The Pandemic Bulletin - 9:56 AM 2/2/2021: COVID-19: Surprising number of US healthcare workers refuse vaccines | Vaccine rollout hits snag as health workers balk at shots


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Vaccine rollout hits snag as health workers balk at shots

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The desperately awaited vaccination drive against the coronavirus in the U.S. is running into resistance from an unlikely quarter: Surprising numbers of health care workers who have seen firsthand the death and misery inflicted by COVID-19 are refusing shots.

It is happening in nursing homes and, to a lesser degree, in hospitals, with employees expressing what experts say are unfounded fears of side effects from vaccines that were developed at record speed. More than three weeks into the campaign, some places are seeing as much as 80% of the staff holding back.

“I don’t think anyone wants to be a guinea pig,” said Dr. Stephen Noble, a 42-year-old cardiothoracic surgeon in Portland, Oregon, who is postponing getting vaccinated. “At the end of the day, as a man of science, I just want to see what the data show. And give me the full data.”

Alarmed by the phenomenon, some administrators have dangled everything from free breakfasts at Waffle House to a raffle for a car to get employees to roll up their sleeves. Some states have threatened to let other people cut ahead of health care workers in the line for shots.

“It’s far too low. It’s alarmingly low,” said Neil Pruitt, CEO of PruittHealth, which runs about 100 long-term care homes in the South, where fewer than 3 in 10 workers offered the vaccine so far have accepted it.

Many medical facilities from Florida to Washington state have boasted of near-universal acceptance of the shots, and workers have proudly plastered pictures of themselves on social media receiving the vaccine. Elsewhere, though, the drive has stumbled.

While the federal government has released no data on how many people offered the vaccines have taken them, glimpses of resistance have emerged around the country.

In Illinois, a big divide has opened at state-run veterans homes between residents and staff. The discrepancy was worst at the veterans home in Manteno, where 90% of residents were vaccinated but only 18% of the staff members.

In rural Ashland, Alabama, about 90 of some 200 workers at Clay County Hospital have yet to agree to get vaccinated, even with the place so overrun with COVID-19 patients that oxygen is running low and beds have been added to the intensive care unit, divided by plastic sheeting.

The pushback comes amid the most lethal phase in the outbreak yet, with the death toll at more than 350,000, and it could hinder the government’s effort to vaccinate somewhere between 70% and 85% of the U.S. population to achieve “herd immunity.”

Administrators and public health officials have expressed hope that more health workers will opt to be vaccinated as they see their colleagues take the shots without problems.

Oregon doctor Noble said he will wait until April or May to get the shots. He said it is vital for public health authorities not to overstate what they know about the vaccines. That is particularly important, he said, for Black people like him who are distrustful of government medical guidance because of past failures and abuses, such as the infamous Tuskegee experiment.

Medical journals have published extensive data on the vaccines, and the Food and Drug Administration has made its analysis public. But misinformation about the shots has spread wildly online, including falsehoods that they cause fertility problems.

Stormy Tatom, 30, a hospital ICU nurse in Beaumont, Texas, said she decided against getting vaccinated for now “because of the unknown long-term side effects.”

“I would say at least half of my coworkers feel the same way,” Tatom said.

There have been no signs of widespread severe side effects from the vaccines, and scientists say the drugs have been rigorously tested on tens of thousands and vetted by independent experts.

States have begun turning up the pressure. South Carolina’s governor gave health care workers until Jan. 15 to get a shot or “move to the back of the line.” Georgia’s top health official has allowed some vaccines to be diverted to other front-line workers, including firefighters and police, out of frustration with the slow uptake.

“There’s vaccine available but it’s literally sitting in freezers,” said Public Health Commissioner Dr. Kathleen Toomey. “That’s unacceptable. We have lives to save.”

Nursing homes were among the institutions given priority for the shots because the virus has cut a terrible swath through them. Long-term care residents and staff account for about 38% of the nation’s COVID-19 fatalities.

In West Virginia, only about 55% of nursing home workers agreed to the shots when they were first offered last month, according to Martin Wright, who leads the West Virginia Health Care Association.

“It’s a race against social media,” Wright said of battling falsehoods about the vaccines.

Ohio Gov. Mike DeWine said only 40% of the state’s nursing home workers have gotten shots. North Carolina’s top public health official estimated more than half were refusing the vaccine there.

SavaSeniorCare has offered cash to the 169 long-term care homes in its 20-state network to pay for gift cards, socially distanced parties or other incentives. But so far, data from about a third of its homes shows that 55% of workers have refused the vaccine.

CVS and Walgreens, which have been contracted by a majority of U.S. nursing homes to administer COVID-19 vaccinations, have not released specifics on the acceptance rate. CVS said that residents have agreed to be immunized at an “encouragingly high” rate but that “initial uptake among staff is low,” partly because of efforts to stagger when employees receive their shots.

