Vitamin D and Covid-19: Why the controversy?

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

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

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

Read here (The Lancet, Jan 11, 2021)

Indian nasal Covid vaccine can be potential gamechanger: Experts

 Indian nasal Covid vaccine can be potential gamechanger: Experts

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

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

Read here (Khaleej Tinmes, Jan 10, 2021)

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

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

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

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

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

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

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

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

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

Read here (The Vibes, Jan 9, 2021)

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

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

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

Read here (The Lancet, Jan 8, 2021)

Thailand, Indonesia and Philippines to roll out Chinese vaccines

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

Read here (CGTN, Jan 8, 2021) 

How Gamaleya’s vaccine (Sputnik V) works

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

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

A second Chinese coronavirus vaccine is said to be effective

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

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

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

10 steps to prevent Malaysia's Covid-19 pandemic slipping into ICU

This back-to-basics public health management of a pandemic, endorsed by 46 experts in their respective fields, was sent to the Malaysian Prime Minister on January 7. They are:

1. To ramp up testing with triaged, mass and frequent testing regimen, utilising inexpensive rapid testing kits (RTK-Ag), instead of PCR, to help slow the transmission of Covid-19.
2. Early RTK-Ag diagnosis of cases within 24 hours will enable rapid isolation of cases and facilitate prompt contact tracing.
3. Automating contact tracing with digital apps will hasten the tracking process, while leveraging on data science and machine learning can identify the hotspots in the nation for targeted screening. Only this find-test-trace-isolate rapid response will bust the Covid-19 clusters and mitigate the sporadic spread of the virus.
4. In anticipation of the increasing Covid-19 cases and to protect the healthcare capacity, we advocate that clinical stage 1 and 2 cases be isolated at home with clear guidelines from the health ministry. Their well-being can be tracked daily with digital apps supported by empowering the local community, and urgent transfers to Covid-19 hospitals organised for cases that deteriorate.
5. We must protect the excellent work of our medical professionals in the Covid-19 hospitals by decanting all non-Covid cases to non-Covid government and private hospitals. This will allow them to focus on the most severe cases and not be distracted by asymptomatic and mild cases, thus ensuring the best outcomes.
6. The POIS initiative (Preventing and early detection of Outbreaks at Ignition Sites) is a tripartite government, private sector and NGO partnership which emphasises early detection testing regime, enhances public health measures and health education of industry and migrant workers. This POIS initiative developed in consultation with industry and WHO can be replicated elsewhere as a public health operational tool, truly embracing a whole-of-government and whole-of-society approach.
7. Similar initiatives must be developed for the other hotspots of Covid-19 outbreaks, namely the prison and detention centres.
8. Expedite the regulatory processes so that immunisation can begin as soon as the first doses of vaccines arrive at the airport. Debunking Covid-19 and vaccine disinformation will empower our rakyat with informed consent when the vaccines arrive. Apart from prioritising the high-risk groups, seriously consider vaccinating migrant workers to protect our industries and the refugee community who are silent epicentres of Covid-19 outbreaks. The cost of the vaccines must be capped at less than RM100 per dose for those getting their shots privately and by extension, the rapid test kits must be capped at less than RM100 per test to ensure more affordable and wider coverage as well as uptake of both vaccines and rapid testing.
9. A Covid-19 task force comprising a cross-sectoral and empowered team of subject matter experts must be immediately formed to provide evidence-based advice on a harmonised whole-of-government response across ministries and agencies. The task force will help steer the nation out of this pandemic by regularly presenting its recommendations and audit of the health economic impact of key decisions to the Cabinet. To ensure independence of the task force, the Malaysian Medical Association, Academy of Medicine Malaysia, Malaysian Public Health Physicians’ Association and Association of Private Hospitals Malaysia are best positioned to select the members.
10. Do not politicise the pandemic but instead secure a bipartisan consensus and approach to flatten the pandemic curve, accelerate efforts to achieve herd immunity as a form of community protection to coexist with the virus. GE15 in the midst of an uncontained pandemic is an unmitigated disaster waiting to happen as the Sabah election has exemplified.

Read here (Free Malaysia Today, Jan 7, 2021)

Open letter to PM: 10 critical actions to manage Covid-19 — Health experts

Read here (Code Blue, Jan 7, 2021)

Pfizer/BioNTech vaccine appears effective against mutation in new coronavirus variants: Study

‘Pfizer Inc and BioNTech’s COVID-19 vaccine appeared to work against a key mutation in the highly transmissible new variants of the coronavirus discovered in the UK and South Africa, according to a laboratory study conducted by the U.S. drugmaker.

‘The not-yet peer reviewed study by Pfizer and scientists from the University of Texas Medical Branch indicated the vaccine was effective in neutralizing virus with the so-called N501Y mutation of the spike protein.’

Read here (Reuters, Jan 7, 2021)

How Covid deniers are taking pages out of the anti-vaccine movement’s playbook

‘One of the most notable things about the COVID-19 pandemic has been how fast two science denialist movements made common cause and, in essence, fused to become one movement. I’m referring, of course, to the antivaccine cranks/grifters and COVID-19 deniers/minimizers/antimaskers/cranks/grifters, who rapidly formed an unholy alliance that ultimately added QAnon conspiracy theorists to the mix to form one of the most toxic groups of conspiracy theorists ever seen.

‘Note that by “toxic,” I don’t just mean toxic personalities, but I also mean toxic to science, medicine, public health, and the politics of trying to respond to the pandemic, with antivaxxers frequently augmenting COVID-19 deniers at various rallies and events, all the while crying “censorship,” infusing the COVID-19 denialist movement with antivaccine pseudoscience and conspiracy theories, and even launching a pre-emptive disinformation war against COVID-19 vaccines.’

Read here (Genetic Literacy Project, Jan 7, 2021)

More or less deadly? Which way is SARS-CoV-2 evolving?

‘Like plague, Covid-19 is a stealth infection, and that might ultimately slow evolution toward lower virulence. Yersinia pestis, the germ that causes plague, tamps down the early immune response, so that infected people can travel and spread infection for days before they feel sick. Similarly, people infected with SARS-CoV-2 seem capable of infecting others before experiencing any symptoms. This sly mode of viral spread may make the evolution of lower virulence less likely, as infected but asymptomatic people are the perfect mobile viral delivery systems.

‘Yet even without an evolutionary process pushing SARS-CoV-2 towards lower virulence, over time, the virus might affect people differently, said Columbia University virologist Vincent Racaniello. “SARS-CoV-2 may become less deadly, not because the virus changes, but because very few people will have no immunity,” he said. In other words, if you’re exposed to the virus as a child (when it doesn’t seem to make people particularly sick) and then again and again in adulthood, you’ll only get a mild infection. Racaniello points out that the four circulating common cold coronaviruses “all came into humans from animal hosts, and they may have been initially quite virulent.” Now, he says, they infect 90 percent of children at young ages. At later ages, all you get is the common cold.’

Read here (Genetic Literacy Project, Jan 7, 2021)

Malaysia's chaotic virus warfare: Sin Chew Daily

‘In Malaysia, infected individuals with light or no symptoms can still stay in the same house as their family members, which is extremely inadvisable as the entire household will eventually get infected. As if that is not enough, the family members will still have to leave the house to buy food and essentials, and that will take the virus to grocery stores, hypermarkets and elsewhere.

‘In view of this, Dr Noor Hisham must reverse this decision. Dr Noor Hisham's second argument is that if the level of virus infection decreases, the patient can be discharged without being tested after ten days in a hospital. This is contrary to WHO requirements.’

Read here (Straits Times, Jan 7, 2021)

What is herd immunity?

‘In this short video, Yale’s Dr. Howard Forman, physician and professor, discusses herd immunity — what it is and how to achieve it for maximum benefit in the age of COVID-19.’

View here (Yale News, Jan 6, 2021)

DG: Health system at breaking point, targeted MCO proposed

‘Rather than the “one size fits all” approach of last year’s MCO, Noor Hisham explained that the proposed new strategy involved different rules for different states. Travel restrictions could be imposed on areas with a high number of infections and clusters.

“We are looking at green and yellow states to see how we can protect them, and control cases from rising. This is important. For states that are red zones, more drastic action will be taken. We might implement more targeted (action) in those states by looking at the clusters in the state. We will also tighten border control by barring people from travelling across states and districts based on the latest (case) trends,” he said.

‘Nevertheless, the decision remained the prerogative of the legislators but Noor Hisham said he had faith in the government making the right call. The goal of the upcoming strategy, he added, was to achieve that precious balance between lives and livelihoods.’

Read here (Malaysiakini, Jan 6, 2021)

Early high-titer plasma therapy to prevent severe Covid-19 in older adults

‘Background: Therapies to interrupt the progression of early coronavirus disease 2019 (Covid-19) remain elusive. Among them, convalescent plasma administered to hospitalized patients has been unsuccessful, perhaps because antibodies should be administered earlier in the course of illness.

