Coronavirus Sars-CoV-2/Covid-19 Megathread

[DGuller]

What's the bottleneck now?  Is it still the supply simply not catching up to demand yet?  Or is it an issue of distribution now?

[Zanza]

Both

[jimmy olsen]

3.4-4.7 million dead 

https://www.bbc.com/news/world-asia-india-57888460?

Covid-19: India excess deaths cross four million, says study

Soutik Biswas
India correspondent

The Covid-19 pandemic has caused excess deaths in India to cross more than four million, a new study has found.

Excess deaths are a measure of how many more people are dying than would be expected compared to the previous few years.

Although it is difficult to say how many of these deaths have been caused by Covid-19, they are a measure of the overall impact of the pandemic.

India has officially recorded more than 414,000 Covid-19 deaths so far.

The country is one of the few major economies without an estimate of excess deaths during the pandemic.

Researchers from the US-based Center for Global Development used three different data sources to estimate India's excess all-cause mortality during the pandemic until 21 June.

They extrapolated death registrations from seven states, accounting for half of India's population. India conducts yearly mortality surveys but has only published numbers up to 2019.

Second, the researchers applied international estimates of age-specific infection fatality rates - the number of people that die from the virus - to data from two countrywide antibody tests, also called sero surveys.

Third, they looked at India's consumer survey of 868,000 individuals across 177,000 households which also records whether any member of the family had died in the past four months.

Taken together, the researchers found that excess deaths were estimated to be in the range of 3.4 million to 4.7 million - about 10 times higher than India's official Covid-19 death toll.

This was also considerably higher than other estimates by epidemiologists, who believed India's excess deaths were five-to-seven times higher.

Not all these deaths were caused by Covid-19 and an estimation of the actual death toll by the disease would be difficult to give, said Arvind Subramanian, India's former chief economic adviser and one of the authors of the study.

Although data on how many people died in the pandemic was patchy, researchers looked at the data on infection rates, based on many sero surveys to get a ballpark estimate of deaths.

They took India's infection numbers and applied estimates from international studies of the probability of death after a Covid-19 infection.

They did this with each different age group, applying international estimates of the Covid-19 infection fatality rate at a given age to the number of infections among Indians in that age group.

The data implied that four million people had died in the pandemic in India, according to Dr Subramanian.

"Two of our three estimates measure all-cause mortality and not Covid-19 deaths. Our second measure is a bit closer to a number of [actual] Covid-19 deaths, but it is only one of three estimates," Dr Subramanian told me.

The researchers - including Justin Sandefur of the Center for Global Development and Abhishek Anand of Harvard University - also said that the first wave last year appeared to have been more lethal than what was popularly believed. Mortality appeared to be moderate because it was "spread out in time and space".

Dr Subramanian said one of the conclusions might be that "India has not been an outlier" and has had "mortality not dissimilar from countries of comparable size and infections".

The researchers said the most "critical take-away, regardless of the sources and estimates", was that actual deaths during the Covid-19 pandemic were "likely to be far greater than the official count".

"The true deaths are likely to be in several millions, not hundreds of thousands, making this arguably India's worst human tragedy since the partition and independence."

[Legbiter]

Over 30 new cases diagnosed yesterday, seems like the experimental results are in. Open borders for vaccinated travelers will result in nightlife spread, although somewhat checked by vaccinations. So far all of our sick are not needing hospital care, their symptoms are more on par with a bad flu or just the sniffles or less. If this had happened back in October, we'd have banned all gatherings of more than 20 people, etc. Instead we're asking people to get tested if they have symptoms and tightening the border slightly. 

[mongers]

Over 30 new cases diagnosed yesterday, seems like the experimental results are in. Open borders for vaccinated travelers will result in nightlife spread, although somewhat checked by vaccinations. So far all of our sick are not needing hospital care, their symptoms are more on par with a bad flu or just the sniffles or less. If this had happened back in October, we'd have banned all gatherings of more than 20 people, etc. Instead we're asking people to get tested if they have symptoms and tightening the border slightly. 

So an excellent programme of border restrictions and close track/tracing is compromised by half measures.

Another experiment for the international community to digest?

Hot on the heals of the UK's new 'let's throw all caution to the winds and party like it's 2019'

[crazy canuck]

Over 30 new cases diagnosed yesterday, seems like the experimental results are in. Open borders for vaccinated travelers will result in nightlife spread, although somewhat checked by vaccinations. So far all of our sick are not needing hospital care, their symptoms are more on par with a bad flu or just the sniffles or less. If this had happened back in October, we'd have banned all gatherings of more than 20 people, etc. Instead we're asking people to get tested if they have symptoms and tightening the border slightly. 

Consistent with nightlife spread, one of our warships is now quarantined in Halifax harbour at the end of their mission.  The captain granted shore leave in Reykjavik because he thought it would be safe.  But one of the crew has now tested positive.