Some facilities have vaccinated workers in stages so that the staff is not sidelined all at once if they suffer minor side effects, which can include fever and aches.

The hesitation isn’t surprising, given the mixed message from political leaders and misinformation online, said Dr. Wilbur Chen, a professor at the University of Maryland who specializes in the science of vaccines.

He noted that health care workers represent a broad range of jobs and backgrounds and said they are not necessarily more informed than the general public.

“They don’t know what to believe either,” Chen said. But he said he expects the hesitancy to subside as more people are vaccinated and public health officials get their message across.

Some places have already seen turnarounds, such as Our Lady of the Lake Regional Medical Center in Baton Rouge, Louisiana.

“The biggest thing that helped us to gain confidence in our staff was watching other staff members get vaccinated, be OK, walk out of the room, you know, not grow a third ear, and so that really is like an avalanche,” said Dr. Catherine O’Neal, chief medical officer. “The first few hundred that we had created another 300 that wanted the vaccine.”

___

Contributing to this report were Associated Press writers Jake Bleiberg in Dallas; Heather Hollingsworth in Mission, Kansas; Janet McConnaughey in New Orleans; Candice Choi in New York; Kelli Kennedy in Fort Lauderdale, Florida; Jay Reeves in Birmingham, Alabama; Brian Witte in Annapolis, Maryland; Jeffrey Collins in Columbia, South Carolina; John Seewer in Toledo, Ohio; Melinda Deslatte in Baton Rouge, Louisiana; and Bryan Anderson in Raleigh, North Carolina.

Read the whole story
 
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COVID-19: Surprising number of US healthcare workers refuse vaccines

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  • A large number of healthcare workers in US nursing homes and hospitals are refusing to get vaccinated against COVID-19. As much as 80% are turning down a shot in some institutions, according to AP.
  • In a number of states, officials have raised the alarm about the low take-up rate of vaccines among healthcare workers.
  • Vaccine skepticism is higher than average among those working in a healthcare setting. Three in ten say they are hesitant to get vaccinated, according to a Kaiser Family Foundation study.
  • Ohio Gov. Mike DeWine has had to warn frontline staff that if they want a vaccine any time soon, they must act now.
  • In recent days, the US has broken records for both the highest daily rise in new COVID-19 cases and for the highest daily death toll.
  • Visit Business Insider's homepage for more stories.

In American nursing homes and hospitals, a surprising number of healthcare workers are refusing to get vaccinated against COVID-19.

As many as 80% of staff are turning down a vaccine in some institutions, according to AP. This is due to unfounded fears about the side-effects of these life-saving shots, AP reported.

The two vaccines administered in the US have been FDA approved, meaning that the benefits outweigh any potential risks. Additionally, neither vaccine has raised any major safety concerns in large-scale clinical trials.

Nonetheless, skepticism exists among healthcare workers and the American public at large.

Dr. Joseph Varon, a critical care doctor from Houston, has said that more than half of the nurses in his unit are objecting to getting inoculated for political reasons. "Most of the reasons why most of my people don't want to get the vaccine are politically motivated," Varon told NPR.

In Portland, Oregon, Dr. Stephen Noble, a cardiothoracic surgeon told AP: "I don't think anyone wants to be a guinea pig. At the end of the day, as a man of science, I just want to see what the data show. And give me the full data."

About a quarter (27%) of the American public is hesitant to get a vaccine, according to a study from the Kaiser Family Foundation. This rises to 29% of those who work in a health care setting, the study shows.

In Ohio, 60% of the state's nursing home workers have decided against a vaccine, the governor said.

Gov. Mike DeWine has announced that he hopes to instill a "sense of urgency" in his state's healthcare workers by offering a stark warning. He has told frontline staff they could miss out on getting a vaccine any time soon if they don't act now, according to The Columbus Dispatch

"Our message today is the train may not be coming back for a while," DeWine said at a press conference.

In other states, there is also concern about the low take-up rates of vaccines by frontline workers.

In North Carolina, public health officials revealed that more than half of those working in nursing homes have so far refused to get a shot, according to AP.

A significant proportion of nursing staff in West Virginia is also refusing to get vaccinated. About 45% have said no to a COVID-19 jab, AP reported.

Martin Wright, who leads the West Virginia Health Care Association, blamed fast-spreading misinformation about vaccines: "It's a race against social media," he said.

Between 20 and 40% of frontline workers in Los Angeles have also refused a COVID-19 shot, public health officials the Los Angeles Times. In neighboring Riverside County, the paper says this rises to 50%.

In a bid to increase the vaccination rates among healthcare workers a number of administrators have resorted to offering raffle tickets and free breakfasts at Waffle House in exchange for a jab, AP reported.

