Show Notes
Omicron emergency
https://www.bbc.co.uk/news/uk-59631570
No one should be in any doubt, there is a tidal wave of Omicron coming
It is now clear that two doses of vaccine are simply not enough to give the level of protection we all need.
But the good news is that our scientists are confident that with a third dose, a booster dose, we can all bring our level of protection back up
At this point our scientists cannot say that Omicron is less severe
a wave of Omicron through a population that was not boosted would risk a level of hospitalisation that could overwhelm our NHS and lead sadly to very many deaths
Aged 18 and over, in England, third jabs from this week Three months since second dose
A third booster dose prevents around 75% of people getting any Covid symptoms from Omicron
Live data, hospital patients who have tested positive
Omicron cases have now been found in hospital
Nadhim Zahawi
Warned of the danger of tens of thousands of hospitalisations,
even if omicron were to prove half as severe as delta
SARS-CoV-2 variants of concern and variants under investigation in England
Technical briefing 31
Data cut off, 6 December
260 confirmed cases of Omicron VOC-21NOV-01 (B.1.1.529),
Identified through sequencing or genotyping in England.
Additional possible cases identified through S gene target failure
Higher risk of transmission from secondary attack rates
Risk of household transmission from an Omicron index case compared to a Delta index case 3.2
Risk of a close contact becoming a secondary case, adjusted odds ratio 2.09
Household secondary attack
Omicron, 21.6%
Delta, 10.7%
Three to eight-fold increased risk of reinfection with the Omicron variant.
A 20 to 40-fold reduction in neutralising activity by Pfizer 2-dose vaccinee sera for Omicron
At least 10 fold loss of activity when compared to Delta
Greater reduction in activity was seen for AZ 2- dose sera
An mRNA booster dose resulted in an increase in neutralising activity irrespective of primary vaccination type
Data are urgently required on the durability of neutralising activity
A moderate to high vaccine effectiveness of 70 to 75% is seen in the early period after a booster dose.
With previous variants, vaccine effectiveness against severe disease, has been higher than effectiveness against mild disease
Lateral flow, similar sensitivity to detect Omicron compared to Delta
Modelling the potential consequences of the Omicron SARS-CoV-2 variant in England
https://cmmid.github.io/topics/covid19/omicron-england.html
https://www.bbc.co.uk/news/uk-59621029
Growth rate of the Omicron variant
Level of immune escape
Intrinsic transmissibility
Immune escape of Omicron
5.1-fold to 12.8-fold reduction in neutralisation relative to Delta
Intrinsic transmissibility
Omicron variant is growing in England at an exponential growth rate of r = 0.29 per day
This corresponds to a 2.4-day doubling time
Reproduction number Rt = 4.0
Generation interval of 5.5 days
Surge in SARS-CoV-2 transmission beginning in late December 2021
Infections exceeding peak levels recorded during the January 2021 wave in England
The most optimistic scenario, 1 December to 30 April in England
Omicron has low immune escape and booster jabs are highly effective
20.9 million infections
175,000 hospital admissions
24,700 deaths
Most pessimistic scenario, 1 December and 30 April in England
34.2 million infections
492,000 hospital admissions
74,900 deaths
Conclusions and discussion Without the implementation of further control measures, hospital admissions resulting from the Omicron wave of transmiss Learn more about your ad choices. Visit megaphone.fm/adchoices
More from Dr. John Campbell
the medical people I interact with at the hospital are far more optimistic than I've seen them since this all began in April last year
Our world in dataUploaded 11-06-23https://ourworldindata.orghttps://ourworldindata.org/grapher/excess-mortality-p-scores-average-baselinehttps://ourworldindata.org/excess-mortality-covidExcess mortality is a term used in epidemiology and public health that refers to the number of deaths from all causes during a crisis above and beyond what we would have expected to see under ‘normal’ conditionsExcess deaths = Reported deaths – Expected deathshttps://ourworldindata.org/excess-mortality-covid#excess-mortality-our-data-sourcesThe Human Mortality Database is maintained by a team of researchers based at the University of California, Berkeley, USA and the Max Planck Institute for Demographic Research in Rostock, Germany. Learn more about your ad choices. Visit megaphone.fm/adchoices Learn more about your ad choices. Visit megaphone.fm/adchoices
