Covid-19 Updates & Info

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Re: Covid-19 Updates & Info

#2356

Post by dryrunguy »

Here's the latest Situation Report. Two things of particular note: 1) Florida continues to seek out new and innovative ways to reach new lows (see section on Pediatric Vaccines) and 2) The section on Universal Healthcare in the U.S. was fascinating. I don't put a lot of stock in those types of analyses because that have to be built on a series of assumptions (e.g., if someone has universal healthcare, they'll actually access the services available to them, which is not at all true--at least in the U.S. Yet, I always find them interesting because if their analyses are even close to correct, so much tragedy and heartbreak could have been avoided.

::

EPI UPDATE The WHO COVID-19 Dashboard reports 534 million cumulative cases and 6.31 million deaths worldwide as of June 15*. The global weekly incidence increased 4.3% from the previous week, following 3 consecutive weeks of decline. Global weekly mortality increased as well—for the first time since early February**—up 7.1% from the previous week.
*The WHO COVID-19 dashboard indicates that there is a delay in reporting for the African Region, so the current totals may not be complete.
**With the exception of a 1-week spike the week of March 21, which appears to be the result of a reporting anomaly in the Americas and South-East Asia.

UNITED STATES
The US CDC is reporting 85.7 million cumulative cases of COVID-19 and 1,007,374 deaths. The average daily incidence has plateaued over the past several weeks, holding relatively steady at approximately 100-110,000 new cases per day. Despite the ongoing elevated daily incidence, we have not observed a corresponding increase in daily mortality. Daily mortality has held relatively steady at approximately 275-325 deaths per day since late April*. *Changes in state-level reporting may affect the accuracy of recently reported data, particularly over weekends. In an effort to reflect the longer-term trends, the numbers reported here may not correspond to the most recent dates.

Despite the absence of a surge in COVID-19 mortality, both new hospital admissions (+6.5% over the past week) and current hospitalizations (+1.8%) continue to increase. Notably, both trends appear to be tapering off to some degree. Considering the plateau in daily incidence, it is possible that hospitalizations could also remain elevated, rather than peaking and then declining.

Community transmission in the US continues to be driven by the BA.2.12.1 sublineage of Omicron (64.2%), followed by BA.2 (14.2%), BA.5 (13.3%), and BA.4 (8.3%). The prevalence of BA.2.12.1 increased slightly from last week, but the prevalence of BA.4 and BA.5 are increasing more rapidly. These 4 sublineages of the Omicron variant represent essentially all new SARS-CoV-2 infections in the US.

PANDEMIC TREATY On June 14, the WHO published an annotated draft outline of the prospective pandemic prevention, preparedness, and response treaty. The treaty is currently being drafted by an intergovernmental negotiating body representing WHO Member States, with the aim of establishing a global system for building and maintaining resilience to pandemics and other large-scale disease threats. The draft outline does not contain much detail, but it presents a framework of priority topic areas to be included in the treaty. The outline is organized such that it addresses equity, systems and tools, governance and leadership, and financing for the 4 key phases of pandemic readiness: prevention, preparedness, response, and recovery. The draft includes some specific items under some sections as well as placeholders for sections on One Health, access and benefit sharing, scientific cooperation, health literacy, and broader governance issues. The stated goal is to finalize the text of the treaty in time for consideration at the 77th World Health Assembly in 2024, and considerable uncertainty remains regarding the treaty’s final structure and content.

Importantly, independent experts around the world are publishing their own recommendations regarding the scope and content of the treaty. In a letter published this week, Women in Global Health emphasize the importance of including explicit language to protect healthcare workers. They argue that a treaty that focuses solely on government responsibilities and actions, pharmaceutical and non-pharmaceutical supplies and products, and patients would be insufficient to ensure a safe and supportive environment to protect frontline healthcare workers, who are critical for pandemic response. Researchers from Georgetown University (US) emphasize that the treaty should be informed by current available evidence to identify appropriate policies, systems, and capabilities. They outline 12 key elements that should be included in an evidence-based treaty, which broadly address 4 key facets of pandemic resilience: “(1) reducing spillover risk, (2) reducing pandemic risk, (3) reducing pandemic impacts, and (4) ensuring recovery and resilience.” Their 12 key elements address the human/animal/environmental interface, strengthening public health and healthcare systems and capacities, medical countermeasure (MCM) research and development, selecting appropriate government response policies and actions, government transparency and accountability, legal issues, and equity and justice.

PEDIATRIC VACCINE In their June 15 meeting, members of the US FDA’s Vaccines and Related Biological Products Advisory Committee (VRBPAC) voted unanimously in favor of authorizing the Moderna and Pfizer-BioNTech SARS-CoV-2 vaccines for use in children aged 6 months to 5 years (21-0 for both vaccines). The 3-dose Pfizer-BioNTech vaccine series demonstrated an overall 80.3% efficacy against symptomatic COVID-19, and the 2-dose Moderna series demonstrated 50.6% efficacy among children aged 6-23 months and 36.8 among those aged 2-5 years. Notably, the top-line efficacy estimate for the Pfizer-BioNTech vaccine is based on only 10 total cases of COVID-19 (7 in the placebo group, 3 in the vaccine group), which contributes to the wide confidence interval, particularly for children aged 6-23 months. The US CDC’s Advisory Committee on Immunization Practices (ACIP) is scheduled to meet June 17-18, and it is expected to issue its recommendation regarding the 2 vaccines. The final FDA authorization and CDC guidance is still required, but it is possible that the first doses for this age group could be available by early next week.

Despite the long-anticipated decision for some parents, it is still unclear how many will choose to vaccinate their youngest children. As health experts have pointed out, infants and preschool-aged children already have a considerable number of recommended routine vaccinations, including several multi-dose series. Adding another 2- or 3-dose series could be a barrier for some parents due to the extra logistical hurdles of additional visits to the doctor’s office. Most states are still anticipating demand for the newest pediatric series and have already ordered millions of doses. Notably, Florida is the only state not to place a pre-order with the federal government. Still, as more evidence continues to surface on the severe illness faced by children hospitalized with COVID-19, many with no underlying health conditions, the scales may tip further in the direction of vaccination.

