Coronavirus: How worried should we be?

On Friday, April 30, the WHO quietly updated a page on its website. In a section on how the coronavirus gets transmitted, the text now states that the virus can spread via aerosols as well as larger droplets. As Zeynep Tufekci noted in The New York Times, perhaps the biggest news of the pandemic passed with no news conference, no big declaration. If you weren’t paying attention, it was easy to miss.



But Marr was paying attention. She couldn’t help but note the timing. She, Li, and two other aerosol scientists had just published an editorial in The BMJ, a top medical journal, entitled “Covid-19 Has Redefined Airborne Transmission.” For once, she hadn’t had to beg; the journal’s editors came to her. And her team had finally posted their paper on the origins of the 5-micron error to a public preprint server.

In early May, the CDC made similar changes to its Covid-19 guidance, now placing the inhalation of aerosols at the top of its list of how the disease spreads. Again though, no news conference, no press release. But Marr, of course, noticed. That evening, she got in her car to pick up her daughter from gymnastics. She was alone with her thoughts for the first time all day. As she waited at a red light, she suddenly burst into tears. Not sobbing, but unable to stop the hot stream of tears pouring down her face. Tears of exhaustion, and relief, but also triumph. Finally, she thought, they’re getting it right, because of what we’ve done.

The light turned. She wiped the tears away. Someday it would all sink in, but not today. Now, there were kids to pick up and dinner to eat. Something approaching normal life awaited.
:- https://www.wired.com/story/the-tee...t-helped-covid-kill/?utm_source=pocket-newtab

 

Top scientists shaken by revelations that Covid isn’t natural but a lab-made virus that ‘escaped’

ThePrint
May 17, 2021

 

This is Where the Next Pandemic is Likely to Emerge
Adele Peters
COVID-19 won’t be the last time a virus jumps from animals to humans and threatens humanity. Now scientists are trying to determine what factors are most likely to incubate the next deadly virus.
In late 2019, it’s likely that the new coronavirus made the jump from a wild animal to the first infected human in Wuhan, China, before spreading throughout the city, and then leaping quickly to the rest of the world. If 2020 seemed like an anomaly, it isn’t: Scientists say that another pandemic will follow at some point in the future. A particular study tries to identify where it might emerge.

“Essentially, this work is trying to identify the biggest gaps in the modern, globalized world where pathogens may be most likely to slip through and lead to extensive global dissemination,” says Michael Walsh, the lead author of the new study and an epidemiologist at the University of Sydney’s School of Public Health.

Three factors are key. In areas where the most wildlife habitat is disappearing, there’s more stress on wild animals, making disease spread more easily, and more contact between humans and animals. All of the worst infectious viruses to emerge in recent decades, including HIV, the first SARS, and Ebola, are “zoonotic,” meaning they spread from animals. (In some cases, viruses spread first to livestock, and then to humans.) Poor health systems are a second risk factor. The cities that are most at risk of being the next to launch a pandemic are also well connected globally through airports.

“Our goal was to identify those areas where the greatest amount of wildlife are sharing space with the greatest amount of people,” Walsh says. “In these spaces, humans are simultaneously putting a high degree of pressure on wildlife species and their environment and increasing their own [human] exposure to new pathogens because of the greater contact with wildlife. The result is an increase in the risk of these new pathogens ‘spilling over’ into human populations.”

 

(cont.)
A report from the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services warns that the emergence of COVID-19 was “entirely driven by human activities,” and that there are hundreds of thousands of other viruses in mammals and birds that could also potentially infect humans if action isn’t taken to protect nature and limit the possibility of them jumping species. Some could be far more deadly than SARS-CoV-2, the virus that causes COVID-19. Without action, pandemics in the future could begin to happen more often—already, new infectious diseases are emerging in humans approximately every eight months.

The 2020 study notes that areas in Africa and parts of Asia are most at risk, both because of contact between people and animals and because of the other factors: While it’s possible that a pandemic could emerge in a location with good health infrastructure, it’s more likely to happen in areas where healthcare is underfunded. “If a new spillover leads to onward human-to-human transmission, then this is more likely to go undetected in areas without good access to healthcare for all and without robust disease surveillance systems in place than in areas where these are present,” says Walsh. Cities like Mumbai, India, and Chengdu, China, are at the highest risk because they’re also major travel hubs, so once a virus emerges in humans, it could quickly spread to other parts of the globe if it’s not detected in time.

Governments can use the study to start to fill the gaps in the cities most at risk, by conserving habitat, improving health infrastructure, both for humans and vet care for livestock, and developing better disease surveillance systems that can systematically monitor pathogens (including, as a last defense, disease surveillance at airports). Societies also “need to think about ways to minimize contact, ways to ‘break the interface’ in other words, between humans and wildlife as much as possible, which means working with forest departments and other land management agencies to think about ways to reduce the sharing of space,” Walsh says.

Adele Peters focuses on solutions to some of the world's largest problems, from climate change to homelessness. Previously, she worked with GOOD, BioLite, and the Sustainable Products and Solutions program at UC Berkeley, and contributed to the second edition of the bestselling book "Worldchanging: A User's Guide for the 21st Century."
:- https://getpocket.com/explore/item/...-is-likely-to-emerge?utm_source=pocket-newtab

 

U.K. at "extreme high risk" for travel with recent explosion in Delta variant COVID infections

CBS This Morning
Jun 29, 2021

 

The New COVID Panic

What vaccinated people should really know about their risk from the delta variant.
By Susan Matthews
July 21, 20212:58 PM
Recently, one of my colleagues took a trip to Florida. He went to see family, in a long-awaited visit that he had previously only managed to make once during the pandemic, driving the whole way from New York while “peeing behind dumpsters.” Now that everyone was fully vaccinated, it seemed totally reasonable to fly there and to have everyone gather, unmasked, together. It was a relief and a joy. They even went to a hockey game indoors with thousands of people.


