Current Global Pandemics | COVID-19

[Typhoon]

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[Typhoon]

[Mod note. Further discussion of vitamin D in the treatment of COVID-19 has been moved to the COVID-19 Pandemic | Anarchy in the USA thread.]

[Doc]

[Mod note. Further discussion of vitamin D in the treatment of COVID-19 has been moved to the COVID-19 Pandemic | Anarchy in the USA thread.]

[User note. Further discussion has been moved to other forums]

[kmich]

Omicron surge sweeps through US hospital staff

[noddy]

Medical system overload is a real problem for my country and is driving all the worst bits of our covid response - their is literally zero fat in the system to deal with any increase in workload.

we have 20 years of running the system down to the bare minimum of cost to thank for that - I cant complain, I was part of the generations that voted for that, and having twice, three times the healthcare costs just in case a 1 in a 100 years pandemic occured was not on the radar.

the trick is now, they cant throw enough money at it - nurses, hospitals, the infrastructure and training, all of those things cant be magically provided out of nowhere.

not looking good really - it drives our desperation for maximum vaccination, hoping the stats can be kept to diabolical rather than disasterous.

I spent 1 1/2 days lying in the corridor for a broken wrist, long before covid happened - our system has nowhere to go.

[kmich]

Medical system overload is a real problem for my country and is driving all the worst bits of our covid response - their is literally zero fat in the system to deal with any increase in workload.

we have 20 years of running the system down to the bare minimum of cost to thank for that - I cant complain, I was part of the generations that voted for that, and having twice, three times the healthcare costs just in case a 1 in a 100 years pandemic occured was not on the radar.

the trick is now, they cant throw enough money at it - nurses, hospitals, the infrastructure and training, all of those things cant be magically provided out of nowhere.

not looking good really - it drives our desperation for maximum vaccination, hoping the stats can be kept to diabolical rather than disasterous.

I spent 1 1/2 days lying in the corridor for a broken wrist, long before covid happened - our system has nowhere to go.

In this country also, hospitals have managed to edge along with fewer staff, higher patient to nursing and provider ratios, and essentially having to do more with less for many years now. There were no spare resources. Staffing the hospital has now become a nightmare, and I fear that if this goes on much longer, sectors of the healthcare system will face collapse. Facilities, physician practices, and clinics will close their doors. Some of this is already happening, how far it will go is now up to the virus.

We have enjoyed an extended period of security without the wars, pandemics, and famines that kill and disrupt societies that have been a regular part of human history and continue to be present in many parts of the world. We tend to believe that our exceptional prosperity, peace, and security are what is normal and what we should expect to continue.

This has allowed us to extol the virtues of individualism, which works fine only if our challenges do not require a collective response that is coordinated and led by government at all levels. When the Covid-19 pandemic presented itself, our governmental processes and institutions were not prepared to act effectively, and, more critically, the population had not maintained the sense of collective responsibility and solidarity to work together to support necessary actions as we mostly did when we accepted OPA rationing and military conscription in WW2.

The good times have spoiled us. The spiritually and psychologically fragile cannot handle existential fears, so they fly off the rails and seek out conspiracies and quack cures in their attempts to cope, but it is all hollow posturing and simply performative. That is why they typically double down on their positions when challenged, so it is best to let them be, pray for them, and wish them the best. We have lost the insight Omar Bradley had. "Bravery is the capacity to perform properly even when scared half to death."

Worked yesterday, on call tonight... Probably should try to get some sleep...

[Typhoon]

Excluding India from the following plot

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appears to have been the correct choice.

Science | COVID-19 may have killed nearly 3 million in India, far more than official counts show

India, from the earliest days of the pandemic, has reported far fewer COVID-19 deaths than expected given the toll elsewhere—an apparent death “paradox” that some believed was real and others thought would prove illusory. Now, a prominent epidemiologist who contended the country really had been spared the worst of COVID-19 has led a rigorous new analysis of available mortality data and concluded he “got it wrong.” India has “substantially greater” COVID-19 deaths than official reports suggest, says Prabhat Jha of the University of Toronto— close to 3 million, which is more than six times higher than the government has acknowledged and the largest number of any country.

