Coronavirus Sars-CoV-2/Covid-19 Megathread

[crazy canuck]

Fuck. I had a friend over on Sunday, first time I had a visitor this year. Just got a text he tested positive today. Fuck. Fuck.

Fuck indeed.

If it is any consolation, that has happened to two other people I know - playing by all the rules and spending some time with another outside who they firmly believed was also playing by all the rules - and they later get told that other person has tested positive.  I think that is an indication of how much more infectious the new variants are (or are becoming).

I have gone further into isolation...

[Eddie Teach]

With Hungary still producing terrible numbers (Monday morning death statistics are usually the lowest coming out of slower weekend reporting and still they were 291 today) schools are being opened up, and Budapest is offering the UEFA 100% stadium attendance for the delayed Euro 2020 matches.

In a perfect symbol of all this the (effectively Fidesz-owned) major sport newspaper had this front page:



On the left they are mourning a 56 years old ex-olympic athlete who lost her life to Covid, while on the right celebrating that only Budapest has committed to full stadiums.

It's like allied with eurasia/at war with eurasia side by side

Except it's Hungary, so they would be at war with Oceania.   

[DGuller]

It's terrible. I'm not getting a vaccine until November or December now. Bah!

Why can't people sign a notional waver saying they accept the risk in order to get vaccinated?

Would getting a 'private' jab or buying an inoculation in a neighbouring country be possibilities?

You have to be a little careful with such schemes.  Sometimes giving individuals a choice to turn down regulatory protections can completely negate regulatory protections.  For example, if you allow people to waive their right to receive a minimum wage in exchange for being chosen for employment, then you don't have minimum wage as a concept.  With vaccines, I can see how individuals might be forced to choose to get a vaccine if their employment opportunities depend on being vaccinated.

[Sheilbh]

In the UK there are moves to make vaccines mandatory for employees in care homes/the care sector or healthcare - both of which sound sensible.

[Duque de Bragança]

In the UK there are moves to make vaccines mandatory for employees in care homes/the care sector or healthcare - both of which sound sensible.

In France as well, it was already the hot topic in early March.
Some employees used the Astra Zeneca issues as an excuse for not taking the shots. Most medical doctors are for it but figures for nurses and lower care home employers were far lower.

[Maladict]

Fuck. I had a friend over on Sunday, first time I had a visitor this year. Just got a text he tested positive today. Fuck. Fuck.

Fuck indeed.

If it is any consolation, that has happened to two other people I know - playing by all the rules and spending some time with another outside who they firmly believed was also playing by all the rules - and they later get told that other person has tested positive.  I think that is an indication of how much more infectious the new variants are (or are becoming).

I have gone further into isolation...

I've been so careful, it's just incredibly annoying. At least that's what I hope is causing this headache.

[saskganesh]

4% of Toronto has been infected over the past year. One in 25. Currently, we are seeing record caseloads. We are also seeing record vaccinations, but some clinics do not have any supply. People are showing up for appointments...and being turned away. Government seems very disorganised right now.

[Tamas]

After, what, two week, my uncle has been moved from the Covid ward of the hospital, after having much improved. He is basically entering after care now for them to look at some liver function thing. It's something he has been complaining to his GP about well before Covid, it just seems like being under surveillance at the ICU gave them some idea of what might be going on, so not necessarily directly linked to covid effects. Would be nice if he actually got something good out of all this.

He only talked to his wife via video chat (no visits allowed) but seemed like he lost a lot of weight. Still, looks like he got lucky.

[The Larch]

Exec. summary: Western countries being a bunch of whiny bitches regarding the AZ and J&J vaccines are hurting vaccination campaigns in the developing world.

Western Warnings Tarnish Covid Vaccines the World Badly Needs
Amid a deep residue of mistrust, American and European cautions on the AstraZeneca and Johnson & Johnson vaccines risk igniting anti-vaccine fervor in countries that can't afford to be particular.

Safety worries about the AstraZeneca and Johnson & Johnson Covid-19 vaccines have jeopardized inoculation campaigns far beyond the United States, undercutting faith in two sorely needed shots and threatening to prolong the coronavirus pandemic in countries that can ill afford to be choosy about vaccines.

With new infections surging on nearly every continent, signs that the vaccination drive is in peril are emerging, most disconcertingly in Africa.

