Tuesday, May 04, 2021

What we know about the Indian B.1.617 variant of coronavirus

India has recorded the world's sharpest spike in coronavirus infections this month, with political and financial capitals New Delhi and Mumbai running out of hospital beds, oxygen and medicines.

Scientists are studying what led to an unexpected surge, and particularly whether a variant of the novel coronavirus first detected in India is to blame.

The variant, named B.1.617, has raised global concern after being reported in some 17 countries including Germany, Belgium, the United Kingdom, Switzerland, the United States, Singapore and Fiji.

Here's what we know about it:

How does the B.1.617 variant differ from regular COVID-19?

The B.1.617 variant contains two key mutations to the outer spike portion of the virus, referred to as E484Q and L452R.

Both are separately found in many other coronavirus variants, but this is the first time they have been reported together.

Virologist Shahid Jameel explained that a "double mutation in key areas of the virus's spike protein may increase these risks and allow the virus to escape the immune system".

The spike protein is the part of the virus that it uses to penetrate human cells.

The WHO has described it as a "variant of interest", along with other strains with known risks, such as those first detected in the United Kingdom, Brazil and South Africa, signifying a higher threat level.

Why India's crisis might be much worse than you imagined

Are variants driving the surge in cases? It's hard to say.

The WHO says more study is urgently needed. Laboratory-based studies of limited sample size suggested potential increased transmissibility, it concluded.

The picture is complicated because the highly transmissible B.117 variant first detected in the UK is behind spikes in some parts of India. In New Delhi, UK variant cases almost doubled during the second half of March.

The Indian variant, though, is widely present in Maharashtra, the country's hardest-hit state.

Prominent US disease modeller Chris Murray, from the University of Washington, said the sheer magnitude of infections in India in a short period of time suggested an "escape variant" may be overpowering any prior immunity from natural infections in those populations.

"That makes it most likely it's B.1.617," he said.

But gene sequencing data in India is sparse, and many cases are also being driven by the UK and South African variants.

Are vaccines effective against it?

White House chief medical adviser Anthony Fauci said earlier this week that preliminary evidence from lab studies suggested Covaxin, a vaccine developed in India, appeared capable of neutralizing the variant.

Public Health England said it was working with international partners but that there was currently no evidence that the Indian variant and two related variants caused more severe disease or rendered the vaccines currently deployed less effective.


China's bid to woo the world with vaccines is backfiring: surge of Covid cases in Chile etc

Chile used a Chinese vaccine in one of the world's fastest vaccination drives, but then saw a strange surge in Covid cases. In the UAE, some recipients had to be given a third injection after two were found to deliver insufficient immunity.

Other nations have been left infuriated by supply failures. Turkey's president rebuked China's foreign minister over shortfalls that forced the closure of vaccination sites, and now cases have exploded.

In Mexico, delays have forced the postponement of second doses.

This weekend, the World Health Organisation (WHO) is weighing up available data to decide whether to give emergency use listing to two key Chinese vaccines, a safety endorsement that guides regulatory agencies around the world.

The move comes amid concerns over the lack of peer-reviewed studies and published data on clinical trials of the vaccines, unlike those developed by Pfizer, AstraZeneca, Moderna and Johnson & Johnson that have received a WHO listing.

'We don't have a lot of clarity about them, which is very unusual,' says Peter English, a British expert on vaccines and communicable diseases, who is concerned about the wide range of results from countries using Chinese vaccines.

Chong Ja Ian, professor of political science at the National University of Singapore, told the Washington Post his government had accepted a Chinese vaccine to avoid giving offence to Beijing but could not approve use given its limited data. 'Singapore has options, unlike some of the countries which have received [the Chinese vaccine] Sinovac,' he added.

There are two main Chinese vaccines being sent around the world. The first to be reviewed by WHO is made by Sinopharm, a huge state-owned firm that claimed 79 per cent efficacy – impressive but significantly lower than jabs made by Western or Russian rivals.

Another by Sinovac, which has distributed more than 260 million doses worldwide, varied in trials from 50.7 per cent efficacy in Brazil – marginally above the 50 per cent threshold deemed acceptable for use – to more than 83 per cent in Turkey. The results of an earlier trial were even worse: the jab was estimated to be just 49.6 per cent effective against symptomatic cases, a figure that dropped to 35 per cent when asymptomatic Covid infections were included.