‘Methods: We conducted a randomized, double-blind, placebo-controlled trial of convalescent plasma with high IgG titers against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in older adult patients within 72 hours after the onset of mild Covid-19 symptoms. The primary end point was severe respiratory disease, defined as a respiratory rate of 30 breaths per minute or more, an oxygen saturation of less than 93% while the patient was breathing ambient air, or both. The trial was stopped early at 76% of its projected sample size because cases of Covid-19 in the trial region decreased considerably and steady enrollment of trial patients became virtually impossible.

‘Results: A total of 160 patients underwent randomization. In the intention-to-treat population, severe respiratory disease developed in 13 of 80 patients (16%) who received convalescent plasma and 25 of 80 patients (31%) who received placebo (relative risk, 0.52; 95% confidence interval [CI], 0.29 to 0.94; P = 0.03), with a relative risk reduction of 48%. A modified intention-to-treat analysis that excluded 6 patients who had a primary end-point event before infusion of convalescent plasma or placebo showed a larger effect size (relative risk, 0.40; 95% CI, 0.20 to 0.81). No solicited adverse events were observed.

‘Conclusions: Early administration of high-titer convalescent plasma against SARS-CoV-2 to mildly ill infected older adults reduced the progression of Covid-19.’

Read here (NCBI-New England Journal of Medicine, Jan 6, 2021)

WHO team blocked from entering China to study origins of coronavirus

‘The World Health Organization said that China has blocked the arrival of a team investigating the origins of the coronavirus pandemic, in a rare rebuke from the UN agency. WHO Director-General Tedros Adhanom Ghebreyesus said two scientists on the United Nations team had already left their home countries for Wuhan when they were told that Chinese officials had not approved the necessary permissions to enter the country. The arrangements had been jointly agreed with China in advance.’

Read here (CNN, Jan 6, 2021)

Early high-titer plasma therapy to prevent severe Covid-19 in older adults (New England Journal of Medicine, Jan 6, 2021)

‘We report the use of convalescent plasma in older adult patients early in the course of Covid-19. The administration of convalescent plasma with high titers of antibodies against SARS-CoV-2 to infected patients within 72 hours after the onset of symptoms reduced the risk of progression to severe respiratory disease by 48%. Although our trial lacked the statistical power to discern long-term outcomes, the convalescent plasma group appeared to have better outcomes than the placebo group with respect to all secondary end points. Our findings underscore the need to return to the classic approach of treating acute viral infections early, and they define IgG targets that facilitate donor selection...

‘In our randomized, controlled trial, the administration of high-titer convalescent plasma against SARS-CoV-2 to infected older adults within 72 hours after the onset of mild symptoms reduced the progression of Covid-19 to severe illness. This simple and inexpensive intervention can reduce demands on the health care system and may save lives. Early infusions of convalescent plasma can provide a bridge to recovery for at-risk patients until vaccines become widely available.’

Read here (New England Journal of Medicine, Jan 6, 2021)

The racism that undergirds global public health

‘With his thin volume (143 pages of text, with 46 pages of notes) Epidemic Illusions: On the Coloniality of Global Public Health, Eugene Richardson takes to task the discipline of epidemiology, and with it, global public health. Utilizing the West Africa Ebola epidemic of 2013-2016 as his canvas, Richardson paints a picture that highlights the racism that undergirds the conventional medical and public health perspectives.

‘Richardson is an infectious disease specialist and an anthropologist. He has extensive experience responding to health crises around the globe, including joining Partners in Health to care for those suffering from Ebola in Port Loko, Sierra Leone.’

Read here (Counterpunch, Jan 5, 2021)

BioNTech warns against delaying second vaccine dose

‘German firm BioNTech warned Tuesday there is no data backing the "safety and efficacy" of delaying the second shot of its Covid-19 vaccine beyond three weeks, as some countries push back the jab to give more people their first dose. BioNTech, which developed the vaccine with US giant Pfizer, said its clinical data showing 95 percent efficacy was based on a two-dose schedule separated by 21 days. "The safety and efficacy of the vaccine has not been evaluated on different dosing schedules," it said. "Although data... demonstrated that there is a partial protection from the vaccine as early as 12 days after the first dose, there is no data to demonstrate that protection after the first dose is sustained after 21 days."

Read here (New Straits Times, Jan 5, 2021) 

Too many Americans still mistrust the Covid-19 vaccines. Here's why

‘According to a December survey undertaken by the Pew Research Center, nearly 40% of Americans say they will definitely not or probably not get the COVID-19 vaccine when it becomes available to them. Gallup polls put the number at 37%. That’s bad news not just for the vaccine refusers themselves but for the public as a whole. Experts including Dr. Anthony Fauci, head of the National Institute for Allergy and Infectious Diseases, had previously concluded that achieving herd immunity—the point at which a population is sufficiently vaccinated that a spreading virus can’t find enough new hosts—would require anywhere from 60% to 70% of Americans to take the vaccines. But lately, he and others have been inching that number upward, now estimating that herd immunity could require as much as 85% vaccine coverage...

‘But most people in the COVID-19 vaccine hesitancy camp are more rational, more measured—informed enough not to believe the crazy talk, but worried enough not to want to be at the head of the line for a new vaccine. “For first responders and for older people with underlying conditions it’s a godsend,” says Padgett. “But I do believe this was rushed. I’m reasonably healthy. Six months to a year just to get more data on it is what I’d need to be vaccinated.”

Read here (Time, Jan 5, 2021)

Europe has fallen behind on Covid-19 vaccination

“LONG COVID”, a collection of debilitating symptoms born of the coronavirus, is a chronic form of the illness, dreaded by patients. The term may also come to describe the progression of the pandemic in Europe. The pan-continental drive to vaccinate the EU’s 450m citizens has started at a glacial pace. Given more than 100,000 daily cases of late—and more deaths than in America—a laggardly inoculation schedule risks extending covid’s grip on Europe for several months.

‘Mainland Europe stands out as a global vaccine straggler, certainly in the rich world. America and Britain have already jabbed 1-2% of their populations; Israel, the world’s stand-out star, is now at 16%, according to Our World in Data, a website. In contrast Germany has administered merely 317,000 jabs, or 0.4% of its people. France did not break the 1,000 mark until January 4th. The Netherlands is due to start its vaccination drive only this week.’

Read here (The Economist, Jan 5, 2021)

India’s push to use untested vaccine rings alarm bells

‘India’s need for speed in providing a Covid-19 vaccine and attempts to push a locally-produced version through for use before a required phase 3 trial was finished has raised doubts and protests from politicians, scientists and academicians.

‘The Drugs Controller General of India (DCGI) approved the Oxford-AstraZeneca vaccine that’s being produced locally by the Serum Institute of India as Covishield. The world’s largest vaccine manufacturer based in Pune said it can readily provide 50 million vaccines to the government for immediate use and can roll out full production to start supplying the population by March.

‘The DCGI also approved a vaccine produced by Bharat Biotech Ltd along with the Indian Council for Medical Research and the National Institute of Virology named Covaxin for emergency use on a trial basis.’

Read here (Asia Times, Jan 4, 2020)

India bars virus vaccine maker from exporting

‘India will not allow the export of the Oxford University-AstraZeneca coronavirus vaccine for several months, the head of Serum Institute of India, which has been contracted to make 1 billion doses of the vaccine for developing nations, said Sunday.

‘With rich nations reserving most of the vaccines that will be made this year, Serum Institute — the world’s largest vaccine manufacturer — is likely to make most of the inoculations for developing countries. The ban on exports, however, means that poorer nations will probably have to wait a few months before receiving their first shots.’

Read here (AP, Jan 4, 2021)

Covid has exposed how incompetent the British state is, from top to bottom

‘Coronavirus has revealed a country so ill-governed that current politicians cannot be blamed for all of it. The traditional model holds that ministers decide on the general direction of policy and officials interpret and implement it. This balance of roles has been eroded at least since the turn of the century, largely by a ministerial craving for headlines that led to a daily welter of central initiatives, interventions and vanity projects. Officials are expected not to challenge but to obey.

‘This has clearly affected the calibre and morale of the civil service, with high-profile departures from Downing Street, the Home Office and Foreign Office. Johnson also gave too much prominence to scientists, hoping to blame them if things went wrong, and then found himself in perpetual conflict with them. This in turn allowed Scotland, Wales and Northern Ireland to appear blessed with decisive and clear-sighted leadership by contrast.’

Read here (The Guardian, Jan 4, 2020) 

Britain takes a gamble with Covid-19 vaccines, upping the stakes for the rest of us: Mixing and matching, and extending interval between doses

‘In an extraordinary time, British health authorities are taking extraordinary measures to beat back Covid-19. But some experts say that, in doing so, they are also taking a serious gamble. In recent days, the British have said they will stretch out the interval between the administration of the two doses required for Covid-19 vaccines already in use — potentially to as long as three months, instead of the recommended three or four weeks. And they have said they will permit the first dose and second dose for any one person to be from different vaccine manufacturers, if the matching vaccine is not available.

‘The moves are borne of a desire to begin vaccinating as many people as quickly as possible, particularly with Britain facing high levels of transmission of an apparently more infectious form of SARS-CoV-2, the virus that causes Covid-19.’