PAXLOVID CLINICAL TRIAL On June 14, Pfizer announced plans to halt enrollment in its current clinical trial for Paxlovid, a SARS-CoV-2 antiviral drug. This decision came after preliminary data did not show a reduction in hospitalization and death among “standard-risk” participants—ie, those who do not have underlying health conditions that put them at elevated risk for severe disease and death. The risk decreased by approximately 50%, but it was not a statistically significant benefit. The drug also failed to demonstrate benefit in terms of alleviating COVID-19 symptoms. Due to the lower risk of severe disease and death among these individuals—and therefore, low benefit from the drug—Pfizer elected to terminate the trial. The current Emergency Use Authorization (EUA) for Paxlovid only applies to high-risk patients. Pfizer indicated that it will include data from this clinical trial in its New Drug Application (NDA) for full US FDA approval for use in high-risk patients.

VARIANT-SPECIFIC VACCINE On June 15, Pfizer and BioNTech announced that the European Medicines Agency (EMA) has initiated a rolling review for their variant-specific candidate SARS-CoV-2 vaccine. Major SARS-CoV-2 vaccine manufacturers have been working to update their vaccine profiles as evidence shows diminishing protection against new variants, particularly against the now-dominant Omicron variant. The Pfizer-BioNTech candidate is among the first updated vaccines to begin a formal regulatory review process. With the rolling submission process, the EMA will be able to review data as they become available. The EMA stated that its review will initially focus on manufacturing quality assurance and safety, followed by clinical trial safety and efficacy data as they become available. The announcement also indicated that the companies intend to submit an application to the US FDA in the near future.

CANADA TRAVEL RESTRICTIONS The Canadian government announced that it will lift some SARS-CoV-2 vaccination requirements for domestic and international travel. Starting June 20, Canada will no longer require vaccination for domestic or outbound air, bus, or rail passengers nor for federally regulated transportation sector personnel. Despite these changes, international travelers may still be subject to vaccination requirements. Notably, Canadian citizens and permanent residents who are not fully vaccinated must provide documentation of a negative SARS-CoV-2 test prior to entering the country, and they are subject to testing and quarantine requirements after their arrival. Travelers who are not citizens nor residents are still required to be fully vaccinated to enter Canada, but vaccination is no longer required for international rail or flights departing Canada. Due to the high risk of transmission, vaccination requirements will remain in effect for cruise ships, and other risk mitigation measures will continue for domestic travel, including mandatory mask use. Canada also announced that it will temporarily suspend mandatory random testing at airports through June 30, in an effort to reduce traveler wait times. Starting July 1, all required testing will be moved off-site to reduce the burden on airports.

UNIVERSAL HEALTH CARE Researchers from several US universities, led by the Yale School of Public Health, published findings from their research on the projected benefit if the US had a universal healthcare system during the COVID-19 pandemic. The study, published in PNAS, found that the US could have prevented nearly 339,000 COVID-19 deaths and saved more than US$105 billion in just hospitalization costs under universal health care, based on excess hospitalizations and mortality attributable to the loss of employer-sponsored insurance and low insurance coverage during the pandemic. At the time the study was conducted, the cumulative COVID-19 mortality in the US was 973,459 deaths, so the projected total benefit of universal healthcare would have reduced US COVID-19 mortality by approximately one-third. In 2020 alone, the researchers estimate that universal health care could have prevented more than 200,000 total deaths, including from COVID-19 and non-COVID-19 causes. The absence of universal health care results in myriad barriers to accessing health services, including screening and testing critical to early diagnosis of COVID-19 and other health conditions as well as preventive services, such as vaccination. And the high cost of care can delay care-seeking behavior, which can result in more severe disease. The additional patient burden from COVID-19 also negatively impacted hospital capacity, which compounds increases in mortality. The researchers argue that the fragmented healthcare system and existing societal vulnerabilities left the US ill-prepared to combat the pandemic.

https://covid19.who.int/
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Re: Covid-19 Updates & Info

#2357

Post by ponchi101 »

dryrunguy wrote: Thu Jun 16, 2022 4:41 pm
...Despite the absence of a surge in COVID-19 mortality, both new hospital admissions (+6.5% over the past week) and current hospitalizations (+1.8%) continue to increase.
...
C'mon, that is poor statistics. An increase of +1.8% is a normal variation; you can't expect to have the same number one week after another.
If this is a long term trend (several weeks of +1.8%) then yes, it is increasing, but on a one week basis, it is not significant.
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Re: Covid-19 Updates & Info

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Post by Deuce »

Brace yourselves, people...
It's not 'back' - because, despite people's comfortable illusions, it never actually left (and pretending it was gone has only helped it to continue)...

COVID-19 Infections Soaring in England...

.
R.I.P. Amal...

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Re: Covid-19 Updates & Info

#2359

Post by dryrunguy »

Here's the latest Situation Report. The section on Antibody Escape definitely piqued my interest--and not in a good way. I also don't quite understand what they mean by "COVID-19 Rebound" after Paxlovid treatment. It's the first time I've seen that term. Does that mean you were sick, got Paxlovid treatment, got better, and then got sick again? Is that what they're talking about? Google seems a bit confused about it, too. So I ask the experts here. :)

::

EPI UPDATE The WHO COVID-19 Dashboard reports 538 million cumulative cases and 6.32 million deaths worldwide as of June 22.* The global weekly incidence remained relatively stable (-0.68%) from the previous week, when incidence was up nearly 8% after 3 weeks of decline. Global weekly mortality decreased as well, down 11% from the previous week. At the regional level, Europe (+17%), Southeast Asia (+46%), and the Eastern Mediterranean (+52%) experienced increases, while the other 3 regions had decreasing trends.
*The WHO COVID-19 dashboard indicates that there is a delay in reporting for the African Region, so the current totals may not be complete.

