Quality news, views and analysis of issues that affect and inform us in the Douglas Shire.

The COVID-19 Report

LOCAL specialist Dr Doug Quarry from International SOS reports in on this week’s developments in the pandemic world.

DR DOUG QUARRY


VACCINES & VARIANTS
1.1 Number of possible SARS-CoV-2 mutations may be limited
1.2 Pfizer vaccine (two doses) neutralised all three major variants
1.3 Powerful antibodies in patients recovered from the B.1.351 (South Africa) variant 1.4 AstraZeneca CEO speaks about its COVID-19 vaccine
1.5 Germany approves AstraZeneca vaccine for over 65s

EPIDEMIOLOGY: UK & US
2.1 Focus on the UK’s success
2.2 Assess the coverage of the vulnerable population when measuring vaccination programs

2.3 Those with prior COVID-19: no increase in antibodies or memory B-cells from second dose

2.4 Remember: there were NO COVID-19 deaths in anyone vaccinated in a clinical trial

OTHER NEWS
3.1 First delivery of COVID-19 vaccine by drone
3.2 Russian disinformation campaign to undermine confidence in Pfizer and other vaccines

3.3 Cyprus to accept vaccinated Britons
3.4 FDA warns against using ivermectin to treat or prevent COVID-19

covid vaccination

VACCINES & VARIANTS



1.1 Number of possible SARS-CoV-2 mutations may be limited


Jason McLellan, a structural biologist at the University of Texas, Austin, has discussed in the New Yorker magazine the concept that SARS-CoV-2 has only a limited number of variations available that will increase its “fitness”**.
“’There’s just not a lot of space for the spike protein to continue to change in ways that allow it to evade antibodies but still to bind to its receptor,’ he said. ‘Substitutions that allow the virus to resist antibodies will probably also decrease its affinity for ACE-2’ – the receptor that the virus uses to enter cells.”
Eric Topol comments: “Yes, let’s hope we have seen peak fitness. It’s certainly possible and it would accelerate our re-entry towards pre-covid life.”
**Viral “fitness” is defined as: “…the ability of a virus to replicate and dominate or replace the other strains/mutants…”



1.2 Pfizer vaccine (two doses) neutralised all three major variants

A new article in the New England Journal of Medicine (NEJM) reports that the three major variants (B.1.1.7, B.1.351, P.1) were neutralized by serum from people vaccinated with two doses of Pfizer vaccine at titres of greater than 1:40.
Eric Topol describes this as: “Quite reassuring.”



1.3 Powerful antibodies in patients recovered from the B.1.351 (South Africa) variant


A non-peer-reviewed preprint from multiple authors in South Africa has demonstrated high levels of antibody with cross-reactivity for the original variant (from the first wave of COVID-19) and the P.1 (Brazil) variant now circulating globally.
“Collectively these data suggest that the antibody response in patients infected with B.1.351 has a broad specificity and that vaccines designed with the B.1.351 sequence may elicit more cross-reactive responses.”
The authors hypothesize that a vaccine based on the B.1.351 (South Africa) variant may elicit antibodies that can protect against multiple circulating SARSCoV-2 lineages.



1.4 AstraZeneca CEO speaks about its COVID-19 vaccine

In an interview with The Australian newspaper, the company’s CEO, Pascal Soriot (based in Sydney) has reiterated that the AstraZeneca vaccine is 100% effective against severe disease.
Mr Soriot went on to compare the AstraZeneca and Pfizer vaccines and then discussed data that is “yet to be released”.
“Clinical data in recent weeks had put the AstraZeneca vaccine at about 76% to 83% efficacy compared with Pfizer’s 93%, but Mr Soriot said results from the clinical trials were measured differently.
“He said after one month AstraZeneca’s clinical trials showed 100% protection against severe disease. Importantly, there was real-world evidence from the vaccine rollout in Britain that if anything put AstraZeneca ahead of Pfizer.
“’In Scotland with 1 million people vaccinated, there is a 94% reduction of hospitalisations for vaccinations,’ he said. ‘The Pfizer vaccine in those studies is 85%, but it varies.
“’One difference between the two vaccines was that the second dose of the AstraZeneca vaccine needed to be given three months after the first. If you do that you get north of 80% efficacy long term.
“’I would say there is more and more data coming out to say the vaccines are very similar,’ Mr Soriot said.”