Read here (Stat News, Jan 4, 2021)

Covid-19 is dangerous, not vaccines — 20 scientists, doctors, and concerned individuals

‘Statements propagating fear-mongering and pseudoscience that attack Covid-19 vaccines’ mRNA (messenger RNA) technologies – which have now been approved by the US’ Food and Drug Administration, the UK’s Medicines and Healthcare Products Regulatory Agency, the European Medicines Agency, and the regulatory bodies of at least seven other countries – risk turning Malaysians off all Covid-19 vaccines entirely, as some may not differentiate between one type of Covid-19 vaccine with another. mRNA and vector-based therapies have actually been used for nearly a decade to treat people with cancer, inherited immunodeficiencies, and metabolic, eye, and neuro-muscular diseases.’

Read here (Code Blue, Jan 4, 2021)

How to spot fake science

Warning signs of pseudoscientific claims:

• Explanations are made up after the fact to fit whatever outcomes are observed.
• Scientific-sounding terms or jargon are used in imprecise, incorrect, or undefined ways.
• Statistics are presented in decontextualized ways, often without properly referencing the source.
• Links and references (if they are provided at all) are internal and do not take you to sources outside the publisher or website.
• Cited evidence is anecdotal or ad hoc and does not come from studies that systematically gathered empirical evidence.
• There are built-in explanations for cases when the idea fails to explain others’ results. (In other words, it’s hard to disprove the idea.)
• Proponents often claim they have been persecuted or silenced by the scientific community.
• Information is presented as special or secret insights available only to the privileged few who have taken the time (or spent the money) to learn about it.
• Findings are not published by reputable sources like peer-reviewed scientific journals, and their claims are reported in obscure news sources.
• Cited experts do not have recognized credentials or they lack qualifications in the field relevant to their claims.
• Ideas from outside the realm of science are presented as scientifically established.

Read here (Biologos, Jan 4, 2021)

Peter Doshi: Pfizer and Moderna’s “95% effective” vaccines—we need more details and the raw data

Peter Doshi: Pfizer and Moderna’s “95% effective” vaccines—we need more details and the raw data 

‘Five weeks ago, when I raised questions about the results of Pfizer’s and Moderna’s covid-19 vaccine trials, all that was in the public domain were the study protocols and a few press releases. Today, two journal publications and around 400 pages of summary data are available in the form of multiple reports presented by and to the FDA prior to the agency’s emergency authorization of each company’s mRNA vaccine. While some of the additional details are reassuring, some are not. Here I outline new concerns about the trustworthiness and meaningfulness of the reported efficacy results...’

Read here (BMJ, Jan 4, 2021) 

Indonesia starts nationwide Sinovac Covid-19 vaccine distribution

Nationwide distribution of the Covid-19 vaccine that was developed by Chinese firm Sinovac Biotech started on Sunday (Jan 3). Mass inoculations are scheduled to begin later this month. The distribution exercise comes after Indonesian state vaccine producer Bio Farma received 1.2 million doses of the vaccine on Dec 6 and 1.8 million doses on Dec 31.

Read here (Straits Times, Jan 3, 2021) 

Feds may cut Moderna vaccine doses in half so more people get shots, Warp Speed adviser says

‘The federal government is in talks with Moderna about giving half the recommended dose of the company's Covid-19 shot to speed up immunization efforts, the head of the Trump administration's vaccine rollout said on Sunday.

‘Operation Warp Speed chief adviser Moncef Slaoui said there is evidence that two half doses in people between the ages of 18 and 55 gives “identical immune response” to the recommended one hundred micorogram dose, but said the final decision will rest with the FDA.’

Read here (Politico, Jan 3, 2021)

Has Covid-19 killed Asia's growth miracle? Khor Hoe Ee

‘It was no fluke that the ASEAN+3 region emerged unscathed from the 2008 crisis. Sound macroeconomic fundamentals, as well as sizable fiscal and financial-sector buffers, enabled policymakers to lead the region out of the crisis quickly by adopting expansionary measures to boost domestic demand.

‘A similar response is needed today. Although the COVID-19 crisis has exposed the vulnerabilities of global supply chains and the economies that depend on them, pursuing a strategy of insourcing or localizing production would be devastating for the global economy.

‘Instead, overcoming supply-chain weaknesses requires enhancing globalization and economic integration, diversifying sources of supply to build resilience, and reforming and strengthening multilateral institutions and multinational forums. These measures will help to ensure that when the next global shock occurs, governments will be equipped to cooperate effectively and resist the lure of protectionism. That would be the best outcome for the global economy, and ASEAN+3 in particular.’

Read here (Japan Times, Jan 3, 2021)

How the pandemic will change travel in 2021, from vaccinations to global nomadism

‘Travel has been changed by past calamities. Safety measures instituted after the 9/11 attacks are now just part of the travel experience. It’s unclear just which changes to the travel landscape will be in place a year from now – or 10 years on – but some answers are starting to come into focus.

‘On the brink of the new year, we looked at nine of the most pressing queries facing the travel industry and individual travellers...’

Read here (Channel News Asia, Jan 2, 2021)

Covid-19 vaccine developers ask the SEC to help keep the secret of how they set prices

‘When the U.S. government awarded over $10 billion in contracts and advance- purchase commitments to drug companies working on COVID-19 vaccine and treatments, it did not require the recipients of government money to agree to offer their products at fair prices or share intellectual property rights to enable faster production.

‘Now, two of the companies awarded those contracts—Pfizer and Johnson & Johnson—are trying to prevent shareholders from voting on resolutions to require the companies to disclose information about the impact of government funding on vaccine access...

‘The shareholder resolutions, filed by members of the Interfaith Center on Corporate Responsibility (ICCR), a shareholder activism organization, ask those two companies to inform their shareholders how "receipt of public financial support for development and manufacture of products for COVID-19 is being, or will be, taken into account when making decisions that affect access to such products, such as setting prices." Similar resolutions were also filed at Eli Lilly, Gilead, Merck, and Regeneron.

‘Both Pfizer and Johnson & Johnson filed "no action requests" with the Securities and Exchange Commission (SEC) in December, asking the agency to rule that the companies can withhold the proposals from shareholders. Neither company responded to The Daily Poster requests for comment.’

Read here (Newsweek, Jan 2, 2021)  

Dr Paul Farmer: Centuries of inequality in the US laid groundwork for pandemic devastation

‘As the United States sets records for COVID-19 deaths and hospitalizations, we speak with one of the world's leading experts on infectious diseases, Dr. Paul Farmer, who says the devastating death toll in the U.S. reflects decades of underinvestment in public health and centuries of social inequality. "All the social pathologies of our nation come to the fore during epidemics," says Dr. Farmer, a professor of medicine at Harvard University, chair of global health and social medicine at Harvard Medical School and co-founder and chief strategist of Partners in Health.’

View here (Democracy Now, Youtube, Jan 1, 2021)

Empty streets vs jubilant crowds: Stark contrast between NYC & Wuhan on NYE provokes envy & accusations

‘Side-by-side comparisons of how New York City and Wuhan, China, rang in the new year have sparked a heated debate on social media about whether the US should have embraced Beijing’s approach to handling the coronavirus pandemic. Photographs showing empty streets on Times Square, typically a hub of merry-making on New Year’s Eve, spread across social media on Thursday night, with several commentators noting that the mood was considerably more festive in Wuhan, the Chinese city where Covid-19 was first detected.’

Read here (RT, Jan 1, 2021)

Fast-spreading UK virus variant raises alarms

‘The U.K. lineage of SARS-CoV-2 has apparently acquired 17 mutations that lead to amino acid changes in its proteins all at once, a feat never seen before in the coronavirus. Crucially, eight of them were in the gene that encodes spike, a protein on the viral surface that the pathogen uses to enter human cells. “There's now a frantic push to try and characterize some of these mutations in the lab,” says Andrew Rambaut, a molecular evolutionary biologist at the University of Edinburgh... Read the story for more details.’

Read here (Science magazine, Jan 1, 2021)

Where is Malaysia headed with Covid-19? Dr Amar-Singh HSS

‘For Malaysia to have a hopeful 2021 where Covid-19 is concerned we need the following changes in outlook and behaviour.

• Transparency is crucial: ‘If we want to move forward then there must be transparency. We must not learn about things first from whispers on social media and cries for help on Twitter or Facebook. We must learn it first from the authorities, no matter how unpalatable the situation...’
• Stop blame shifting and take responsibility: ‘Stop putting the entire blame on the public for the failure to control the pandemic. It is time to stop fining and arresting the average citizen for SOP violations. The failure of some elected representatives in government to maintain effective SOPs and the lack of penalty for them is a major thorn in the side of the public...‘
• We need many voices: ‘We need many people with ideas to speak up. We need many divergent views to be aired and discussed. We need an ongoing national dialogue to chart the best way forward...’ 
• More support is required: ‘The amount of resources and support we have put into dealing with this pandemic is still limited. We need to ramp up our support and initiatives. We urgently need to absorb all the health manpower that is available (before we lose them to our neighbours)...’

Read here (The Malay Mail, Jan 1, 2021)

The mutated virus is a ticking time bomb

‘There is much we don’t know about the new COVID-19 variant—but everything we know so far suggests a huge danger.