UNITED STATES
The US CDC is reporting 86.4 million cumulative cases of COVID-19 and 1,009,444 deaths. The average daily incidence has plateaued over the past several weeks, holding relatively steady at approximately 100-110,000 new cases per day. The current 7-day average is 99,365 new cases per day. Likewise, the average daily mortality has held relatively steady at approximately 250-300 deaths per day since late May.* Notably, the current 7-day average is 248, the lowest level since July 13, 2021.
*Changes in state-level reporting may affect the accuracy of recently reported data, particularly over weekends. In an effort to reflect the longer-term trends, the numbers reported here may not correspond to the most recent dates.

Both new hospital admissions (+1.5% over the past week) and current hospitalizations (+1.1%) continue to increase, although they appear to have stabilized over the past week. Considering the plateau in daily incidence, it is possible that hospitalizations could also remain elevated, rather than peaking and then declining.

Community transmission in the US continues to be driven by the BA.2.12.1 sublineage of Omicron (56%), but BA.5 (23.5%) and BA.4 (11.4%) are now outpacing BA.2 (9.1%). The prevalence of BA.4 and BA.5 now appears to be increasing more rapidly than BA.2.12.1. These 4 sublineages of the Omicron variant represent all new SARS-CoV-2 infections in the US.

PEDIATRIC VACCINES Taking the recommendation of its advisory committee, the US FDA on June 17 authorized pediatric formulations of both the Moderna and Pfizer-BioNTech SARS-CoV-2 vaccines for children as young as 6 months old. The following day, US CDC Director Dr. Rochelle Walensky endorsed the agency’s Advisory Committee on Immunization Protection (ACIP)’s recommendation that all children younger than age 5 get vaccinated against COVID-19. US President Joe Biden visited a vaccine clinic in Washington, DC, on June 21 to mark the rollout of the last major phase of vaccinations in the nation, with virtually all individuals now eligible to receive at least 1 of 3 authorized or approved SARS-CoV-2 vaccines. In his remarks, President Biden said the availability of vaccines for the youngest children marks a “monumental step forward” and provides “some peace of mind” for parents who have been waiting 18 months since the first vaccines were authorized for adults. There are about 19 million children aged 6 months to 5 years in the US.

The Biden administration has said 10 million doses are available for distribution to states and healthcare providers, but only 2.5 million doses of the Pfizer-BioNTech vaccine and 1.3 million doses of the Moderna vaccine have been ordered to date. While some parents have expressed excitement and relief at the vaccines’ availability, it remains unclear how many will vaccinate their young kids. Only 29% of 5-11 year-olds are fully vaccinated, while 59% of those aged 12-17 years are fully vaccinated. Some parents already are facing challenges securing an appointment to get their children vaccinated, despite a federal operational plan released and implemented earlier this month. While neighborhood pharmacies and pharmaceutical chains are included in this phase of the vaccination campaign, many are expecting families to go to primary care physicians and pediatricians because of trust, familiarity, and relationships that may not exist at the pharmacy. Additionally, some parents are weighing the differences between the 2-dose Moderna and 3-dose Pfizer-BioNTech vaccines for children.

The FDA also authorized Moderna’s vaccine for children and adolescents ages 6-17 last week. The CDC’s ACIP is meeting today to discuss clinical considerations and recommendations for the vaccine in that age group. The Pfizer-BioNTech vaccine is already available for adolescents and older children.

ANTIBODY ESCAPE A correspondence letter in the New England Journal of Medicine published June 22 by authors from the Beth Israel Deaconess Medical Center in Boston provides new evidence that Omicron subvariants, including BA.4 and BA.5, are showing substantial escape from neutralizing antibodies provided by vaccination or infection. The authors evaluated neutralizing antibody titers against against the original wildtype SARS-CoV-2 and Omicron subvariants BA.1, BA.2, BA.2.12.1, and BA.4 or BA.5 among 27 participants vaccinated with the Pfizer-BioNTech vaccine who had no indications of prior infection and 27 participants with recent infection with the BA.1 or BA.2 subvariants a median of 29 days earlier (range: 2-113 days), a majority of whom were vaccinated. Among vaccinated but never infected participants, neutralizing antibody titers compared to wild-type SARS-CoV-2 were lower by “a factor of 6.4 against BA.1, by a factor of 7.0 against BA.2, by a factor of 14.1 against BA.2.12.1, and by a factor of 21.0 against BA.4 or BA.5.” Participants with a prior history of infection with BA.1 or BA.2 showed similar trends with neutralizing antibody titers compared to wild-type SARS-CoV-2 lowered by “a factor of 6.4 against BA.1, by a factor of 5.8 against BA.2, by a factor of 9.6 against BA.2.12.1, and by a factor of 18.7 against BA.4 or BA.5.” The authors asserted that these findings indicate that the Omicron variants continue to feature further neutralization escape, which may lead to increased infection among populations with prior immunity against the virus. Findings in a recent Lancet Infectious Diseases correspondence provided similar evidence of substantial escape from neutralizing antibodies against Omicron variants among individuals vaccinated with the Sinopharm vaccine, with only partial recovery after a booster shot of the same vaccine.

SARS-COV-2 REINFECTION The newest Omicron subvariants of BA.4 and BA.5 are driving increases in new SARS-CoV-2 infections in several regions, with many people experiencing reinfections despite immunity from prior infection or vaccination (1+ shots). These subvariants appear to be able to evade antibodies more easily than their predecessors, possibly due to new and different spike proteins. Though global COVID-19-associated mortality appears to be decreasing, a new preprint study posted on Research Square cautions that reinfections pose an increased risk of hospitalization (HR 2.98), all-cause mortality (HR 2.14), and sequelae in pulmonary and other organ systems. The risk of these adverse outcomes—including those impacting the heart, blood, kidneys, lungs, and brain—were most pronounced in the acute phase of infection but persisted throughout the 6-month follow up. Additionally, for every reinfection (1, 2, 3+) there was a stepwise increase in risk for all sequelae evaluated, including hospitalization. Although not yet peer-reviewed, the study serves as a signal that the COVID-19 pandemic remains a threat to the health of the world’s population, and individuals must continue to take precautions to prevent infection.