So far, according to the Bloomberg vaccine tracker, the US has administered over seven million vaccine doses. 

The need to successfully roll out the vaccine has never been more apparent. In recent days, the US has broken records for both the highest daily rise in new COVID-19 cases and for the highest daily death toll.

On Friday, there were a record-breaking 307,579 new daily cases, according to Worldometer.

On Thursday, Worldometer shows that 4,245 people died from coronavirus-related complications,



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In addition to long-term care facilities, the drugstore chain is offering shots to select groups in Indiana, Massachusetts, New York and Puerto Rico.

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South Africa gets first vaccine doses

One million shots of coronavirus vaccine were flown into South Africa on Monday, where Cyril Ramaphosa's government has been criticized for not securing shots sooner

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406 more COVID-19 deaths announced

There have been 406 COVID-19 deaths and 18,607 new cases bringing the death total to 106,564.

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The head of the Centers for Disease Control and Prevention says new COVID-19 cases and hospitalizations are down in recent weeks, but three mutations that are causing concern have been detected in the U.S. (Feb. 1)

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On an unusually dreary Johannesburg day, a figurative ray of sunshine: the arrival of the first pallets of coronavirus vaccines that will, in about two weeks, begin making their way into the arms of South Africans.

President Cyril Ramaphosa and other dignitaries stood on the tarmac, masked and under dark umbrellas in the driving rain, as the Emirates flight carrying the first vaccine shipment landed at Johannesburg’s OR Tambo International Airport Monday afternoon. This shipment of the AstraZeneca vaccine was purchased from an Indian manufacturer, officials said.

Ramaphosa did not speak to the public, but in a statement, said, “The scale of delivery is unprecedented in terms of the number of people who have to be reached within a short space of time.”

Family members and volunteers from the Saaberie Chishty Society lower the body of a COVID-19 victim into a grave at the Avalon cemetery in Lenasia, South Africa, Jan. 4, 2021.
Family members and volunteers from the Saaberie Chishty Society lower the body of a COVID-19 victim into a grave at the Avalon cemetery in Lenasia, South Africa, Jan. 4, 2021.

The first vaccines, he said, will go to 1.2 million front-line health workers. 

South Africa is the continent’s viral hotspot, with 1.4 million confirmed cases since the virus turned up in the country in March. The nation experienced the start of a second wave -- featuring a new variant that is significantly more contagious -- in late December, but the peak of that wave appears to be subsiding. Current vaccines are expected to work on the South African variant, called 501.V2, said the head of the nation’s coronavirus task force, Dr. Salim Abdool Karim.

The rest of the continent is awaiting shipment of about 300 million vaccines. South Africa will now become the fifth African nation to roll out vaccinations, after Morocco, Egypt, the Seychelles and Guinea.

Ramaphosa is expected to address the nation late Monday about its continuing coronavirus precautions and restrictions.

 



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Paper titleSARS-CoV-2 seropositivity and subsequent infection risk in healthy young adults: a prospective cohort study

Corresponding Author:  Stuart C. Sealfon, MD, Professor of Neurology, Neuroscience and Pharmacological Sciences, Icahn School of Medicine at Mount Sinai

Bottom Line: Although antibodies induced by infection to SARS-CoV-2 are largely protective, they do not guarantee effective immunity against subsequent infection, as evidenced through a longitudinal, prospective study of young Marine recruits. Previously infected study participants identified by seropositivity are susceptible to repeat infection, with nearly one-fifth the incidence rate of those without evidence of previous infection. Among the seropositive group, those who became infected again had lower antibody titers than those that were uninfected, and most lacked detectable baseline neutralizing antibodies. Findings suggest that COVID-19 vaccination may be necessary for control of the pandemic in previously infected young adults.

Results:  Among 189 seropositive participants, 19 (10.1%) had at least one positive PCR test for SARS-CoV-2 during the six-week follow-up. In contrast, 1,079 (48.0%) of the 2,246 seronegative participants tested positive. The incidence rate ratio was 0.18 (95% CI 0.11-0.28, p<0.00001). Among seropositive recruits, infection was associated with lower baseline full-length protein IgG titers (p=<0.0001). Compared with seronegative recruits, seropositive recruits had about 10-fold lower viral loads and trended towards shorter duration of PCR positivity (p=0.18) and more asymptomatic infections (p=0.13). Among seropositive participants, baseline neutralizing titers were detected in 45 of 54 (83.3%) uninfected and in 6of 19 (31.6%) infected participants during the 6 weeks of observation.