‘A more transmissible variant of COVID-19 is a potential catastrophe in and of itself. If anything, given the stage in the pandemic we are at, a more transmissible variant is in some ways much more dangerous than a more severe variant. That’s because higher transmissibility subjects us to a more contagious virus spreading with exponential growth, whereas the risk from increased severity would have increased in a linear manner, affecting only those infected.’

Read here (The Atlantic, Jan 1, 2021) 

The economic case for global vaccinations: An epidemiological model with international production networks

‘We show that the global GDP loss of not inoculating all the countries, relative to a counterfactual of global vaccinations, is higher than the cost of manufacturing and distributing vaccines globally. 

‘Our estimates suggest that up to 49 percent of the global economic costs of the pandemic in 2021 are borne by the advanced economies even if they achieve universal vaccination in their own countries.’

Download PDF here (NBER.org, January, 2021) 

There are four types of Covid-19 vaccines: Here’s how they work

‘The fight against COVID-19 has seen vaccine development move at record speed, with more than 170 different vaccines in trials. But how are they different from each other and how will they protect us against the disease?

‘There are more vaccine candidates simultaneously in the pipeline for COVID-19 than ever before for an infectious disease. All of them are trying to achieve the same thing – immunity to the virus, and some might also be able to stop transmission. They do so by stimulating an immune response to an antigen, a molecule found on the virus. In the case of COVID-19, the antigen is typically the characteristic spike protein found on the surface of the virus, which it normally uses to help it invade human cells.

‘The four main types of Covid-19 vaccines: There are four categories of vaccines in clinical trials: (1) Whole virus, (2) Protein subunit, (3) Viral vector and (4) Nucleic acid (RNA and DNA). Some of them try to smuggle the antigen into the body, others use the body’s own cells to make the viral antigen.’

Read here (Gavi, as Jan 2021)

Watch here (Gavi, Youtube, as Jan 2021)

China clamps down in hidden hunt for coronavirus origins

‘The government is handing out hundreds of thousands of dollars in grants to scientists researching the virus’ origins in southern China and affiliated with the military, the AP has found. But it is monitoring their findings and mandating that the publication of any data or research must be approved by a new task force managed by China’s cabinet, under direct orders from President Xi Jinping, according to internal documents obtained by the AP. A rare leak from within the government, the dozens of pages of unpublished documents confirm what many have long suspected: The clampdown comes from the top.’

Read here (AP, Dec 31, 2020)

From terrified to triumphant: How China flipped 2020

‘If your neighbor’s house is on fire, you should help them. In Jan/Feb, the US gleefully watched China burn and bragged about American exceptionalism. That’s when the US and the EU should have given generous aid to China to contain the pandemic. Then, from April on, western societies refused to learn anything from China. Filled with hubris and undeserved overconfidence, the West kept fumbling for months. Incompetent governments and irrational public couldn’t agree upon simple things like wearing masks or even if COVID-19 is real.

‘As the West imploded, China soared to the skies.

‘To put it succinctly, China had a stellar year. And with Trump’s loss, the U.S. is more polarized than ever before. By the time Biden’s administration gets its geopolitical strategy together, everyone from Asia to Europe would see the writing on the wall — that China will inevitably be the #1 economy soon. 2020 started out as a terrifying year, but ended up as the most pivotal year that sealed China’s unique status in the 21st century.’

Read here (World Affairs, Dec 31, 2020)

The next pandemic is already on the horizon... But experience can help

"We have to remember why (Covid-19) was detected when it was," Dr Josie Golding, epidemics lead at global health research funder Wellcome, said. "It was because there was experience in (China) from Sars and from avian influenza, there were systems in place to detect strange pneumonia coming up."

‘Dr Golding added: "Covid-19 is going to put a lot of those systems and experience in countries… The countries who dealt with it better and faster at the beginning were the ones who had that historical knowledge. I think that is going to make a big difference when it comes to the next Disease X."

Read here (Straits Times, Dec 31, 2020) 

Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine (Pfizer clinical trial)

BACKGROUND: ‘Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the resulting coronavirus disease 2019 (Covid-19) have afflicted tens of millions of people in a worldwide pandemic. Safe and effective vaccines are needed urgently.’

METHODS: ‘In an ongoing multinational, placebo-controlled, observer-blinded, pivotal efficacy trial, we randomly assigned persons 16 years of age or older in a 1:1 ratio to receive two doses, 21 days apart, of either placebo or the BNT162b2 vaccine candidate (30 μg per dose). BNT162b2 is a lipid nanoparticle–formulated, nucleoside-modified RNA vaccine that encodes a prefusion stabilized, membrane-anchored SARS-CoV-2 full-length spike protein. The primary end points were efficacy of the vaccine against laboratory-confirmed Covid-19 and safety.’

RESULTS: ‘A total of 43,548 participants underwent randomization, of whom 43,448 received injections: 21,720 with BNT162b2 and 21,728 with placebo. There were 8 cases of Covid-19 with onset at least 7 days after the second dose among participants assigned to receive BNT162b2 and 162 cases among those assigned to placebo; BNT162b2 was 95% effective in preventing Covid-19 (95% credible interval, 90.3 to 97.6). Similar vaccine efficacy (generally 90 to 100%) was observed across subgroups defined by age, sex, race, ethnicity, baseline body-mass index, and the presence of coexisting conditions. Among 10 cases of severe Covid-19 with onset after the first dose, 9 occurred in placebo recipients and 1 in a BNT162b2 recipient. The safety profile of BNT162b2 was characterized by short-term, mild-to-moderate pain at the injection site, fatigue, and headache. The incidence of serious adverse events was low and was similar in the vaccine and placebo groups.’

CONCLUSIONS: ‘A two-dose regimen of BNT162b2 conferred 95% protection against Covid-19 in persons 16 years of age or older. Safety over a median of 2 months was similar to that of other viral vaccines. (Funded by BioNTech and Pfizer; ClinicalTrials.gov number, NCT04368728. opens in new tab.)’

Read here (New England Journal of Medicine, Dec 31. 2020)

Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine

‘This phase 3 randomized, observer-blinded, placebo-controlled trial was conducted at 99 centers across the United States. Persons at high risk for SARS-CoV-2 infection or its complications were randomly assigned in a 1:1 ratio to receive two intramuscular injections of mRNA-1273 (100 μg) or placebo 28 days apart. The primary end point was prevention of Covid-19 illness with onset at least 14 days after the second injection in participants who had not previously been infected with SARS-CoV-2.

‘The trial enrolled 30,420 volunteers who were randomly assigned in a 1:1 ratio to receive either vaccine or placebo (15,210 participants in each group). More than 96% of participants received both injections, and 2.2% had evidence (serologic, virologic, or both) of SARS-CoV-2 infection at baseline... 

‘The mRNA-1273 vaccine showed 94.1% efficacy at preventing Covid-19 illness, including severe disease. Aside from transient local and systemic reactions, no safety concerns were identified. (Funded by the Biomedical Advanced Research and Development Authority and the National Institute of Allergy and Infectious Diseases; COVE ClinicalTrials.gov number, NCT04470427. opens in new tab.)’

Read here (New England Journal of Medicine, Dec 30, 2020)

China vaccinates a million (interim target: 15 million by mid-February) but some take a jab back

‘Workers kept in the dark about the vaccine injected and are warned not to take any photos of the process...

‘At least a million priority or at-risk Chinese have had their first shots of indigenous Covid-19 vaccines after guidelines kicked in on December 15. Several populous provinces and gateway cities from Guangdong to Shandong and Henan to Shanghai are included as Beijing triages vaccine distribution to regions more exposed to Covid flare-ups and “backflows.” The interim goal, cited by the National Health Commission (NHC) and Xinhua, is to immunize at least 15 million police officers and medical and customs personnel by the Chinese New Year in mid-February...

‘Yet initial feedback from those chosen for the pilot scheme appears to be less than ideal. As seen on forums and WeChat groups popular among medical workers and immigration officers and through Asia Times’ interviews of airport workers in Shanghai, major complaints center around the elusive manner in which these drugs are produced and administered.’

Read here (Asia Times, Dec 30, 2020) 

Spain to keep register of those who refuse Covid vaccine

‘Spain is to set up a register of people who refuse to be vaccinated against coronavirus and share it with other European Union nations, the health minister has said. Salvador Illa said the list would not be made accessible to the public or to employers. He said the way to defeat the virus was "to vaccinate all of us - the more the better".

Read here (BBC, Dec 29, 2020)

German Covid-19 vaccination campaign overshadowed by mishaps

‘Germany's COVID-19 vaccination campaign has been overshadowed by an overdose mishap in the north and problems with the transportation of the vaccine in the south which lead to 1,000 shots being sent back.’

Read here (Reuters, Dec 28, 2020)

Vaccine diplomacy not as simple as a shot in the arm

‘Concerns including dearth of vaccine data and perceived use for geopolitical goals stand in the way of China's soft power push...