MODERNA BIVALENT BOOSTER Moderna announced June 22 that it plans to seek regulatory approval for an updated booster vaccine, mRNA-1273.214, after new clinical data on the bivalent candidate showed success against newer Omicron variants. The announcement comes in anticipation of fall booster shots, with the company saying it could ship doses as early as August. Moderna found that mRNA-1273.214 increased neutralizing titers against BA.4 and BA.5 Omicron subvariants among all participants (95% CI: 5.0, 5.9). Neutralizing titers increased by 6.3-fold (95% CI: 5.7, 6.9) among specifically seronegative patients. However, the boost to neutralizing titers for BA.4 and BA.5 was not quite as high as the boost in neutralizing titers against the original Omicron variant, BA.1, or the Delta variant. Moderna noted that a peer-reviewed manuscript describing clinical trial data should be available soon.

Scientists are hopeful that this new booster, as well as others under investigation, will aid in improving protection against a potential surge in the fall. However, both Moderna and BioNTech leadership expressed concern that regulatory processes needed to update boosters could cause delays, hoping that future updates to the most recent strains can be done without clinical trials. In a separate announcement, Moderna said it will establish a new research and manufacturing center in the UK, allowing that country to gain access to mRNA platform-based vaccines.

COVID-19 REBOUND Following a US CDC health advisory issued last month warning about the potential for recurrence of COVID-19 or “COVID-19 rebound” following treatment with the antiviral Paxlovid, several new studies suggest potential causes of the occurrence and support initial studies’ findings that rebound happens in only a small proportion of patients. A study published June 20 in Clinical Infectious Diseases examined the experience of one patient with rebound following Paxlovid treatment. The researchers, from the University of California San Diego School of Medicine, isolated the SARS-CoV-2 BA.2 variant from the patient with symptom relapse and sampled their plasma to test for viral immunity. They found the isolate had not developed drug resistance, nor did the patient have impaired immunity, leading them to hypothesize the rebound likely was the result of insufficient exposure to the drug.

Another study (preprint), posted to medRxiv and conducted by US NIH researchers, examined clinical, virologic, and immune measurements of 7 patients with COVID-19 rebound, 6 who had taken Paxlovid and 1 without previous treatment. Again, the researchers found no evidence of drug resistance, viral mutation, or impaired immune response. Instead, they found the rebounds were associated with elevated SARS-CoV-2-specific antibody and cellular immune responses, possibly due to the body trying to clear residual viral antigens possibly shed from dying infected cells. Both studies were very small and may not be generalizable to all COVID-19 rebound cases; additional larger studies are needed to confirm their findings. On June 21, the US CDC’s Morbidity and Mortality Weekly Report (MMWR) published a study examining 5,287 Paxlovid-treated patients aged 12 years and older, finding less than 1% experienced COVID-19-related hospitalization or emergency room visits 5-15 days after treatment was dispensed.

PANDEMIC INEQUALITY The COVID-19 pandemic has drastically impacted people’s health, income, and various social risk factors, worsening existing inequalities and exposing others. Nature uses 6 graphs to explore the pandemic’s effects. The graphs express various data sets examining specific issues globally, in low- and middle-income countries, and in the US, UK, and Brazil. Notably, by the end of this year, 75 million more people will be pushed into poverty—living on less than US$1.90 per day—than was expected before the pandemic, derailing gains made prior to 2020 and highlighting the need for increased efforts to get the world back on track toward the UN Sustainable Development Goals.

US NATIONAL PUBLIC HEALTH SYSTEM A bipartisan commission of health leaders this week released a set of recommendations to overhaul public health in the US, with the aim of creating a “national public health system” to protect and improve health, advance health equity, and effectively respond to emergencies. The authors call for changes that could address current health challenges—including rising maternal mortality, overdoses, and diabetes—and avoid a repeat of what it called a “splintered” response to COVID-19 that led to widely disparate outcomes nationwide. The Commonwealth Fund Commission on a National Public Health System proposal outlines actions for the US Congress; the administration of US President Joe Biden; and state, local, tribal, and territorial governments to create a coordinated and collaborative national public health system.
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Re: Covid-19 Updates & Info

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Re: Covid-19 Updates & Info

#2361

Post by ponchi101 »

dryrunguy wrote: Thu Jun 23, 2022 5:00 pm Here's the latest Situation Report. The section on Antibody Escape definitely piqued my interest--and not in a good way. I also don't quite understand what they mean by "COVID-19 Rebound" after Paxlovid treatment. It's the first time I've seen that term. Does that mean you were sick, got Paxlovid treatment, got better, and then got sick again? Is that what they're talking about? Google seems a bit confused about it, too. So I ask the experts here. :)

...
I think it is kind of odd, too. They say a small percentage of people "rebounded", so I wonder why are they singling out the drug. :?:
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Re: Covid-19 Updates & Info

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Here's the latest Situation Report. No mention of Wimbledon. Yet.

::

US FDA CONSIDERS VACCINE UPDATES Today, the US FDA Vaccines and Related Biological Products Advisory Committee (VRBPAC) is meeting to discuss if and how the strain compositions of COVID-19 vaccines should be modified going forward. The meeting will be livestreamed on the FDA website here with presentation materials also available for download. Presentations and discussion points expected to be covered include: evolution of SARS-CoV-2 variants thus far, as well as models predicting future evolution; current effectiveness of COVID-19 vaccines; related recommendations from the WHO on the subject; clinical trial data evaluating COVID-19 vaccines with varying strain composition; and the FDA perspective on the issue, including considerations for and data required to support authorization of any modified vaccines. The committee will then vote regarding recommendations for a COVID-19 vaccine strain composition, weighing the potential expected increases in immunity against the expense and complexity of a change in composition. Experts are hopeful that an updated strain composition could help provide increased protection from a potential fall surge, although there is concern that the speed of SARS-CoV-2 mutations and slowness of updates to formulations could reduce efficacy of boosters, as vaccine protection wanes and composition becomes outdated compared with circulating variants.