[The Larch]

Twitter suspends Marjorie Taylor Greene's account over Covid misinformation

Republican had claimed the disease was not dangerous for non-obese people and the under-65s

The Republican congresswoman Marjorie Taylor Greene's Twitter account was temporarily suspended on Monday over tweets that violated the social media company's Covid-19 misinformation policy.

Greene posted that the coronavirus was not dangerous for non-obese people and those under 65, and that organisations should not force "non-FDA" approved vaccines or masks on people. These tweets have been labelled as "misleading".
(...)
Greene's account will remain locked for 12 hours, according to Twitter.

In a video statement on Facebook Live, Greene acknowledged that she had been temporarily suspended from the platform and blamed the Biden administration for trying to control free speech.

"Remember, last week when our press secretary said the White House is working to stop the spread of [misinformation] because they want to be careful and they want to be in control of the information that is shared about Covid-19 and vaccines, isn't that concerning?" Greene said.

The Republican representative has come under fire before for remarks on the pandemic. In June she apologised after comparing Covid-19 mask requirements and vaccinations to the Holocaust that killed 6 million Jews.

[Zanza]

Read about another study that says 1 in 10 infected suffer from Long Covid and 1 in 5 of the Long Covid patients have organ damage, so 1 in 50 Covid cases with organ damage. That's a lot of cases with long-term health implications.

One of the common symptoms is an inflammation of the heart. Which massively increases risk of arrhythmia and other heart diseases. Another common symptom is damage to the lungs.

[Sheilbh]

Interesting - UK JCVI (scientific advisers on vaccine roll-outs/scheduling etc) have only recommended quite limited vaccination program for teens - though they note there are some studies in progress that may cause them to re-evaluate.

The basic point is that in their view:

The health benefits in this population are small, and the benefits to the wider population are highly uncertain. At this time, JCVI is of the view that the health benefits of universal vaccination in children and young people below the age of 18 years do not outweigh the potential risks.

Full report here:
https://www.gov.uk/government/publications/covid-19-vaccination-of-children-and-young-people-aged-12-to-17-years-jcvi-statement/jvci-statement-on-covid-19-vaccination-of-children-and-young-people-aged-12-to-17-years-15-july-2021

But their key considerations in this are:

Considerations
Direct health benefits

JCVI has carefully examined the risk of COVID-19 to children and young people. The evidence strongly indicates that almost all children and young people are at very low risk from COVID-19. Where symptoms are seen in children and young people, they are typically mild, and little different from other mild respiratory viral infections which circulate each year. The incidence of severe outcomes from COVID-19 in children and young people is extremely low. In England, between February 2020 and March 2021 inclusive, fewer than 30 persons aged less than 18 years died because of COVID-19, corresponding to a mortality rate of 2 deaths per million. During the second wave of the pandemic in the UK, the hospitalisation rate in children and young people was 100 to 400 per million. Most of those hospitalised had severe underlying health conditions.

[]b]For children and young people without underlying health conditions that put them at high risk of severe outcomes from COVID-19, the direct individual health benefits of COVID-19 vaccination are limited. While vaccination of younger cohorts could reduce the risk of outbreaks of COVID-19 in school settings, the vast majority of those infected in any outbreak will either be asymptomatic or have mild disease. Currently, less data are available on the safety of COVID-19 vaccines in children and young people compared to adults, and JCVI carefully considered reports of myocarditis following the use of the Pfizer-BioNTech BNT612b2 and Moderna mRNA-1273 vaccines in younger adults. At this time JCVI does not consider that the benefits of vaccination outweigh the potential risks.[/b] Until more safety data have accrued and their significance for children and young people has been more thoroughly evaluated, a precautionary approach is preferred.

Paediatric Inflammatory Multisystem Syndrome Temporally associated with SARS-COV2 infection (PIMS-TS), also called Multisystem Inflammatory Syndrome in Children (MIS-C), is a rare inflammatory disorder related to previous recent SARS-COV2 infection. During the second wave, PIMS-TS was estimated to occur in 5 per 10,000 children infected with SARS-CoV2 in the UK, with a case fatality ratio of 1%. The underlying cause for PIMS-TS is not properly understood. Specifically, it is not known how COVID-19 vaccination might influence the occurrence or severity of PIMS-TS. JCVI's view is that the available data are insufficient to advise on COVID-19 vaccination for the prevention of PIMS-TS. JCVI will continue to review and update this advice as new data emerge.

Concerns have been raised regarding post-acute COVID-19 syndrome (long COVID) in children. Emerging large-scale epidemiological studies indicate that this risk is very low in children, especially in comparison with adults, and similar to the sequelae of other respiratory viral infections in children.

Indirect health benefits

Modelling from the University of Warwick and from Public Health England (PHE) indicate that vaccinating children and young people could have some impact on hospitalisations and deaths in older adults. However, the extent of such benefits are considered highly uncertain, and by autumn 2021, all eligible adults should have been offered 2 doses of COVID-19 vaccine. A successful adult COVID-19 immunisation programme would mean that education staff and adult household members of students should have been vaccinated, reducing the risk of onward transmission from children to adults in school or at home, respectively.