Studies in Chile found alarmingly low levels of protection after the first shot, with one reporting a single dose to be only three per cent effective, while a second found it was 16 per cent effective, rising to 67 per cent after the second shot.

These figures, along with the arrival of more virulent strains and a relaxation of rules, might help to explain why Chile's hospitals were overwhelmed with patients as cases rose to record levels last month, despite an impressively fast vaccine rollout. Chile has vaccinated more than four in ten citizens, not far behind British and Israeli rates – yet its confirmed fatality rate from Covid is 16 times higher than the UK, with ten times more cases.

Such figures are a shattering blow to China's efforts to promote its pharmaceutical industry, which has been plagued by scandals and low trust within its own borders, as well as setting back global efforts to curb the spread of the virus.

'This suggests Chinese vaccine science is not as advanced as in other areas,' said Nikolai Petrovsky, a vaccine developer and professor of medicine at Flinders University in Adelaide, Australia.

Prof Petrovsky said China was relying largely on older technologies that use inactivated viruses mixed with aluminium-based compounds, called adjuvants, that stimulate human immune systems. This well-established process is similar to how vaccines have been made for a century, but it is harder to ensure quality control and eliminate variability when inactivated viruses are rushed into mass production, compared with modern genetic techniques being harnessed by the West.

'Unless Chinese firms can improve standards and provide data to show consistent effectiveness, their vaccines are likely to be used only by desperate countries where any vaccine may be attractive, particularly if provided for free,' said Prof Petrovsky.

Last week, the EU warned that China's vaccine diplomacy is backed by 'disinformation and manipulation efforts to undermine trust in Western-made vaccines'. 'Russia and China are using state-controlled media, networks of proxy media outlets and social media to achieve these goals.'


Welcome to the promised land

by Jeff Jacoby

FOR IMMIGRANTS who come to America from a dictatorship or a theocracy, writes Roya Hakakian, "the hardest task of all" is figuring out "how to go about the business of living." A question that never even occurs to native-born Americans — "How do free people live?" — is one that immigrants from all but the most privileged backgrounds must grapple with.

Having entered the United States as a refugee from Iran in 1985, Hakakian knows firsthand how disorienting freedom can be to those who grew up without it.

"What is the shape of a day," she asks in A Beginner's Guide to America, her compelling and insightful portrait of the immigrant experience, "that is not fitted between the hours of official curfew or electricity outage? What is a night without fear? What is one that does not end at sundown because bars, discos, music, dancing, and gambling are not banned?" In the old country, it took all of one's mental and emotional energy to resist the government's oppression. In America, she tells newcomers who are going through what she once went through, the challenges are of a very different sort — not the least of which is getting used to a society in which freedom is taken for granted and the pursuit of happiness is a national ambition.

There is no shortage of books about immigration policy, immigration's history, or the economic and social effects of immigration. But "A Beginner's Guide to America" is something different. Written in the form of a manual for new immigrants, it is intended as a window for US-born natives on what the process of Americanization feels like to those going through it.

Hakakian, who came to the United States speaking no English, is today an accomplished essayist, poet, journalist, and human rights activist. She doesn't sugar-coat America's failings and imperfections, and her book notes candidly the strain of anti-immigrant hostility that has always existed here. Yet love and gratitude for her adopted country far outweigh the disappointments. However mean or obnoxious the nativists, she writes, "America remains the pioneer, however imperfectly, in accepting immigrants."

From the moment a newcomer arrives in America, signs of that acceptance are everywhere. At the airport, for example, "pinned on the ... chest pockets of the officers guiding everyone are name tags — 'Sanchez,' 'McWilliams,' 'Cho,' 'Al-Hamed' — and, by God, all of them are Americans!" This ethnic diversity is "the surest sign of America," Hakakian exults. "In the monochrome life you just left behind, such a motley human landscape would have been unthinkable."

Again and again, Hakakian calls attention to such seemingly unremarkable details, infusing them with insight into the American character.

Streets, she observes, are named for trees, birds, or natural features — not, as is common elsewhere, for "old wars and bygone enmities." There may be the occasional Washington Boulevard or Franklin Street, but no avenue or public square proclaims the glory of glowering ayatollahs or all-powerful despots.