When my colleague got home, he started to feel like he had a cold. He didn’t think much of it—until he got a call from one of his family members in Florida who had tested positive for COVID-19. Eventually, all the adults who gathered on that trip got sick, including my colleague’s mother-in-law and father-in-law. My colleague’s wife also tested positive; he didn’t, but given his symptoms, including loss of smell, it seemed like a probable COVID case.
As I spoke to my colleague about it, he was still sifting through exactly what he was feeling. He’d forgotten how miserable being sick is, for one thing, and his case—a “mild one” by medical definitions—knocked him out for about a day and a half. He, his wife, and his father-in-law still had a lingering cough, and he was worried about long-term effects, particularly because his father-in-law is undergoing treatment for a serious health issue.
Mostly, he felt frustrated. He’s a journalist—he’s pretty tuned in to the news. He knew breakthrough cases were possible, but he had seen many assurances that they were extremely rare and not that big of a deal. “I feel like I had very inaccurate information,” he told me, “and I would have made my decisions in a very different light if I knew what I know now.” He would have worn a mask at the hockey game, for example—even though no one was wearing a mask at the hockey game, and the Centers for Disease Control and Prevention said it’s fine for vaccinated people not to wear masks inside.

He acknowledged it might be possible that he and his family just got really unlucky—and maybe a year from now, as long as everyone recovers fully, he’ll be able to look back on this and say “OK, well, the vaccines still did their job.” But right now, he feels worried—worried that breakthrough cases are more common than we think, that vaccinated people will get sicker than they think, that fears about the delta variant are not overblown, and that it might still get worse. Mostly, he’s worried that vaccinated people are not quite as in the clear as many of us seem to think we are.

 

(cont.)
He’s not alone. The day we spoke, the Dow had its worst day in months as the markets seemed to ingest that same fear, that we’re not as close to the “end” of the pandemic as it seemed. COVID cases are spiking in many parts of the U.S., especially in places like Missouri and Arkansas, which are lagging behind in vaccination rates and experiencing severe outbreaks fueled by the delta variant. Last week, Los Angeles mandated that people wear masks when indoors in public spaces again, regardless of their vaccination status. All of this is enough to be thoroughly freaking plenty of people out. Many of them are people like my co-workers, who also heard my colleague’s story—scary stories travel widely!—but know the gist of the vaccine science and now are wondering what to believe. The story sparked a slew of questions that essentially boiled down to the same ones we have all been trying to answer for ourselves since the start of this pandemic: How can I keep myself and my loved ones safe? How much do I have to give up to do so? And what am I supposed to do to keep everyone else as safe as possible, too?
The most important answer to these questions ought to be very familiar by now: The vaccines work. Most importantly, the vaccines are very effective at doing the main thing these vaccines are supposed to do: prevent severe illness and death. My colleague didn’t enter (and overburden) the health care system with his disease, which is still essentially the point. And in the midst of a lot of eye-popping numbers being tossed around—cases growing by 50 percent sounds scary, a low number of cases doubling less so—I think this chart is striking enough to be useful:

But I also don’t think that this chart means things are simple, or that my colleague’s fears are overblown. The bars on the right side of that second chart are not zero. Even with these very effective vaccines, there are still going to be infections—herd immunity is a long game, not a short one—and some of those infections are going to be severe. There are even going to be a very small percentage of vaccinated people who die—according to the CDC, as of July 12, 5,189 vaccinated people have been hospitalized with COVID-19, and 1,093 have died. (Even that somewhat scary number has caveats: 1,456 of those hospitalized were reported asymptomatic, or were hospitalized for something not related to COVID.) There is still plenty we don’t know, including precisely how much worse delta is, and how much worse whatever comes after delta will be. We do know that vaccinating as many people as possible is our best path toward minimizing the badness of whatever that is, and that in the U.S., we are doing better than many of us seem willing to accept.

Still, just because we can hold onto the knowledge that the vaccines are working (they are) doesn’t mean we shouldn’t strive to get a clearer understanding of breakthrough cases. What my colleague’s story underscores is that we need to reorient how we think about these cases, how likely they are, how problematic they are if they happen to you, and whether it all means we’re backsliding into another lockdown. The bad news is that reporting this article has changed how I’ve thought about the risk of breakthrough cases (I now suspect it’s higher than I had thought) and what it would be like to get one (worse than I had thought). The good news is that I don’t think that means we’re heading back toward lockdown, even though I think we are, once again, going to be tasked with having to think a little bit more about our personal risk calculus—especially if you want to avoid COVID entirely. But the most interesting thing I’ve learned is that if you are fully vaccinated, avoiding a “mild” case of COVID, even if it sucks, might not actually be as important as you think. Given that we have just spent a year and a half dramatically altering our lives to avoid COVID, reorienting in this way is understandably going to take a little bit of time. But it’s worth the effort.

 

(cont.)
The most important thing to realize is that breakthrough cases are going to continue to surface in our lives. “The goal was never to eradicate COVID from being annoying—it was to eradicate it from being a killer,” said Dara Kass, an emergency medicine physician in New York. (She emphasized, again, that the vaccines are very good at doing the latter.) And so even while you have likely heard that breakthrough cases are “rare,” that’s a subjective assessment that is probably worth adjusting upward. There hasn’t been a firm percentage available beyond these vague characterizations—and the CDC is only tracking breakthrough cases that result in hospitalization or death, a decision a Harvard doctor called “disappointing” on the medical school’s blog. But medical professionals are starting to think about this more and more, and the suspicion is that they will happen with increasing frequency—and we shouldn’t be surprised when we do.