Why the Research Is Interesting: With the onset of mass SARS-CoV-2 vaccination programs and the increasing proportion of previously infected individuals, the risk of reinfection after natural infection is an important question for modeling the pandemic, estimating herd immunity, and guiding vaccination strategies. And since young adults, of whom a high percentage are asymptomatically infected and become seropositive in the absence of known infection, can therefore be a source of transmission to more vulnerable populations, it’s important to evaluate protection against subsequent SARS-CoV-2 infection conferred by seropositivity to determine the need for vaccinating previously infected individuals in this age group.

Who: Scientists from the Icahn School of Medicine at Mount Sinai, in collaboration with researchers from the Naval Medical Research Center, utilized the COVID-19 Health Action Response for Marines (CHARM) study, a longitudinal, prospective cohort study that has been previously described and published in NEJM, to examine how protective detectable antibodies are to preventing subsequent infections with SARS-CoV-2, the virus that causes COVID-19. The study population consisted of 3,249 predominantly male, 18-20-year-old Marine recruits who, upon arrival at a Marine-supervised two-week quarantine prior to entering basic training, were assessed for baseline SARS-CoV-2 IgG seropositivity (defined as a 1:150 dilution or greater on receptor binding domain and full-length spike protein enzyme-linked immunosorbent [ELISA] assays.) The presence of SARS-CoV-2 was assessed by PCR at initiation, middle and end of quarantine. After appropriate exclusions, including participants with a positive PCR during quarantine, the study team performed three bi-weekly PCR tests in both seronegative and seropositive groups once recruits left quarantine and entered basic training.

When: All study data was collected between May and October, 2020. The prospective study observation period began when Marine recruits arrived at Marine Corps Recruit Depot – Parris Island (MCRDPI) to commence basic training.

What: The study evaluated protection against subsequent SARS-CoV-2 infection conferred by seropositivity in young adults to determine the need for vaccinating previously infected individuals in this age group.

How: After appropriate exclusions, including participants with a positive PCR during quarantine, the study team performed three biweekly PCR tests in both seropositive and in seronegative groups once recruits left quarantine and entered basic training and baseline neutralizing antibody titers on all subsequently infected seropositive and selected seropositive uninfected participants.

Study Conclusions: Seropositive young adults had about one-fifth the risk of subsequent infection compared with seronegative individuals. Although antibodies inducted by initial infection are largely protective, they do not guarantee effective SARS-CoV-2 neutralization activity or immunity against subsequent infection. These findings may be relevant for optimization of mass vaccination strategies.

Funding: Defense Health Agency and Defense Advanced Research Projects Agency (DARPA)

Said Mount Sinai's Dr. Stuart Sealfon of this work: "Our findings indicate that reinfection by SARS-CoV-2 in healthy young adults is common."

###

FOR IMMEDIATE RELEASE: Posted January 29, 2021 on MedRxiv

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4:13 PM 2/1/2021

Covid-19 Rates in India

M.N.: My hypothesis and explanation: 

1. Sars-Cov-2 was present in India, just like everywhere else, for quite some time, probably for decades if not longer. It was and is largely asymptomatic, and the populace developed the adequate immunity to it: 

Quote: 

Serological surveys – random testing for antibodies – show a majority of people in certain areas of India may have already been exposed to the coronavirus, without developing symptoms. Last week, preliminary findings from a fifth serological study of 28,000 people in India’s capital showed that 56% of residents already have antibodies, though a final report has not yet been published. The numbers were higher in more crowded areas. Last summer, another survey by Mumbai’s health department and a government think tank found that 57% of Mumbai slum-dwellers, and 16% of people in other areas, had antibodies suggesting prior exposure to the coronavirus.

2. Bacteria and viruses compete with each other. 

Quotes: 

“All of us have pretty good immunity! Look at the average Indian: He or she has probably had malaria at some point in his life, or typhoid or dengue,” says Sayli Udas-Mankikar, an urban policy expert at the Observer Research Foundation in Mumbai. “You end up with basic immunity toward grave diseases.”

“COVID-19 deaths are lower in countries where people are exposed to a diverse range of microbes and bacteria.”

3. It is doubtful that masks make any difference. 

Original Research18 November 2020 | Effectiveness of Adding a Mask Recommendation to Other Public Health Measures to Prevent SARS-CoV-2 Infection in Danish Mask Wearers | A Randomized Controlled Trial

Danish mask study

Masks make no difference in Covid-19 transmission

______________________________

The Mystery Of India’s Plummeting COVID-19 Cases

February 1, 20213:29 PM ET

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A mural in New Delhi is part of public health messaging in India. The country has seen a dramatic decline in new cases since fall, but researchers aren’t sure why. Sanchit Khanna/Hindustan Times via Getty Images hide caption

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Sanchit Khanna/Hindustan Times via Getty Images

A mural in New Delhi is part of public health messaging in India. The country has seen a dramatic decline in new cases since fall, but researchers aren’t sure why.