In Malawi, people are asking doctors how to flush the AstraZeneca vaccine from their bodies. In South Africa, health officials have stopped giving the Johnson & Johnson shot, two months after dropping the AstraZeneca vaccine. And in the Democratic Republic of Congo, 1.7 million AstraZeneca doses have gone unused.

The sense of uncertainty deepened on Wednesday when an advisory committee to the U.S. Centers for Disease Control and Prevention delayed a decision for seven to 10 days on lifting a pause on the Johnson & Johnson vaccine, saying it wanted more data on a rare blood clotting disorder. Those shots were halted on Tuesday over concerns about the disorder, which emerged in six women, and on Wednesday the panel learned of two more examples.

Also on Wednesday, the European Union said it would not make any more purchases of the AstraZeneca or Johnson & Johnson vaccines, but would pivot to relying solely on those, like Pfizer's and Moderna's, that are based on a newer technology and have not raised similar safety concerns.

The actions of American and European officials reverberated around the world, stoking doubts in poorer countries where a history of colonialism and unethical medical practices have left a legacy of mistrust in vaccines. If the perception takes hold that rich countries are dumping second-rate shots on poorer nations, those suspicions could harden, slowing the worldwide rollout of desperately needed doses.

Dr. Sara Oliver of the C.D.C. told the advisory panel that prolonging the pause in using the Johnson & Johnson vaccine "could have global implications."

Already, doctors say, the recent pauses have vindicated vaccine skeptics and made many others feel duped.

"People, especially those who were vaccinated, felt like they had been tricked in a way — they were asking, 'How do we get rid of the vaccine in our body?'" said Precious Makiyi, a doctor and behavioral scientist in Malawi, where health workers have been racing to empty their shelves of nearly expired AstraZeneca doses. "We fought so hard with vaccine messaging, but what has happened this past week has brought us back to square zero."

African health officials have reacted with fury at the breezy reassurances of American and European lawmakers that people denied the AstraZeneca or Johnson & Johnson shots could be given another vaccine. In much of the world, there are no other vaccines.

And even as American health officials stressed that they paused use of the Johnson & Johnson vaccine on Tuesday in "an abundance of caution," they forced global health officials to begin crafting the difficult case that shots that might not be safe enough for the world's rich were still suited to its poor.

"It's sending vaccine confidence into a crater," Ayoade Alakija, a co-chair of the African Union's Africa Vaccine Delivery Alliance, said of rich countries' actions. "It's irresponsible messaging, and it speaks to the selfishness of the moment that there wouldn't be more consultation and communication."

What rich countries call caution, poorer nations will experience as a devastating gamble with the survival of their citizens against Covid-19. "Out of an abundance of caution, let us not destroy vaccine confidence in places that only have access to one type of vaccine," Dr. Alakija said.

The Johnson & Johnson and AstraZeneca shots have been considered especially crucial for less developed and hard-to-reach parts of the world, because they are less expensive and easier to store than Moderna's or Pfizer's, and the Johnson & Johnson vaccine requires just one dose.

AstraZeneca's shot is being used in at least 118 countries. Lately, amid shortages of that vaccine, some regions have pivoted to Johnson & Johnson's: Two weeks ago, the African Union acquired 400 million doses.

Together, the two vaccines account for a third of the portfolio of Covax, the international effort to procure and distribute vaccines.

But it is becoming more apparent by the day that those shots are becoming afterthoughts in wealthy nations. After canceling Johnson & Johnson appointments, American states offered people the pricier Pfizer or Moderna vaccines instead.

The European Union said on Wednesday that it had acquired another 50 million doses of the Pfizer vaccine, allowing it to curb use of AstraZeneca's vaccine and phase it out altogether next year. Many European nations have already restricted the use of that shot, after clotting problems emerged in a small number of recipients.

Those decisions, intended for domestic audiences, have nevertheless resounded in countries where variants are spreading, physical distancing is a luxury and there is no choice of shots.

Health officials fear that any setbacks in vaccinations could sow the seeds of the next calamitous outbreak, one that deluges hospitals and exports new mutations around the world. In those places, doctors said, the math is obvious: Many more people will die without the AstraZeneca and Johnson & Johnson vaccines than with them.