 

(cont.)
“Breakthrough is the next frontier,” Bill Hanage, an epidemiologist at Harvard, wrote to me. Kass affirmed what many doctors have been reporting anecdotally—that the vast majority of patients ending up in hospitals with COVID are unvaccinated. But, she added, “more and more vaccinated people will keep getting positive COVID tests. We really don’t know how many officially or what that means.” We know breakthrough infections are not as serious or deadly in most cases, but we simply don’t know how common they currently are—or will be as delta continues to spread.
Another disconnect is what we think of as “severe illness” and what is actually severe illness. My colleague said he could not imagine describing the illness he had experienced as anything other than “severe”—he was unable to do anything for 36 hours and said it was on par with having debilitating food poisoning. But when I asked a couple doctors about this, they disagreed with his ranking. “Technically, it sounds like he had a mild bout of COVID-19, by strict case definitions,” emergency physician and sometime Slate contributor Jeremy Samuel Faust wrote to me. “Mild does not mean pleasant. In fact, you can have fever, chills, body aches, and feel downright terrible for a week or more and still be categorized as ‘mild.’ ”

To approach even a moderate (or severe) case of COVID, “there must be significant lung involvement as evidenced by low oxygen levels, for example,” Faust said. “It really can be miserable. But you’re at home, not in the ICU.”

Hanage told me that a vaccinated friend of his had just had a mild case that lasted four days. And that still means the vaccines are doing what scientists like him believed they would. “Vaccination effectively removes the threat of nationally overburdened healthcare—even though locally serious outbreaks remain not only possible but likely,” he said.
If the “mild” cases of COVID that can break through are more severe than the colds we used to accept as a normal consequence of traveling, that is worth being clear about. So, yes: Vaccines greatly reduce the severity of illness. But you can still get very sick, in layman’s terms. It can be much more than a sniffle. (Frankly, the fact that you can get that sick from mild COVID should be yet another reason to avoid getting what doctors call severe COVID.)

My colleague was also frustrated by the fact that everyone in his group got sick—he had believed that because they were all vaccinated, perhaps only one person would get ill if they came into contact with the virus. Hanage said that wasn’t quite true, either: “I’m not that surprised that breakthrough infections cluster, given the very pronounced clustering of transmission in general,” he said. Even if just one person picked it up at the hockey game, they continued to spend time together indoors afterward and experienced sustained exposure.

What was most upsetting to my colleague was the other people he might have put at risk while thinking he was doing the right thing—his father-in-law, who had higher risk due to his illness, and his nanny and his mother, both of whom are at higher-risk ages. The word he used the most to sum up his feelings was embarrassed. While no one should be blamed for getting sick during a pandemic, I could certainly relate—there’s still an element of all of this that feels deeply and darkly connected to our personal decisions, which is tinged with a sort of problematic morality. It’s almost worse in the post-vaccine landscape, when deciding to mask or not can also be read as a judgment on how much you believe in vaccines, or how much you are still making taking COVID precautions your personality. Anyone who has been in a scenario where you recently would have worn a mask but now suddenly no one is wearing a mask anymore can likely relate.

 

(cont.)
Kass had a useful way of framing this feeling. She thinks it’s yet another example in the pandemic of some people trying really hard to do everything right, while others aren’t even bothering to get vaccinated. As my colleague Shannon Palus put it in March, “The wrong people are heeding the calls for more caution.” Thinking back to my colleague’s hockey game, the CDC still recommends that anyone who is unvaccinated wear a mask whenever they are indoors in public. I am willing to bet that not everyone in that stadium was vaccinated.


All of this is making people—yes, probably mostly vaccinated people—rethink the basic questions they thought their vaccine had answered for them: Can I go to restaurants and bars unmasked? Can I go back to the office? Can I see my grandma? Can I go on vacation? Can I unmask at my people-facing job? Can I have a wedding, or a party? The answer to those questions is not quite as easy as “yes, if you’re vaccinated.” It depends partly on how many in your group are vaccinated, but the actual answer is basically the same as it’s been all pandemic: It depends on your risk tolerance, it depends on what is happening with case counts locally (though, as more people travel, this might become a less reliable tool), and it depends on any unique risk factors in your group. Kass’ perspective felt novel to me: She said she suspects that in the end, a lot of people are going to end up boosting their immunity by suffering through a mild case of COVID. So no one should feel that bad about getting sick after they’re vaxxed. What matters is getting the order right: “If everyone who gets vaccinated still gets COVID but doesn’t die, that’s a success,” she said. The issue is that it doesn’t feel like a success for vaccinated people. Plus, “if you get infected after you’re vaxxed, it’s all you talk about,” she said. And right now, that’s understandably freaking out a lot of vaccinated people who thought they were in the clear.

 

(cont.)
But vaccines—as much as we want them to and as much as we maybe were even promised they would—have not wiped out the risk of any illness at all, and therefore they have not wiped out the need for personal risk calculus. “A lot of people getting breakthrough disease won’t be fun, even if they don’t end up in hospital,” Hanage said. There are still good reasons to want to avoid COVID, even a milder, vaxxed version—if you are spending time with higher-risk people, like the immunocompromised who can’t get the same efficacy from vaccines; if you have unvaccinated kids you’re worried about (though kids are a slightly different situation). But you already know how to limit your chance of exposure—you’ve had plenty of practice at that. Pay attention to case counts (and vaccination rates) if you travel. Even though the CDC says you don’t have to, maybe still mask up in specific situations, like indoor situations where there might be lots of unvaccinated people. “I think in areas with high case counts (or some combination of cases and low vaccination rates), masking indoors in public makes a great deal of sense,” Faust said. “Even here in Boston, where the case counts are low, I would mask in indoor settings where everyone’s vaccination status is unknowable.”

You also don’t have to do this—as ever, living through this pandemic means taking the risks and precautions that are reasonable to you. (Obligatory caveat: Get vaccinated if you can.) The reason why everything feels so confusing right now is because we’re getting closer and closer to the point where COVID is something that we just have to live with—just as we live with a million other things that are risky but make us happy, like driving or eating meat from a questionable restaurant. Many people take different approaches to these things. That’s what we’ll eventually have to settle into with this risk, too. There will be guidance, and some of it will be evidence-based and some of it won’t, and maybe it will shift over time, and we will all have to decide how much to take it into account. Like we do with everything
:- https://slate.com/technology/2021/0...akthrough-cases.html?utm_source=pocket-newtab

 

How the Delta variant achieves its ultrafast spread
Viral load is roughly 1,000 times higher in people infected with the Delta variant than those infected with the original coronavirus strain, according to a study in China.
Sara Reardon
Since first appearing in India in late 2020, the Delta variant of SARS-CoV-2 has become the predominant strain in much of the world. Researchers might now know why Delta has been so successful: people infected with it produce far more virus than do those infected with the original version of SARS-CoV-2, making it very easy to spread.

