H5N1

‘I hope you die’: How the COVID pandemic unleashed attacks on scientists

Via Nature News & Comment: ‘I hope you die’: how the COVID pandemic unleashed attacks on scientists. Excerpt:

Infectious-diseases physician Krutika Kuppalli had been in her new job for barely a week in September 2020, when someone phoned her at home and threatened to kill her.  

Kuppalli, who had just moved from California to the Medical University of South Carolina in Charleston, had been dealing with online abuse for months after she’d given high-profile media interviews on COVID-19, and had recently testified to a US congressional committee on how to hold safe elections during the pandemic. But the phone call was a scary escalation. “It made me very anxious, nervous and upset,” says Kuppalli, who now works at the World Health Organization (WHO) in Geneva, Switzerland.  

She called the police, but didn’t hear that they took any action. The threatening e-mails, calls and online comments continued. The police officer who visited Kuppalli after a second death-threat call suggested she should get herself a gun.  

Kuppalli’s experience during the pandemic is not uncommon. A survey by Nature of more than 300 scientists who have given media interviews about COVID-19 — many of whom had also commented about the pandemic on social media — has found wide experience of harassment or abuse; 15% said they had received death threats.

Some high-profile examples of harassment have been well documented. Anthony Fauci, head of the US National Institute of Allergy and Infectious Diseases, was assigned personal security guards after he and his family received death threats; UK chief medical adviser Chris Whitty was grabbed and shoved in the street; and German virologist Christian Drosten received a parcel with a vial of liquid labelled ‘positive’ and a note telling him to drink it. In one extraordinary case, Belgian virologist Marc Van Ranst and his family were placed in a safe house when a military sniper went on the run after leaving a note outlining his intentions to target virologists.  

These examples are extreme. But in Nature’s survey, more than two-thirds of researchers reported negative experiences as a result of their media appearances or their social media comments, and 22% had received threats of physical or sexual violence. Some scientists said that their employer had received complaints about them, or that their home address had been revealed online. Six scientists said they were physically attacked.  

Coordinated social-media campaigns and threatening e-mails or phone calls to scientists are not new: topics such as climate change, vaccination and the effects of gun violence have drawn similar attacks in the past. But even scientists who had a high profile before COVID-19 told Nature that the abuse was a new and unwelcome phenomenon tied to the pandemic. Many wanted the extent of the problem discussed more openly.  

“I believe national governments, funding agencies and scientific societies have not done enough to publicly defend scientists,” one researcher wrote in their survey response.  

Some researchers say that they have learnt to cope with the harassment, accepting it as an unpleasant but expected side effect of getting information to the public. And 85% of survey respondents said that their experiences of engaging with the media were always or mostly positive, even if they were harassed afterwards.  

“I think scientists need training for how to engage with the media and also about what to expect from trolls — it’s just a part of digital communication,” one wrote. Source: Nature analysis But Nature’s survey suggests that even though researchers try to shrug off abuse, it might already have had a chilling effect on scientific communication. Those scientists who reported higher frequencies of trolling or personal attacks were also most likely to say that their experiences had greatly affected their willingness to speak to the media in the future.  

That is concerning during a global pandemic which has been accompanied by a battery of disinformation and misinformation, says Fiona Fox, chief executive of the UK Science Media Centre (SMC) in London — an organization that collates scientific comment and organizes press briefings for journalists. “It’s a great loss if a scientist who was engaging with the media, sharing their expertise, is taken out of a public debate at a time when we’ve never needed them so badly,” she says.  

Tracking harassment  

In June, the Australian SMC in Adelaide asked researchers on its COVID-19 media lists about their experiences. The centre had been alerted to online bullying and hate campaigns directed at scientists, and wanted to know whether it was a broader problem, says Lyndal Byford, the centre’s director of news and partnerships.  

