Thursday 18 November 2021

Covid Commentary and Roundup of News



A round up of news stories covering booster jabs, age risk in Covid demographics, antiviral drugs, and vaccines and long Covid.

The main concerns are waning vaccination, which can be improved by boosters (see booster jabs), and death and Long Covid, both of which have risk reduced by vaccines, but where the reduction is very much age related.

For example, someone aged 80 who is fully vaccinated essentially takes on the risk of an unvaccinated person of around 50 – much lower, but still not nothing, and so we can expect some deaths. The effectiveness of vaccines is often given as one figure, which is misleading. The stories below show how age is such a significant factor, especially with breakthrough infections and their severity.

New antiviral drugs now emerging (see below) may help reduce that risk of hospitalisation and death.

Long covid can be debilitating, and is also an issue with breakthrough infections (see story below). Unfortunately, no good statistics are being kept and published locally on long covid and vaccination and age ranges, so we are very much in the dark here.

A case below shows this is still very much a risk, and while we may rejoice that in our local statistics hospital numbers remain low, long covid is likely to increase as numbers of cases of Covid rise - because the probabilities of more of the population being affected increases directly with cases in the community.

Current trends - over 1,000 cases of Covid known in the community almost suggest a move towards herd immunity though infection, even though this is not stated as public policy.

The current numbers of direct contacts of active cases (over 8,000) and the testing capacity (2,000 swabs per day), as well as the single site of the harbour for testing suggest a rethink is on the cards. As direct contacts unless showing symptoms are only strongly advised to keep more isolated, the gap between being a direct contact and getting a PCR test is now in the order of around 3 or more days. This in turn means more Covid can seed the community.

Opening the airport PCR test site again should help process more people and keep numbers down. Opening the airport PCR lab as well as the hospital one would also get the direct contacts down rapidly. These are simple measures which will help slow the spread of Covid, as once people test positive, they must by law self-isolate for 10 days.

Apart from that, the increase in lateral flow tests is also a help. Unlike PCR tests, lateral flow tests cannot detect very low levels of coronavirus in a sample. This means the test may not give a positive result if you have only recently been infected; are in the incubation period.

However, a recent study in Clinical Epidemiology showed that lateral flow tests (LFTs) are likely more than 80% effective at detecting any level of infection and also more than 90% effective at detecting those who are most infectious when using the test.

And finally mandatory mask wearing will also stop the spread in the community. As we know from past experience, "strongly advise" means for a number of people "mainly ignore". The effectiveness of mandatory mask wearing has been seen last November, and again this summer when numbers were high. Again, not 100% effective, but like a Swiss cheese, the more layers of protection against Covid the better the outcome. Reliance on boosters and lateral flow tests may not be enough. Each has "holes" in it.

Last year, mask wearing and other restrictions came too little, too late, and most of the Christmas period was spent in lockdown - bad for mental health, hospitality industry. Acting too late was the main cause of the need for a more severe lockdown, and it is about time that lesson was learnt. 

If we lose Christmas again, despite these obvious lessons from the past, you know who to blame.

Booster Jabs

Double-jabbed vulnerable and elderly people are dying from Covid-19 due to the efficacy of the vaccine waning, a senior adviser has said.

The effects of coronavirus vaccines are known to wane some five or six months after the second dose, as discovered in multiple studies during the pandemic.


It comes as the government launches a campaign to encourage take-up of booster jabs this autumn.

While most of those dying with Covid-19 are unvaccinated, reports last week said Number 10 was concerned about hospital admissions and deaths among double-vaccinated people rising due to waning immunity.

https://www.independent.co.uk/news/uk/home-news/vaccine-waning-immunity-covid-deaths-b1953158.html

Vaccines and Covid: The Age Risk Profile

The coronavirus vaccines are still working extremely well, research shows, even in the era of the dangerous delta variant. Unvaccinated individuals are more than 10 times as likely to be hospitalized with COVID-19 and more than 10 times as likely to die from the disease as vaccinated people, according to a new report from the Centers for Disease Control and Prevention (CDC).

But on the rare occasion that a vaccinated person does fall seriously ill with COVID-19 — it’s happened to about 0.008 percent of the 176 million fully vaccinated Americans — it’s likely to be an older adult. About 70 percent of breakthrough infections that have required hospitalization have been in adults 65 and older, the latest CDC data shows. This population also accounts for 87 percent of breakthrough deaths.

https://www.aarp.org/health/conditions-treatments/info-2021/older-people-breakthrough-covid.html

Mounting data suggest that older people are at higher risk of severe disease from a breakthrough infection of COVID-19—and scientists say that should come as no surprise. After all, older age brackets have been disproportionately at risk throughout the pandemic, and that continues to be true even once someone is fully vaccinated.

Health officials are seeing worrying evidence that older age groups continue to be at higher risk from the pandemic. According to the latest data from the Centers for Disease Control and Prevention, people over 65 account for 67 percent of hospitalizations and 85 percent of deaths from breakthrough cases. And recent media reports citing data from Seattle, Washington, and the United Kingdom show that older vaccinated people face similar—and, in some cases, greater—risks of severe disease than unvaccinated children.

In September the CDC reported that the vaccines are only about 78 percent effective at preventing infection among people of all ages after six months.

https://www.nationalgeographic.com/science/article/why-older-vaccinated-people-face-higher-risks-for-severe-covid-19

Antiviral Drugs

Pharmaceutical giant Pfizer requested emergency authorization Tuesday for Paxlovid, a five-day antiviral pill regimen the company found to reduce the risk of hospitalization or death by 89 percent.

The announcement comes as covid-19 cases increase in many parts of the country, raising fears among public health officials that a fifth case surge could hit the nation during the winter. If authorized, the drug could help stave off hospitalizations and deaths that are already overwhelming hospitals in states such as Colorado and Minnesota.

https://www.washingtonpost.com/nation/2021/11/16/covid-delta-variant-live-updates/

Vaccines and Long Covid: The Risk is Always There

People who are fully vaccinated against Covid-19 appear to have a much lower likelihood of developing long Covid than unvaccinated people even when they contract the coronavirus, a study published Wednesday indicated.

The research is among the earliest evidence that immunization substantially decreases the risk of long Covid even when a breakthrough infection occurs. Already, researchers had said that by preventing many infections entirely, vaccines would reduce the number of cases of long Covid, but it wasn’t clear what the risk would be for people who still got infected after vaccination.

https://www.statnews.com/2021/09/01/vaccination-reduces-risk-long-covid-even-when-people-are-infected-study/

People like April Zaleski know COVID-19’s worst outcomes aren’t limited to severe disease and death, even for the fully vaccinated. Zaleski, a 32-year-old from Idaho, caught COVID-19 in July 2021 after being vaccinated in January. She recovered after a couple weeks and thought the worst was behind her. But then her fatigue came back with force, along with brain fog, shortness of breath, vertigo and a skyrocketing heart rate. She began to suspect she had Long COVID, the name adopted by people who suffer symptoms long after their initial infection.

Long COVID “was on my radar,” Zaleski says, “but having been vaccinated, I hoped that my chances of that happening were slim to none.”

Indeed, the vast majority of vaccinated people who catch COVID-19 will not develop Long COVID, just as they will not die or go to the hospital; many won’t even have symptoms or realize they’re infected. But some will develop symptoms that don’t go away. Some, like Zaleski, already have. “There are so many people who are recovering from COVID, and that’s absolutely wonderful,” she says. But others “are struggling with long-term symptoms, and I just wish that people knew that side of COVID better.”

https://time.com/6102534/breakthrough-infections-long-covid/

No comments: