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Covid-19 #30: Vaccines and All That JJAZ

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This is a good article on the India crisis.  A few relevant quotes...

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At Sir Ganga Ram Hospital, a huge facility in the middle of India’s capital, 37 fully vaccinated doctors came down with Covid-19 earlier this month.  The infections left most with mild symptoms, but it added to their growing fears that the virus behind India’s catastrophic second wave is different.

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“There is a lot of jumping to conclusions that B.1.167 is the explanation for what’s happening,” said Jeffrey Barrett, director of the Covid-19 genomics initiative at the Wellcome Sanger Institute in Britain. “These other things are probably more likely to be the explanation.”

Preliminary evidence suggests that the variant is still responsive to vaccines, although slightly less so. India relies heavily on the Oxford-AstraZeneca vaccine, which clinical trials show is less powerful than the vaccines made by Pfizer-BioNTech and Moderna and could perhaps be more easily thwarted by mutations.

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So far, data from the Indian Council of Medical Research up to April 21 shows an extremely low breakthrough infection rate, though perhaps not as low as that of the United States. The data shows 0.02 percent to 0.04 percent of vaccinated people falling ill. The rate in the United States, which relies on different vaccines, is 0.008 percent.

Quote

At Sir Ganga Ram hospital, the 37 doctors who became infected after immunization had received their first dose of the AstraZeneca vaccine between late January to early February and then their second dose four to six weeks after that. The hospital employs about 500 doctors.

Covaxin (the domestically produced vaccine used in India) has a reported 78% efficacy.  Similar to AZ, the other vaccine used there.  But AZ for one, has reportedly struggled against the South African variant (but that was based on one small trial).  The Indian variant has some similarities to the South African one, so it is possible that its efficacy has fallen below the mid-70s.

37 doctors out of 500 is 7%.  Not all doctors will be exposed to COVID but you could imagine that a lot of them would be.  If 150 doctors are exposed, that would leave you with an efficiacy of 75%.

The other interesting question is how badly were the doctors affected?  It is hoped that while AZ may not protect somebody extremely well from the SA variant, it would at least protect against serious illness.  The NYT article does say most of them had mild symptoms. But you'd have to compare against a similar unvaccinated group to see did they do better or worse.

3 hours ago, JoannaL said:

I just read an article today (in German so no link) that in some African countries (Malawi and Uganda) they are starting to throw away vaccine (AZ -  from COVAX) because it has exceeded its expiration date because of vaccine hesitancy. There is a lot of distrust against vaccination in general there, and also the feeling that Covid isnt that bad ,  some person in the interview compared it to Ebola and said its really not that bad so why risk a vaccination?

Compared to Ebola?  That is supposed to be horrendous!  Maybe that is the problem, if you have faced Ebola, COVID-19 may feel minor.  But yes, I also read that COVAX was taking back some of its AZ vaccine because it was unused in Africa.  A problem.  India has shown how badly things can get.

Filippa shared a link previously on vaccine uptake.  Its fascinating.  Ireland has had 100% uptake of the first dose for those over 80.  It will be interested to see how well we'll do for the other age groups.  I know there has been more resistance from the 60-70 age group because their only option is AZ.  But that may still work out hopefully.

https://covid19-vaccine-report.ecdc.europa.eu/#3_Uptake_of_at_least_one_vaccine_dose_among_adults

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Reminder that Modi was Silicon Valley's candidate.

https://www.buzzfeednews.com/article/ryanmac/facebook-blocking-posts-hashtag-resign-modi

 

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Facebook temporarily hid posts calling for the resignation of Indian Prime Minister Narendra Modi, marking the platform's latest foray in a series of controversial decisions affecting free speech in a country experiencing a full-blown COVID-19 crisis.

On Wednesday, the world’s largest social network said that posts with the hashtag or text #ResignModi “are temporarily hidden here” because “some content in those posts goes against our Community Standards.” Because the posts were hidden, it’s unclear what content violated the rules of a company whose executives have often expressed a commitment to open expression.

After hiding posts with the hashtag for about three hours, Facebook reversed its decision and allowed users to find and access posts with the criticism of Modi, just after this story was published.

Last week, the Indian government ordered Twitter to block access to more than 50 tweets that criticized Modi’s handling of the pandemic. The Wall Street Journal also reported that Facebook and Instagram had blocked posts about Modi on the orders of the government.

It was not immediately clear whether Facebook's hiding of the #ResignModi hashtag came at the behest of the Indian government,or if it was done at the company’s discretion. The hashtag was hidden within India, according to people who shared screenshots on Twitter, and in the United States, Canada, and England based on searches run by BuzzFeed News....

 

 

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Posted (edited)
24 minutes ago, Padraig said:

This is a good article on the India crisis. 

I would be careful with that article, not too much data at all, lots of speculation and anecdotes, ( and with the greatest respect to cardiac surgeons quoted in that piece, they would know nothing about managing covid) - the lack of data there is particularly striking, but more details can help as opposed to the headline of '37 doctors who got vaccinated got covid'; they mention that they had the first dose in late Jan/Early Feb, with the second dose likely being March/ April.

We are not sure when they got infected with COVID ( which is a key part of the puzzle) - it could have been a few days after their first dose, between the two doses, or after the second dose - we have no idea because it is not stated in the article. In addition, remember, protection kicks in 2-3 weeks after the first dose. Without all those details, it is hard to reach any conclusions.

( There is a whole separate debate to be had about how poor I have found NYT's reporting on covid over the last year, but I'm too lazy to get into all that)

Edited by Raja

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I got dose 2 of Pfizer yesterday. Took the day off work today just in case, but nothing worse than a sore arm and a bit of a headache (which might not even be related since I get headaches kind of a lot!). Glad to have the day off though.

We had a small bump locally, going from <3% positivity rate in early March up to almost 6% by mid-April. But now it's trending down again, current rolling average is 4.7%. Hope that continues!

Also I had a random date from over 3 years ago reach out to me and ask to meet up for drinks, so I guess the populace is slowly coming alive! :lol:

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Posted (edited)

 

1 hour ago, Raja said:

I would be careful with that article, not too much data at all, lots of speculation and anecdotes, ( and with the greatest respect to cardiac surgeons quoted in that piece, they would know nothing about managing covid) - the lack of data there is particularly striking, but more details can help as opposed to the headline of '37 doctors who got vaccinated got covid'; they mention that they had the first dose in late Jan/Early Feb, with the second dose likely being March/ April.

I'm not sure I'd completely agree with that.  I accept that there has been a lot of poor reporting on COVID but I'm not expecting an article to be definitive, when things are very uncertain.  Reading it reminded me of the early reporting from China regarding COVID.  Nobody knew much.  There were a lot of anectotes.  But you can't ignore a story just because you don't know everything.

There are definitely good reporting in the article.  For example, I think its good that it highlights that the variant rife in India is as much the UK variant as the new Indian one.  That suggests that this crisis may be more controllable than otherwise.

And in fairness, the headline isn't about 37 doctors getting COVID.  It's one of the first lines in the article.   Maybe that is still overly alarming but what is going on in India is alarming.

While its not very clear, the article actually gives most of the required info on those doctors.

  • 37 fully vaccinated doctors came down with Covid-19 earlier this month (i.e. that is, early April).
  • 37 doctors who became infected had received their first dose of the AstraZeneca vaccine between late January to early February and then their second dose four to six weeks after that. (that means they should have been fully vaccinated by approximately mid March).
Edited by Padraig

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Ok, a pause for a moment.  Let’s assume that we will all need a re-up in 12-24 months.  DOES IT MATTER WHICH SHOT YOU GET?  That is, if you originally got Moderna, will you have to seek that out or will any MRNA shot do?  What about an adenovirus base?  What about the Novovax shot?  

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2 hours ago, Starkess said:

I got dose 2 of Pfizer yesterday. Took the day off work today just in case, but nothing worse than a sore arm and a bit of a headache (which might not even be related since I get headaches kind of a lot!). Glad to have the day off though.

I’m glad yours went smoothly.  I got Pfizer #2 yesterday and I’ve had a low fever and flu-ish feeling all day today.  I was able to work through it with Tylenol but I’d really like it to wrap up before another busy day tomorrow.

I’m going to eat plenty of ice cream now to fuel my antibody production.

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Posted (edited)
2 hours ago, Padraig said:

 Nobody knew much.  There were a lot of anectotes.  But you can't ignore a story just because you don't know everything.