PFIZER-BIONTECH OMICRON-ADAPTED VACCINES Pfizer-BioNTech shared new data over the weekend of 2 Omicron-adapted vaccine candidates, both exhibiting positive safety, tolerability, and immunogenicity, and even outperforming the companies’ current vaccine. Given at 30 microgram and 60 microgram doses as a fourth booster dose, the monovalent candidate elicited a 13.5- and 19.6-fold increase in neutralizing geometric titers against Omicron BA.1, respectively, compared to pre-booster levels. The bivalent candidate, which contains antigens to both Omicron and the original strain, exhibited a 9.1- and 10.9-fold increase at the same dosages against BA.1. Both candidates were well-tolerated among participants of the phase 2/3 trial of adults over age 56. Preliminary lab studies show both candidates neutralize BA.4 and BA.5, but to a lesser extent than BA.1. The companies have shared the data with the US FDA ahead of its Vaccines and Related Biological Products Advisory Committee (VRBPAC) meeting today, alongside data from ongoing COVID-19 booster studies. The companies also shared the data with the European Medicines Agency (EMA) ahead of the June 30 meeting of the International Coalition of Medicines Regulatory Authorities (ICMRA).

MODERNA VACCINE FOR OLDER CHILDREN Children and adolescents aged 6 through 17 years can now receive the Moderna COVID-19 vaccine in the US, following publication of the US CDC Advisory Committee on Immunization Practices’ (ACIP) recommendations and CDC Director Dr. Rochelle Wallensky’s endorsement. The US FDA authorized the vaccine for that age group last week. Adolescents and teens ages 12-17 receive the same dosage as adults, while younger children ages 6-11 receive half of that dose, administered in 2 shots separated by 4-8 weeks. The Pfizer-BioNTech vaccine is already available for adolescents and older children.

A decision on the Moderna vaccine for this age group was delayed due to FDA review of data on the risk of heart problems, including myocarditis and pericarditis, among adolescent boys. However, the FDA said the vaccine’s benefits outweigh the risks, which are very small and also observed with the Pfizer-BioNTech vaccine. COVID-19 carries a much greater risk of heart problems than either vaccine, which are both safe overall. To minimize the risk of transient heart problems related to the vaccines, the CDC recommends that boys and men aged 12 through 39 years space their doses by 8 weeks. That recommendation, particularly for young adult men, is supported by findings from a recent study from Canada published in JAMA Network Open.

LONG COVID/PASC Researchers worldwide are investigating the potential causes of post-acute sequelae of SARS-CoV-2 infection (PASC), commonly known as long COVID. Blood clots, persistent virus, and immune system abnormalities—or a combination of those or other underlying mechanisms—are leading theories about what could be causing long-term symptoms following recovery from acute infection. To date, there is no agreement on how to define and diagnose long COVID, and estimates of its prevalence range from 5% to 50% of recovered patients. Recent data published by the US CDC, collected between June 1 and June 13, 2022, show that nearly 1 in 5 US adults who previously had COVID-19 continue to experience symptoms of long COVID, such as fatigue, rapid heartbeat, shortness of breath, muscle weakness, chronic pain, or cognitive difficulties. Overall, about 1 in 13 US adults, or 7.5% of the population, have symptoms lasting 3 or more months after COVID-19 recovery that were not experienced prior to infection. Women were more likely than men to currently have long COVID (9.4% vs. 5.5%), according to the data, findings that are supported by a review published June 20 in Current Medical Research and Opinion.

The CDC data show that older adults are less likely to have long COVID than younger adults, but the symptoms are often overlooked in older individuals and some research suggests seniors are more likely to develop long-term symptoms. A study from Denmark published June 22 in The Lancet Child & Adolescent Health found that among children ranging in age from 0 through 14 years, those who previously tested positive for SARS-CoV-2 were more likely to experience at least 1 symptom for 2 months or more than children who never tested positive. Additionally, one-third of children who previously tested positive experienced at least 1 long-term symptom they did not have prior to infection, including mood swings, rashes, and stomach aches, memory and concentration problems, and fatigue. While any person of any age can experience long COVID, the question of why remains a mystery. But most scientists and public health officials agree that unraveling that mystery, including standardizing the condition’s definition and diagnosis and finding treatments, represents an urgent global emergency to prevent mass suffering.

ESTIMATES OF DEATHS AVERTED Last week, a study published in The Lancet Infectious Diseases reported results from transmission modeling efforts estimating that COVID-19 vaccination programs may have prevented 19.8 million deaths (95% CI: 19.1-20.4 million) worldwide during their first year of rollout, even though global vaccination targets were not reached. The figure is based on using excess deaths to determine the true mortality burden of COVID-19, although modelers also found that using COVID-19 mortality alone and not excess deaths yielded a finding of 14.4 million deaths prevented (95% CI: 13.7-15.9 million), including 7.4 million (95% CI: 6.8-7.7 million) deaths prevented in countries provided vaccine by the COVID-19 Vaccines Global Access (COVAX) Advance Market Commitment. However, if vaccination coverage targets of 20% or 40% had been met in low-income countries, further reductions in mortality in those nations of 45% (95% CI: 42-49%) and 111% (95% CI: 105-118%), respectively, could have been reached. Experts noted that the study highlighted not only the importance of vaccination but also equitable access, with the majority of predicted prevented deaths occurring among high-income and upper-middle-income nations. Notably, China was not included in the analysis due to its status as the origin of the outbreak and its large influence on estimates due to its population size.

CHINA The National Health Commission of China today announced a reduction of the country’s quarantine policy for overseas travelers to 7 days in a centralized facility and an additional 3 days at home. Previously, travelers were required to stay 14-21 days in centralized quarantine depending on the city of entry and destination. The announcement also includes similar guidelines for close contacts of confirmed COVID-19 cases, requiring 7 days in centralized quarantine and 3 days of health monitoring at home, compared to the prior minimum 14-day requirement. China remains an outlier, as most nations have dropped their vaccination and quarantine requirements for international travelers.