Amid the clotting concerns, the World Health Organization and African Union have not wavered in recommending the use of the AstraZeneca and Johnson & Johnson's vaccines. In Britain, AstraZeneca's vaccine remains the backbone of the country's speedy inoculation campaign, despite people under 30 being offered alternatives. Congo, after spurning the AstraZeneca shot in light of unease in Europe, said on Tuesday that it would start the much-delayed inoculations next week.

And in Dakar, the capital of Senegal, people continued to line up on wooden benches on Wednesday for the AstraZeneca shot as they watched their children run through the corridors of a medical center.

"We don't have a choice," said Alioune Badara Diagne, 34, who lives in the city's lively Ouakam neighborhood. Despite talk of vaccination pauses in wealthy nations and rumors of vaccine makers using Africans as "guinea pigs," he said, Westerners themselves were continuing to be injected. He added, "The vaccine is our only hope."

But in much of the world, the American regulators who endorsed Tuesday's pause on Johnson & Johnson vaccinations act as sort of surrogate decision makers on drugs and vaccines, giving their hesitation extra weight in African nations.

"I became even more skeptical when I heard that the United States suspended Johnson & Johnson," said Lawmond Lawse Nwehla, 32, an engineer in Dakar. "They said it was effective and then they stopped it. So I wonder why."

In immediately pausing the use of Johnson & Johnson's shot, American regulators reacted more aggressively than did their British counterparts, who backed the AstraZeneca vaccine even as they investigated clotting cases.

The costs of the American approach were already evident in Europe, where many nations stopped and then restarted AstraZeneca vaccinations, only to find that it had become a pariah. Most people in France, Germany and Spain distrusted the vaccine.

"Once you take the cork out of the bottle, I'm not sure you can get it back in particularly easily," said Anthony Cox, a vaccines safety expert at the University of Birmingham in England.

South Africa immediately copied the American pause on Johnson & Johnson vaccinations, infuriating doctors who are still clamoring for shots, especially in remote parts of the country. In February, health officials dropped the AstraZeneca vaccine over its limited efficacy against a dangerous variant there.

To date, only half of 1 percent of the population is vaccinated, and a mere 10,000 shots are being given each day. At that rate, it could take weeks, if not longer, for a single rare blood clotting case to emerge, said Jeremy Nel, an infectious disease doctor in Johannesburg. He was dismayed by the decision to pause shots, given the risk to vaccine confidence in a country where two-fifths of the people say they have no intention of being vaccinated.

"The slower you go, that failure is measured in death," Dr. Nel said. "Even if you delay for a week, there is a non-trivial chance that will cost lives."

The solution in many European countries — to stop using seemingly riskier vaccines in younger people, who are at lower risk from Covid-19 — would be unworkable in Africa, where the median age in many countries is below 20.

And any further restrictions would compound the hurdles facing Covax, among them a paucity of funding for every part of inoculation programs beyond the touchdown of doses at airports.

Mali, in western Africa, has administered 7 percent of the AstraZeneca doses that Covax has delivered. Sudan, in eastern Africa, has given 8 percent of the doses it has received.

Skittishness over the AstraZeneca and Johnson & Johnson vaccines, analysts fear, could stoke demand for Russian- and Chinese-made shots about which far less is known. As it is, some global health officials have turned their attention to the Novavax vaccine, which is not yet authorized but makes up a third of Covax's portfolio.

"Even at this stage of the pandemic, we have our fingers crossed that some vaccine will work to help vaccinate developing countries, instead of ramping up production of vaccines we know work," said Zain Rizvi, an expert on medicines access at Public Citizen, an advocacy group.

In Kenya, where enthusiasm for vaccines is high in cities but perilously low in rural areas, "the story about blood clots from Europe could not have come at a worse time," said Catherine Kyobutungi, the director of the African Population and Health Research Center there. "Even those who were perhaps on the fence, and leaning toward getting vaccinated, all of a sudden had second thoughts," she said.

The American pause on Johnson & Johnson shots promised a second media furor.

"When the F.D.A. suspends, it makes headlines for days," she said. "When it lifts the suspension, it doesn't make as many headlines."

[Maladict]

After, what, two week, my uncle has been moved from the Covid ward of the hospital, after having much improved. He is basically entering after care now for them to look at some liver function thing. It's something he has been complaining to his GP about well before Covid, it just seems like being under surveillance at the ICU gave them some idea of what might be going on, so not necessarily directly linked to covid effects. Would be nice if he actually got something good out of all this.