Sanchit Khanna/Hindustan Times via Getty Images

Last September, India was confirming nearly 100,000 new coronavirus cases a day. It was on track to overtake the United States to become the country with the highest reported COVID-19 caseload in the world. Hospitals were full. The Indian economy nosedived into an unprecedented recession.

But four months later, India’s coronavirus numbers have plummeted. Late last month, on Jan. 26, the country’s Health Ministry confirmed a record low of about 9,100 new cases – in a country of nearly 1.4 billion people. It was India’s lowest daily tally in eight months. On Monday, India confirmed about 11,000 cases.

“It’s not that India is testing less, or things are going underreported,” says Jishnu Das, a health economist at Georgetown University. “It’s been rising, rising — and now suddenly, it’s vanished! I mean, hospital ICU utilization has gone down. Every indicator says the numbers are down.”

Scientists say it’s a mystery. They’re probing why India’s coronavirus numbers have declined so dramatically – and so suddenly, in September and October, months before any vaccinations began.

They’re trying to figure out what Indians may be doing right, and how to mimic that in other countries that are still suffering.

“It’s the million-dollar question. Obviously, the classic public health measures are working: Testing has increased, people are going to hospitals earlier, and deaths have dropped,” says Genevie Fernandes, a public health researcher with the Global Health Governance Program at the University of Edinburgh. “But it’s really still a mystery. It’s very easy to get complacent, especially because many parts of the world are going through second and third waves. We need to be on our guard.”

Scholars are examining India’s mask mandates and public compliance, as well as climate, demographics and patterns of diseases that typically circulate in the country.

Mask and mandates

India is one of several countries – mostly in Asia, Africa and South America – which have mandated masks in public spaces. Prime Minister Narendra Modi appeared on TV wearing a mask very early in the pandemic. The messaging was clear.

In many Indian municipalities, including the megacity Mumbai, police hand out tickets – fines of 200 rupees ($2.75) – to violators. Mumbai’s mask mandate even applies outdoors, to joggers on the beach and passengers in open-air rickshaws.

“Every time they fine a person 200 rupees, they also give them a mask to wear,” explains Fernandes, a Mumbai native. “Very stereotypically, we [Indians] are known to break rules! You see traffic rules being broken all the time,” she says, laughing.

But in the pandemic, when it comes to masks, “the police, the monitoring, enforcement – all that was ramped up,” she says.

Authorities reportedly collected the equivalent of $37,000 in mask fines in Mumbai on New Year’s Eve alone.

But the fines and mandates appear to have worked: In a survey published in July, 95% of respondents said they wore a mask the last time they went out. The survey was conducted by phone in June by the National Council of Applied Economic Research (NCAER), India’s biggest independent economic policy group.

Awareness is widespread. Whenever you make a phone call in India — on landlines and mobiles — instead of a ringtone, you hear government-sponsored messages warning you to wash your hands and wear a mask. One message was recorded by Bollywood legend Amitabh Bachchan, 78, who battled and recovered from COVID last summer.

The mask and hand-washing messages have now been replaced with new ones urging people to get vaccinated; India began vaccinations on Jan. 16.

Heat and humidity

Aside from mask compliance, there’s also India’s climate: Most of the country is hot and humid. That too has deepened the mystery. There’s some evidence India’s climate may help reduce the spread of respiratory viruses. But there’s also some evidence to the contrary.

A review of hundreds of scientific articles, published in September in the journal Plos One, found that warm and wet climates seem to reduce the spread of COVID-19. Heat and humidity combine to render coronaviruses less active – though the certainty of that conclusion, the review says, is low. Previous research has also found that droplets of the virus may stay afloat longer in air that’s cold and dry.

“When the air is humid and warm, [the droplets] fall to the ground more quickly, and it makes transmission harder,” Elizabeth McGraw, director of the Center for Infectious Disease Dynamics at Penn State, told NPR last year. (Although the science of transmission is still evolving.)

In a survey of COVID cases in India’s Punjab state, Das, the health economist at Georgetown, found that 76% of patients there did not infect a single other person – though it’s unclear why. He and his colleagues examined data collected from contact tracing, and found that most patients infected only a few other people, while a few patients infected many. Overall, 10% of cases accounted for 80% of infections. One implication, which Das says he’s investigating further, is the possibility of making contact tracing more efficient by first testing a patient’s immediate family members. If no one at all is infected, the process can end there.

“The temperature, of course, is in our favor. We do not have too cold of a climate,” says Dr. Daksha Shah, an epidemiologist and deputy executive health officer for the city of Mumbai. “So many viruses are known to multiply more in colder regions.”

