly our globalised world collapses when push comes to shove. The effect of all this on national security, on industrial policy and on the movement of people around the world will be felt for many years to come.’

Read here (The Spectator, Jan 30, 2021)

The vaccine, migrant workers and herd immunity -- Jeyakumar Devaraj

‘Let us look at the numbers - our population is 31 million. We have six million migrant workers and another 200,000 refugees. So altogether there are 37.2 million people residing in Malaysia. 

‘The government has said that children and pregnant women will not be given the Covid vaccine - that is about six million children 12 years and below and 0.5 million pregnant women. 6.5 million is 17.5 percent of 37.2 million.

‘In other words, we could achieve our 80 percent immunisation rate if all migrant workers also took the vaccine. But if all of them didn’t, then we would have 12.7 million not vaccinated - children, pregnant mums, migrant workers and refugees - and 12.7 million is 34 percent of 37.2 million. We only achieve a vaccination rate of 63 percent - far short of the 80 percent we need to get herd immunity!’

Read here (Malaysiakini, Jan 30, 2021)

Malaysia in Covid-19 crisis? — Musa Mohd Nordin

‘We are plagued with the Double Whammy. MCO + EO. A poorly managed Pandemic in bed with a poorly managed Politics. Pandemic + Politics. It cannot get any more worse! Yesterday Malaysia was in panic mode! Triggered by the humongous Covid-19 numbers Chill out Malaysia! It is NOT REAL TIME case numbers. These are just BACKLOG cases only just being reported

‘Contact Tracing is virtually at a STANDSTILL. An officer at a PKD had 600 contacts to trace and yesterday was slapped with another 700 to trace These are all the manifestations of a failure of the system. There is a breakdown in the FTTIS work flow! How much longer can we tolerate these failings and lackluster performance?

‘It has been SYSTEMS GO in Selangor over and above the efforts of JKNS. They are our buddies in Selangor to rid Covid-19. Please share this widely with your friends in Selangor.

‘STFO is the Operations arm of STFC [Selangor Task Force on Covid-19] led by Public Health Physician, Prof Farhan [Asst Prof Dr Mohammad Farhan bin Rusli (Consultant Public Health Physician, International Islamic Universiti Malaysia)] to bust Covid-19. It aims TO FLATTEN THE CURVE IN THE COMMUNITY WITHIN 4 WEEKS. The MCO + EO has interrupted STFO operations. With JKNS they are resuming with vigor with the blessings of the State Government.

STFO Blueprint of Action

1. ALL +ve or household that is +ve to register under SELangkah (so that state govt can provide home kits
2. ALL high risk and household with HIGH risk persons, to pre register SELangkah: (a) for B40, we provide voucher (FREE testing) to go to nearest Selcare clinic panel (static) or mass screening (mobile); (b) for non-B40, encourage them to do testing (we provide list of participating Selcare panel clinic)
3. Community mass screening (mobile) to HIGH RISK RANK areas (from ACURA) to HIGH RISK individuals OR HOUSEHOLDS with HIGH RISK individuals (from pre-register SELangkah) e.g. (a) Old folks home (b) Hemodialysis centers (c) Nursing homes for the elderly 
4. Mass screening (mobile) to HIGH RISK super spreaders e.g. (a) communities living in crowded spaces (b) families in PPR flats (c) migrants (d) refugees. Data obtained from community leaders, refugee/migrant centric NGOs, UNHCR.
5. State / Selgate to buy RTK-Ag in bulk. To provide at minimal cost to Selcare Clinic panel. Participating Selcare Clinic panel to provide at standard low cost price. At least 2 participating Selcare panel per district.
6. To encourage ADUN to subsidise the cost and liase with respective participating Selcare clinic panels
7. To increase  Health Education Advocacy to do testing and isolate: (a) SYMPTOMATIC individuals with +ve close contacts must ASAP do testing & treatment (if needed) at nearest KKM's facility. Call 999 if severe symptoms (b) ASYMPTOMATIC individuals with +ve close contacts, encourage to do testing at nearest participating Selcare Clinic panel (c) SYMPTOMATIC inviduals with NO +ve close contacts, must do testing at nearest KKM's facility (or participating Selcare clinic - if KKM reject testing)
8. Activate GEOFENCING via SELangkah AND communicate SELamat warning system
9. Home Kits provided by STFO: Face Masks, Hand sanitiser, Information pamphlet,  Foodpack / vouchers -- for B40, unemployed, does day jobs,  SpO2 monitors include training and monitoring (for high risk patients only)