Byford shared the results with Nature. Fifty researchers answered the SMC’s informal survey. Nearly one-third reported experiencing emotional or psychological distress after talking about COVID-19; 6 people (12%) reported receiving death threats, and 6 said they had received threats of physical or sexual violence. “I think any organization involved in helping scientists communicate would find that quite disturbing,” Byford says.  

To get a broader sense of the scale of harassment, Nature adapted the Australian SMC’s survey, and asked science media centres in the United Kingdom, Canada, Taiwan, New Zealand and Germany to send it to scientists on their COVID-19 media lists. Nature also e-mailed researchers in the United States and Brazil who had been prominently quoted in the media.

The results are not a random sample of researchers who have given media interviews on COVID-19, because they represent only the experiences of the 321 scientists who chose to respond (predominantly in the United Kingdom, Germany and the United States). But the numbers reveal that researchers in many countries are facing abuse related to the pandemic, and the proportions reported were higher than in the Australian survey. More than one-quarter of respondents to the Nature survey said they always or usually received comments from trolls or were personally attacked after speaking in the media about COVID-19. And more than 40% reported experiencing emotional or psychological distress after making media or social media comments.

Politicized science
To some extent, this harassment of scientists reflects their rising status as public figures. “The more prominent you are, the more abuse you’re going to get,” says historian Heidi Tworek at the University of British Columbia in Vancouver, Canada, who is studying online abuse of health communicators in the pandemic. Most US public-health departments have also received harassment directed at staff and officials, adds Beth Resnick, a public-health researcher at Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland, who has surveyed 580 departments in a study that is not yet published.

And such attacks might have little to do with the science itself and more to do with who’s talking. “If you’re a woman, or a person of colour from a marginalized group, that abuse will probably include abuse of your personal characteristics,” says Tworek. For instance, Canada’s chief public-health officer Theresa Tam is Asian Canadian, and abuse levelled against her included a layer of racism, Tworek says. Kuppalli, a female scientist of colour, says she also experienced this. Abusers told her she “needs to go back where she came from”.

Effectiveness of mRNA BNT162b2 COVID-19 vaccine up to 6 months in a large integrated health system in the USA: A retrospective cohort study

Via The Lancet: Effectiveness of mRNA BNT162b2 COVID-19 vaccine up to 6 months in a large integrated health system in the USA: a retrospective cohort study. The summary:

Background  

Vaccine effectiveness studies have not differentiated the effect of the delta (B.1.617.2) variant and potential waning immunity in observed reductions in effectiveness against SARS-CoV-2 infections. We aimed to evaluate overall and variant-specific effectiveness of BNT162b2 (tozinameran, Pfizer–BioNTech) against SARS-CoV-2 infections and COVID-19-related hospital admissions by time since vaccination among members of a large US health-care system.  

Methods  

In this retrospective cohort study, we analysed electronic health records of individuals (≥12 years) who were members of the health-care organisation Kaiser Permanente Southern California (CA, USA), to assess BNT162b2 vaccine effectiveness against SARS-CoV-2 infections and COVID-19-related hospital admissions for up to 6 months. Participants were required to have 1 year or more previous membership of the organisation.   Outcomes comprised SARS-CoV-2 PCR-positive tests and COVID-19-related hospital admissions. Effectiveness calculations were based on hazard ratios from adjusted Cox models. This study was registered with ClinicalTrials.gov, NCT04848584.  

Findings  

Between Dec 14, 2020, and Aug 8, 2021, of 4 920 549 individuals assessed for eligibility, we included 3 436 957 (median age 45 years [IQR 29–61]; 1 799 395 [52·4%] female and 1 637 394 [47·6%] male). For fully vaccinated individuals, effectiveness against SARS-CoV-2 infections was 73% (95% CI 72–74) and against COVID-19-related hospital admissions was 90% (89–92). Effectiveness against infections declined from 88% (95% CI 86–89) during the first month after full vaccination to 47% (43–51) after 5 months. Among sequenced infections, vaccine effectiveness against infections of the delta variant was high during the first month after full vaccination (93% [95% CI 85–97]) but declined to 53% [39–65] after 4 months. Effectiveness against other (non-delta) variants the first month after full vaccination was also high at 97% (95% CI 95–99), but waned to 67% (45–80) at 4–5 months. Vaccine effectiveness against hospital admissions for infections with the delta variant for all ages was high overall (93% [95% CI 84–96]) up to 6 months. 

Interpretation  

Our results provide support for high effectiveness of BNT162b2 against hospital admissions up until around 6 months after being fully vaccinated, even in the face of widespread dissemination of the delta variant. Reduction in vaccine effectiveness against SARS-CoV-2 infections over time is probably primarily due to waning immunity with time rather than the delta variant escaping vaccine protection.

Hospitalisation among vaccine breakthrough COVID-19 infections

Via The Lancet Infectious Diseases: Hospitalisation among vaccine breakthrough COVID-19 infections.

Emergency use authorisations granted by the US Food and Drug Administration for three SARS-CoV-2 vaccines represent an important milestone in the response to the COVID-19 pandemic. Data presented from the VIVALDI study by Shrotri and colleagues and other phase 3 clinical trials have shown robust vaccine efficacies (>85%) at preventing severe symptomatic disease. Although rare, emerging reports describe breakthrough SARS-CoV-2 infections in fully vaccinated individuals. 

We describe the impact of vaccination on admission to hospital in patients with confirmed SARS-CoV-2 infection using real-world data collected by the Yale New Haven Health System. We did a systematic review of patients admitted to hospital with SARS-CoV-2 (confirmed by a positive PCR test at the time of admission) between March 23 and July 1, 2021. SARS-CoV-2 vaccination status was recorded, including the specific vaccine type (mRNA-1273 [elasomeran; Moderna], BNT162b2 [tozinameran; Pfizer–BioNTech], or Ad.26.COV2.S [Janssen]) and vaccination dates. Patients were considered fully vaccinated if the final dose (either second dose of BNT162b2 or mRNA-1273, or first dose of Ad.26.COV2.S) was administered at least 14 days before symptom onset or a positive PCR test for SARS-CoV-2. 

In total, we identified 969 patients who were admitted to a Yale New Haven Health System hospital with a confirmed positive PCR test for SARS-CoV-2. Severity of COVID-19 infection was determined on the basis of established guidelines. 

172 (18%) of 969 patients had received at least one dose of a COVID-19 vaccine at the time of admission to hospital. Among these patients, 103 had received a partial vaccine course (one dose of BNT162b2 or mRNA-1273), 15 had received a complete course (two doses of BNT162b2 or mRNA-1273 or one dose of Ad.26.COV2.S within 14 days before symptom onset or a positive PCR test), and 54 were fully vaccinated (appendix pp 1–2). 

Patients deemed to have a breakthrough SARS-CoV-2 infection—ie, the 54 patients who were fully vaccinated—were evaluated for illness severity. Among this cohort, we found that 25 (46%) patients were asymptomatic (admitted to hospital for a non-COVID-19-related diagnosis but with an incidental positive PCR test for SARS-CoV-2), four (7%) had mild disease, 11 (20%) had moderate disease, and 14 (26%) had severe or critical illness. Among those with severe or critical illness, the median age was 80·5 years (IQR 76·5–85·0); four of 14 patients required intensive care, one required mechanical ventilation, and three died. 

Pre-existing comorbidities in the 14 patients with severe or critical illness included overweight (body–mass index >25 kg/m2; n=9), cardiovascular disease (n=12), lung disease (n=7), malignancy (n=4), type 2 diabetes (n=7), and use of an immunosuppressive agent (n=4; appendix pp 3). 13 of 14 patients had received BNT162b2 (appendix p 1–2). 