According to current estimates, the Delta variant could be more than twice as transmissible as the original strain of SARS-CoV-2. To find out why, epidemiologist Jing Lu at the Guangdong Provincial Center for Disease Control and Prevention in Guangzhou, China, and his colleagues tracked 62 people who were quarantined after exposure to COVID-19 and who were some of the first people in mainland China to become infected with the Delta strain.

The team tested study participants’ ‘viral load’ — a measure of the density of viral particles in the body — every day throughout the course of infection to see how it changed over time. Researchers then compared participants’ infection patterns with those of 63 people who contracted the original SARS-CoV-2 strain in 2020.

In a preprint posted 12 July1, the researchers report that virus was first detectable in people with the Delta variant four days after exposure,compared with an average of six days among people with the original strain, suggesting that Delta replicates much faster. Individuals infected with Delta also had viral loads up to 1,260 times higher than those in people infected with the original strain.
The combination of a high number of viruses and a short incubation period makes sense as an explanation for Delta’s heightened transmissibility, says epidemiologist Benjamin Cowling at the University of Hong Kong. The sheer amount of virus in the respiratory tract means that superspreading events are likely to infect even more people, and that people might begin spreading the virus earlier after they become infected.

And the short incubation makes contact tracing more difficult in countries such as China, which systematically tracks each infected person’s contacts and require them to quarantine. “Putting it all together, Delta’s really difficult to stop,” Cowling says.

Genetics researcher Emma Hodcroft at the University of Bern in Switzerland agrees that the mechanism makes sense. She and Cowling both suspect that estimates of the exact difference in viral load between Delta and the original strain are likely to shift as more scientists study the virus in various populations.

A number of other questions about the Delta variant remain unanswered. It’s still unclear, for instance, whether it is more likely to cause severe disease than the original strain, and how good it is at evading the immune system. Hodcroft expects some of this information will emerge as researchers look more closely at broader and more diverse populations of people infected with Delta and other variants. “This virus has surprised us,” she says.
:- https://www.nature.com/articles/d41586-021-01986-w?utm_source=pocket_discover

 

Your Vaccinated Immune System Is Ready for Breakthroughs
Getting COVID-19 when you’re vaccinated isn’t the same as getting COVID-19 when you’re unvaccinated.

By Katherine J. Wu
July 26, 2021
A new dichotomy has begun dogging the pandemic discourse. With the rise of the über-transmissible Delta variant, experts are saying you’re either going to get vaccinated, or going to get the coronavirus.

For some people—a decent number of us, actually—it’s going to be both.

Coronavirus infections are happening among vaccinated people. They’re going to keep happening as long as the virus is with us, and we’re nowhere close to beating it. When a virus has so thoroughly infiltrated the human population, post-vaccination infections become an arithmetic inevitability. As much as we’d like to think otherwise, being vaccinated does not mean being done with SARS-CoV-2.
Post-vaccination infections, or breakthroughs, might occasionally turn symptomatic, but they aren’t shameful or aberrant. They also aren’t proof that the shots are failing. These cases are, on average, gentler and less symptomatic; faster-resolving, with less virus lingering—and, it appears, less likely to pass the pathogen on. The immunity offered by vaccines works in iterations and gradations, not absolutes. It does not make a person completely impervious to infection. It also does not evaporate when a few microbes breach a body’s barriers. A breakthrough, despite what it might seem, does not cause our defenses to crumble or even break; it does not erase the protection that’s already been built. Rather than setting up fragile and penetrable shields, vaccines reinforce the defenses we already have, so that we can encounter the virus safely and potentially build further upon that protection.

To understand the anatomy of a breakthrough case, it’s helpful to think of the human body as a castle. Deepta Bhattacharya, an immunologist at the University of Arizona, compares immunization to reinforcing such a stronghold against assault.

Without vaccination, the castle’s defenders have no idea an attack is coming. They might have stationed a few aggressive guard dogs outside, but these mutts aren’t terribly discerning: They’re the system’s innate defenders, fast-acting and brutal, but short-lived and woefully imprecise. They’ll sink their teeth into anything they don’t recognize, and are easily duped by stealthier invaders. If only quarrelsome canines stand between the virus and the castle’s treasures, that’s a pretty flimsy first line of defense. But it’s essentially the situation that many uninoculated people are in. Other fighters, who operate with more precision and punch—the body’s adaptive cells—will eventually be roused. Without prior warning, though, they’ll come out in full force only after a weeks-long delay, by which time the virus may have run roughshod over everything it can. At that point, the fight may, quite literally, be at a fever pitch, fueling worsening symptoms.
Vaccination completely rewrites the beginning, middle, and end of this story. COVID-19 shots act as confidential informants, who pass around intel on the pathogen within the castle walls. With that info, defensive cells can patrol the building’s borders, keeping an eye out for a now-familiar foe. When the virus attempts to force its way in, it will hit “backup layer after backup layer” of defense, Bhattacharya told me.

 

(cont.)
Prepped by a vaccine, immune reinforcements will be marshaled to the fore much faster—within days of an invasion, sometimes much less. Adaptive cells called B cells, which produce antibodies, and T cells, which kill virus-infected cells, will have had time to study the pathogen’s features, and sharpen their weapons against it. While the guard dogs are pouncing, archers trained to recognize the virus will be shooting it down; the few microbes that make their way deeper inside will be gutted by sword-wielding assassins lurking in the shadows. “Each stage it has to get past takes a bigger chunk out” of the virus, Bhattacharya said. Even if a couple particles eke past every hurdle, their ranks are fewer, weaker, and less damaging.