Persons who are immunosuppressed are at higher risk of serious disease from COVID-19 and may not generate a full immune response to vaccination. Given the potential for indirectly protecting persons who are immunosuppressed, JCVI advises an extension of the current offer of vaccination to persons aged 12 to 17 years who are household contacts of those who are immunosuppressed. Information should be readily available explaining the limits of the existing data on safety and that the main benefits from vaccination are related to the potential for indirect protection of their household contact who is immunosuppressed.

Wider health implications and operational considerations

Following disruptions in routine programmes because of the pandemic, there is an urgent need to catch up on non-COVID-19 school immunisations such as human papillomavirus (HPV) and meningitis (MenACWY) vaccinations, and there may be a need to offer other routine vaccines (such as mumps, measles and rubella (MMR)) in the school setting as part of overall recovery. Any extension to the childhood influenza programme also needs to be taken into account. The health benefits from these various non-COVID-19 school-based immunisation programmes are well established, and some may provide the last effective opportunity to complete an individual's immunisation course and provide timely and/or lifelong protection. Although relative benefits have not been formally compared, in JCVI's view, most non-COVID-19 childhood immunisations are likely to offer more benefits to children and young people than a COVID-19 immunisation programme.

On top of existing routine programmes, a COVID-19 programme for children and young people is likely to be disruptive to education and will require more resource. The scale of additional resources required will be considerable.

Non-health benefits of vaccination

The pandemic has impacted on the provision of education to children, which in turn has indirectly affected the wider health and well-being of children. In considering the value of vaccination to children, JCVI recognises that there is no agreed methodology to assess indirect educational benefits against potential health risks. Vaccinating secondary school students would provide direct protection against symptomatic infection and reduce the risk of outbreaks in secondary schools. This may allow more students to remain in school and reduce days off school because of SARS-CoV2 infection. The adverse educational impacts of school closures or days off school fall disproportionately on students from more deprived areas and may be of long-term importance. Reducing days off school could mitigate some of the health inequalities related to COVID-19. Children and young people who have SARS-CoV2 infection generally do not become so unwell that they need to take much, or any, time off sick from education. Moreover, recent changes to national policy on NPIs in schools, in the context of a successful adult vaccination programme, should substantially reduce the impact of COVID-19 on children and young people's education.

Data from the adult COVID-19 vaccination programme indicates that vaccine coverage is lower in more deprived neighbourhoods compared to less deprived neighbourhoods. How similarly differential vaccine uptake among school-aged children might affect health inequalities should be considered ahead of any policy decision on this front.

Should the government wish to consider vaccination of children and young adults aged less than 18 years with the primary aim of reducing the SARS-CoV2 infection rate (asymptomatic and symptomatic cases) irrespective of other direct or indirect benefits as discussed above, the known benefits from vaccination are likely to be limited. In this instance, JCVI favours deferral of a universal offer of vaccination until more data have accrued, including a clearer understanding of the impact of COVID-19 in the UK within the context of a successful adult vaccination programme.

[Legbiter]

Consistent with nightlife spread, one of our warships is now quarantined in Halifax harbour at the end of their mission.  The captain granted shore leave in Reykjavik because he thought it would be safe.  But one of the crew has now tested positive.

Yeah we went from only 4 planes landing each day at Keflavik airport 3 weeks ago to almost 40 planes per day for the last couple of weeks. Vaccinated tourists were not required to quarantine on arrival, hence the nightlife spread. This delta variety spreads like Captain Trips, full vaccination only affords somewhere between 60-70% transmission protection in each instance. So that's a big disappointment right there because the vaccines were 80-90% effective in preventing transmission against the old varieties. In the next 10 days we'll see how vaccinated oldies and people with chronic conditions fare, if hospitalizations don't increase and threaten to overwhelm the health system we'll wait a bit and see before imposing stronger control measures. Mask mandates and visitor controls to hospitals and nursing homes have already been reimposed. Full contact tracing and quarantine will continue.

[Josquius]

A thought- if this is here to stay then kids remain a forever problematic vector.
Shouldn't this factor into school placements in some way?
Be even tighter with post-code rules.
Or go the other way and where possible in cities try to factor in parents jobs (asking the impossible there of course).

[Tamas]

A thought- if this is here to stay then kids remain a forever problematic vector.
Shouldn't this factor into school placements in some way?
Be even tighter with post-code rules.
Or go the other way and where possible in cities try to factor in parents jobs (asking the impossible there of course).

Eventually we will have to reach the "taking it on the chin" phase. But I wish England went for that when more than half the people got their second shots.

[Sheilbh]

Eventually we will have to reach the "taking it on the chin" phase. But I wish England went for that when more than half the people got their second shots.

More than half of people have had their second shots - up to around 55% of the country now (69% of eligible people).

[Zanza]

I predict that within a few months we will figure out that it would have been better to vaccinate all children as well immediately.

[mongers]

I predict that within a few months we will figure out that it would have been better to vaccinate all children as well immediately.

Especially after a variant/s that evades much of the vaccine protection inevitable turns up.