Read here (Malay Mail, Jan 31, 2021)

Covid-19: It’s all doom and gloom unless… — Dr Musa Mohd Nordin

‘There is much misunderstanding about the Covid-19 situation in the country. In particular, the high rates in the Klang Valley and the role of the only state task force, the Selangor Task Force on Covid-19 (STFC)...

‘In many ways, if the STFC had not stepped in, did mass testing, rolled out POIS (Prevention of Outbreaks at Ignition Sites), allocated Z millions for FTTIS (find, test, trace, isolate, and support), the situation in Selangor would be far worse, critical even...

‘And other states, industries, agencies, etc, are buying in STFC’s POIS programme and implementing it. This tripartite initiative between government-industry-NGOs pivots on three preventative strategies namely, enhanced public health measures, early detection testing regime and health education. So STFC doesn’t just talk but rolls out programmes, mass testing, POIS, procuring vaccines, etc, to end the pandemic...

‘At the end of the day, we are in it together. If we refuse to learn from each other and operationalise the best public health practices, we are in for a rough ride.

‘I hope the national task force, as petitioned by the 46 top physicians, is rapidly recognised, accepted, and formalised to empower it to immediately re-strategise and transform the mindset, and policy at the top end of the Health Ministry, so that the operations at ground zero will be a truly rapid-response FTTIS which has zero-tolerance for cases, clusters or outbreaks.

‘MCOs are the blunt tools of those who have failed to operationalise the back-to-basics of pandemic management and in my opinion, they should either seek a second opinion from the task force and/or gracefully exit to minimise further harm to the nation and allow the task force to steer the nation out of this Covid-19 conundrum and to protect the lives and livelihood of its rakyat.’

Read here (Malaysiakini, Jan 30, 2021) 

Bill Gates, Big Pharma and entrenching the vaccine apartheid

‘It appears that South Africa and India were right. Under the current rules, the vaccine cannot be made quickly or cheaply enough to meet global demand, which vaccines are only going to those countries that can afford it. This is a “catastrophic moral failure”, said the head of the World Health Organisation (WHO), Tedros Adhanom Ghebreyesus. Some activists have described the situation as a “vaccine apartheid”...

‘Nonetheless, the proposal for a patent waiver has been repeatedly rejected at the WTO by wealthier countries including the European Union, the United Kingdom, US and Switzerland; countries which, as Reuters wryly noted, are “all home to major pharmaceutical companies”. They also all enjoy early access to the vaccine.

‘Nor has South Africa and India’s proposal received support from the most influential non-state actor in global public health: Bill Gates...

‘But despite Gates’ stated commitment to an equitable distribution of the Covid vaccine, he is refusing to back South Africa and India’s calls for a waiver on patents... 

‘This should not come as a surprise: the Gates Foundation has historically been opposed to efforts to reform intellectual property protections for pharmaceutical companies — putting it at odds with other public health NGOs such as Doctors Without Borders (MSF) — and has in fact lobbied for developing countries to impose even stronger protections for drug companies’ patents. This is perhaps because Gates’ own fortune is built on intellectual property, specifically the copy­rights and patents associated with Windows and Microsoft.’

Read here (Mail&Guardian of South Africa, Jan 30, 2021)

How influencers, celebrities, and FOMO [fear of missing out] can win over vaccine skeptics

‘Drawing from product innovation theory, Rohit Deshpandé and colleagues offer three recommendations to speed adoption of COVID-19 vaccines...

‘Governments are prioritizing certain groups to receive the vaccine, with medical professionals and certain government personnel at the top, followed by first responders and vulnerable populations, and then the general population. The diffusion of innovations model indicates that each of these groups will have five customer segments based on their willingness to get vaccinated earlier or later. For example, some medical professionals will be eager to get vaccinated early (the innovators, early adopters, and majority) while others will wait (the late majority and laggards).