He only talked to his wife via video chat (no visits allowed) but seemed like he lost a lot of weight. Still, looks like he got lucky.

Good news 

[Sheilbh]

Exec. summary: Western countries being a bunch of whiny bitches regarding the AZ and J&J vaccines are hurting vaccination campaigns in the developing world.

Yeah - that's been the biggest fear about this. After the first suspensions in the EU Georgia and several countries in South-East Asia stopped using AZ as well, though it's the only vaccine they have.

Worst case scenario is it tarnishes a good vaccine so much that people don't want it and chunks of the world aren't vaccinated, if this sticks then the best case scenario may be the developing world does accept Chinese vaccines which may not be as effective but people get some level of vaccination (obviously politically, that's not ideal for Europe and America - but is far better than no vaccines).

You even see it online. Zeynep Tufekci's been writing on Twitter about how the US should just release their AZ stockpile because, by the time it's approved, everyone there will have had the chance to get another vaccine. And there's so many comments from other people about how it'd be wrong to release a vaccine to the rest of the world that the FDA hasn't approved or how there's one set of vaccines for rich, white people and one for poor, brown people and that would be wrong. It's crazy when over 50 million Europeans have had AZ, it's been approved by numerous agencies but it still has all these PR issues.

That it's happening with J&J is also a shame - it's another vaccine that is relatively cheap and easy to store.

I think there are definitely circumstances where there's a probably good case for using other vaccines - Denmark may be one, New Zealand, Australia, Korea spring to mind too. If you've got very few cases and you're able to stop new cases cases coming in then I think you can probably take it slow just using other vaccines (though you might be cut off if the rest of the world does start implementing vaccine passports - and there may be other sort of costs if you have to maintain restrictions for longer). But for most countries in this pandemic with lots of cases I think the lives saved from rolling out hugely outweigh the risk and lives cost (and there may be a connection with the pill which would change the risk country to country).

After, what, two week, my uncle has been moved from the Covid ward of the hospital, after having much improved. He is basically entering after care now for them to look at some liver function thing. It's something he has been complaining to his GP about well before Covid, it just seems like being under surveillance at the ICU gave them some idea of what might be going on, so not necessarily directly linked to covid effects. Would be nice if he actually got something good out of all this.

He only talked to his wife via video chat (no visits allowed) but seemed like he lost a lot of weight. Still, looks like he got lucky.

Oh I'm really glad to hear that

[mongers]

After this is over perhaps the public needs to 'educated' about the relative risks they face, medical and others causes, because it seems to some a one in a million chance is a big risk; maybe those are the same people who think the one in 30 million odds for winning the lottery are a good wager?

Just for comparison, at the start of January the average Brit had a one in 2,000 chance of dying from Covid-19 by the end of the month.

[Sheilbh]

Interesting possible piece of the puzzle on the clotting point - pre-print in the UK so lots of caveats - but it seems like incidents of CVST are significantly higher from covid itself than AZ or J&J. This sort of makes some sense because I remember reading about weird blod clotting issues with covid which weren't like a normal coronavirus:


That doesn't change the risk picture because the CVST will be included in stats on bad outcomes with covid. But I wonder if it's a part of what's happening?

[Josquius]

I've been wondering with all this unnecessary vaccine passport fuss...
Why isn't the WHO on top of this and just incorporating it into the existing yellow book system?

After this is over perhaps the public needs to 'educated' about the relative risks they face, medical and others causes, because it seems to some a one in a million chance is a big risk; maybe those are the same people who think the one in 30 million odds for winning the lottery are a good wager?

Just for comparison, at the start of January the average Brit had a one in 2,000 chance of dying from Covid-19 by the end of the month.

Yes, that people don't understand numbers has clearly been a problem for some time,.

[Sheilbh]

In really positive vaccines work news - Scotland had 1 covid case in care homes last week. It was peaking at 700 a week in January (and probably higher last year).

Lockdown is responsible for most of the fall in cases in general society - but I think in care homes it's a sort of micro-society where 95% of the residents and I think about 90% of the staff have been vaccinated I think we may be far more seeing the effects of vaccines.