The new estimates for India come as little surprise to Laxminarayan. “My starting point is that unless you can tell me why India is different, I’m going to assume that India is the same as any other country,” he says. “I don’t believe in exceptionalism of any kind unless it’s well justified.” His team last month published a study in The Lancet that focused on the Indian district of Chennai and concluded that reported deaths “greatly underestimated pandemic-associated mortality.”

A worldwide comparison of all-cause mortality before and during the pandemic, published in eLife 6 months ago, suggests undercounting is widespread. Russia had 4.5 times more deaths than normal, far beyond its official COVID-19 tally, and the trend has continued, the researchers recently tweeted. Tajikistan, Nicaragua, Uzbekistan, Belarus, and Egypt also had profound disconnects.

[kmich]

Deaths are likely underreported worldwide for two reasons, both of which disproportionately affect India.

To have an accurate death count one needs the adequate national infrastructure for accurate data to be reported. This has been a problem in varying degrees in nations around the world. India is a large, complex, diverse country of 1.4 billion, where you can stroll the ritzy Plaza Mumbai one day and the next be in a rural area where people live as they did a millennia ago.

Millions are itinerant laborers, many millions more live “off the grid” in its large rural expanses. People live and die in the streets. And even if you are “on the grid” its reliability is uneven in much of the country to put it kindly. India being able to achieve an adequate mortality data base to track Covid-19 mortality is unlikely, and this is true for most developing nations in the world. Even in many developed nations with far greater resources, such as the U.S., mortality reporting is based on a very loose infrastructure of state, provincial, and local departments with varied resources and competencies which makes them vulnerable to the second factor: political ambitions.

Political leaders will do what they can to minimize or suppress data that reflect poorly on their management of the pandemic. The less open, more illiberal or authoritarian nations are, the less likely their reporting can be trusted to be free of political interference. The Modi government bungled the Delta (B.1.617.2) variant, so there would be motivation for the government to minimize or suppress death counts that exposed their hubris and incompetence. The lockdown India initiated last summer severely disrupted the lives of millions, particularly the large itinerant labor population.

It is important to emphasize that the above problems in mortality reporting affect all nations in various degrees, so the reported Covid mortality rates should be viewed with caution.

[Typhoon]

Indeed.

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[Miss_Faucie_Fishtits]

Dr. John Campbell seems well considered by all audiences, speaking from the UK. Here we're considering downgrading COVID parameters to an endemic classification:

U3W84wb5jKo

[kmich]

A National Strategy for the “New Normal” of Life With COVID

As the Omicron variant of SARS-CoV-2 demonstrates, COVID-19 is here to stay. In January 2021, President Biden issued the “National Strategy for the COVID-19 Response and Pandemic Preparedness.” As the US moves from crisis to control, this national strategy needs to be updated. Policy makers need to specify the goals and strategies for the “new normal” of life with COVID-19 and communicate them clearly to the public.

SARS-CoV-2 continues to persist, evolve, and surprise. In July 2021, with vaccinations apace and infection rates plummeting, Biden proclaimed that “we’ve gained the upper hand against this virus,” and the Centers for Disease Control and Prevention (CDC) relaxed its guidance for mask wearing and socializing.1 By September 2021, the Delta variant proved these steps to be premature, and by late November, the Omicron variant created concern about a perpetual state of emergency.

In delineating a national strategy, humility is essential. The precise duration of immunity to SARS-CoV-2 from vaccination or prior infection is unknown. Also unknown is whether SARS-CoV-2 will become a seasonal infection; whether antiviral therapies will prevent long COVID; or whether even more transmissible, immune-evading, or virulent variants will arise after Omicron.

Another part of this humility is recognizing that predictions are necessary but educated guesses, not mathematical certainty. The virus, host response, and data will evolve. Biomedical and public health tools will expand, along with better understanding of their limitations. The incidence of SARS-CoV-2, vaccination rates, hospital capacity, tolerance for risk, and willingness to implement different interventions will vary geographically, and national recommendations will need to be adapted locally.

It is imperative for public health, economic, and social functioning that US leaders establish and communicate specific goals for COVID-19 management, benchmarks for the imposition or relaxation of public health restrictions, investments and reforms needed to prepare for future SARS-CoV-2 variants and other novel viruses, and clear strategies to accomplish all of this.

