Friday, September 24, 2021

Group most at risk of being hospitalised and killed by Covid despite vaccination

The world is experiencing the largest vaccination event in history in its attempt to deal with the global coronavirus pandemic. But despite the marked effectiveness of the various vaccines, there is still a risk – albeit small – of “breakthrough” cases.

Now a new study has identified those unlucky few who are most at risk of ending up with a serious case of Covid despite having had the jab.

Some 5.7 billion Covid-19 vaccinations have already been administered worldwide. And their effectiveness is evident, as previously locked down nations begin to reopen and pressure on hospitals starts to ease.

According to data collected by the Royal Institution of Australia’s Cosmos magazine, 92 per cent of those dosed with AstraZeneca can fight off the virus before it gets bad enough for hospitalisation. In the case of Pfizer, that figure is about 96 per cent.

“It’s clear that the vaccines are highly effective, and without them we would be facing a much deadlier pandemic,” says Yale University associate professor of medicine (cardiology) Hyung Chun.

However, among the vaccinated, there will still be a few who still suffer severe illness. And these are who the Yale study has sought to identify.

Those most at risk of severe illness

Yale studied 969 instances of Covid-19 over 14 weeks between March and July in its local New Haven Health System.

Of these, just 54 had been fully vaccinated. “The majority of fully vaccinated patients experience mild or no symptoms if infected with SARS-CoV-2,” Dr Chun says.

Of the 54 “breakthrough” cases, just 14 advanced to a severe stage. Four ultimately needed emergency intensive care. Three died.

“These cases are extremely rare, but they are becoming more frequent as variants emerge and more time passes since patients are vaccinated,” Dr Chun says.

According to the study, most of the severe cases were aged between 65 and 95. Many had pre-existing conditions, especially type-2 diabetes and heart disease. Some had been taking immune-system suppressing medications.

Again, those “breakthrough” deaths must be put into perspective.

The US Centres for Disease Control and Prevention (CDC) said that, as of August 30, it knew of 12,908 vaccinated Covid-19 patients who had needed hospitalisation. Those who died amounted to fewer than 0.008 per cent of America’s vaccinated population.

Arms race

Dr Chun pointed out that many of the patients in the March to July study did not have the highly infectious Delta variant of Covid-19. How much this mutation has changed the equation is yet to be determined.

Covid-19 – essentially the same type of virus as the common cold – shows the same tendency to adapt to vaccinations over time. Exactly how fast and by how much remains to be seen.

Monash University virologist Dr Vinod Balasubramaniam says Delta has become the dominant variant worldwide, “causing spikes in new and breakthrough infections” among vaccinated populations.

“There is some indication that the Delta variant may also result in more severe disease,” he says.

And the imprint vaccines leave on the body’s immune system are not permanent.

The Royal Institution of Australia’s Elizabeth Finkel says a UK preprint shows Pfizer effectiveness waning from 90 per cent to 78 per cent after three months. AstraZeneca’s strength fell from 69 per cent to 61 per cent over the same time frame.

But Covid’s previous behaviour remains the best indicator of future trends.

Those most likely to be at risk of severe illness, Dr Chun says, are those with existing health conditions.

“Identifying who is more likely to develop severe Covid-19 illness after vaccination will be critical to ongoing efforts to mitigate the impact of these breakthrough infections,” the Yale report reads.

“As effective as the vaccines are, with emerging variants and increasing cases of breakthrough infections, we need to continue to be vigilant in taking measures such as indoor masking and social distancing,” Dr Chun says.

Dr Vinod agrees: “We must first understand that the vaccines we have currently are not a miracle cure. They were designed to provide immunity against symptoms caused by the virus and the possibility of reducing transmission of the virus from person to person.”

Many researchers expect Covid-19 to become a seasonal infection, like the flu virus.

People will gradually develop a degree of immunity through both illness and vaccination, and this will protect most from severe disease.

But, like the flu, future Covid is still likely to have a severe impact upon some.

“Having had Covid-19 is unlikely to give you lifelong immunity,” says Dr Vinod. “But, even if you are infected again, the second infection will likely be less serious. We might need booster doses against variants and to provide optimal immunological memory against the disease.

“If SARS-CoV-2 experiences antigenic evolution at rates that are similar to influenza, annual shots for vulnerable populations may well be necessary.”