Vaccination for SARS-CoV-2 is highly effective against infection with SARS-CoV-2 or hospitalisation with COVID-19. In our real-world assessment of patients admitted to hospital with a positive SARS-CoV-2 PCR test, we found that nearly a fifth of patients had received at least one dose of the vaccine, and we observed that many patients had not completed the full vaccine course. 

The finding that more than a quarter of fully vaccinated patients admitted to hospital with SARS-CoV-2 were severely or critically ill with COVID-19 could be reflective of numerous factors, including the emergence of SARS-CoV-2 variants that might confer decreased vaccine effectiveness and an ineffective immune response mounted against vaccines among those with comorbidities—eg, older age, overweight, and use of immunosuppressive agents. 

Although the incidence of severe or critical COVID-19 illness remains low in those who are fully vaccinated, we observed a higher number of patients with severe or critical illness in those who received the BNT162b2 vaccine than in those who received mRNA-1273 or Ad.26.COV2.S (total number of vaccine doses distributed in Connecticut [USA] until May 17, 2021, was 1 358 175 for BNT162b2, 1 044 420 for mRNA-1273, and 267 000 for Ad.26.COV2.S). This finding would benefit from further investigation. 

Overall, although vaccines have undoubtedly conferred widespread protection against SARS-CoV-2 infection worldwide, future studies are needed to identify and mitigate factors that are associated with inadequate vaccine response in those with breakthrough infections.

WHO monitoring new coronavirus variant named Mu

Via The Guardian: WHO monitoring new coronavirus variant named Mu.

The World Health Organization has added another version of coronavirus to its list of “variants of interest” amid concerns that it may partially evade the immunity people have developed from past infection or vaccination. 

The Mu variant, also known as B.1.621, was added to the WHO’s watchlist on 30 August after it was detected in 39 countries and found to possess a cluster of mutations that may make it less susceptible to the immune protection many have acquired. 

According to the WHO’s weekly bulletin on the pandemic, the Mu variant “has a constellation of mutations that indicate potential properties of immune escape”. Preliminary data suggests it may evade immune defences in a similar way to the Beta variant first discovered in South Africa, the report adds, but this needs to be confirmed by further work.

 The Mu variant was first identified in Colombia in January 2021. Since then, sporadic cases and some larger outbreaks have been recorded around the world. Beyond South America, cases have been reported in the UK, Europe, the US and Hong Kong. While the variant makes up less than 0.1% of Covid infections globally, it may be gaining ground in Colombia and Ecuador where it accounts for 39% and 13% of Covid cases respectively. 

 Scientists and public health officials are particularly eager to know whether the Mu variant is more transmissible, or causes more serious disease, than the Delta variant that is dominant in much of the world. “The epidemiology of the Mu variant in South America, particularly with the co-circulation of the Delta variant, will be monitored for changes,” the WHO bulletin states. 

At least 32 cases of the Mu variant have been detected in the UK, where the pattern of infections suggests it was brought in by travellers on multiple occasions. A report by Public Health England (PHE) in July said most were found in London and in people in their 20s. Some of those testing positive for Mu had received one or two doses of Covid vaccine. 

The Mu variant was added to PHE’s list of variants under investigation in July. The designation, which refers to Mu as VUI-21JUL-01, means the variant will be monitored to see how it behaves. So far it has not raised alarm as much as Alpha and Delta, which are classified as more serious variants of concern, largely because of their increased transmissibility but also concerns about evading immune defences. 

A risk assessment of the Mu variant released by PHE in August highlighted laboratory work that suggests the variant is at least as resistant as the Beta variant to immunity arising from vaccination. But more evidence is needed from other laboratory studies and real-world cases of the variant. How much of a threat the variant poses is highly uncertain and depends on whether cases grow substantially in the weeks and months ahead, particularly in the presence of the fast-spreading Delta variant. 