‘So, how do we maximize the number of individuals in any prioritized group who are willing, if not eager, to get vaccinated as soon as possible?

‘The answer requires keen understanding of each segment, for example, of both the seniors in the early majority and the seniors that are laggards less keen on taking the vaccine. The diffusion of innovations research indicates that a combination of personal and societal factors influence the rate of adoption within and between segments factors, with the ultimate driver being word of mouth.

‘For the COVID-19 vaccine, the personal factors include people’s perceived efficacy and need for the vaccine, past immunization experiences, and opinions about vaccines more generally, along with those of their families.

‘Societal drivers include the advice of experts, media, and other influencers within their demographic, socioeconomic, and innovation adoption segment. Influencers will need to mitigate concerns about the “newness” of the vaccine, such as the probability of side effects and solutions when they occur. They will also need to reinforce the positive consequences of taking the vaccine, such as the ability to visit family, go to work, and have more entertainment options.’

Read here (Harvard Business School, Jan 29, 2021)

Covid-19: Novavax vaccine shows 89% efficacy in UK trials

‘A new coronavirus vaccine has been shown to be 89.3% effective in large-scale UK trials. The Novavax jab is the first to show in trials that it is effective against the new virus variant found in the UK, the BBC's medical editor Fergus Walsh said. The PM welcomed the "good news" and said the UK's medicines regulator would now assess the vaccine.’

Read here (BBC, Jan 29, 2021) 

Coronavirus antibody therapies explained

How do bamlanivimab and REGN-CoV-2 work?: ‘Both antibody treatments are designed to block the SARS-CoV-2 spike protein and thus prevent the virus from attaching to and entering human cells. These identical so-called monoclonal antibodies are lab-engineered and designed to attack one specific virus in one distinct way.

‘Bamlanivimab contains one monoclonal antibody. REGN-CoV-2, in contrast, consists of two monoclonal antibodies. US pharma company Regeneron says its antibody cocktail lowers the viral load, which helps symptoms dissipate more quickly.

‘The advantage of Regeneron's drug cocktail is that by containing two antibodies, it increases the chance that at least one of them will prove effective during treatment, virologist Sandra Ciesek told German public broadcaster NDR.’

Read here (DW, Jan 29, 2021)

Covid-19 rarely spreads through surfaces. So why are we still deep cleaning?

‘Armed with a year’s worth of data about coronavirus cases, researchers say one fact is clear. It’s people, not surfaces, that should be the main cause for concern. Evidence from superspreading events, where numerous people are infected at once, usually in a crowded indoor space, clearly point to airborne transmission, says Marr. “You have to make up some really convoluted scenarios in order to explain superspreading events with contaminated surfaces,” she says.

‘Hand washing is crucial, says Marr, because surface transmission can’t be ruled out. But it’s more important to improve ventilation systems or to install air purifiers than to sterilize surfaces, she says. “If we’ve already paid attention to the air and we have some extra time and resources, then yes, wiping down those high-touch surfaces could be helpful,” she says.

‘Households can also ease up, says Pickering. Quarantining groceries or disinfecting every surface is going too far. “That’s a lot of work and it also is probably not reducing your exposure that much,” she says. Instead, reasonable hand hygiene, as well as wearing a mask and social distancing to reduce exposure from close contacts is a better place to focus efforts.’

Read here (Nature, Jan 29, 2021)

How to redesign Covid vaccines so they protect against variants

‘Some aspiring vaccine makers have had their eye on the threat that escape variants might pose from the start. A team at Gritstone Oncology decided to focus on this potential problem by designing a vaccine that targets multiple sites on several viral proteins, in contrast to first-generation shots that target only the spike protein, says Andrew Allen, president of the company in Emeryville, California. The hope is that the vaccine, which should soon start clinical trials, will make it difficult for the virus to evade immunity because many genetic changes would be necessary for it to do so. “You can either play whack-a-mole and chase the variants, or you can try to get ahead of them,” Allen says.