In the best-case scenario, the virus might even be instantly sniped at by immune cells and antibodies, still amped up from the vaccine’s recent visit, preventing any infection from being established at all. But expecting this of our shots every time isn’t reasonable (and, in fact, wasn’t the goal set for any COVID-19 vaccine). Some people’s immune cells might have slow reflexes and keep their weapons holstered for too long; that will be especially true among the elderly and immunocompromised—their fighters will still rally, just to a lesser extent.
Changes on the virus side could tip the scales as well. Like invaders in disguise, wily variants might evade detection by certain antibodies. Even readily recognizable versions of the coronavirus can overwhelm the immune system’s early cavalcade if they raid the premises in high-enough numbers—via, for instance, an intense and prolonged exposure event.

With so many factors at play, it’s not hard to see how a few viral particles might still hit their mark. But a body under siege isn’t going to throw its hands up in defeat. “People tend to think of this as yes or no—if I got vaccinated, I should not get any symptoms; I should be completely protected,” Laura Su, an immunologist at the University of Pennsylvania, told me. “But there’s way more nuance than that.” Even as the virus is raising a ruckus, immune cells and molecules will be attempting to hold their ground, regain their edge, and knock the pathogen back down. Those late-arriving efforts might not halt an infection entirely, but they will still curb the pathogen’s opportunities to move throughout the body, cause symptoms, and spread to someone else. The inhospitality of the vaccinated body to SARS-CoV-2 is what’s given many researchers hope that long COVID, too, will be rarer among the immunized, though that connection is still being explored.

 

(cont.)
Breakthroughs, especially symptomatic ones, are still uncommon, as a proportion of immunized people. But by sheer number, “the more people get vaccinated, the more you will see these breakthrough infections,” Juliet Morrison, a virologist at UC Riverside, told me. (Don’t forget that a small fraction of millions of people is still a lot of people—and in communities where a majority of people are vaccinated, most of the positive tests could be for shot recipients.) Reports of these cases shouldn’t be alarming, especially when we drill down on what’s happening qualitatively. A castle raid is worse if its inhabitants are slaughtered and all its jewels stolen; with vaccines in place, those cases are rare—many of them are getting replaced with lighter thefts, wherein the virus has time only to land a couple of punches before it’s booted out the door. Sure, vaccines would be “better” if they erected impenetrable force fields around every fortress. They don’t, though. Nothing does. And our shots shouldn’t be faulted for failing to live up to an impossible standard—one that obscures what they are able to accomplish. A breached stronghold is not necessarily a defeated stronghold; any castle that arms itself in advance will be in a better position than it was before.

 

(cont.)
There’s a potential silver lining to breakthroughs as well. By definition, these infections occur in immune systems that already recognize the virus and can learn from it again. Each subsequent encounter with SARS-CoV-2 might effectively remind the body that the pathogen’s threat still looms, coaxing cells into reinvigorating their defenses and sharpening their coronavirus-detecting skills, and prolonging the duration of protection. Some of that familiarity might ebb with certain variants. But in broad strokes, a post-inoculation infection can be “like a booster for the vaccine,” Su, of the University of Pennsylvania, told me. It’s not unlike keeping veteran fighters on retainer: After the dust has settled, the battle’s survivors will be on a sharper lookout for the next assault. That’s certainly no reason to seek out infection. But should such a mishap occur, there’s a good chance that “continuously training immune cells can be a really good thing,” Nicole Baumgarth, an immunologist at UC Davis, told me. (Vaccination, by the way, might mobilize stronger protection than natural infection, and it’s less dangerous to boot.)

We can’t control how SARS-CoV-2 evolves. But how disease manifests depends on both host and pathogen; vaccination hands a lot of the control over that narrative back to us. Understanding breakthroughs requires some intimacy with immunology, but also familiarity with the realities of a virus that will be with us long-term, one that we will probably all encounter at some point. The choice isn’t about getting vaccinated or getting infected. It’s about bolstering our defenses so that we are ready to fight an infection from the best position possible—with our defensive wits about us, and well-armored bodies in tow.
:- https://www.theatlantic.com/science/archive/2021/07/anatomy-of-a-vaccine-breakthrough/619562/

 

Authorities racing to contain deadly Nipah virus outbreak in India

Authorities racing to contain deadly Nipah virus outbreak in India
Arshad R. Zargar
Tue, September 7, 2021, 6:22 AM
New Delhi — Authorities in India's southern Kerala state are racing to contain an outbreak of the Nipah virus. The virus, which is not related to the coronavirus behind the current global pandemic and is far more deadly, killed a 12-year-old boy in Kerala over the weekend, prompting stepped-up efforts to trace his contacts. New infections have been confirmed.

The boy was admitted to a hospital a week ago with high fever. As his condition worsened and doctors suspected inflammation of his brain (encephalitis), his blood samples were sent to the National Institute of Virology, where tests confirmed a Nipah infection. He died early on Sunday.

Government authorities have stepped up contact tracing efforts, identifying, quarantining and testing people who may have come into contact with the young victim. According to the state's health minister, Veena George, 188 people who came into contact with the boy had been identified by Monday. Of them, 20 were considered high-risk primary contacts — primarily his family members, all of whom were being held under strict quarantine or hospitalized.

Two healthcare workers who came into contact with the victim were already showing symptoms of Nipah infection by Monday. They were admitted to a hospital and their blood samples sent for testing.

Climate change's role in the COVID pandemic

Authorities sealed off the area within about a two-mile radius of the boy's home, and they were screening people for symptoms in all adjoining districts of Kerala state. The neighboring state of Tamil Nadu was also on high alert for any suspect cases of fever.