[noddy]

https://www.tga.gov.au/media-release/tg ... -nuvaxovid

The Therapeutic Goods Administration (TGA) has granted provisional approval to Biocelect Pty Ltd (on behalf of Novavax Inc) for its COVID-19 vaccine, NUVAXOVID. This is the first protein COVID-19 vaccine to receive regulatory approval in Australia.

This protein vaccine is provisionally approved and included in the Australian Register of Therapeutic Goods (ARTG) for active immunisation to prevent COVID-19 in individuals 18 years of age and older. It is recommended that the vaccine is given in 2 doses administered 3 weeks apart.

the first vaccine using traditional protein techniques is now available, which should help with those that are worried about mRNA.

[kmich]

https://www.tga.gov.au/media-release/tg ... -nuvaxovid

The Therapeutic Goods Administration (TGA) has granted provisional approval to Biocelect Pty Ltd (on behalf of Novavax Inc) for its COVID-19 vaccine, NUVAXOVID. This is the first protein COVID-19 vaccine to receive regulatory approval in Australia.

This protein vaccine is provisionally approved and included in the Australian Register of Therapeutic Goods (ARTG) for active immunisation to prevent COVID-19 in individuals 18 years of age and older. It is recommended that the vaccine is given in 2 doses administered 3 weeks apart.

the first vaccine using traditional protein techniques is now available, which should help with those that are worried about mRNA.

Any addition to our toolbox in combating this disease is always most welcome:

Efficacy and Safety of NVX-CoV2373 in Adults in the United States and Mexico.

Hopefully you are right about a recombinant spike protein nanoparticle vaccine reducing vaccine hesitancy and resistance. I am very skeptical, although I am likely biased from my practice exposure. The people I see who let go of their vaccine resistance typically are patients in serious medical conditions that could prove fatal or the people who are close to them.

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[Typhoon]

Nature | The pandemic’s true death toll: millions more than official counts

Countries have reported some five million COVID-19 deaths in two years, but global excess deaths are estimated at double or even quadruple that figure.

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[kmich]

Our cases of hospitalization are declining, although the people that do show up in the ER are a lot sicker for some reason. People are dying daily over the past 2 weeks, all unvaccinated except one, an elderly renal transplant patient.

Are we turning a corner on the pandemic? Who knows? I certainly don’t. Too many possibilities for new VOC arriving as long as we continue to have populations that have not attained some level of immunity through vaccination or natural infection.

I do know that the nursing staff are beyond exhausted, also angry and frustrated with an accumulation of abuse they have taken from patients due to the fetid swamp of conspiracy mongering and misinformation out there. I support my nurses and support staff the best I can. As I have said before, I don’t get angry and frustrated with people who are too spiritually impoverished to address existential challenges. it just makes me sad.

I will admit though that I sometimes fantasize that those who spread misinformation eventually being dropped into the Malebolges of Dante's eighth circle of hell established for fraudsters. Likely to become a busy place when this pandemic is over.

I know my fantasy does seem mean spirited. On the other hand, a major thread through the Inferno of the Divina Commedia is Dante, the pilgrim, learning to lose sympathy for the damned.

[Typhoon]

Breakthrough COVID-19 infection milder in vaccinated patients

By Kate Madden Yee, AuntMinnie.com staff writer

February 1, 2022 -- The imaging and clinical characteristics of breakthrough COVID-19 infections are milder in vaccinated people compared with those who are partially vaccinated or unvaccinated, according to a study published February 1 in Radiology.

The study findings further support the efficacy of COVID-19 vaccination when it comes to mitigating severity of disease infection, wrote a team led by Dr. Jong Eun Lee of Chonnam National University Hospital in Dong-gu, Gwangju, South Korea.

"[We found that] patients with COVID-19 breakthrough infections had a higher proportion of CT scans without pneumonia compared to unvaccinated patients, and vaccination status was significantly associated with the need for supplemental oxygen and [intensive care unit (ICU)] admission," the group wrote.