“At present, there is no evidence that VUI-21JUL-01 is outcompeting the Delta variant and it appears unlikely that it is more transmissible,” the report states, though it goes on to warn: “Immune escape may contribute to future changes in growth.” 

Part of the concern about Mu comes from the particular mutations it carries. One genetic change, the P681H mutation, is found in the Alpha variant first detected in Kent and has been linked to faster transmission. Other mutations, including E484K and K417N, may help the virus evade immunity defences, which could give the variant an advantage over Delta as immunity rises into the autumn.

COVID-19 in Canada: Experience and response to waves 2 and 3

Via JAMA Network, Dr, Allan S. Detsky and Dr.Isaac I. Bogoch offer a concise summary of our situation: COVID-19 in Canada: Experience and Response to Waves 2 and 3.

The first wave of COVID-19 infections in Canada began in January 2020 and wound down about 5 months later. This Viewpoint describes the Canadian experience and response to the larger second and third waves of COVID-19 infections during the period September 2020 through August 2021. 

Provincial and Territorial Responses 

Canada’s 10 provincial and 3 territorial governments have jurisdiction over most health care issues. The provincial chief medical officers of health issued directives on mask mandates, testing, and contact tracing. The premier of each province (the equivalent of a US state governor) had the power to issue broad directives on all issues, including business closures and stay-at-home orders for the entire population. Provincial governments were responsible for managing testing capacity, school policies, practices in long-term care (LTC) facilities, and acute care activity (eg, pausing scheduled surgeries). 

The third wave of COVID-19 infections overwhelmed the capacity of acute care hospitals, particularly intensive care units (ICUs) in Ontario, Alberta, and Manitoba. Although Canada did not experience the high rates of infection that occurred in the United Kingdom and United States during the first wave, by the third wave the per capita rates of infection in Alberta and Manitoba reached the highest level of any state or province in North America, and the rates in Ontario and Saskatchewan were not far behind. In Ontario and Manitoba, some patients who required ICU care were transferred from hospitals where they sought care to other distant locations. 

Lack of ICU capacity in each jurisdiction was a major variable that led governments to enact drastic policies like stay-at-home orders and school closures. For example, in April when patients with COVID-19 occupied nearly 600 of Ontario’s approximately 2000 ICU beds (1300 with ventilator capacity), it triggered stay-at-home orders and shut down the economy. By May, 920 of Ontario’s ICU beds were occupied by patients with COVID-19. Several provinces closed in-person learning. Compared with the first wave during which public adherence was high, stay-at-home orders were more contentious. Mobility and personal contact were not nearly as reduced by government mandates in the second and third waves.4 Mask mandates were introduced in July 2020 and most of the public was willing to wear masks indoors thereafter. 

The third wave was driven by the more transmissible Alpha (B.1.1.7) variant. Improvement in infection control practices in LTC facilities after the first wave varied across the country, with Quebec showing significant improvement, and Ontario almost none. Deaths in LTC facilities and retirement homes declined substantially following the first rollout of vaccines, which began in December 2020 and prioritized residents and staff in LTC settings. The vast majority of residents of LTC facilities were vaccinated by the middle of February 2021. As such, the third wave had little effect on LTC facilities’ residents, who had accounted for most COVID deaths in the prior 2 waves.6 The Atlantic provinces fared very well during this period by restricting travel from outside the region and swiftly responding to new cases with community-based rapid testing to limit outbreaks. 

Federal Government Response 

The federal government was responsible for 3 main issues: border control, vaccine procurement, and approval of drugs and vaccines. On February 22, 2021, the government instituted a controversial policy of requiring all international travelers to Canada who arrived by air to be quarantined for 3 days in hotels chosen by the government, to receive COVID-19 tests before and after arriving in Canada, and to complete their 14-day quarantine at home. The implementation of this policy was clumsy, with many people spending considerable time booking rooms, high costs, lack of food, and cases of COVID-19 transmission in the quarantine hotels. Some people simply refused to comply, accepting the fine instead. A loophole was created by allowing people to fly to border airports in the United States (eg, Buffalo and Seattle) and enter Canada by land. 