I'm not ignoring it, but I find little value in anecdotes where things like this are said

Quote

“The current wave of Covid has a different clinical behavior,” said Dr. Sujay Shad, a senior cardiac surgeon at Sir Ganga Ram Hospital, where two of the doctors needed supplemental oxygen to recover. “It’s affecting young adults. It’s affecting families. It’s a new thing altogether. Two-month-old babies are getting infected.”

We've known that it can affect young adults and we know that household transmission is also very common. What 'different clinical behaviour' have I learned after reading that? Okay, maybe you can make the argument that two month old babies getting infected might be the 'different clinical behaviour', but again, that is really not saying much and there is no attempt to provide details. Same with 'new thing altogether' - again, I have no idea what they mean ( the diarrhea stuff later in the piece is lacking as well)

I still don't think there is enough information there regarding the doctors getting covid whilst being vaccinated, particularly as the article goes onto say the following.

Quote

Officials in India are trying to track how many fully vaccinated people have fallen ill, a measure called the breakthrough infection rate. That could suggest how virulent any variant in India might be. They have focused on frontline medical workers, who are more likely to have received both doses of the AstraZeneca vaccine.

So far, data from the Indian Council of Medical Research up to April 21 shows an extremely low breakthrough infection rate

Plus, we're not even sure how good these vaccines are at preventing infections altogether, yes? What were the characteristics of these doctors that got the infection after vaccination? Was it mild? Did they require oxygen? How many of them required ICU admission? CPAP? Did they have severe disease?

Maybe I expect a lot better than that article, I do not think that is unreasonable. To me, articles have to be more than quotes without substance and without detail. And the NYT has done this multiple times during the last few months, there were articles about COVID 19 and how it affects the heart which also suffered from similar issues.

I think we'll agree to disagree on the merits of that article.

2 hours ago, Padraig said:

Maybe that is still overly alarming but what is going on in India is alarming.

I know it's alarming. I'm Indian and my whole family is in India. They also live in the state with the worst outbreak.

Edited by Raja

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Posted (edited)
10 minutes ago, Raja said:

I know it's alarming. I'm Indian and my whole family is in India. They also live in the state with the worst outbreak.

This is awful for you, because there's nothing you can do -- like us, with what is happening to our familia and friends in Cuba, and we can't even send them money, because of what the rethugs have done, and the orange demon and Miami finished.

Just now Biden in his address to Congress, stated, "white supremacy is terrorism."  And there it is, for us all around the world. Racism, bigotry of every kind destroys each of us and the planet.

 

 

Edited by Zorral

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I got pfizer #2 this morning and was not prepared for diarrhea (anything but that!). Arm got super sore right off the bat, and I'm now starting to get achey all over. 

100% worth it. 

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Posted (edited)

I'm sorry Raja :(

So Poland is coming out of the third wave and a lot of articles were mentioning similar stuff as the India article “It’s affecting young adults. It’s affecting families. It’s a new thing altogether. Two-month-old babies are getting infected.”

My take on that is

1) the British variant (which is common in Poland) does actually affect younger people and children more - it's been said it's more contagious and more symptomatic in younger people

2) many more people are getting infected than during the second wave (we didn't really have a first wave to speak of) so you obviously see more younger people affected

3) people (and especially younger people) are tired of restrictions and aren't as compliant, so they get sick more.

4) older people are vaccinated to a much higher degree so fewer get sick, which means that you mostly see younger people getting sick

BUT

it's also been reported that the actual age of people who are dying or end up in ICU hasn't really changed. It still kills older people.

---

I would also agree that some doctors falling ill is not that mysterious for  reasons Pod already mentioned. Doctors are exposed to much higher viral loads than regular people, and I bet their PPE is not always that meticulous in a crisis situation because there's no time for making sure it is.

Edited by Filippa Eilhart

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I’m really sorry Raja, it’s so sad and frightening what’s happening in India. :( 

The situation here is quite similar to what Filippa described above. I addition,

- the willingness to get vaccinated has slowed down to the point that if it doesn’t pick up, we will have more vaccines than people who want one by June. 

- several restrictions (that have been regularly broken anyway by younger people) were lifted promoting free(r) social mingling

- there’s an overall sensation that the pandemic is “over” which is hardly the reality especially when we look at what’s going on in India or Brazil. Or you know, just the wee fact the we have the most deaths by population in the world (that is if statistics are to be trusted). And before we know, wave 4 will be on us and only god knows what it will bring. 
 