‘Rich nations have bought almost all of next year's supply of the two vaccine front runners - one by Pfizer-BioNTech and the other by Moderna - according to the People's Vaccine Alliance (PVA), a network of organisations that includes Amnesty International, Oxfam and Global Justice Now. Canada, for instance, has ordered enough vaccines to inoculate each Canadian five times, although it has pledged to share any excess with other countries.

‘The situation is such that nine in 10 people in 67 developing countries - including nations like Cambodia, Laos and Pakistan - stand little chance of being vaccinated next year, said the PVA this month. To these countries, China's vaccines are a lifesaver.’

Read here (Straits Times, Dec 28, 2020)

Covid-19 vaccines for Malaysia: A call for transparency in registration & purchasing

By Citizens’ Health Initiative (citizenhealthinitiative@gmail.com)

With the exception of the People’s Republic of China and a few other countries like New Zealand, Vietnam, Cuba, Senegal, and Kerala state in India, which seem to have largely brought Covid-19 under control without the help of vaccines, most countries are struggling with succeeding waves of the pandemic and a likely global spread of a more contagious mutant of SARS-CoV-2.  

The collateral damage to economic and social well-being worldwide has been unprecedented, and it underscores the urgently felt need for vaccines and a return to some semblance of normalcy.

Despite a major lapse with a 16,000 plus person religious gathering which erupted into several clusters locally and in the region (March 2020), Malaysia had performed creditably earlier.

Sources of current outbreaks

Unfortunately, since October 2020, a resurgence of clusters emerged from non-compliant returnees from abroad, and porous Sabah state border controls, exacerbated by lax enforcement of SOPs during the September 2020 Sabah state elections. 

Immigration and health authorities were not sufficiently pro-active to prevent its further spread in the peninsula, resulting in numerous outbreaks, especially among workers in congested accommodations and workplaces, and in prisons and detention centres.

Unlike Singapore’s experience with outbreaks in migrant dormitory complexes, we in Malaysia are additionally reaping the consequences of decades of corrupt mismanagement of labor migration, viz. a persistently large pool of undocumented migrant workers (currently estimated at 1.2-1.5 million) who have strong incentives to avoid contact with government agencies.   

Senior Minister Ismail Sabri’s disastrous U-turn in going after undocumented migrants (after initially promising them sanctuary and no arrests and deportation during the pandemic) greatly complicated pandemic control efforts, in particular the crucially important contact tracing.

As generally younger daily-paid workers, more likely to ride out the milder symptoms of Covid-19 infection, they are now even less inclined to cooperate in testing and isolation, given the risks of arrest, detention and deportation.

\We thus face the prospect of protracted and repeated seeding of the general population by the asymptomatic or mildly symptomatic, especially undocumented workers reluctant to seek treatment unless severely ill. (We should also note that active avoidance of contact tracing and testing involves others disinclined to divulge network contacts or contact history, e.g. underworld elements, drug and sexual encounters, etc).

As in many other countries, many Malaysians support efforts to secure vaccines to enhance pandemic control efforts.

Procuring vaccines for Malaysia

The minister for Science, Technology, and Innovation Khairy Jamaluddin has announced commitments to purchase a basket of Covid-19 vaccines, and options for further orders .

Khairy Jamaluddin needs to be transparent about the technical rationales, criteria, and pricing for his ministry’s purchasing decisions.  In particular, he needs to respond to very pertinent points raised by the Covid Research Centre (KL) , chest specialist Dr Jeyakumar Devaraj , and others, which include the following:

• there is currently little information on long-term safety beyond 2 months or on durability of protection, for all candidate or approved vaccines (any late-manifesting adverse effects will only be detected by conscientious follow-up surveillance, monitoring, and reporting systems).  This is especially pertinent for novel mRNA vaccines, in comparison with the more familiar inactivated whole-virus vaccines with which we have decades of experience
• the decision by the UK’s Medicines and Healthcare Products Regulatory Agency (MHRA) to grant immunity to Pfizer from legal liability for late-manifesting adverse effects, and the Pfizer CEO declining to be among the early vaccinees (claiming selflessness in prioritising those more vulnerable, in contrast to some vaccine researchers who vaccinated themselves even before phase 1 human trials) perhaps reflects the true risk perception or assessment of the pharmaceutical corporations (whose profitable research and development work has been highly subsidised by governments for ‘vaccine nationalist’ reasons)
• stringent logistic requirements (deep-freeze or ultra-low temperature facilities) for the mass deployment of mRNA vaccines to under-served remote areas
• one additional advantage of the inactivated whole-virus vaccine is that the host immune response is mounted against a spectrum of antigens from the whole virus, rather than against a much more limited array of antigenic sub-components of say, the spike protein.  This could provide some insurance against mutations, say in the coding sequences for the spike protein, which might render vaccines directed solely against the spike protein wholly or partially ineffective.

Beyond the immediate urgency of securing access to adequate quantities of safe, efficacious and affordable vaccines, the larger question of our continuing dependency on foreign vaccine developers, producers and suppliers remains unaddressed.

National capabilities in production of medicines and vaccines

Consider Cuba, a nation of 12 million citizens hamstrung by a 60-year economic blockade by the US, which has invested in human and material resources to become a biotech power-house:  recombinant hepatitis B vaccines, synthetic polysaccharide vaccine against Haemophilus influenzae type B , CIMAvax vaccine against lung cancer , and innovative treatment of diabetic foot ulcers.

Cuba’s repeated offers of scientific collaboration in R&D, and joint ventures to position Malaysia as a regional production and distribution platform for Southeast Asia , have elicited only a lukewarm response.  Tan Sri Dr Abu Bakar Suleiman, the retired Director General of Health, has shown greater foresight and entrepreneurial verve as chairman of Bioven , which is shepherding CIMAvax through US-FDA and UK phase 3 clinical trials .

It is not too late to make the necessary strategic decisions for a promising growth area (pharmaceuticals and vaccines) in the national and regional economies of the newly launched RCEP.

For more information/clarifications, please contact:

• Chan Chee Khoon     cheekhoon50@gmail.com 
• Chee Heng Leng        cheehengleng@gmail.com 

Endorsers

• Aliran
• Citizens’ Health Initiative
• Freedom
• Kuala Lumpur & Selangor Chinese Assembly Hall (KLSCAH) 
• Malaysian Physicians for Social Responsibility (MPSR)
• North South Initiative
• Pengguna Pahang
• Parti Sosialis Malaysia (PSM)
• Pergerakan Tenaga Akademik Malaysia (GERAK)
• Suara Rakyat Malaysia (SUARAM)
•  Childline Foundation

Seismic change: How Covid-19 altered world events in 2020

‘The year 2020 has been like no other. The coronavirus infected more than 67 million people, impacted 80% of jobs, and placed billions in lockdown... Here are just four political issues, from four continents, which were altered by the pandemic:

1. The US election
2. Hong Kong's protests
3. Ethiopia's Tigray crisis
4. Israel's political crisis’

Read here (BBC, Dec 27, 2020)

Covid-19 has shown us that good health is not just down to biology

‘Of all the lessons we’ve learned from this pandemic, the most significant is how unequal its effects have been. Wealth, it turns out, is the best shielding strategy from Covid-19. As poorer people crowded together in cramped housing, the rich escaped to their country retreats. Two of the largest risk factors for dying from Covid-19 are being from a deprived background and being from a minority-ethnic background, pointing to the underlying role of social inequalities, housing conditions and occupation.

\‘Our society’s recovery from this disease should be centred on building more equal, resilient societies, where people in all parts of the world have access to both protection from the disease and access to research developments. It all starts with government. At the end of a gruelling 11 months, I’m left with Abraham Lincoln’s words in my mind: the pandemic has shown that we need “government of the people, by the people, for the people” – not just government for the wealthy elite. Perhaps that’s the strongest legacy of Covid-19.’

Read here (The Guardian, Dec 25, 2020)

UK scientists trial drug to prevent infection that leads to Covid

‘British scientists are trialling a new drug that could prevent someone who has been exposed to coronavirus from going on to develop the disease Covid-19, which experts say could save many lives.

‘The antibody therapy would confer instant immunity against the disease and could be given as an emergency treatment to hospital inpatients and care home residents to help contain outbreaks. People living in households where someone has caught Covid could be injected with the drug to ensure they do not become infected too. It could also be given to university students, among whom the virus has spread rapidly because they live, study and socialise together.’

Read here (The Guardian, Dec 25, 2020)

Sinovac's Covid-19 vaccine has 91% efficacy, Turkey says

‘Sinovac Biotech's COVID-19 vaccine candidate has shown an efficacy of 91.25% in Turkey, officials said Thursday, reporting the latest results of clinical trials of the Chinese-developed shot beyond China. Turkish Health Minister Fahrettin Koca and professor Serhat Unal, a member of the government's COVID-19 advisory board, reported the preliminary results of Phase 3 trials at a news conference in Ankara.

‘Unal added that the efficacy "is likely to increase" in the later stages of the trials, as the number of volunteers now administered a placebo is lower than the number of volunteers who have been administered the vaccine, known as CoronaVac.’