Vaccines 

Health Canada approved the first vaccine (Pfizer-BioNTech) on December 9, 2020, and vaccinations were administered to health care workers that same month. Initially, provinces adhered to the dosing interval of 21 and 28 days established by Pfizer and Moderna but when it became clear that adequate vaccine supply would not be forthcoming during the second wave (due to several events, such as when the United States did not export any vaccines, and Pfizer refurbished its plant in Belgium delaying scheduled deliveries), the National Advisory Committee on Immunization (NACI) recommended a dosing interval of up to 16 weeks. All provinces switched to that interval although some groups (eg, Indigenous peoples of Canada, some patients with cancer, patients with organ transplants, and people receiving dialysis) were given second vaccine doses at 21 and 28 days in some regions. 

After a relatively slow start, Canada has achieved higher rates of both first and second vaccine doses than most countries. For instance, by August 5, 72% of the total Canadian population had received at least 1 dose of a COVID-19 vaccine and 61% were fully vaccinated, compared with 69% and 58% in the United Kingdom, 65% and 54% in Italy, 65% and 49% in France, 58% and 50% in the United States, and 46% and 33% in Japan, respectively.

AstraZeneca Vaccine

Canada approved the AstraZeneca vaccine for emergency use on February 26, 2021. NACI initially recommended using the vaccine only for people younger than 65 years (because of few older participants in vaccine randomized trials), then recommended this vaccine for everyone older than 18 years, and subsequently recommended the vaccine only for people older than 40 years because of concerns about vaccine-induced immune thrombotic thrombocytopenia (VITT). Federal and provincial leaders assured the public that the vaccine was safe and actively promoted a slogan: “Take the first shot you are offered.” However, when the rate of VITT was estimated to be roughly 1 in 60 000 people and Canada had reached a total of 13 cases (in April 2021), provincial governments altered their approaches. Even though no cases of VITT had been found after administration of mRNA vaccines to date, Canada was in the middle of its worst wave and the supply of mRNA vaccines was insufficient to meet demand. As a result, provincial governments continued to recommend the AstraZeneca vaccine, until NACI recommended that mixing vaccines was acceptable on May 30, 2021. By June 2021, most of Canada had abandoned using the AstraZeneca vaccine and eventually donated 17 million doses to the COVAX program.

The Future

By the end of July, the total new cases per day had declined to about 600 in all of Canada, but began to rebound in early August as the Delta variant became predominant and public health measures were lifting. As of August 14, Canada’s 7-day average of daily new cases was 1608 and rising. Provinces took different paces for lifting restrictions, mostly based on metrics such as health care system capacity, vaccine uptake, and community COVID-19 burden (eg, cases, hospitalizations, and deaths). For example, Alberta and Saskatchewan lifted virtually all public health COVID-19 prevention measures in July 2021, and in August, Canada allowed fully vaccinated Canadians and US residents to enter the country without quarantine.

Canada remains vulnerable in several areas. Children younger than 12 years are not yet eligible for vaccination and could be a potential source of outbreaks in the fall, and governments have done little to expand relatively limited ICU capacity so far. The next year will see Canada addressing new challenges that will require some difficult government decisions and individual choices, including implementing vaccine mandates, vaccine “passports,” and the upcoming campaign to vaccinate children. Canada’s significant access to and uptake of vaccines will most likely help lessen the effects of a fourth or subsequent waves of COVID-19, but disparate interprovincial public health policies and limited critical care capacity continue to pose challenges.

New Zealand Covid update: 82 new cases as outbreak worsens despite nationwide lockdown

Via The Guardian: New Zealand Covid update: 82 new cases as outbreak worsens despite nationwide lockdown.