But there’s also some scientific evidence to the contrary, that India might actually be more conducive to the coronavirus: Research published in December in the journal GeoHealth says that urban India’s severe air pollution might exacerbate COVID-19. Not only does pollution weaken the body’s immune system, but when air is thick with pollutants, those particles may help buoy the virus, allowing it to stay airborne longer.

A paper published in July in The Lancet says extreme heat may also force people indoors, into air-conditioned spaces – and thus might contribute to the virus’ spread. The National Resources Defense Council has warned that extreme heat can lead to a spike in other illnesses – dehydration, diarrhea – that might lead to overcrowding in hospitals and clinics already struggling to treat victims of COVID-19.

Prevalence Of Other Diseases

Another point to consider about India is how many other diseases are already rampant: Malaria, dengue fever, typhoid, hepatitis, cholera. Millions of Indians also lack access to clean drinking water, sanitation and hygienic food. Some experts speculate that people with robust immune systems may be more likely to survive in India in the first place.

“All of us have pretty good immunity! Look at the average Indian: He or she has probably had malaria at some point in his life, or typhoid or dengue,” says Sayli Udas-Mankikar, an urban policy expert at the Observer Research Foundation in Mumbai. “You end up with basic immunity toward grave diseases.”

Two new scientific papers support that thesis, though they have yet to be peer-reviewed: One study by Indian scientists from Chennai and Pune, published in October, found that low and lower-middle income countries with less access to health-care facilities, hygiene and sanitation actually have lower numbers of COVID-19 deaths per capita. Another study by scientists at India’s Dr. Rajendra Prasad Government Medical College, published in August, found that COVID-19 deaths are lower in countries where people are exposed to a diverse range of microbes and bacteria.

But experts warn these two studies are preliminary, and should only serve as a springboard for more investigation.

“They’re not based on any biological data. So they’re good for generating a hypothesis, but now we really need to do the studies that will result in explanations,” says Dr. Gangandeep Kang, an infectious diseases researcher at the Christian Medical College in Vellore, India. “I hope scientists work more on this soon. We need deeper dives into India’s immune responses.”

According to Health Ministry figures, the coronavirus has killed 154,392 people in India as of Feb. 1. That’s a mortality rate of 1.44-percent — much lower than that of the United States or many European countries. (But Brazil’s death rate is higher than India’s, and Brazil and India are both lower-middle income countries.)

Demographics

India is a very young country as well. Only 6% of Indians are older than 65. More than half the population is under 25. Those who are young are less likely to die of COVID, and more likely to show no symptoms if infected.

A study of nearly 85,000 coronavirus cases in India, published in November in the journal Science, found that the COVID mortality rate actually decreases here after age 65 – possibly because Indians who live past that age are such outliers. There are so few of them.

“Those Indians who do live that long tend to be more healthy than average, or more wealthy — or both,” says health economist Das.

Serological surveys – random testing for antibodies – show a majority of people in certain areas of India may have already been exposed to the coronavirus, without developing symptoms. Last week, preliminary findings from a fifth serological study of 28,000 people in India’s capital showed that 56% of residents already have antibodies, though a final report has not yet been published. The numbers were higher in more crowded areas. Last summer, another survey by Mumbai’s health department and a government think tank found that 57% of Mumbai slum-dwellers, and 16% of people in other areas, had antibodies suggesting prior exposure to the coronavirus.

But many experts caution that herd immunity – a controversial term, they say – would only begin to be achieved if at least 60% to 80% of the population had antibodies. It’s also unclear whether antibodies convey lasting immunity or for how long. More serological surveys are needed, they say.

TIMING

India’s climate and demographics have not changed during the pandemic. And the drop in India’s COVID-19 caseload has been recent. It hit a peak in September and has declined inexplicably since then.

In fact, India’s numbers went down exactly when experts predicted they would spike: In October, when millions of people gathered for the Hindu festivals of Diwali and Durga Puja. It’s when air pollution is also worst, and experts feared that would exacerbate the pandemic too.

Cases have also declined despite what many thought would be a super-spreader event: Tens of thousands of Indian farmers camping out on the capital’s outskirts for months.

Shah, the epidemiologist, wonders if, just like more infectious variants of the coronavirus have been discovered in the U.K. and elsewhere, perhaps a milder variant may have started mutating in India.

“Some processes must have happened. This is an evolution of the virus itself. In some places there are mutations happening,” she says. “We need some more, deeper evidence and deeper studies.”

The truth is, scientists just don’t know.

“Three options: One is that it’s gone because of the way people behaved, so we need to continue that behavior. Or, it’s gone because it’s gone and it’s never going to come back, great!” says Das, from Georgetown. “Or, it’s gone, but we don’t know why it’s gone — and it may come back.”

That last option is what keeps scientists and public health experts up at night.

So for now, Indians are kind of holding their breath – just doing what they’re doing — until they get vaccinated.