‘Because updating the construction of existing vaccines is relatively simple, a new RNA vaccine could be designed and manufactured for clinical testing within six weeks, Weissman estimates. But that is only the beginning. “Mass-producing a vaccine is hard. To start all over again will be hard,” says Offit. Some researchers are expecting periodic updates to coronavirus vaccines, as with flu, to become a way of life. “This is not unusual,” says Stanley Plotkin, a consultant who advises companies on vaccines. But it could mean that worries over supply chains and logistics will continue for some time.’

Read here (Nature, Jan 29, 2021)

Why it takes 2 shots to make mRNA vaccines do their antibody-creating best – and what the data shows on delaying the booster dose

‘With current vaccine shortages, and problems with setting up the infrastructure to vaccinate millions of people, many physicians are concerned that the second dose of vaccine won’t be delivered in the prescribed three-to-four-week window.

‘That booster shot is necessary for the T-cells to stimulate the memory B-cells to produce massive quantities of antibodies. If the booster isn’t given within the appropriate window, lower quantities of antibodies will be produced that may not provide as powerful protection from the virus.’

Read here (The Conversation, Jan 29, 2021)

What about the Chinese Covid-19 vaccines? — Dr Musa Mohd Nordin

‘The Chinese vaccines are rapidly making inroads into the Malaysian vaccine market place. After the 39 per cent Pfizer-BioNTech, 10 per cent AstraZeneca-Oxford and 10 per cent COVAX vaccine advance bookings, there is now reported, a 22 per cent booking of the Sinovac vaccine. 

‘China’s Sinovac Lifesciences Co Ltd, manufactures the inactivated vaccine, CoronaVac which is administered intramuscularly, two doses, two weeks apart. And can be stored in a standard refrigerator at 2-8 degree Celsius, unlike the arctic temperatures required for the mRNA vaccines...’

Read here (Malay Mail, Jan 29, 2021) 

Pregnant women can pass antibodies to their foetus: Some implications for vaccinations

‘A study published in JAMA: Pediatrics provides evidence that pregnant women may be able to pass IgG antibodies against SARS-CoV-2 to their fetus. The study involved 1,417 women who recently gave birth. Among 83 mothers with detectable SARS-CoV-2 antibodies, 72 (86.7%) transferred IgG antibodies to their fetus—as detected in the newborns’ cord blood. IgM antibodies were not detected in any cord blood specimens, and antibodies were not detected in any infants born to mothers without detectable antibodies. The concentration of antibodies in the cord blood was significantly correlated with the concentration in the mother, but the antibodies were successfully transferred by mothers who exhibited symptomatic disease and asymptomatic infection. The study did not explicitly evaluate the ability to transfer antibodies developed as a result of vaccination; however, the researchers indicate that the results align with similar studies on transplacental transfer of vaccine-conferred antibodies for other diseases. Further research is necessary to determine the recommended timing for vaccination of pregnant women in order to achieve sufficient transplacental transfer of SARS-CoV-2 antibodies to the fetus.’ [John Hopkins Newsletter]

Assessment of maternal and neonatal cord blood SARS-CoV-2 antibodies and placental transfer ratios

‘Our findings demonstrate the potential for maternally derived antibodies to provide neonatal protection from SARS-CoV-2 infection and will help inform both neonatal management guidance and design of vaccine trials during pregnancy. Further studies are needed to determine if SARS-CoV-2 antibodies are protective against newborn infection; if so, at what concentration; and whether the transplacental kinetics of vaccine-elicited antibodies are similar to naturally acquired antibodies.’

Read here (Jama Pediatrics, Jan 29, 2021)

Habitual use of vitamin D supplements and risk of coronavirus disease 2019 (Covid-19) infection: A prospective study in UK Biobank

Abstract

Background: Previous studies have related vitamin D supplementation to a lower risk of acute respiratory tract infection. Emerging evidence suggests that vitamin D insufficiency is related to a higher risk of coronavirus disease 2019 (COVID-19) infection.

Objectives: We aimed to investigate the prospective association between habitual use of vitamin D supplements and risk of COVID-19 infection, and assess whether such an association differed according to the different levels of circulating and genetically predicted vitamin D.