10,000 Unnecessary Cancer Deaths Linked to COVID-19 Pandemic, Lockdown in UK

A lack of face-to-face doctor visits in the UK since the start of the COVID pandemic may result in 10,000 unnecessary deaths due to cancer, according to a report from University College London published this week.

Researchers with the university stated that a drop in emergency referrals from general practitioners in 2020 across the United Kingdom resulted in some 40,000 late diagnoses of cancer. The delays, combined with longer National Health Service (NHS) treatment due to the pandemic, mean that thousands will die “significantly earlier” from cancer, the report found.

The study found that more than 60 percent of people surveyed by the university were concerned about talking to their general practitioner (GP) about “minor health problems” amid the pandemic. Before the CCP virus’s spread, around 80 percent of appointments with doctors were in person, but only 57 percent of consultations were face-to-face in July, the report noted.

“The immediate effect of the pandemic was to delay early diagnosis. Even before the pandemic, Britain’s performance was not up there with the best of the world,” said report co-author David Taylor, a professor with University College London, according to The Telegraph.

“There is some evidence to suggest every month treatment is delayed can increase the risk of early death by seven percent,” he said. “Some of it is about patients not presenting, worrying about being a burden on their GP, some of it is about access problems.”

In October 2020, a report from health care analyst firm Dr Foster stated that the NHS’s guidance that residents should “Stay Home, Protect the NHS, Save Lives” scared patients away from seeking medical attention last year.

Dr Foster Director of Strategy and Analytics Tom Binstead said of the report last year: “Overall, the analysis suggests that the long-term effects of the pandemic are likely to be far-reaching, with a future spike in demand possible due to missed diagnoses and postponed procedures.

“Cancers may now require a greater level of treatment, or even be untreatable, if they have been left undetected or untreated as a result of the crisis.”

A spokesperson for the NHS told The Telegraph and other news outlets on Sept. 21 that during the pandemic, the agency prioritized individuals who sought care for cancer.

Services for cancer are at “pre-pandemic levels,” while the latest monthly figures suggest “more than 200,000 people referred for checks and more than 27,000 starting treatment,” the spokesperson said.


New COVID-19 Variant With ‘Unique Mutations’ Discovered at Kentucky Nursing Home

A new variant of the COVID-19 virus has been discovered at a Kentucky nursing home, where it has reportedly infected 45 residents and health care personnel, according to scientist William A. Haseltine.

The variant, called R.1, originated in Japan and infected many residents and workers in the Kentucky nursing home who were fully vaccinated, Haseltine said.

R.1 has now received more than 10,000 entries in the GISAID SARS-CoV-2 database, the world’s largest database that researchers use to track and record genomic data.

“The variant contains five mutations previously noted in variants of concern or interest … It also contains many unique mutations,” Haseltine wrote for Forbes.

“R.1 is a variant to watch. It has established a foothold in both Japan and the United States. In addition to several mutations notably in the spike and nucleocapsid protein in common with variants of concern, R.1 has a set of unique mutations that may confer an additional advantage in transmission, replication, and immune suppression.”

Haseltine’s comments come just days after the Food and Drug Administration’s (FDA) vaccine advisory panel voted to recommend against providing Pfizer booster vaccines to the general public, but recommended the shots for Americans aged 65 and older and for those who are at high risk, dealing a blow to the Biden administration’s vaccination agenda.

While U.S. health officials, some other countries, and vaccine makers have argued that boosters are needed for everyone, many scientists, including some inside the FDA, have disagreed, noting that regulators haven’t yet independently verified all of the available data.

Some FDA staff have also noted that it isn’t currently clear if those who receive a booster dose would have an increased risk of adverse reactions, such as myocarditis (inflammation of the heart muscle) or pericarditis (inflammation of the outer lining of the heart).

Since April, increased cases of myocarditis and pericarditis have been reported in the United States following vaccinations using the Pfizer-BioNTech and Moderna vaccines, most notably among adolescents and young adults, according to the Centers for Disease Control and Prevention.

A recent study from several top scientists at the World Health Organization (WHO) and FDA has also found that the general population doesn’t need a booster dose and instead called for current supplies of vaccines to be given to unvaccinated populations, such as low-income countries.

“Even if boosting were eventually shown to decrease the medium-term risk of serious disease, current vaccine supplies could save more lives if used in previously unvaccinated populations,” the authors wrote.




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