The Lancet Commission on lessons for the future from the COVID-19 pandemic Uploaded 16-09-2214th September 2022https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)01585-9/fulltexthttps://covid19commission.orgWHO responseWHO acted too cautiously and too slowlySeveral important mattersTo warn about human transmissibility of the virusTo declare a Public Health Emergency of International ConcernTo support international travel protocols designed to slow the spread of the virus(This delay contributed to the spread of the virus and limited the possibilities for risk mitigation.)To endorse the public use of face masks as protective gearTo recognise the airborne transmission of the virus.(These delayed and vague recommendations from WHO continued until late April, 2021.) Just 1 example, after receiving an open letterFrom 238 scientists in July, 2020,asking the organisation to address airborne transmissionWHO did not change until April 30, 2021.Multiple failures of international cooperationToo many governments have failed to adhere to basic norms of institutional rationality and transparency, and the world's major powers have failed to collaborate to control the pandemic.Specific pointsLack of timely notification of the initial outbreak of COVID-19Costly delays in acknowledging the crucial airborne exposure pathway of SARS-CoV-2, and in implementing appropriate measures at national and global levels to slow the spread of the virus.Lack of coordination among countries regarding suppression strategiesFailure of governments to examine evidence and adopt best practices for controlling the pandemic,and managing economic and social spilloversShortfall of global funding for low-income and middle-income countries (LMICs)Failure to ensure adequate global supplies and equitable distribution of key commodities,protective gear, diagnostics, medicines, medical devices, and vaccinesLack of timely, accurate, systematic dataInfections, deaths, viral variants, health system responses, and indirect health consequencesAgain the report raised lab leak possibilityPoor enforcement of appropriate levels of biosafety regulations in the lead-up to the pandemic, raising the possibility of a laboratory-related outbreakFailure to combat systematic disinformationLack of global and national safety nets to protect populations experiencing vulnerability.As of May 31, 2022There were 6·9 million reported deaths and 17·2 million estimated deaths from COVID-19Institute for Health Metrics and Evaluationhttps://covid19.healthdata.org/global?view=cumulative-deaths&tab=trendThis staggering death toll is both a profound tragedy and a massive global failure at multiple levels. Sustainable development processSet back by several years, Deep underfinancing, Sustainable Development Goals and,aims of the Paris Climate Agreement. Previous publicationsLancet 2021https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02833-6/fulltextLancet Jan 2022https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)02871-3/fulltexthttps://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)01585-9/fulltext Learn more about your ad choices. Visit megaphone.fm/adchoices Learn more about your ad choices. Visit megaphone.fm/adchoices
Dr. Melissa McCann is a general practitioner in Queensland, Australia
Monkeypox virus, seldom reported outside African until now, Uploaded 27-07-22https://www.nejm.org/doi/full/10.1056/NEJMoa2207323?emp=marcom&utm_source=nejmlist&utm_medium=email&utm_campaign=aomev2&utm_content=version-a&ssotoken=U2FsdGVkX19dsxXEVZT5ggLZ3zieDxejeViMkwTigM4Q7ECfBTJmfTXUrKWkbZ3up0jDhhQjYR6OydzgkC%2F1LL8S5l7OuFDLsP2LiBwfKJ3ymNN4hp0Z%2FNASEYMuetIqeQIQ9ETL8BABCQut7e8xEQeWPlduFdyPMYgAugUePHtSEs5rFR%2BGWfFOCIPZs9Wb7aJf%2FyzhvvLSrzqDKmNt4Q%3D%3D&cid=DM1289135_Notable_Articles_Engaged&bid=1085207852Endemic in AfricaCases now worldwideMETHODSFormed an international collaborative group,international case series, presentation, clinical course, outcomes of PCR confirmed infectionsRESULTSWe report 528 infections diagnosed between April 27 to June 24, 2022Cases, 528, at 43 sites in 16 countries98% in gay or bisexual men, 75% were White, 41% had HIVmedian age 38Transmission suspected to have occurred through sexual activity95% of casesPresentation in this series95% rash (with 64% having less than 10 lesions)73% anogenital lesions41% had mucosal lesions(with 54 having a single genital lesion)Common systemic features preceding the rashfever (62%)lethargy (41%)myalgia (31%)headache (27%)lymphadenopathy (56%)Concomitant sexually transmitted infections109 of 377 (29%)Among the 23 people with a clear exposure historymedian incubation period, 7 days (range, 3 to 20)Monkeypox virus DNADetected in 29 of the 32 (in whom seminal fluid was analyzed)ManagementAntiviral treatment given to 5% of cases70 (13%) were hospitalizedMostly for pain managementsevere anorectal pain (21)soft-tissue superinfection (18)pharyngitis limiting oral intake (5)eye lesions (2)acute kidney injury (2)myocarditis (2)infection-control purposes (13)No deaths were reportedCONCLUSIONSMonkeypox manifested with a variety of dermatologic and systemic clinical findings. Need for rapid identification and diagnosis of cases to contain further community spread. Learn more about your ad choices. Visit megaphone.fm/adchoices Learn more about your ad choices. Visit megaphone.fm/adchoices