Meaningful, too, is something else that to Americans is perfectly humdrum: Purchases can be returned for a refund.

This evokes disbelief in many immigrants, Hakakian says, since it would have been unthinkable in their native land. Yet it should evoke their joy and even patriotism as well, for "the exercise of returning goods is the surest sign of America's greatness to them." The right to get a refund demonstrates that the ordinary consumer is "formidable" here. More than that, she writes, it is evidence that in America, "anything is possible because a one-time decision need not be destiny."

Like foreign-born observers going back to Alexis de Tocqueville, Hakakian marvels at America's extraordinary culture of charity and volunteerism. "Americans do not help because you are one of them," she writes. "They help because that is what they do." They clean up beaches and register voters, coach Little League and support unknown artists, raise funds in a walkathon and serve meals at the homeless shelter. Hakakian describes America as a "land of strangers" who "bond through shared love."

Above all, perhaps, America is the "great equalizer," the land where "you can get to know the bogeyman of your past." Here, the detested or feared "other" of one's homeland — the Jew, the Pakistani, the Hutu, the Arab — is simply a fellow citizen. In America, someone an immigrant would once have shunned is the doctor who treats her illness or the mechanic who fixes her car. As foreigners become American, old bigotries fade away.

Lyrical and perceptive, A Beginner's Guide to America is an immigrant's love letter to the nation that took her in, and a timely reminder of what millions of human beings endure when they uproot their lives to become Americans by choice.


Also see my other blogs. Main ones below:

http://snorphty.blogspot.com (TONGUE-TIED)

http://edwatch.blogspot.com (EDUCATION WATCH)

http://antigreen.blogspot.com (GREENIE WATCH)

http://pcwatch.blogspot.com (POLITICAL CORRECTNESS WATCH)

http://australian-politics.blogspot.com/ (AUSTRALIAN POLITICS

http://awesternheart.blogspot.com.au/ (THE PSYCHOLOGIST)

https://heofen.blogspot.com/ (MY OTHER BLOGS)


Sunday, May 02, 2021

The risks of getting a J&J shot: What you need to know

In weighing all their options on Friday, federal regulators made the decision to lift their suspension of the use of the one-shot Johnson & Johnson COVID-19 vaccine for a simple reason: It might just save your life.

That’s true even for women aged 18-49. So far, 13 of 15 reported cases of rare blood clotting and low platelets among J&J shot recipients have occurred among that demographic, and regulators believe that it is likely that the vaccine is associated with the condition. Three have died and seven have been hospitalized, with four in intensive care. The remaining five have been discharged.

Connecticut has resumed offering J&J to residents in addition to the Moderna and Pfizer/BioNTech vaccines that have been available to residents since the beginning of the year. With 136,000 J&J doses in reserve and a number of walk-up clinics opening in coming days, residents will have more ways to get the single-shot option.

But will they? Or will the “pause” have scared away people that could benefit from it the most?

“Oftentimes people kind of overread the relative risks,” said Josh Geballe, the state’s chief operating officer, at a press conference on Monday. “So there was a little bit of initial apprehension. I think it will take some time to see how that plays out.”

The Centers for Disease Control and Prevention and the Food and Drug Administration “have full confidence that this vaccine’s known and potential benefits outweigh its known and potential risks in individuals 18 years of age and older,” FDA Acting Commissioner Janet Woodcock said during a press conference Friday night. The agencies chose not to limit the use of the vaccine by age or gender but to add a warning label for young women.

Here’s a walkthrough of the numbers behind the FDA’s decision — and what they mean. There are two parts to determining whether to take the J&J vaccine: Understanding the implications of making a decision, and understanding the implications of inaction in the face of the morbidity and mortality dangers posed by COVID-19.

What are the risks of getting the J&J vaccine?

Based on available data, the risk varies based on demographic characteristics. Reported cases have largely clustered by gender, although one man developed the condition in a Johnson & Johnson clinical trial. Among the 15 women, “the age ranged from 18 to 59, with a median age of 37,” said Rochelle Walensky, the director of the CDC during a press conference Friday night. These cases include the six that were initially reported; in addition, the CDC “broadened our case definition to make sure we were capturing all of the possible cases,” she said.