Read here (Nikkei, Dec 25, 2020)

Fauci says herd immunity could require ‘between 70% and 90%’ to get COVID-19 vaccine

‘Herd immunity against the novel coronavirus could require vaccination rates "between 70 per cent and 90 per cent", Dr Anthony Fauci, the most prominent US infectious disease expert, said in an interview published on Thursday (Dec 24). More than 1 million Americans have received a first dose of a vaccine since Dec 14, according to the US Centers for Disease Control, or only about 0.3 per cent of the population.

‘Fauci, who is advising both President Donald Trump and President-elect Joe Biden on the pandemic, acknowledged that he had incrementally increased his estimates from earlier in the year, when he tended to say only 60 per cent to 70 per cent would need to be inoculated for herd immunity to be reached.’

Read here (Channel News Asia, Dec 25, 2020)

Covid-19 vaccine: Hold your horses, let us play safe! Jeyakumar Devaraj

• Malaysia should rely on old tech vaccines comprise of viral proteins. Let us not experiment on our population with the “sophisticated” vaccines that use RNA and DNA technology.
• Offer the old tech COVID-19 vaccines to the high risk groups initially, and then later to the entire population. But do not make it mandatory for any particular group. Let people make an informed choice.
• Provide clear information to the public. We should be honest with our people. The authorities should also tell the people that at present we do not have data regarding long term safety of the RNA and DNA vaccines.
• Provide the old tech COVID-19 vaccine free to the population.
• Conduct post COVID-19 vaccination surveillance to obtain an accurate estimate of side effects arising from the vaccines.
• It is high time for civil society groups and concerned individuals to voice up and urge for a cautious and measured approach to the mass vaccination of the Malaysian public.

Read here (Focus Malaysia, Dec 24, 2020)

Special Reuters report: How a British Covid-19 vaccine went from pole position to troubled start

‘Much was riding on the Oxford vaccine, a British-led endeavour also involving UK drugs firm AstraZeneca. Prime Minister Boris Johnson’s government was desperate for a success story after its early mishandling of the pandemic contributed to one of the world’s highest death tolls from COVID-19 - around 65,000 by mid-December. The government has secured 100 million doses. On Nov. 23, Oxford and AstraZeneca delivered positive news. They announced that the regimen of a half dose followed by a full dose booster appeared to be 90% effective in preventing COVID-19. Two full doses scored 62%. Oxford researchers have said they aren’t certain why the half-dose regimen was much more effective.

‘Johnson called the vaccine team and tweeted his thanks “for their brilliant work.” He went on, “These results are incredibly encouraging and a major step forward in our fight against COVID-19.” Oxford and AstraZeneca are now hoping for quick authorization by Britain’s regulator. But questions about the trial and the results won’t go away...’

Read here (Reuters, Dec 24, 2020)

The autopsy, a fading practice, revealed secrets of Covid-19

‘The COVID-19 pandemic has helped revive the autopsy. When the virus first arrived in U.S. hospitals, doctors could only guess what was causing its strange constellation of symptoms: What could explain why patients were losing their sense of smell and taste, developing skin rashes, struggling to breathe and reporting memory loss on top of flu-like coughs and aches?

‘At hospital morgues, which have been steadily losing prominence and funding over several decades, pathologists were busily dissecting the disease’s first victims — and finding some answers. “We were getting emails from clinicians, kind of desperate, asking, ‘What are you seeing?’” said NYU Langone’s Dr. Amy Rapkiewicz. ‘Autopsy,’ she pointed out, means to see for yourself. “That’s exactly what we had to do.”

Read here (AP News, Dec 24, 2020)

Longform podcast: Ed Yong of The Atlantic

‘Ed Yong spent 2020 covering the pandemic for The Atlantic. His latest feature is "How Science Beat the Virus." He says: “I am trying to give readers a platform that they can stand on to observe this raging torrent that is the pandemic, this cascade of information that is threatening to sweep us all away. I’m trying to give people a rock on which they can stand so that they can observe what is happening without themselves being submerged by it. But I am trying to construct that platform while also being submerged in it.”

Listen to the podcast here (Longform, Dec 23, 2020)

The vaccine news is great, but Big Pharma is still fooling us

‘Heroic work went into the development of the coronavirus vaccines. But that does not mean this industry deserves your affection...

‘I recall feeling, at the start of this pandemic, both horror at the unfolding calamity, and also a small sense of hope that as in other times of hardship, people would find ways to change the world for the better. There was talk of community support, mutual aid and the rediscovery of the positive powers of the state to protect its citizens. Much of that has dimmed now, and it often seems that we simply want relief - to go back to the way the world was before, and as soon as possible.

‘We have to get back to that place. Yet this may be the best chance in our lifetimes to break the hold of an industry that, until recently, was rightly vilified. The public is following these developments closely, and the state support that underwrites pharmaceutical profits couldn't be more obvious: Operation Warp Speed alone has dispensed over US$10 billion to the industry.

‘Pay it to make the vaccine, sure. That's a service. But we shouldn't be afraid to demand more: Public support should mean a public vaccine, one that reaches people as quickly as possible - profitable or not. The pharmaceutical industry wouldn't be able to rake in its profits and restore its reputation without funding that comes from our tax dollars. We shouldn't let Big Pharma forget it.’

Read here (Straits Times, Dec 22, 2020)

The mysterious link between Covid-19 and sleep

‘The coronavirus can cause insomnia and long-term changes in our nervous systems. But sleep could also be a key to ending the pandemic... 

‘The newly discovered coronavirus had killed only a few dozen people when Feixiong Cheng started looking for a treatment. He knew time was of the essence: Cheng, a data analyst at the Cleveland Clinic, had seen similar coronaviruses tear through China and Saudi Arabia before, sickening thousands and shaking the global economy. So, in January, his lab used artificial intelligence to search for hidden clues in the structure of the virus to predict how it invaded human cells, and what might stop it. One observation stood out: The virus could potentially be blocked by melatonin...

‘After he published his research, though, Cheng heard from scientists around the world who thought there might be something to it. They noted that, in addition to melatonin’s well-known effects on sleep, it plays a part in calibrating the immune system. Essentially, it acts as a moderator to help keep our self-protective responses from going haywire—which happens to be the basic problem that can quickly turn a mild case of COVID-19 into a life-threatening scenario.’

Read here (The Atlantic, Dec 22, 2020)

World's media ask how it went so wrong for 'Plague Island' Britain

‘In the eyes of the world’s media, Britain – a “Plague Island” led by a man who thinks “optimism is a substitute for hard truths and proper management” – is currently getting a good lesson in “what ‘reclaiming sovereignty’ means”...

‘Much of the blame was on Boris Johnson, whose U-turn on Christmas had “once more shown the yawning gulf between the prime minister’s airy promises and the real world,” said Germany’s Die Welt. That vacuum, however, is now “fast being filled with the anger and fear of a nation hit ever since by horror story upon horror story”. The continental blockade could well be “preparing the British for what Brexit might actually mean”, the paper said, “since there is still no agreement on a trade deal, 10 days before the deadline.”

‘The Netherlands’ NRC Handelsblad said that no one in the UK would have a normal Christmas: “not even a tiny bit of one. The ports are closed; London’s stations witnessed a veritable exodus; tens of kilometres of trucks are stranded on the country’s motorways; ministers are publicly saying the virus is out of control.”...

The Sydney Morning Herald: ‘Britain’s response to the pandemic had been “mired in inaction, plagued by failures of the state to mobilise and Johnson’s own destructive habit of promising false dawns simply because he cannot stand to be the bearer of bad news”.’

Read here (The Guardian, Dec 22, 2020)

Long Covid guidelines need to reflect lived experience

‘Since May, 2020, increasing attention has been given to the experiences of people with COVID-19 whose symptoms persist for 4 or more weeks. According to the Office for National Statistics (ONS), an estimated 186 000 people (95% CI 153 000–221 000) in private households in England currently have COVID-19 symptoms 5–12 weeks or longer after acute infection. The ONS estimate that one in five people have symptoms that persist after 5 weeks, and one in ten have symptoms for 12 weeks or longer after acute COVID-19 infection. Research on long COVID is growing, including into the underlying pathology, consequences, and sequelae, as well as rehabilitation for patients. Evidence suggests that a considerable proportion of people with long COVID have severe complications. We have lived experiences of long COVID, with a range of symptoms lasting for more than 6 months...

‘Guidelines must represent the complexity of long COVID, including the areas where evidence is still emerging. Hasty attempts to rename the condition or compare it to other conditions is a disservice to thousands of people, and could result in missed pathology to the detriment of the patient. Comprehensive long COVID guidelines are essential to prevent an epidemic of long-term, chronic disease as a result of early mismanagement of pathology, and the potential implications of such an epidemic for health systems and economies.’

Read here (The Lancet, Dec 21, 2020)

There are thousands of Covid strains, so this new scare is NOT a big deal, but politicians just love their new authoritarianism

‘Let me set the scene. The world (we are told) is in the grip of a deadly plague. Health services (we are told) are on the brink of collapse. And just when you think things cannot get any worse, the horrific news comes down from on high that our invisible enemy has mutated into an even scarier form. Although it is too early to know anything of substance about it, it is entirely possible that it is more contagious, or more dangerous, or – who knows – maybe both.