Over the weekend, Beijing said it would allow primary and secondary schools to reopen for in-person instruction, with youth sports soon to follow at non-school locations. Shanghai officials also declared that the city reported no new local cases in 2 months, following a 2-month citywide lockdown that ended June 1. The lockdown effort was in line with China’s zero-COVID policy to stop all outbreaks. The policy is being discussed with renewed interest after authorities in Beijing mentioned that the strict policy could be in place for 5 years. The notice was published Monday on the official Communist Party newspaper of the capital, Beijing Daily, and republished by other media outlets, but officials quickly removed the reference to “5 years” from most online publications, as well as a hashtag on the microblogging site Weibo.

COVID-19 RECOVERY As world leaders drop the COVID-19 pandemic from their agendas, and US federal, state, tribal, and local governments roll back pandemic-related funding and mitigation efforts—such as mask mandates—local officials, grassroots organizations, and frontline community health workers continue to push for and implement piecemeal strategies to help increase vaccination rates, draw attention to the need for research into long COVID, and improve trust in and funding for public health systems. There is a need for the US to create “a sustainable infrastructure that can keep more people from getting COVID, regardless of their social circumstances,” writes Ed Yong in The Atlantic. Indeed, the US Government Accountability Office (GAO) last week released a report recommending that the US Department of Health and Human Services (HHS) prioritize the development of a real-time, public health situational awareness network to help raise public awareness to facilitate the early detection of and rapid response to future and potentially catastrophic disease outbreaks, such as COVID-19.
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Re: Covid-19 Updates & Info

#2363

Post by ponchi101 »

So, the vaccines saved around 20MM people. Roughly the size of a medium country.
But science sucks.
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Re: Covid-19 Updates & Info

#2364

Post by Suliso »

Somebody refered to this article on TW. Yahoos went on on how many people have been maimed and killed by the vaccine. Not a shred of evidence of course. It's like a religion...
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Re: Covid-19 Updates & Info

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Post by ponchi101 »

Suliso wrote: Wed Jun 29, 2022 4:23 am Somebody refered to this article on TW. Yahoos went on on how many people have been maimed and killed by the vaccine. Not a shred of evidence of course. It's like a religion...
About to get me started.
My loony friend N and I went to play padel a few days ago. We used to play at a facility that is a vaccination center too. I mentioned that I went there for my second booster, and was going to talk about how hellacious traffic had been, but he interrupted me with "let's not talk about THAT, we will never agree".
I did say I was talking about the traffic, but I still felt it was odd. So, there is NO evidence that can convince you that the vaccines are safe and effective? Because, for us, there is certainly evidence and data that could prove they are unsafe and detrimental: just show us the number of people truly hurt by them, compiled by a reputable organization.
Yes, it is a cult.
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Re: Covid-19 Updates & Info

#2366

Post by ti-amie »

Suliso wrote: Wed Jun 29, 2022 4:23 am Somebody refered to this article on TW. Yahoos went on on how many people have been maimed and killed by the vaccine. Not a shred of evidence of course. It's like a religion...
It's like a religion It's like a cult.

Fixed it for ya! :)
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Re: Covid-19 Updates & Info

#2367

Post by ti-amie »

Polio is rearing its head again. So is measles.
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Re: Covid-19 Updates & Info

#2368

Post by Deuce »

Last year, I met a guy who played pickleball in our league. We live near each other, and so would drive to the courts together (where we play mostly doubles, switching partners pretty much every game). In addition, we'd call each other to play outside of league times.

Nice guy... in the car we would inevitably talk of various elements of life... We got along well, and a friendship was establishing itself rather naturally.
You can see where this is going...

One day in the car, the subject of COVID vaccines came up. That is when I discovered that he doesn't believe in the vaccines. From that point, I decided not to drive in the same car as him - but we remained friendly, and still played pickleball together for another month or so... After playing one day, we had a discussion about COVID. He says he believes COVID exists, but that it's no more serious than the typical 'flu. He said that he thinks the vaccines are dangerous. I also learned within this discussion that he regularly attended anti-mask and anti-vaccine protests.
I asked him if he thinks that all of the measures to protect against COVID are part of a conspiracy. He said "Yes." I asked him what he thinks the reason for the conspiracy is. He said "I don't know yet." :roll:

I then told him that it would be absolutely impossible for 95% of the politicians in the world, 95% of the media in the world, and 95% of the medical professionals in the world to all agree to manipulate the population of the world in the same manner at the same time, and also keep that conspiracy hidden. Absolutely 100% impossible.

Then a few days after that, I saw him inside a grocery store (when masks were mandatory). He was wearing his mask under his nose, and not covering his mouth properly. And the mask was obviously an old one. In other words, the mask was entirely useless - it had the same effect as wearing no mask.
At that point, I decided that I did not want to associate with this person any longer. His beliefs are one thing - but not having enough respect for other people to wear a mask in public indoor places was unacceptable to me.
And so I do not talk with or associate with him anymore. If he is at pickleball at the same time as I am, I'll play on the same court as him - because it's outside - I've even partnered with him for a few games... but I don't say a word to him. He is persona non grata in my life.
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Re: Covid-19 Updates & Info

#2369

Post by Deuce »

R.I.P. Amal...

“The opposite of courage is not cowardice - it’s conformity. Even a dead fish can go with the flow.”- Jim Hightower
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Re: Covid-19 Updates & Info

#2370

Post by dryrunguy »

Here's the latest Situation Report. Haven't read it yet.

::

EPI UPDATE The WHO COVID-19 Dashboard reports 543 million cumulative cases and 6.33 million deaths worldwide as of June 29. The global weekly incidence increased 21.32% from the previous week. Global weekly mortality increased as well, up 7.43% from the previous week. At the regional level, Europe (+40%), the Americas (+15%), Southeast Asia (+32%), and the Eastern Mediterranean (+47%) experienced increases, while the Western Pacific (-3%) and Africa (-34%) had decreasing trends. The number of new weekly deaths increased in the Eastern Mediterranean (+22%), Southeast Asia (+15%), and the Americas (+11%) and decreased in the Western Pacific (-6%), Europe (-5%) and Africa (-1%).