New Zealand’s Covid-19 outbreak has worsened, with 82 new cases taking the total infected to 415. 

All of Saturday’s cases were in Auckland, with the Pacific community again over-represented with 62 cases. 

New Zealand has reached day 11 of a harsh lockdown designed to curb the spread of the virus. The vast majority of recent cases are coming from household contacts, and not gatherings or essential workplaces. However, New Zealand’s battle to eliminate the highly infectious Delta variant appears delicately poised.

The NZ prime minister, Jacinda Ardern, has previously advised she expected cases to near a peak after eight to 10 days, and on Friday said the government did not expect further “big jumps” in cases. 

New Zealand has extended its nationwide lockdown until Tuesday. Ardern said her cabinet would decide on the lockdown setting in Auckland and the neighbouring Northland region on Monday, but said it was likely Auckland would stay in level 4 – the highest setting – for another two weeks. 

Saturday’s total of 82 – up from 70 on Friday – is New Zealand’s fifth-worst day for cases during the entire coronavirus pandemic. 

On 17 August, the government put the nation into full lockdown after only a single community case was detected in the city of Auckland. New Zealand has reported 26 deaths from the virus in a population of 5 million since the pandemic began. 

New Zealanders lived virus-free in the six months leading up to the latest outbreak, going to workplaces, shops and sport stadiums without needing to wear masks, while children attended school. Then a traveller returning from Sydney brought the Delta variant, which escaped from a quarantine hotel.

The outbreak has grown to about 350 known cases and is straining New Zealand‘s contact-tracing system as workers try to track down 30,000 other people who might have been exposed. 

The lockdown prevents most people from leaving home other than to exercise, or to buy groceries or medicine. Retail stores are closed, as are restaurants – including takeaway – schools and most businesses. 

New Zealand’s vaccine rollout has been the slowest of any developed nation, with only 39% of people having gotten at least one shot and 22% fully vaccinated. The country chose to use only the Pfizer vaccine and did not approve its use until two months after US regulators first approved it for emergency use. 

The government blamed the initial slowness of the rollout on Pfizer’s delivery schedule. 

Vaccinations have sped up rapidly since the outbreak began, with health workers now giving doses to nearly 2% of the population every day.

Switzerland: The threat of 'COVID-22'

Via the Swiss newspaper Blick: Swiss Federal Institute of Technology researcher Sai Reddy warns of new corona super-variants. Excerpt from the Google translation of an interview:

Can you already see variants that are even more dangerous than Delta? 

There are the well-known variants Beta from South Africa and Gamma from Brazil. Both have developed escape mutations: They can partially avoid the antibodies. Delta, on the other hand, is much more contagious, but has so far not developed any escape mutations. 

And the next step is a combination? 

It is inevitable. It is the next phase of the pandemic when Beta or Gamma become more infectious or Delta develops escape mutations. That will be the big problem for the coming year. Covid-22 could get worse than what we are witnessing now. 

How can we respond to that? 

If such a variant appears, we have to recognize it as early as possible and the vaccine manufacturers have to adapt the vaccine quickly. The emergence of this new variant is the big risk. We have to prepare for it. 

What will the coming autumn and winter look like? 

It will be six very tough months. Summer 2021 felt like 2019. But the coming autumn and winter will be like last year. This is due to the delta variant and the fact that we do not have a higher vaccination rate. We cannot control the variant, but we can influence the vaccination rate. 

What does the future of this pandemic look like? 

The virus and our immune system are now closely linked - like two dancers: the immune system moves and the virus reacts. We will dance with the virus for a long time. Probably for years, maybe for the rest of our lives.

Iran's COVID-19 deaths hit record daily high of 709

Via Reuters: Iran's COVID-19 deaths hit record daily high of 709.

DUBAI, Aug 24 (Reuters) - Iran on Tuesday reported a record daily 709 deaths from COVID-19 as the worst-hit country in the Middle East faced a fifth surge in infections led by the highly contagious Delta variant. 