‘Was that the situation at the weekend as the UK was plunged into what’s rapidly become its worst crisis since World War II (and certainly the worst self-induced one), just ahead of Christmas? No, this was the precise situation FIVE MONTHS AGO, when I wrote about Spike D614G, a mutant variant of coronavirus that we were told could be up to NINE TIMES more contagious. You may not remember because that mutant strain turned out to be a total nothing burger. So why would this one be any different?’

Read here (RT, Dec 21, 2020)

Suspicions grow that nanoparticles in Pfizer’s COVID-19 vaccine trigger rare allergic reactions

‘Severe allergy-like reactions in at least eight people who received the COVID-19 vaccine produced by Pfizer and BioNTech over the past 2 weeks may be due to a compound in the packaging of the messenger RNA (mRNA) that forms the vaccine’s main ingredient, scientists say. A similar mRNA vaccine developed by Moderna, which was authorized for emergency use in the United States on Friday, also contains the compound, polyethylene glycol (PEG).

‘PEG has never been used before in an approved vaccine, but it is found in many drugs that have occasionally triggered anaphylaxis—a potentially life-threatening reaction that can cause rashes, a plummeting blood pressure, shortness of breath, and a fast heartbeat. Some allergists and immunologists believe a small number of people previously exposed to PEG may have high levels of antibodies against PEG, putting them at risk of an anaphylactic reaction to the vaccine.’

Read here (Science magazine, Dec 21, 2020)

New Covid strain in the UK: What we know in 500 words

‘European countries ban UK passengers in bid to contain new mutation, which is 70 percent more infectious and ripping through London...

‘Vaccines should still be effective against it and the new strain is not believed to be any more deadly, but people are increasingly worried because this mutation appears to be 70 percent more infectious. The new variant, which has been named VUI-202012/01 (the first Variant Under Investigation in December 2020), is thought to have first occurred in mid-September in the country’s southeast, in the capital London or the county of Kent.

‘Susan Hopkins of Public Health England said the agency notified the government on December 18 when modelling revealed the full seriousness of the new strain. The UK submitted its findings to the World Health Organization the same day.’

Read here (Aljazeera, Dec 20, 2020)

A-Z inventions of Covid-19

‘The pandemic may have brought the world to its knees, but the side effects are not all negative. The Straits Times locks down the upsides of the coronavirus.’

Read here (Straits Times, Dec 20, 2020)

European Commission embarrassed by Covid-19 vaccine price leak

‘The tweeted information gave the following price per dose for each vaccine maker, in either euros or US dollars according to the respective contract:

1. AstraZeneca: €1.78
2. Johnson & Johnson: US$8.50
3. Sanofi/GlaxoSmithKline: €7.56
4. Pfizer/BioNTech: €12.00
5. Curevac: €10.00
6. Moderna: US$18.00’

Read here (Malay Mail, Dec 18, 2020) 

The influence of the anti-vaccine movement

‘To try to understand why anti-vaccine sentiment is so prevalent in the United States, I recently spoke by phone with Dr. Peter Hotez, a professor of pediatrics and molecular virology at Baylor College of Medicine, and the co-director of the Texas Children’s Center for Vaccine Development. In March, he will publish a book called “Preventing the Next Pandemic: Vaccine Diplomacy in a Time of Anti-Science.” During our conversation, which has been edited for length and clarity, we discussed the historical reasons for vaccine skepticism among many Black Americans, how doctors can speak the truth without appearing political, and how the fight over vaccines became so similar to the fight over every political issue in America.’

Read here (The New Yorker, Dec 18, 2020)

From control rooms to testing, several strategies helped Uttar Pradesh contain pandemic

‘Several factors distinguish the handling of the pandemic in the state but I aim to discuss a few in this article. Of the many innovative steps taken there are three clear winners. 

‘First is the setting up of Team 11 — a group of 11 senior government officials tasked with managing different aspects like surveillance and contact tracing, testing and treatment, sanitisation, containment, enforcement, doorstep delivery, issues of migrants, communication strategy, etc — in March itself...

‘The second winner is the Integrated Covid Command and Control Centre (ICCC) set up in every district. This is the nerve centre of pandemic management in the district, sending testing teams to different areas as per plan, ensuring surveillance and contact tracing, sending positive patients to different Covid hospitals or placing them under home isolation...

‘The third winner is the integrated data management portal (upcovid19tracks.in). It provides us with the ability to crunch and analyse data on a daily basis... 

‘Let me also discuss two strategic interventions, out of many, which we have taken. 

‘The first is the widespread use of the drug, ivermectin, not just for treatment of cases but also as a prophylactic. The state government provides free medicines to all patients in home isolation or in government COVID-19 facilities, which have more than 1.5 lakh beds. We have used the combination of ivermectin and doxycyclin to successfully treat over three lakh home-isolated patients with mild symptoms so far. This combination has also been used by the hospitals across the state for admitted COVID-19 patients. But what is more interesting is the state’s successful use of ivermectin as a prophylactic.

‘The second strategic intervention is the targeted testing of selected groups. We started doing this in June with residents of urban slums, workers at nursing homes, pharmacy shops, bus and auto drivers, shopkeepers, security guards in malls, hospitals, etc.’  

Read here (Indian Express, Dec 17, 2021) 

Hang on for 3 more months

‘Some simple advice for anyone contemplating a holiday gathering: Wait until March...The fight against the coronavirus has been called a “national marshmallow test” [for the United States] that we’re failing. In a famous study, children were left alone with a marshmallow for 15 minutes, and promised a second if they didn’t eat the first. Kids who were better at delaying gratification were found to be more successful later in life. At first, this correlation was explained as demonstrating the importance of willpower and executive function.

‘Later, a team of researchers set out to replicate this study and uncovered something profound. Once they adjusted for factors such as household income, mother’s education, and home environment at age 3, the effect disappeared...

‘If we failed our national marshmallow test this summer and fall, perhaps that says something about how little reason the public was given for optimism. Hope can’t just be a slogan or a pep talk; it must be justified by facts, experiences, and trustworthy promises. And in fairness, until last month, it was less clear when and how this would all end... But hope is justified today.’

Read here (The Atlantic, Dec 17, 2020)

Twenty images that offer a lens on 2020

‘McKinsey designers highlight the photos and illustrations that helped us tell the visual story of a remarkable year...

‘The way we see the world may well have changed in the course of 2020—as the global pandemic has upended our personal and professional lives. As the year draws to a close, we turned to McKinsey’s designers to get perspective on the images that helped bring our insights to life.

‘While we sometimes commission bespoke art for our articles and reports, for the most part we curate our visuals from outside image libraries. Even in prepandemic times, this presented special challenges when it came to selection (does the visual messaging fit the topic and tone of the piece?) and adaptation (is the image treatment consistent with our style and brand?). But in a year where much of the world spent many months maintaining some level of physical distancing, large swaths of the images in the libraries we access—those that showed people in the close proximity we were all used to before the pandemic—became unusable.

‘See our designers’ favorites from this year and why they resonated, then read the stories behind them to understand some of the year’s most important issues.’

Read here (McKinsey & Co, Dec 17, 2020)

WHO vaccine scheme 'risks failure', leaving poor countries with no COVID-19 shots until 2024

 ‘In internal documents reviewed by Reuters, the scheme's promoters say the programme is struggling from a lack of funds, supply risks and complex contractual arrangements which could make it impossible to achieve its goals.

"The risk of a failure to establish a successful COVAX Facility is very high," says an internal report to the board of Gavi, an alliance of governments, drug companies, charities and international organisations that arranges global vaccination campaigns. Gavi co-leads COVAX alongside the WHO.’

Read here (Reuters, Dec 16, 2020)

A pandemic atlas: How Covid-19 took over the world in 2020

‘Journalists from The Associated Press around the world assessed how the countries where they are posted have weathered the pandemic — and where those countries stand on the cusp of year two of the contagion.’ Wonderful pictures...

View here (Associated Press, Dec 16, 2020)

Rapid Covid-19 home test developed in Australia approved for emergency use in US

‘A rapid, over-the-counter Covid-19 test developed by Australian firm Ellume has been given emergency approval in the United States. The US Food and Drug Administration (FDA) approved the Brisbane-based company’s 20-minute Covid-19 Home Test on Tuesday as the US battles the virus that has infected 16.5 million people and killed more than 300,000 people in the country.

“By authorising a test for over-the-counter use, the FDA allows it to be sold in places like drug stores, where a patient can buy it, swab their nose, run the test and find out their results in as little as 20 minutes,” the FDA commissioner, Stephen Hahn, said in a statement.’

Read here (The Guardian, Dec 16, 2020)

Teachers should receive COVID-19 vaccine priority: UNICEF

‘The head of the UN children's agency, UNICEF, called on Tuesday (Dec 15) for teachers to be among those given priority access to the COVID-19 vaccines. "The COVID-19 pandemic has wreaked havoc on children's education around the globe. Vaccinating teachers is a critical step towards putting it back on track," UNICEF chief Henrietta Fore said in a statement. Teachers should be "prioritised to receive the COVID-19 vaccine, once frontline health personnel and high-risk populations are vaccinated," she said.’