UNITED STATES
The US CDC is reporting 87.2 million cumulative cases of COVID-19 and 1,012,166 deaths. The average daily incidence has plateaued over the past several weeks, holding relatively steady at approximately 100-110,000 new cases per day. The current 7-day average is 108,505 new cases per day. The average daily mortality has held relatively steady at approximately 250-300 deaths per day since late May* However, the 7-day average appears to be rising and currently is 321 deaths per day.
*Changes in state-level reporting may affect the accuracy of recently reported data, particularly over weekends. In an effort to reflect the longer-term trends, the numbers reported here may not correspond to the most recent dates.

Both new hospital admissions (+13% over the past week) and current hospitalizations (+5%) continue to increase. Considering the plateau in daily incidence, it is possible that hospitalizations could also remain elevated, rather than peaking and then declining.

Community transmission in the US is now being driven by the Omicron BA.5 (36.6%) and BA.4 (15.7%) sublineages, which together are now more prevalent than the BA.2.12.1 sublineage (42%). Along with BA.2 (5.7%), these 4 sublineages of the Omicron variant represent all new SARS-CoV-2 infections in the US.

OMICRON BA.4/BA.5 SARS-CoV-2 Omicron subvariants BA.4 and BA.5 have overtaken BA.2.12.1 as the dominant strains in the US. While BA.2.12.1 still makes up approximately 42% of new cases as of June 25, BA.4 accounts for 15.7% and BA.5 accounts for 36.6%, for a combined total of 52.3%. BA.4 and BA.5 were first detected in South Africa in November 2021, and they are now fueling a worldwide increase in cases. Additionally, hospitalizations are on the rise in Israel, Portugal, South Africa, the UK, and the US. The increases in case and hospitalization numbers are likely due to the fact that BA.4 and BA.5 contain mutations that are believed to aid in immune evasion. This means that prior infection with an earlier Omicron strain, such as BA.1 from winter 2022, might not be enough to protect against disease. BA.4 and BA.5 also are capable of escaping some immunity from vaccines, but vaccinated individuals still tend to fare better than those relying on natural immunity alone. It is increasingly likely that more individuals will start experiencing reinfections. There are concerns that multiple reinfections could put individuals at a higher risk for health problems, but research on the matter is ongoing.

In a June 29 briefing, WHO Director-General Dr. Tedros Adhanom Ghebreyesus noted that BA.4 and BA.5 are responsible for an approximately 20% increase in the number of COVID-19 cases worldwide. COVID-19 cases are on the rise in 110 countries and deaths are increasing in half of the 6 regions monitored by the WHO. Dr. Tedros also spoke out against complacency in the face of the pandemic, stressing that the pandemic is changing and not yet over. He urged the international community to quickly work toward achieving 100% vaccination rates for healthcare workers and individuals over age 60 years. Dr. Tedros also re-emphasized the need for a pan-coronavirus vaccine that can stand up to the rapid evolutionary rate of SARS-CoV-2. Notably, BioNTech announced this week that the company and its partner Pfizer will begin human trials of a pan-coronavirus vaccine in the second half of the year.

VACCINE UPDATES FOR OMICRON The US FDA Vaccines and Related Biological Products Advisory Committee (VRBPAC) on June 28 voted 19-2 to recommend the agency take steps to authorize updated COVID-19 booster shots targeting some form of the SARS-CoV-2 Omicron variant that has been dominant since the beginning of this year. A confluence of factors makes the US population more susceptible to a winter COVID-19 surge, including waning immunity, the possible emergence of a new variant, and colder weather that pushes more people indoors. Current vaccines and boosters are based on the spike protein structure and characteristics of only the original SARS-CoV-2 virus, so introducing individuals to an Omicron spike protein should broaden the body’s immune response against additional versions of the virus, whether currently circulating or a future but similar variant. Many committee members expressed dismay over the limited amount of data on updated vaccine formulations—including if or how well they might provide additional protection—and unknowns about which variants will be circulating this fall.

In an announcement released today, the FDA said that based on the committee’s discussions, it has advised manufacturers seeking to update their COVID-19 vaccines to develop modified versions that add spike protein components of the Omicron BA.4/BA.4 subvariants to current vaccine formulations to create a 2-component, or bivalent, booster vaccine. The decision paves the way for vaccine companies to start manufacturing Omicron-containing doses to potentially be ready for use beginning in early to mid-fall. The FDA did not recommend a change to the primary vaccination formulations.

Introducing another booster this year may come with its own suite of challenges in terms of communication, including possibly moving away from the term booster to something like “another annual shot.” A significant proportion of individuals in the US who are eligible to receive third or fourth shots have yet to do so, leaving them more vulnerable as BA.4 and BA.5 become predominant and highlighting the need for a comprehensive communication strategy about who should get additional shots, when, and why. The administration of US President Joe Biden on June 29 announced an agreement to purchase 105 million doses of the Pfizer-BioNTech COVID-19 vaccine for US$3.2 billion for a fall vaccination campaign, with options for an additional 195 million doses. Pfizer-BioNTech will provide its new formulation based on FDA recommendations. Both Pfizer-BioNTech and Moderna are working on vaccine booster reformulations.

US MATERNAL MORTALITY A new study examining maternal mortality rates in the US before and during the COVID-19 pandemic was published June 28 in the peer-reviewed journal JAMA Network Open. The study compared pre-pandemic and pandemic maternal mortality using de-identified records from the National Center for Health Statistics. Deaths occurring in 2018, 2019, or January-March 2020 were classified as pre-pandemic. Deaths occurring from April-December 2020 were classified as during the pandemic. The study found that maternal mortality rose from 18.8 per 100,000 live births to 25.1 per 100,000 live births. This represents an increase of 33%, higher than the 22% increase in mortality expected as a result of the pandemic. Late maternal mortality increased 41%.