This is the second time in three years that a Nipah virus outbreak has been reported in Kerala, which is also reeling under a high rate of COVID-19 infections. The state reports about 68% of India's approximately 40,000 new cases every day.

What is Nipah virus?

Like the coronavirus, Nipah is a zoonotic virus, or one that is transmitted from animals to humans. Transmission generally occurs when humans either come into direct contact with the animals, or through consumption of contaminated food. But a high number of human-to-human transmission cases of Nipah have also been reported.

Fruit bats of the family Pteropodidae — commonly known as the "flying fox" — are the natural carriers of Nipah. They are known to transmit the virus to other animals including pigs, dogs, cats, goats, horses and sheep.


Animal Husbandry department and Forest officials deposit a bat into a container after catching it inside a well at Changaroth in Kozhikode in the Indian state of Kerala on May 21, 2018. / Credit: Getty
An infected human typically shows symptoms including fever and headache for anywhere between three days and two weeks, followed by a cough, sore throat and respiratory issues. The condition later progresses swiftly to swelling in the brain cells, leading to drowsiness, confusion, and then possible coma and death.

There is no cure or vaccine for Nipah yet, and patients are only given supportive medical care.

According to the World Health Organization, up to 75% of Nipah infections prove fatal. The mortality rate for the coronavirus, by comparison, is believed to be about 2%. About 20% of survivors experience neurological symptoms that can persist, including seizures and personality changes.

A wider threat?

The Nipah virus was first discovered in Malaysia in 1999 during an outbreak among pig farmers. Since then, there have been multiple outbreaks — all of them in South and Southeast Asia. In all, it is known to have killed more than 260 people.

 

(cont.)
A 2004 Bangladesh outbreak was traced back to humans consuming date palm sap that had been contaminated by infected fruit bats. The last outbreak in India, which hit Kerala in 2018, killed 17 of the 18 people who caught it. Those infections were all traced back to fruit bats found dead in the water of a family's well. Nipah is considered less contagious than the coronavirus, but it's much higher mortality rate, a longer incubation period of up to 45 days, and its ability to infect a much wider variety of animals all make Nipah a cause of significant concern for epidemiologists trying to predict and prevent the next pandemic.

Veasna Duong, head of virology at the Institut Pasteur research lab in Phnom Penh, Cambodia, has studied human-bat interactions in the region, and he told the BBC earlier this year that the close proximity that people and bats find themselves in at markets and other crowded places across Asia poses a serious risk.

 

(cont.)
"This kind of exposure might allow the virus to mutate, which might cause a pandemic," Duong told the BBC's Future program, adding that in some circumstances, the virus could even find a host to carry it out of Asia.

"We observe [fruit bats] here and in Thailand, in markets, worship areas, schools and tourist locations like Angkor Wat – there's a big roost of bats there," he told the BBC's Future program. "In a normal year, Angkor Wat hosts 2.6 million visitors. That's 2.6 million opportunities for Nipah virus to jump from bats to humans annually in just one location."

Scientists warn that as the climate warms and humans destroy more natural habitat of species like the fruit bats in Asia, opportunities for new zoonotic variants to emerge increase.

The WHO says in its note on the Nipah virus that, "the risk of international transmission via fruits or fruit products (such as raw date palm juice) contaminated with urine or saliva from infected fruit bats can be prevented by washing them thoroughly and peeling them before consumption. Fruit with signs of bat bites should be discarded."

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:- https://www.yahoo.com/news/authorities-racing-contain-deadly-nipah-134800596.html

 

Merck pill seen as 'huge advance,' raises hope of preventing COVID-19 deaths
By Deena Beasley and Carl O'donnell
Oct 1 (Reuters) - An experimental antiviral pill developed by Merck & Co (MRK.N) could halve the chances of dying or being hospitalized for those most at risk of contracting severe COVID-19, according to data that experts hailed as a potential breakthrough in how the virus is treated.

If it gets authorization, molnupiravir, which is designed to introduce errors into the genetic code of the virus, would be the first oral antiviral medication for COVID-19.

Merck and partner Ridgeback Biotherapeutics said they plan to seek U.S. emergency use authorization for the pill as soon as possible and to make regulatory applications worldwide.

"An oral antiviral that can impact hospitalization risk to such a degree would be game-changing," said Amesh Adalja, senior scholar at the Johns Hopkins Center for Health Security.

Current treatment options include Gilead Sciences Inc's (GILD.O) infused antiviral remdesivir and generic steroid dexamethasone, both of which are generally only given once a patient has already been hospitalized.

"This is going to change the dialogue around how to manage COVID-19," Merck Chief Executive Robert Davis told Reuters.

Existing treatments are "cumbersome and logistically challenging to administer. A simple oral pill would be the opposite of that," Adalja added.

The results from the Phase III trial, which sent Merck shares up more than 9%, were so strong that the study is being stopped early at the recommendation of outside monitors.

Shares of Atea Pharmaceuticals Inc (AVIR.O), which is developing a similar COVID-19 treatment, were up more than 21% on the news.

Shares of COVID-19 vaccine makers Moderna Inc (MRNA.O) were off more than 10%, while Pfizer (PFE.N) was down less than 1%.

Jefferies analyst Michael Yee said investors believe "people will be less afraid of COVID and less inclined to get vaccines if there is a simple pill that can treat COVID."

Pfizer and Swiss drugmaker Roche Holding AG (ROG.S) are also racing to develop an easy-to-administer antiviral pill for COVID-19. For now, only antibody cocktails that have to be given intravenously are approved for non-hospitalized patients.

White House COVID-19 response coordinator Jeff Zients said on Friday that molnupiravir is "a potential additional tool... to protect people from the worst outcomes of COVID," but added that vaccination "remains far and away, our best tool against COVID-19."

A planned interim analysis of 775 patients in Merck's study looked at hospitalizations or deaths among people at risk for severe disease. It found that 7.3% of those given molnupiravir twice a day for five days were hospitalized and none had died by 29 days after treatment. That compared with a hospitalization rate of 14.1% for placebo patients. There were also eight deaths in the placebo group.