Part of the rationale behind the pause was also to help physicians understand how to treat the condition; the CDC specifically discouraged the use of heparin, a common blood thinner, when it put the pause into effect. “Of the additional cases that were reported to the CDC, none of them received heparin, likely improving their outcome and demonstrating that our systems worked,” Walensky said.

On Friday, the Advisory Committee on Immunization Practices discussed additional updates on the management of the condition, including recommending other anti-coagulants and cautioning against platelet infusion. Current guidance also recommends a course of treatment with immunoglobulins “that appears to reverse this process in, at least, a number of people who received it,” said Peter Marks, director of the Center for Biologics Evaluation and Research at the FDA, during a press conference Friday night.

What are the benefits of getting the J&J vaccine for you?

While the risk of complications may vary by age and gender, the Johnson & Johnson vaccine has shown to be effective at preventing illness across demographic groups, FDA data show. In the J&J trials, efficacy was measured in the relative reduction of the risk of contracting COVID-19 and was found to be 72%.

The efficacy rate is widely misunderstood to mean that people still have a 30% chance of contracting COVID after vaccination with J&J. This would only be true if infection rates were so high that everyone without protection was guaranteed to get sick with COVID-19, which isn’t the case. The true risk of contracting the virus after vaccination is much lower, depending on present rates of community transmission. Whatever the present risk of getting infected, it would reduce by 72% on average post-J&J vaccination.

But these rates don’t take into account the most serious outcome of contracting COVID-19: death. In the clinical trial, none of the J&J recipients died; 16 in the placebo group did.

The data also show that 28 days after vaccination, none of the J&J recipients required medical intervention, which was defined separately from severe COVID. Five people in the placebo group did, however.

What are the consequences for you of not getting vaccinated at all?

If vaccination carries risks, the decision not to get vaccinated carries greater risks.

The CDC’s Advisory Panel on Immunization Practices considered the chances of being hospitalized and dying of COVID against any risk posed by the vaccine and concluded that the vaccine was beneficial on balance for individuals of all demographics under consideration.

What are your other options?

Connecticut continues to receive the Moderna and Pfizer vaccines, both of which use different biotechnology — based on mRNA — than the J&J, which is an adenovirus vaccine. The CDC has not identified any cases of these rare blood clots and low platelet counts among recipients of either; 5.2 million doses have been administered in the United States so far, per the CDC. Five potential cases of the rare clotting were identified but without the low platelet count observed in the case of the J&J vaccine.

“Individuals with questions about which vaccine is right for them should discuss their options with a medical provider,” Woodcock said.

Why are the CDC and FDA making this your decision?

Unlike some European regulators in the case of another adenovirus vaccine, the CDC and FDA did not limit the use of the J&J but chose instead to add a warning label.

Modeling shows that limiting the Johnson & Johnson vaccine to individuals above 50 would have severely reduced the vaccine’s ability to prevent hospitalizations and deaths nationally in all transmission scenarios. Vaccination is as much about a community as it is about an individual; vaccines have been proven to be effective at reducing transmission of the disease in addition to conferring immunity upon their recipients. The estimates look at direct and indirect benefits of vaccination with J&J over a six-month period in the United States.

Population-level modeling aside, the CDC also wanted to be sensitive to the fact that “some people want a one-and-done. Some people will not have access to another vaccine in the near future, and I think that this risk trade-off is one that people have to individually measure for themselves,” Walensky said.

The public should take heart in the fact that the CDC was able to identify rare clots, act on the knowledge quickly and conduct “rational risk-benefit analysis, which was done in the open,” said Saad Omer, director of the Yale Institute for Global Health. “This should be reassuring to people.”


The best vaccination strategy is simple: Focus on Americans 65 and older

Now that covid-19 vaccines are increasingly becoming available to people beyond health-care workers and those in long-term care, the question turns to who should be immunized next. For many people, the answer is essential workers. But while many workers face an elevated risk and should receive a vaccine soon, we believe the most ethically justified path forward is to focus on individuals 65 and older.