The largest increases in maternal mortality were seen in Hispanic populations, at 74.2%, and non-Hispanic Black populations, at 40.2%, compared to an increase of 17.2% in non-Hispanic White populations. The largest increases in maternal mortality were seen for underlying cause-of-death codes related to indirect causes of death such as other viral diseases (2,374.7%), diseases of the respiratory system (117.7%), and diseases of the circulatory system (72.1%). Maternal mortality increases associated with direct causes of death were largely due to diabetes (95.9%), hypertension disorders (39%), and other pregnancy-related conditions (48%). The authors call for future studies that examine ethnic and racial disparities along with specific causes of COVID-19-related maternal mortality. They also expressed hope that improvements due to the rollout of vaccines could be realized in future analyses.

The new study further confirms a trend seen before the pandemic, when maternal mortality rates were twice as high in the US as in many other high-income countries. More resources are needed to protect pregnant populations from the dangers associated with COVID-19, but pre-existing issues that lead to high maternal mortality must also be addressed to protect this often overlooked high-risk population in the US.

MONOCLONAL ANTIBODY THERAPIES The US government is expected to use up its supplies of Eli Lilly’s monoclonal antibody therapy for COVID-19 in late August because its pandemic funding is running out. Lilly said it agreed to supply the US with an additional 150,000 doses of bebtelovimab for about US$275 million in order to meet demand through the end of August. The agreement includes an option for an additional 350,000 doses that must be applied no later than September 14. Currently, the federal government is distributing about 30,000 doses per week. The antibody received US FDA emergency use authorization earlier this year for use among non-hospitalized patients with mild-to-moderate COVID-19 who are at high risk of disease progression, and the drug has shown effectiveness against the Omicron variant. If the federal government is unable to procure more doses than currently agreed upon, Lilly will need to sell the treatment directly to hospitals and states, a move that would represent a first test of shifting a COVID-19-related drug to the commercial market.

The US FDA and the Assistant Secretary for Preparedness and Response (ASPR) authorized a shelf-life extension for another monoclonal antibody therapy, Evusheld (tixagevimab co-packaged with cilgavimab) made by AstraZeneca. The shelf life of certain lots of the refrigerated treatment can be extended from 18 months to 24 months. Evusheld is authorized for pre-exposure prophylaxis of COVID-19 in certain adults and pediatric individuals. Several experts are hoping for more funding and research into antibody treatments for COVID-19 and other ailments, with some noting that antibodies can have more long-lasting impacts than vaccines, especially among people with immunodeficiencies, and could serve as a key solution during the next pandemic.

DIGITAL SOLUTIONS FOR INFODEMIC During the COVID-19 pandemic, the public has been faced with an overabundance of information, including false or misleading content, in both online and offline environments. To address the online information epidemic, the WHO Regional Office for Europe published a policy brief on how digital solutions can be used to address this so-called “infodemic” to help improve the public health response to COVID-19 and future health emergencies. The brief outlines what WHO is doing to address the infodemic in Europe and globally and highlights 6 specific policy considerations for policymakers and other key stakeholders to help improve infodemic management, including reinforcing multistakeholder networks for infodemic management; strengthening overall risk communication and community engagement; implementing continuous monitoring of harmful and false online content; improving digital literacy approaches and organizing infodemic management trainings; advocating for infodemic management through communication campaigns; and ensuring safe online platforms, which protect people from harmful content.

RESEARCH ROUNDUP The research roundup provides quick synopses of COVID-19-related research.

From Emerging Infectious Diseases, a case report from Thailand of a veterinarian who was diagnosed with COVID-19 after treating and being sneezed on by a domestic cat owned by a person infected with SARS-CoV-2 at the time. Genetic analysis supports the hypothesis that viral transmission occurred from the owner to the cat and then from the cat to the veterinarian. Notably, the veterinarian was wearing an N95 during the cat’s examination, leading the researchers to postulate her eyes were left vulnerable to infection when the cat sneezed in her face, highlighting the importance of face shields or goggles, in addition to masks, to prevent transmission.

From JAMA Internal Medicine, a study suggesting that patients of African ancestry with sickle cell trait (SCT) and associated history of one of several kidney conditions were at increased risk of mortality and acute kidney failure following COVID-19. The results strongly support advising that patients with SCT be regarded as at high-risk of COVID-19.

From The Journal of Infectious Diseases, a cohort study evaluating the risk of SARS-CoV-2 infection and severe COVID-19 disease in persons with Down syndrome (DS) and matched controls prior to available vaccination. Though the risk of infection among individuals with DS was 32% lower than their matched counterparts (aHR 0.68, 95% CI: 0.56-0.83), the rate of severe COVID-19 disease was 6-fold higher (aHR 6.14, 95% CI: 1.87-20.16). The results support better infection monitoring, early treatment, and vaccination for individuals with DS.

From the New England Journal of Medicine, a cohort study of US children aged 5-11 who were vaccinated on or after November 23, 2021, compared with matched controls who were unvaccinated to estimate the effectiveness of the Pfizer-BioNTech vaccine at the start of the Omicron surge. The estimated vaccine effectiveness against symptomatic COVID-19 was 18% (95% CI: -2 to 34) at 14 to 27 days after the first dose and 48% (95% CI: 29 to 63) at 7 to 21 days after the second dose, showing moderate protection as Omicron was becoming dominant.

From Pediatrics, a multicenter prospective observational cohort study conducted in 25 US pediatric hospitals that followed COVID-19 patients under age 21 who were hospitalized between May 2020 and May 2021 for COVID-19 or multisystem inflammatory syndrome in children (MIS-C) for 2-4 months after admission. The researchers found that more than 1 in 4 children with COVID-19 or MIS-C experienced persistent symptoms or activity impairment for at least 2 months. Those patients with MIS-C who have respiratory problems or obesity had a higher risk of prolonged recovery.

From Scientific Reports, a mathematical modeling study examining how human movement—from home to other locations such as school, work, and elsewhere—social distancing behavior, and other restrictive measures such as quarantine affect COVID-19 dynamics within a population. The study’s model showed that SARS-CoV-2 transmission is most attributable to the home location, including gatherings of relatives and close friends. Therefore, limiting encounters or travel to other locations is only effective if the same social distancing measures are also effectively implemented in the home setting.

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