"Antiviral treatments that can be taken at home to keep people with COVID-19 out of the hospital are critically needed,” Wendy Holman, Ridgeback's CEO, said in a statement.

 

(cont.)
'A HUGE ADVANCE'
Scientists welcomed the potential new treatment to help prevent serious illness from the virus, which has killed almost 5 million people around the world, 700,000 of them in the United States.
“A safe, affordable, and effective oral antiviral would be a huge advance in the fight against COVID," said Peter Horby, a professor of emerging infectious diseases at the University of Oxford.
The study enrolled patients with laboratory-confirmed mild-to-moderate COVID-19, who had symptoms for no more than five days. All patients had at least one risk factor associated with poor disease outcome, such as obesity or older age.
Drugs in the same class as molnupiravir have been linked to birth defects in animal studies. Merck has said similar studies of molnupiravir – for longer and at higher doses than used in humans – indicate that the drug does not affect mammalian DNA.

Merck said viral sequencing done so far shows molnupiravir is effective against all variants of the coronavirus including the highly transmissible Delta, which has driven the recent worldwide surge in hospitalizations and deaths.

It said rates of adverse events were similar for both molnupiravir and placebo patients, but did not give details.

Merck has said data shows molnupiravir is not capable of inducing genetic changes in human cells, but men enrolled in its trials had to abstain from heterosexual intercourse or agree to use contraception. Women of child-bearing age in the study could be pregnant and also had to use birth control.

The U.S. drugmaker said it expects to produce 10 million courses of the treatment by the end of 2021.

The company has a U.S. government contract to supply 1.7 million courses of molnupiravir at a price of $700 per course.

Davis said Merck has similar agreements with other governments, and is in talks with more. Merck said it plans a tiered pricing approach based on country income criteria.

The U.S. government has the option to purchase up to an additional 3.5 million treatment courses if needed, a U.S. health official told Reuters. The official asked to remain anonymous because they were not authorized to comment publicly on the contract.

Merck has also agreed to license the drug to several India-based generic drugmakers, which would be able to supply the treatment to low- and middle-income countries.

Molnupiravir is also being studied in a Phase III trial for preventing infection in people exposed to the coronavirus.

Merck officials said it is unclear how long the FDA review will take, although Dean Li, head of Merck's research labs, said, "they are going to try to work with alacrity on this."

Reporting by Deena Beasley and Carl O'Donnell; Additional reporting by Josephine Mason, and Ahmed Aboulenein; Editing by Lincoln Feast, Kirsten Donovan, Alexander Smith, Bill Berkrot and Sonya Hepinstall
:- https://www.reuters.com/business/he...-study-2021-10-01/?utm_source=pocket_discover

 

‘Worst we’ve seen so far’: New COVID-19 variant Omicron is ‘highly transmissible’, Canada unveils new travel restrictions
Elisabetta Bianchini
Fri, November 26, 2021, 1:44 PM
The World Health Organization has classified the new COVID-19 variant found in South Africa, 'Omicron'. As concerns grow about the 'highly transmissible' variant, the Canadian government has introduced travel restrictions and a ban on foreign nationals coming into the country from seven African countries.

These five measures, which will be in place until Jan. 31, 2022, include:

• 
  
  
  • Banning the entry of foreign nationals into Canada who have travelled through seven Southern Africa countries in the last 14 days. These seven countries are South Africa, Mozambique, Botswana, Zimbabwe, Lesotho, Eswatini and Namibia.
  • For all individuals who have arrived from the above countries in Canada in the last 14 days, they must now quarantine and to go for a COVID-19 test. These individuals need to stay in isolation until they get a negative result.
  • Canadians and permanent residents who have travelled to any of the Southern African countries within the last 14 days must have proof of a negative COVID-19 molecular test, taken within 72 hours of their scheduled departure to Canada. They will be tested on arrival and must stay at an approved quarantine hotel until they get a negative result. They can then continue their quarantine at home until their Day 10 test result comes through.
  • As there are no direct flights from Southern Africa to Canada, Canadians returning from that region through an indirect route will need to obtain a negative COVID-19 pre-departure test, from a third country, before continuing their journey to Canada.
  • Global Affairs Canada will issue a travel advisory asking all Canadians to not travel to Southern Africa for the time being.

Is Canada doing enough?
Minister of Health, Jean-Yves Duclos, called this a "belt and suspenders" approach.

"In terms of the risks for Canadians at this point, Dr. Theresa Tam, Canada’s chief public health officer, stressed that we know "very little" about this variant, including how transmissible it is, whether it increases severity of illness and its impact on vaccines. But she did say that people should not be surprised if this variant is detected in Canada.
"We still don't know if it’s more transmissible," Dr. Tam said. "There’s certainly signals in South Africa itself that in one region, one of the localized areas, that there’s been an acceleration in the number of cases."

"We still don't know whether that’s because they have more relaxed public health measures or whether this virus has gained a biological advantage over what’s already present in Southern Africa."

As we head into the holiday season, Canada's chief public health officer stressed that Canadians should "exercise a degree of caution" over the Christmas and New Year period.

"I know people are very anxious to get back to their social settings but I think that keeping on the layer of protection, masking, ventilation and distancing, and gathering with people that you know, and you know their vaccination status, and keeping as many layers of protection is really important, for now," Dr. Tam said.
It may seem like an overreaction from some perspective, but it’s really to be following an abundance of caution principal. We really want to make sure that we do all we can and need to do to protect the health and safety of Canadians."Jean-Yves Duclos, Minister of Health
In terms of the risks for Canadians at this point, Dr. Theresa Tam, Canada’s chief public health officer, stressed that we know "very little" about this variant, including how transmissible it is, whether it increases severity of illness and its impact on vaccines. But she did say that people should not be surprised if this variant is detected in Canada.
"We still don't know if it’s more transmissible," Dr. Tam said. "There’s certainly signals in South Africa itself that in one region, one of the localized areas, that there’s been an acceleration in the number of cases."
Canadian premiers called on the Prime Minister Justin Trudeau to halt flights to countries in Africa where this variant has been recorded.
"I was briefed by Dr. Kieran Moore, Ontario's Chief Medical Officer of Health, about the new variant that's been found in several countries in Africa that early reports suggest could be vaccine resistant," a statement from Ontario Premier Doug Ford reds.