The primary reason to prioritize people in this age group is simple: They account for more than 80 percent of covid-19 deaths, even though they are only about 16 percent of the population. This disproportionate toll is why the Biden administration’s vaccine plan encourages states to expand vaccine eligibility to those who are 65 and older.

But while many places — such as D.C., New York and Florida — are converging on a 65-and-older strategy, whether seniors qualify for vaccination largely depends on where they live. In New Mexico and Connecticut, you need to be at least 75 years old. In Colorado and Nevada, 70 is old enough. And in Hawaii and Virginia, older adults must compete with many other people for the same limited vaccine supply, including essential workers.


Portland Mayor Ted Wheeler Gets Mugged by Reality

Antifa, that figment of right-wing fever dreams, may have finally found a believer in hard-left Portland Mayor Ted Wheeler.

You remember antifa. It’s the black-clad, Portland-based anarchist mob that New York Congressman Jerrold Nadler famously dismissed as “a myth that’s being spread only in Washington, DC.”

A “myth,” Jerry? Try telling that to Ted Wheeler.

As The Wall Street Journal editorial board reports, “A well-known politician on Friday denounced ‘self-described anarchists who engage in regular criminal destruction’ and want to ‘burn,’ ‘bash’ and ‘intimidate.’ He called for ‘higher bail’ and ‘tougher pretrial restrictions’ on rioters. And he pleaded with the public to cooperate with police and identify miscreants: ‘Our job is to unmask them, arrest them, and prosecute them.’ Donald Trump? Sheriff Arpaio? Nope. That was Portland, Ore., Mayor Ted Wheeler, the ├╝ber-progressive, who made a national reputation last year by apologizing for vandals and rioters he said were merely exercising their right to protest against an unjust America.”

All this is a humiliating flip-flop for the guy who enabled antifa to engage in a nearly year-long orgy of nonstop rioting, and the guy who last June vowed to defund his city’s police force. As The Oregonian’s Everton Bailey Jr. reported at the time, “Wheeler pledged the city will divert $12 million from the police bureau and other city departments to directly support communities of color, defund three police units including the gun violence reduction team and ban officers from using chokeholds as part of plans to reform the Portland Police Bureau.”

Wheeler, who’s also — get this — the city’s police commissioner, said, “My privilege as a white man, my privilege as the mayor and the leader of the institutions of power in this community I believe shielded me from time to time from the many difficult and uncomfortable truths about our history and about our society.”

Clearly, that mea culpa wasn’t good enough for antifa. Nor, we think, was it properly directed. Wheeler seemed to be trying to atone to the city’s black residents for his white privilege, but last time we checked, antifa was as lily-white as Wheeler.

In any case, as the Journal reports, unbridled antifa rioters “shot fireworks at law enforcement, firebombed government buildings, and set fire to cop cars and a police union hall” — all while the milquetoast mayor carried on like a modern-day Neville Chamberlain.

And now, he’s crying uncle. Yep, the guy who slashed $27 million from the city’s 2021 police funding, the guy who called Donald Trump’s decision to send in federal forces to quell the rioting last July “an attack on our democracy,” has finally been mugged by reality. He’s now begging for the citizens of Portland to start ratting out that mob he’s been trying to appease these many months.

As The Daily Wire’s Emily Zanotti reports, “Wheeler extended a city-wide state of emergency and begged for Portland residents to assist law enforcement in ‘unmasking’ and identifying members of the ‘self-described anarchist mob’ that have rioted through the city nearly every night since last May.”

Wheeler, it seems, has learned a valuable lesson in human nature: Weakness is provocative. Better late than never.

And who knows? Maybe Wheeler’s wisdom will wind its way north to Seattle, where the people clearly want law and order, and where feckless Mayor Jenny Durkan seems to be holding out hope for that Summer of Love.


Also see my other blogs. Main ones below:

http://snorphty.blogspot.com (TONGUE-TIED)

http://edwatch.blogspot.com (EDUCATION WATCH)

http://antigreen.blogspot.com (GREENIE WATCH)

http://pcwatch.blogspot.com (POLITICAL CORRECTNESS WATCH)

http://australian-politics.blogspot.com/ (AUSTRALIAN POLITICS

http://awesternheart.blogspot.com.au/ (THE PSYCHOLOGIST)

https://heofen.blogspot.com/ (MY OTHER BLOGS)