The health ministry said the total number of cases had reached 4.75 million with 40,623 new infections over the past 24 hours. Total fatalities rose to 103,357, state TV reported. 

Authorities imposed a two-week road travel ban between cities in the Islamic Republic until Aug. 27, except for essential vehicles. Non-essential businesses and public offices were allowed to reopen on Sunday after a week of mandatory shutdown to help limit the spread of coronavirus infections. 

The government has not yet announced whether or not new restrictions will be imposed soon.  

Health authorities have warned that daily deaths might reach 800 in coming weeks if Iranians fail to respect health precautions. 

Social media users have criticised the government for being slow to vaccinate people - only about 6.5 million of the 83 million population are fully inoculated. Officials have blamed U.S. sanctions and delays in importing vaccines. 

Food, medicine and other humanitarian supplies are exempt from U.S. sanctions reimposed on Tehran in 2018 after President Donald Trump walked away from a 2015 deal between world powers and Iran over its nuclear programme. 

But the U.S. measures, which target sectors including oil and financial activities, have deterred some foreign banks from processing financial transactions with Iran. Tehran says this has frequently disrupted efforts to import essential medicines and other humanitarian items.

Cuba’s health system buckles under strain of overwhelming Covid surge

Via The Guardian: Cuba’s health system buckles under strain of overwhelming Covid surge. Excerpt:

Julia, a community doctor in Havana, was drafted to the intensive care unit soon after Covid-19 first reached Cuba. 

Last week, her cousin died from the virus. This week, she also tested positive amid a surge in cases which has pushed the island’s vaunted health service to its limits and prompted rare public criticism from Cuban doctors. 

“It hurts to see people die from this terrible virus,” she said, recovering at home from nausea after being injected with an immune booster. “The mood among doctors gets worse by the day.” 

After recording one of the world’s lowest Covid rates last year, Cuba now has one of the western hemisphere’s highest. The island, which reported 12,225 confirmed cases in all of 2020, has reported almost 50 times that so far this year. And with the Delta variant having taken root, a lack of medical supplies is crippling the medical response. 

“There are no antibiotics, no painkillers, the basic list of medicines is almost all out of stock,” said Daniela, a family doctor in Havana who has hardly had a day off since the pandemic began. 

In the face of extreme scarcity, doctors are increasingly prescribing herbal remedies. Mortuaries are overwhelmed. The country’s main oxygen factory recently broke down, compounding the intensive care crisis. 

Cuba last year hospitalised everybody who tested positive for Covid, including asymptomatic cases. But even for a country with the world’s highest doctor-to-patient ratio, average daily case loads of 9,000 have made that protocol unworkable. Now children, the elderly, pregnant women and severe cases are hospitalised, while others must isolate at home. 

Hundreds of doctors have been brought back from international “missions” abroad – a major hard currency generator for the state – to support exhausted colleagues. But the move has not been enough to stop the system, which last year was a model of test, track and isolate, from fraying.

New COVID-19 cases and hospitalizations among adults, by vaccination status — New York, May 3–July 25, 2021

Via MMWR: New COVID-19 Cases and Hospitalizations Among Adults, by Vaccination Status — New York, May 3–July 25, 2021. The summary:

What is already known about this topic? 

Real-world studies of population-level vaccine effectiveness against laboratory-confirmed SARS-CoV-2 infection and COVID-19 hospitalizations are limited in the United States. 

What is added by this report? 

During May 3–July 25, 2021, the overall age-adjusted vaccine effectiveness against hospitalization in New York was relatively stable (91.9%–95.3%). The overall age-adjusted vaccine effectiveness against infection for all New York adults declined from 91.7% to 79.8%. 

What are the implications for public health practice? 

These findings support the implementation of multicomponent approach to controlling the pandemic, centered on vaccination, as well as other prevention strategies such as masking and physical distancing.