Read the whole story

 

· · · · · · · · · ·
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Dr. Rochelle Walensky, the new head of the Centers for Disease Control and Prevention and the former infectious disease chief at Mass. General Hospital, said Friday that it is likely the United States is experiencing community spread of the COVID-19 virus variant that was first discovered in South Africa.

The first two cases of the variant were diagnosed in South Carolina on Thursday.

“What’s happened over the last week or so is that we’ve really scaled up the surveillance and the sequencing in this country,” Walensky said on the “Today” show. “And I think we were always concerned that we had it here and we hadn’t yet detected it. And now we have evidence of these two cases in South Carolina that it is in fact here.”

South Carolina officials said the two individuals who contracted the variant lived in different parts of the state, do not appear to be connected, and neither had traveled recently. Those facts are what Walensky said was “concerning” about the cases.

“The presumption at this point is that there has been community spread of this strain,” she said.

The variant first detected in South Africa is not the only strain of the virus that has emerged in the United States in recent weeks. The first U.S. case of the variant initially detected in Brazil was diagnosed in Minnesota earlier this week, and the CDC has reported at least 315 U.S. cases of the variant that was discovered in the United Kingdom.

Two cases of the U.K. variant have been detected in Massachusetts.

“Today” host Savannah Guthrie asked Walensky how concerned she was about the mutating viruses presenting diminishing returns for how effective the COVID-19 vaccines will be.

The former MGH chief said more data on how different vaccines are faring against the variants is needed.

“That has always been our concern,” Walensky said. “When viruses mutate and they develop strains and dominant strains, they usually do so for some advantage to the virus. That may come in the tune of our vaccines not working as well. That said, I also want to note that we never expected a vaccine as efficacious as the Moderna and Pfizer [vaccines] at 95 percent efficacy. And I would say even a vaccine that has 50, 60 percent efficacy would still be a real tool in our toolbox to fight this pandemic.

“Furthermore, I know that these mRNA vaccines have the capacity to use and to engineer the mRNA, so it would be more potent against these strains,” she added. “And that work is already actually ongoing, so it may just lend us to feel like we need a booster effect further down the road. So all of that science is ongoing in anticipation.”

In addition to discussing the virus variants, Walensky weighed in on school reopenings, saying that teachers “should be early in queue” for vaccinations and getting shots in the coming weeks.

She also spoke about masks, saying the CDC recommends people use a multilayer cloth mask, procedure mask, or medical mask.

Her comments came as other health experts have pressed for a national plan to get everyone access to high-filtration masks, like N95s, to help stop the spread of COVID-19.

“Fifty-nine percent of Americans are wearing a mask right now … certainly N95s offer the best filtration, but in fact, they’re very hard to tolerate for long periods of time,” the CDC director said. “And I think the difference between a two-layer cloth mask and an N95 mask is relatively small compared to the difference of getting 41 percent of the American population masked.”

Information from the Associated Press was used in this report.


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Read the whole story

 

· · ·

1:23 PM 2/1/2021 – South African Coronavirus variant with no travel history in England – one more indication that this variant is “local”, of the “community origin”, and of the “sustained community transmission”, just like so many other variants and in so many other and various locations. These facts prompt us to review the basic postulates of the Covid-19 as the travel driven phenomenon and they might indicate the universally present internal, “local”, innate origins of this putative infection rather than acquired from the extraneous sources. This dichotomy is of course extremely important and has to be researched very thoroughly. It has the enormous implications for the understanding of the “Covid-19 Pandemic” and its correct, efficient, and the evidence based management. Michael Novakhov

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The News And Times Blogs Network – newsandtimes.netThe News And Times Blogs Network – <a href=”http://newsandtimes.net” rel=”nofollow”>newsandtimes.net</a>
South African Coronavirus variant with no travel history in England – one more indication that this variant is “local”, of the “community origin”, and of the “sustained community  transmission”, just like so many other variants and in so many other and various locations. These facts prompt us to review the basic postulates of the Covid-19 as the travel driven phenomenon and they might indicate the universally present  internal, “local”, innate origins of this putative infection rather than acquired from the extraneous sources. This dichotomy is of course extremely important and has to be researched very thoroughly. It has the enormous implications for the understanding of the “Covid-19 Pandemic” and its correct, efficient, and the evidence based management. 
Michael Novakhov 

Read the whole story

 

· ·
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The United Kingdom detected the South African variant of coronavirus among 11 people with no history of travel to the regions where the variant is currently circulating. 

Owing to this discovery, mass testing is underway in the infected region. On Monday, the government announced that all infected people were self-isolating and that authorities had undertaken contact tracing to limit further transmission of the virus.