Read here (Channel News Asia, Dec 15, 2020)

How to wear a face mask with style: Match Covid-19’s must-have accessory with top fashion brands

‘Masks, the must-have accessory of 2020, historically served as a theatrical tool in Greek theatre. Employed to magnify actors’ emotions and allow easy multitasking between different roles, the stage props were heavy on drama and often depicted exaggerated visages. Way before Covid-19, creative names like Alexander McQueen, Thom Browne, Viktor & Rolf, Marc Jacobs for Louis Vuitton and Japan’s Anrealage all offered interpretations of this theatrical tradition in their fashion collections.

‘As masks have become the new normal in 2020, designers and fashionistas alike are incorporating the accessory into daily fashion ensembles; think of Lady Gaga’s rivet-embellished pink mask. Here in our latest shoot, we blend the whimsy of the accessory’s past with the season’s newest high fashion to reveal a real style statement...’

Read here (South China Morning Post, Dec 15, 2020)

Relaxing Covid rules at Christmas will cost lives: Rare joint statement by two major UK medical journals

‘The British government came under intense pressure on Tuesday to revise its plan to relax COVID-19 restrictions for five days around Christmas, with two influential medical journals making a rare joint appeal for the policy to be scrapped... In what was only their second joint editorial in more than 100 years, the British Medical Journal and the Health Service Journal said the government should be tightening the rules rather than allowing three households to mix over five days. “We believe the government is about to blunder into another major error that will cost many lives,” the editorial said.’

Read here (Reuters, Dec 15, 2020)

These drugs might prevent severe Covid

‘Even with vaccines on the way, treatments are needed to prevent the disease from getting worse—and to be ready for COVID-25, COVID-37, and so on...

‘In an interview with Scientific American, Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, described the desired characteristics of early COVID treatments. “My overwhelming preference is for direct-acting antiviral agents that can be administered orally” and that suppress the virus completely within a week or less, he said. “That, to me, is the highest priority.” 

‘Scientists have begun on differing paths to search for these drugs... One of the current leading contenders for treating mild COVID is an antiviral pill that was previously developed for influenza. At first called EIDD-2801, the drug was found to protect mice from severe lung disease caused by two other coronaviruses—SARS-CoV and MERS-CoV... 

‘Repurposing existing drugs can also yield some surprises by finding ones that are not logical candidates to work against COVID-19. Fluvoxamine, a pill used for treating anxiety disorders, shows some promise in treating early COVID...’

Read here (Scientific American, Dec 14, 2020) 

Intellectual property monopolies block vaccine access

‘The authors of “Want Vaccines Fast? Suspend Intellectual Property Rights (IPR)" argue that IPR are the main stumbling block. Meanwhile, South Africa and India have proposed that the World Trade Organization (WTO) temporarily waive its Trade-Related Aspects of Intellectual Property Rights (TRIPS) rules limiting access to COVID-19 medicines, tools, equipment and vaccines.

 ‘The proposal – welcomed by the WHO Director-General and supported by nearly 100 governments and many civil society organisations around the world – goes beyond the Doha Declaration’s limited flexibilities for national emergencies and circumstances of extreme urgency. But Brazil, one of the worst hit countries, opposes the proposal, together with the US, the EU, the UK, Switzerland, Norway, Canada, Australia and Japan, insisting the Doha Declaration is sufficient.’

Read here (ksjomo.org, Dec 14, 2020)

Whose liability for Pfizer’s vaccine?

‘The well-known The Independent newspaper reports that the United Kingdom Department of Health and Social Care has confirmed that Pfizer required, and has been given, an indemnity by the government, protecting it from legal action if any ill-effects arise from the dispensation of the vaccine.

‘What does this mean? What is the effect in law of such an indemnity? Simply, that the country that provides the indemnity becomes primarily and independently liable if anything goes wrong with the uptake of the vaccine.’

Read here (The Sun Daily, Dec 14, 2020)

Oxford-AstraZeneca vaccine: Bogus reports, accidental finds - the story of the jab

‘In the early hours of Saturday 11 January, Prof Teresa Lambe was woken up by the ping of her email. The information she had been waiting for had just arrived in her inbox: the genetic code for a new coronavirus, shared worldwide by scientists in China. She got to work straight away, still in her pyjamas, and was glued to her laptop for the next 48 hours. "My family didn't see me very much that weekend, but I think that set the tone for the rest of the year," she says...

‘That weekend was the first step on a journey to create a vaccine at lightning speed, for a disease that would, in a matter of months, claim more than 1.5 million lives. I have been following the efforts of the Oxford scientists since the start. There have been dramas along the way, including:

• A rush to charter a jet when a flight-ban prevented vaccine from getting into the country
• Dismay at totally false reports on social media that the first volunteer to be immunised had died
• Concern that falling infection rates over the summer would jeopardise the hope of quick results
• How an initial half-dose of the vaccine unexpectedly provided the best protection
• An admission from the chief of Oxford's partner, drug company AstraZeneca, that it would have run the trials "a bit differently".

Read here (BBC, Dec 14, 2020)

A 4-point checklist for assessing countries' vaccine readiness

‘Even before the vaccines begin to arrive in ports around the world, the focus will shift to the preparedness of in-country logistics, especially in low and middle-income countries (LMICs) and to their health systems' ability to deploy and administer the vaccine to their populations. Any weaknesses in health system readiness – in vaccine distribution, storage, refrigeration, prioritization or delivery – will need to be quickly assessed, addressed and resolved at unprecedented speed before any effective immunization campaign can begin.

‘Here's how countries, and especially LMICs, can assess their readiness along four key dimensions: awareness, acceptance, accessibility and availability.’

Read here (World Economic Forum, Dec 14, 2020)

Readmission and death after initial hospital discharge among patients with Covid-19 in a large multi-hospital system

‘Although more patients are surviving severe coronavirus disease 2019 (COVID-19), there are limited data on outcomes after initial hospitalization. We therefore measured the rate of readmission, reasons for readmission, and rate of death after hospital discharge among patients with COVID-19 in the nationwide Veterans Affairs (VA) health care system...

‘In this national cohort of VA patients, 27% of survivors of COVID-19 hospitalization were readmitted or died by 60 days after discharge, and this rate was lower than matched survivors of pneumonia or heart failure. However, rates of readmission or death were higher than pneumonia or heart failure during the first 10 days after discharge following COVID-19 hospitalization, suggesting a period of heightened risk of clinical deterioration. Study limitations include the inability to measure readmissions to non-VA hospitals and an older, male-predominant study population, who may be at higher risk of severe manifestations of COVID-19. Public health surveillance or clinical trials focused exclusively on inpatient mortality may substantially underestimate burdens of COVID-19.’

Read here (JAMA Network, Dec 14, 2020)

How science beat the virus... And what it lost in the process

“To study COVID‑19 is not only to study the disease itself as a biological entity,” says Alondra Nelson, the president of the Social Science Research Council. “What looks like a single problem is actually all things, all at once. So what we’re actually studying is literally everything in society, at every scale, from supply chains to individual relationships.”

‘The scientific community spent the pre-pandemic years designing faster ways of doing experiments, sharing data, and developing vaccines, allowing it to mobilize quickly when COVID‑19 emerged. Its goal now should be to address its many lingering weaknesses. Warped incentives, wasteful practices, overconfidence, inequality, a biomedical bias—COVID‑19 has exposed them all. And in doing so, it offers the world of science a chance to practice one of its most important qualities: self-correction.’

Read here (The Atlantic, Dec 14, 2020)

When a virus is the cure

‘As bacteria grow more resistant to antibiotics, bacteriophage therapy is making a comeback...

‘Phages, or bacteriophages, are viruses that infect only bacteria. Each kingdom of life—plants, animals, bacteria, and so on—has its own distinct complement of viruses. Animal and plant viruses have always received most of our scientific attention, because they pose a direct threat to our health, and that of our livestock and crops. The well-being of bacteria has, understandably, been of less concern, yet the battle between viruses and bacteria is brutal: scientists estimate that phages cause a trillion trillion infections per second, destroying half the world’s bacteria every forty-eight hours. As we are now all too aware, animal-specific viruses can mutate enough to infect a different animal species. But they will not attack bacteria, and bacteriophage viruses are similarly harmless to animals, humans included. Phage therapy operates on the principle that the enemy of our enemy could be our friend.’

Read here (The New Yorker, Dec 14, 2020) 

Is mass vaccination the best strategy for all countries? A doctor's surprising view

‘COVID-19 is now the second-leading cause of death in the U.S. for 2020. The virus has killed more than 90 people per 100,000, reports Johns Hopkins University. 

‘But in other parts of the world, the virus hasn't been such a big problem. It's not a top killer. Some global health experts are beginning to ask whether immunizing large swaths of the population is the best use of resources for these countries. That's a question that Dr. Chizoba Barbara Wonodi of Johns Hopkins University has been thinking about as mass nationwide vaccine campaigns begin rolling out in rich countries such as the United Kingdom and the United States.’

Read here (NPR, Dec 14, 2020)