COVID-19 vaccines have proved to be effective in slowing the pace of the pandemic, but they don't completely prevent reinfection, Jeong and colleagues noted. Breakthrough infections of the disease are defined as detection of SARS-CoV-2 RNA or antigen 14 days or more since a person has received all recommended COVID-19 vaccines.

"Although the risk of infection is much lower among vaccinated individuals, and vaccination reduces the severity of illness, clinical and imaging data of COVID-19 breakthrough infections have not been reported in detail," senior author Dr. Yeon Joo Jeong, PhD, said in a statement released by the RSNA.

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Representative cases showing extent and pattern of pneumonia on chest x-ray (CXR) and CT images. (A and B) A 65-year-old female with breakthrough infection two months after a second dose of the Pfizer vaccine (fully vaccinated). The patient had a history of hypertension. (A) Chest x-ray obtained at admission showing no abnormal opacification in both lung zones. The extent of pneumonia on the chest x-ray was scored as 0 (no evidence of pneumonia). (B) Axial chest CT image at the lower lobe level (obtained on the same day) showing patient negative for pneumonia; CT extent of pneumonia was scored as 0 (no evidence of pneumonia). (C and D) A 48-year-old male with one month after a first dose of the AstraZeneca vaccine (partially vaccinated). The patient had no history of comorbidity. (C) Chest x-ray obtained at admission showing no abnormal opacification in both lung zones. The extent of pneumonia on chest x-ray was scored as 0 (no evidence of pneumonia). (D) Axial chest CT image obtained on the same day showing unilateral ground-glass opacity with a nonrounded morphology in the left lower lobe (arrows). CT extent of pneumonia was scored as 1 (1% to 25% involvement) and this case was classified as indeterminate appearance of COVID-19 according to the RSNA chest CT classification system. Images and caption courtesy of the RSNA.

In the new study, Lee's group evaluated data from 761 adult patients with COVID-19 disease and available baseline chest x-rays from a database called the Korean Imaging Cohort for COVID-19 (KICC-19) from between June and August 2021. Patients were divided into groups according to vaccination status; the investigators then assessed any differences in clinical and imaging findings and associations between factors such as vaccination status and health outcomes.

The investigators found a dramatic difference in the incidence of breakthrough COVID-19 infection by vaccination status, as well as the percentage of negative results on chest CT (of the total patient cohort, 54% underwent chest CT while in the hospital). Lee and colleagues also found that fully vaccinated patients also had lower risk of needing supplemental oxygen and ICU admission than unvaccinated people.

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The research offers further evidence of the benefits of the COVID-19 vaccine, according to an accompanying editorial by Dr. Mark Schiebler and Dr. David Bluemke, PhD, both of the University of Wisconsin-Madison School of Medicine and Public Health.

"The authors have furthered our understanding of vaccine effectiveness," the two wrote. "If seeing is believing, the visual evidence provided by Lee et al. might even help to strengthen the hand of public health officials still working to overcome the problem of vaccine hesitancy. We can only hope."

[Parodite]

1s1UX2ZNsh4

[kmich]

SARS-CoV-2 Omicron Variant Neutralization after mRNA-1273 Booster Vaccination

Together, these results showed that after the primary two-dose series of the mRNA-1273 vaccine, neutralization titers against the omicron variant were 35.0 times lower than those against the D614G variant. These lower titers could lead to an increased risk of severe breakthrough infection. However, a booster dose of mRNA-1273 vaccine was associated with neutralization titers against the omicron variant that were 20.0 times higher than those assessed after the second dose of vaccine, and these titers may substantially reduce the risk of breakthrough infection. The decline in neutralization of the omicron variant 6 months after the booster injection was similar to the decline in neutralization titers against the D614G variant 7 months after the second dose.

[Nonc Hilaire]

UK says COVID death stats have always been inaccurate. Time to stop announcing.

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https://www.dailymail.co.uk/news/articl ... blame.html

[noddy]

if we ignore reason for deaths and just count the amount of them the story doesnt change much.

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between the vaccinations and omicron the conditions are not the same as they were 2 years ago - the problem we have now is everyone camped off in ideological tribes and refusing to budge on position.

my country is moving quite swiftly to the no restrictions position, but its going to be a fight against the fear worshippers.

[Nonc Hilaire]

Death by all causes is really the best metric.