The authorities are undertaking testing across three different regions in the UK London, south-east, West Midlands, eastern England, and the North West. “Surge testing” would be undertaken, implying people with no symptoms will also be tested for the new variant to limit the spread.
“Every person over 16 living in these locations is strongly encouraged to take a Covid test this week, whether they are showing symptoms or not,” the government announced in a statement.

Also read: As virus variants spread, ‘no one is safe until everyone is safe’
In January, the government detected cases of the Brazilian and South African variants, but these cases were linked to travel. Since December 22, 105 cases of the South African variant have been identified in the country.

It is normal for viruses to mutate, and the same holds true for coronavirus. A variant was discovered first in the UK, which is thought not only to be more transmissible, but also more fatal.

While the world rushes to vaccinate its citizens, this has triggered fears of the vaccines not being effective enough. The South African variant seems to be more transmissible, but with no evidence of it being more severe.

Also read: Fauci says UK coronavirus variant to become more dominant in US by March

Laboratory tests, however, have shown that the new variant reduces the efficacy of vaccines.

Studies undertaken for two coronavirus vaccines developed by Novavax and Johnson & Johnson showed that the vaccines had less ability to protect against sickness brought on by the South African variant.

The News And Times Information Network – Blogs By Michael Novakhov – thenewsandtimes.blogspot.com

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The post Blogs from Michael_Novakhov (30 sites): The News And Times: 4:13 PM 2/1/2021 – The Mystery Of India’s Plummeting COVID-19 Cases first appeared on Michael Novakhov - Shared News and Tweets - michaelnovakhov-sharednewslinks.net - The News And Times.
To date, nearly 17,000 have died of the disease in the county. … signifying that at least 1 in every 1,000 Californians has been killed by COVID-19. … which, while not necessarily more deadly than other strains of the virus, … still in a very dangerous period in terms of cases, hospitalizations and deaths.”.
The post January was deadliest month of COVID-19 pandemic in LA and California first appeared on The News And Times.
• Your neighborhood pharmacist can help speed the vaccine rollout
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  1. COVID-19 Vaccine: Will It Protect Against New Variants And Do You Need A 2nd Dose?  NPR
  2. Moderna president details plans to ramp up COVID-19 vaccine production l GMA  Good Morning America
  3. The top COVID news stories you missed in the past few days  Popular Science
  4. These 'vaccine hunters' are getting their shots ahead of schedule by gaming the system  CNN
  5. More Americans Have Received at Least 1 Covid Vaccine Dose Than Tested Positive  Bloomberg
  6. View Full Coverage on Google News

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  1. Japan plans to extend its state of emergency as Covid-19 cases rise and Olympics loom  CNN
  2. Japan Set to Extend State of Emergency for Another Month  U.S. News & World Report
  3. Japan extends emergency amid vaccine, Olympic uncertainty  Associated Press
  4. Japan concerned over EU COVID-19 vaccine supply uncertainty  Washington Post
  5. Japan Set to Extend Covid Emergency as Economy Sputters  Bloomberg
  6. View Full Coverage on Google News
Michael Novakhov retweeted:
A secret GOP election autopsy says Trump’s COVID shitshow cost him the White House trib.al/5FXJWVv
Michael Novakhov retweeted:
The National Counterintelligence Center put out a new fact sheet about China's collection of genomic and healthcare data, adding to this warning from DOD I published last year:

dni.gov/files/NCSC/doc…

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apnews.com/article/corona…
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Covid-19 and collapse of health care - Google Search google.com/search?q=Covid…
Covid-19 and collapse of healthcare - Google Search google.com/search?q=Covid…

EtOp9nSWgAIAUkU.png:large

Covid-19 and collapse of health care system - Google Search google.com/search?newwind… nejm.org/doi/full/10.10…
doctors quit medicine in droves - Google Search google.com/search?newwind… lookforzebras.com/are-doctors-qu…
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health workers refuse covid vaccine - Google Search google.com/search?q=healt… cbsnews.com/news/covid-vac…
COVID-19: Surprising number of US healthcare workers refuse vaccines - Business Insider businessinsider.com/covid-19-surpr…
skepticism about Covid-19 and the vaccines among healthcare workers and the American public at large. - Google Search google.com/search?q=skept… govtech.com/em/safety/Heal…
Vaccine rollout hits snag as health workers balk at shots apnews.com/article/corona…

A mutation of the Kent coronavirus variant that is better able to evade the immune system has been detected.

Public Health England explained that it's called E484K and is also found in the spike protein of the South African variant.

Read more here:
https://news.sky.com/story/covid-19-mutation-of-kent-variant-detected-in-samples-could-help-virus-evade-immune-system-12206375

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Sen. Susan Collins spoke on behalf of a group of 10 Republicans who met with President Biden and Vice President Harris to discuss further Covid-19 relief and called the meeting a “good exchange of views.”
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