We cannot repeat the same mistakes that allowed the Alpha and Delta variants to enter our country. Our best defense right now is stopping the variant at the border. Until we are certain that the vaccines are effective against this new variant, I am calling on the Government of Canada to follow other governments by immediately banning all flights and passengers from countries of concern.Ontario Premier Doug Ford

Ford's statement also calls for an additional requirement that anyone arriving before this flight ban can be implemented be tested and quarantined, in addition to reintroducing testing on arrival for all travellers coming to Canada, regardless of the country they are travelling from.

"We still don't know whether that’s because they have more relaxed public health measures or whether this virus has gained a biological advantage over what’s already present in Southern Africa."

As we head into the holiday season, Canada's chief public health officer stressed that Canadians should "exercise a degree of caution" over the Christmas and New Year period.

"I know people are very anxious to get back to their social settings but I think that keeping on the layer of protection, masking, ventilation and distancing, and gathering with people that you know, and you know their vaccination status, and keeping as many layers of protection is really important, for now," Dr. Tam said.
เปิดดูไฟล์ 5818968
‘Worst we’ve seen so far’: New COVID-19 variant Omicron is ‘highly transmissible’, Canada unveils new travel restrictions
Elisabetta Bianchini
Fri, November 26, 2021, 1:44 PM·5 min read
The World Health Organization has classified the new COVID-19 variant found in South Africa, 'Omicron'. As concerns grow about the 'highly transmissible' variant, the Canadian government has introduced travel restrictions and a ban on foreign nationals coming into the country from seven African countries.

These five measures, which will be in place until Jan. 31, 2022, include:

• 
  
  
  • Banning the entry of foreign nationals into Canada who have travelled through seven Southern Africa countries in the last 14 days. These seven countries are South Africa, Mozambique, Botswana, Zimbabwe, Lesotho, Eswatini and Namibia.
  • For all individuals who have arrived from the above countries in Canada in the last 14 days, they must now quarantine and to go for a COVID-19 test. These individuals need to stay in isolation until they get a negative result.
  • Canadians and permanent residents who have travelled to any of the Southern African countries within the last 14 days must have proof of a negative COVID-19 molecular test, taken within 72 hours of their scheduled departure to Canada. They will be tested on arrival and must stay at an approved quarantine hotel until they get a negative result. They can then continue their quarantine at home until their Day 10 test result comes through.
  • As there are no direct flights from Southern Africa to Canada, Canadians returning from that region through an indirect route will need to obtain a negative COVID-19 pre-departure test, from a third country, before continuing their journey to Canada.
  • Global Affairs Canada will issue a travel advisory asking all Canadians to not travel to Southern Africa for the time being.

Is Canada doing enough?
Minister of Health, Jean-Yves Duclos, called this a "belt and suspenders" approach.

It may seem like an overreaction from some perspective, but it’s really to be following an abundance of caution principal. We really want to make sure that we do all we can and need to do to protect the health and safety of Canadians."Jean-Yves Duclos, Minister of Health

In terms of the risks for Canadians at this point, Dr. Theresa Tam, Canada’s chief public health officer, stressed that we know "very little" about this variant, including how transmissible it is, whether it increases severity of illness and its impact on vaccines. But she did say that people should not be surprised if this variant is detected in Canada.

"We still don't know if it’s more transmissible," Dr. Tam said. "There’s certainly signals in South Africa itself that in one region, one of the localized areas, that there’s been an acceleration in the number of cases."

"We still don't know whether that’s because they have more relaxed public health measures or whether this virus has gained a biological advantage over what’s already present in Southern Africa."

As we head into the holiday season, Canada's chief public health officer stressed that Canadians should "exercise a degree of caution" over the Christmas and New Year period.

"I know people are very anxious to get back to their social settings but I think that keeping on the layer of protection, masking, ventilation and distancing, and gathering with people that you know, and you know their vaccination status, and keeping as many layers of protection is really important, for now," Dr. Tam said.


Calls from provincial leaders
Canadian premiers called on the Prime Minister Justin Trudeau to halt flights to countries in Africa where this variant has been recorded.

"I was briefed by Dr. Kieran Moore, Ontario's Chief Medical Officer of Health, about the new variant that's been found in several countries in Africa that early reports suggest could be vaccine resistant," a statement from Ontario Premier Doug Ford reds.

We cannot repeat the same mistakes that allowed the Alpha and Delta variants to enter our country. Our best defense right now is stopping the variant at the border. Until we are certain that the vaccines are effective against this new variant, I am calling on the Government of Canada to follow other governments by immediately banning all flights and passengers from countries of concern.Ontario Premier Doug Ford

Ford's statement also calls for an additional requirement that anyone arriving before this flight ban can be implemented be tested and quarantined, in addition to reintroducing testing on arrival for all travellers coming to Canada, regardless of the country they are travelling from.

Alberta Premier Jason Kenney echoed the Ontario premier, also calling for a flight ban from countries where this variant has been detected.

"I call on the federal government to follow Britain’s lead by banning travel from countries where this dangerous new COVID19 variant is circulating," a tweet from Kenney reads. "Canada must not repeat the mistake of its open-borders policy at the beginning of the global pandemic."

This comes after the U.K. suspended flights from six African countries (South Africa, Namibia, Lesotho, Botswana, Eswatini and Zimbabwe), after this "super variant" was called "worst we've seen so far" by authorities.
;- https://news.yahoo.com/new-covid-19...ravel-rules-172453034.html?fr=yhssrp_catchall