It’s sad to accept that there’s no end in sight.

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8 hours ago, Raja said:

I know it's alarming. I'm Indian and my whole family is in India. They also live in the state with the worst outbreak.

I'm sorry to hear that.  I hope things improve very soon.

We probably are coming at the article from two different directions.  An article can work by giving less knowledgeable people a small sense of what is going on in another country.  But it may not work at all if you already have a very good sense of what is going on.

9 hours ago, Mlle. Zabzie said:

et’s assume that we will all need a re-up in 12-24 months.  DOES IT MATTER WHICH SHOT YOU GET?  That is, if you originally got Moderna, will you have to seek that out or will any MRNA shot do?  What about an adenovirus base?  What about the Novovax shot?  

I'm assuming it doesn't.  As you suggest, Novavax (and many other developing vaccines) could mainly be used as boosters in the US.  That wouldn't work if you had to be consistent with your original dose.

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The mayor's announced the entire city is to open entirely on July 1st.

It's the same scenario as initially with the corona virus in China -- it's not here, we're fine.  India and Brasil -- and Mexico and most of Latin America are surging out of control, and he is going to stop all the safety containment protocols.

O the fall is going to be just Grrrrrrrrrrrrrrrrrrrrrrrrrrr8!

In the meantime, the costs of everything from gasoline (we are even having shortages in areas already; there aren't enough drivers for the tanker truck deliveries x-country), to tampex and food are going up steeply on June 1st.

 

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Got dose 2 of Pfizer about 3 hours ago. The mass vaccination site I was at seemed to be at about 75% capacity, maybe a bit less. When I had gotten dose 1 they were at full capacity, and turning away people with appointments until 5 minutes before their scheduled time. This time they were much more relaxed.

Not feeling any side effects yet, but its still early going.

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https://www.google.co.uk/amp/s/news.sky.com/story/amp/almost-70-of-adults-in-england-now-have-coronavirus-antibodies-latest-figures-suggest-12289249
 

Almost 70% of adults in England now have antibodies for Covid. Which is flipping marvellous. This is getting closer to herd immunity every day, and you would expect if there was the ‘data not dates’ approach the government promised then we might be opening up a little quicker than we are.

Very good news though 

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20 minutes ago, Heartofice said:


https://www.google.co.uk/amp/s/news.sky.com/story/amp/almost-70-of-adults-in-england-now-have-coronavirus-antibodies-latest-figures-suggest-12289249
 

Almost 70% of adults in England now have antibodies for Covid. Which is flipping marvellous. This is getting closer to herd immunity every day, and you would expect if there was the ‘data not dates’ approach the government promised then we might be opening up a little quicker than we are.

Very good news though 

It's excellent news, and makes me hope that at this rate that our case count might begin to drop a bit more as it's been static at ~2.5k/day for a while now. Certainly it seems possible that that could drop in the next two months.

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47 minutes ago, Leap said:

It's excellent news, and makes me hope that at this rate that our case count might begin to drop a bit more as it's been static at ~2.5k/day for a while now. Certainly it seems possible that that could drop in the next two months.

I think getting to 2.5k from basically 60k is a fantastic achievement. Deaths are also very very low which is worth noting 

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Posted (edited)
14 minutes ago, Heartofice said:

I think getting to 2.5k from basically 60k is a fantastic achievement. Deaths are also very very low which is worth noting 

It really is, in fact I think it was one of the most rapid drops in cases that's been seen throughout the pandemic. But opening too quickly was the mistake we've made twice already, and I'd rather wait the extra few weeks now than have to deal with cases rising again in six weeks time, even if there's a cap on how they can go. To be honest I think cases would have dropped further by now if we hadn't opened outdoor pubs up.

 

Edit: although having been to the pub a few times, I do not overly regret that decision.

Edited by Leap

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24 minutes ago, Leap said:

It really is, in fact I think it was one of the most rapid drops in cases that's been seen throughout the pandemic. But opening too quickly was the mistake we've made twice already, and I'd rather wait the extra few weeks now than have to deal with cases rising again in six weeks time, even if there's a cap on how they can go. To be honest I think cases would have dropped further by now if we hadn't opened outdoor pubs up.

Sure you could get cases to 0 if you locked everyone in their houses. But that’s the trade off isn’t it. I’m sure if you owned a pub or a shop you are happy that people  are able to come to you.

 

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