1.5 Germany approves AstraZeneca vaccine for over-65s


The BBC reports that” “Germany’s vaccine commission has approved the use of the Oxford-AstraZeneca jab in people aged over 65. The country previously approved it for under-65s only, citing insufficient data on its effects on older people.
“That led to public scepticism about its effectiveness, with some Germans spurning it and leaving many doses unused. But German Chancellor Angela Merkel said recent studies had now provided enough data to approve it for all ages.”


EPIDEMIOLOGY UK & US



2.1 Focus on the UK’s success


Image Source / UK COVID Dashboard
Will cases start to increase as schools re-open?


2.2 Assess the vulnerable population when measuring vaccination programs


Scott Gottlieb has tweeted about the importance of assessing risk reduction when assessing vaccination programs, not only the pure percentage of the population vaccinated.
The US is soon to cross 60% of those over age 65 vaccinated and 70% of those over 75 vaccinated. The overall vulnerability of the population to COVID-19 is obviously declining.
The table below shows the reducing number of cases in a high-risk population in the US – residents in long-term care facilities.


Image Source / COVID Tracking project



2.3 Prior COVID-19: no increase in antibodies or memory B-cells from second dose


Eric Topol has commented on a new non-peer reviewed longitudinal analysis of antibody and memory B cell responses in SARS-CoV2 in naive and recovered individuals following mRNA vaccination, published on medRix.
The finding of no increase in circulating antibodies or antigen-specific memory B-cells from a second dose provides more support for one-dose for those who have previously had confirmed COVID-19, according to Topol.
• SPAIN: has imposed a six-month vaccine delay on those who have had COVID-19 • FRANCE: has recommended a single vaccine dose for people who have had COVID-19.



2.4 Remember: there were NO COVID-19 deaths in anyone vaccinated in a clinical trial


Monica Gandhi’s table reminds us that there were no COVID-19 deaths in anyone vaccinated in a clinical trial.


OTHER NEWS



3.1 First delivery of COVID-19 vaccine by drone


Gavi has made the first deliveries of COVAX-19 vaccine by autonomous drone. The delivery of approximately 2.5 million doses began this week in Ghana.



3.2 Russian disinformation campaign against Pfizer and other vaccines


The Wall Street Journal reports that Russian intelligence agencies are trying to undermine confidence in Pfizer’s and other Western vaccines, using online publications that have questioned the vaccines’ development and safety.
The article reports that there are Russian websites linked to Russian intelligence services publishing false information questioning vaccine safety and efficacy.



3.3 Cyprus to accept vaccinated Britons

The New York Times reports that: “Cyprus has announced a plan to allow vaccinated residents of Britain to visit the island beginning in May, a further signal that countries, particularly those dependent on tourism, could resort to inoculation certificates to reopen their borders.”



3.4 FDA warns against using ivermectin to treat or prevent COVID-19


The US Food and Drug Administration (FDA) has issued guidance warning consumers against using the antiparasitic drug ivermectin to treat or prevent COVID-19.
The agency says it issued the guidance in light of growing interest in the drug as a COVID-19 treatment and multiple reports of patients hospitalized or needing medical support “after self-medicating with ivermectin intended for horses”.
Ivermectin, which is not an antiviral, has not been approved by the FDA for treating or preventing COVID 19, the guidance emphasized.
“Using any treatment for COVID-19 that’s not approved or authorised by the FDA, unless part of a clinical trial, can cause serious harm,” the FDA says.


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