Methods: This study included 8297 adults who have records of COVID-19 test results from UK Biobank (from 16 March 2020 to 29 June 2020). The use of vitamin D supplements, circulating vitamin D levels, and main covariates were measured at baseline (2006-2010). Genetically predicted vitamin D levels were evaluated by genetic risk score.

Results: After adjustment for covariates, the habitual use of vitamin D supplements was significantly associated with a 34% lower risk of COVID-19 infection (OR, 0.66; 95% CI, 0.45-0.97; P = 0.034). Circulating vitamin D levels at baseline or genetically predicted vitamin D levels were not associated with the risk of COVID-19 infection. The association between the use of vitamin D supplements and the risk of COVID-19 infection did not vary according to the different levels of circulating or genetically predicted vitamin D (P-interactions = 0.75 and 0.74, respectively).

Conclusions: Our findings suggest that habitual use of vitamin D supplements is related to a lower risk of COVID-19 infection, although we cannot rule out the possibility that the inverse association is due to residual confounding or selection bias. Further clinical trials are needed to verify these results.

Read here (American Journal of Clinical Nutrition, Jan 29, 2021)

Just like Pfizer, China says vaccines can beat new strains

‘Virologists and vaccine specialists with China’s National Health Commission (NHC) said on Wednesday they had a detailed plan to upgrade homegrown vaccines against Covid-19 to “version 2.0” within two months to stop the spread of new mutant strains found across the United Kingdom and South Africa.

‘The claim coincided with Pfizer’s announcement on Wednesday that its Covid-19 vaccine works against mutated variants found in the UK and South Africa, according to a lab study. China’s claim comes as local firms SinoPharm and Sinovac crank out their Covid-19 shots for mass inoculations.’

Read here (Asia Times, Jan 28, 2021)

All countries should pursue a Covid-19 elimination strategy: Here are 16 reasons why

‘As governments draw up their battle plans for year two, we might expect them to base their strategies on the wealth of data about what works best. And the evidence to date suggests that countries pursuing elimination of Covid-19 are performing much better than those trying to suppress the virus. Aiming for zero-Covid is producing more positive results than trying to “live with the virus”.

‘Here are 16 reasons why we think all countries should at least consider an elimination approach:

1. It saves lives.
2. The elimination of community transmission also spares populations from “long-Covid”.
3. Elimination is pro-equity.
4. Countries that have eliminated Covid-19 are experiencing less economic contraction.
5. Elimination is achievable and works in a variety of settings.
6. The virus can be eliminated even after intense local transmission has occurred.
7. It’s easier if more countries adopt this approach.
8. The rollout of effective vaccines will make Covid-19 elimination easier to achieve.
9. Having an explicit “zero-Covid” goal provides a strong motivating and coordinating focus.
10. It is sustainable.
11. If the virus mutates, elimination still works.
12. It also still works if vaccines provide only limited long-term protection.
13. It may reduce emergence of more dangerous virus variants.
14. The use of lockdowns should be less necessary.
15. Vigorous control of Covid-19 infection has substantial co-benefits.
16. It provides a good interim strategy while we identify an optimal long-term approach, which is currently uncertain.  

Read here (The Guardian, Jan 28, 2021)

German officials say AstraZeneca vaccine shouldn't be given to over-65s, citing lack of data

‘Germany's vaccine commission said the AstraZeneca coronavirus vaccine should not be given to people older than 65 years, amid a bitter dispute between the European Union and the drugmaker over delayed supplies.

‘The Standing Committee on Vaccination (STIKO) at Germany's Robert Koch Institute (RKI), the country's main public health authority, found there is insufficient data on the effectiveness of the vaccine, developed by AstraZeneca and the University of Oxford, for this age group, according to a statement from the interior ministry on Thursday. "Due to the small number of study participants in the age group ≥65 years, no conclusion can be made regarding efficacy and safety in the elderly. This vaccine is therefore currently recommended by STIKO only for persons aged 18-64 years," the panel said in its recommendation.’

Read here (CNN, Jan 28, 2021) 

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)