Coronavirus Covid-19 - opšta tema

[vememah]

 

 

 

 

 

 

 

[vememah]

 

 

 

 

 

Edit: okačio čovek u međuvremenu i krive za broj umrlih u poređenju s ranijim talasima

 

 

Edited December 9, 2021 by vememah

[vememah]

Quote

A group of seven Germans aged 25 to 39 have contracted the Omikron variant of the coronavirus in South Africa, although all have already received their booster vaccination. Wolfgang Preiser, a member of the research consortium that discovered the variant, told the Tagesspiegel newspaper. (...)
The individuals received these vaccines in this order:
Persons 1 to 5: Biontech, Biontech, Biontech.
Person 6: Biontech, Biontech, Moderna
Person 7: Astrazeneca, Biontech, Biontech
Booster vaccinations were administered to subjects between five and ten months after the second vaccinations. The booster vaccinations were at least one month but no more than two months ago. (...)
None of the seven Germans had to deal with a severe course of the infection. "Of course, one can now say: these are young people anyway. But you can already assume that at least a severe course is prevented," Preiser said.

https://www.tagesspiegel.de/wissen/erste-berichtete-booster-durchbrueche-mit-omikron-sieben-junge-deutsche-infizieren-sich-in-suedafrika-trotz-dritt-impfung/27879838.html (prevod: Deepl)

[vememah]

 

[vememah]

Quote

Cases of the Omicron variant could be spreading even faster in England than in South Africa, according to a senior scientific adviser, who warned that the variant was a “very severe setback” to hopes of bringing the pandemic under control.

Prof John Edmunds, an epidemiologist at the London School of Hygiene and Tropical Medicine and a member of the government’s Scientific Advisory Group for Emergencies (Sage), said that plan B measures announced by the prime minister [Boris Johnson] were “absolutely not an overreaction” even if Omicron turned out to be milder than the current dominant variant. (...)

Speaking at the online event, Edmunds dismissed suggestions that the Omicron variant might be “good news” if it hospitalised people at only half the rate as the Delta variant. The hope comes largely from hospital admissions in South Africa, where the population is far younger than in the UK and so less likely to experience severe Covid illness in the first place. While the average age in the UK is just over 40, it is less than 28 in South Africa.

Edmunds said there was “not a shred of evidence” that Omicron was half as pathogenic as the Delta variant, but added that even if this were the case, it might not make the difference people hoped for. “This is a very severe setback. There is no question about that.”

“If you are worried about the time [at] which the NHS might start to get very stressed, then halving the hospitalisation rate means that buys you two to three days. I think it’s really silly to suggest this is good news; it couldn’t be further from that,” he added. “This is as bad news as you can possibly get, quite frankly.”

It will take several weeks for scientists to get a sense of how severe the disease is in the UK, where the vast majority of people have some immunity against earlier variants either through vaccination or previous infection. This week, Pfizer released data from a small lab study suggesting that three shots of its vaccine might hold up well against the Omicron variant, but Edmunds said it was the most optimistic of five or so studies he had seen on vaccine protection against the variant.

Despite the uncertainties, Edmunds said it was “absolutely critical” for people to get their booster doses “as rapidly as possible”: “I think it will help, and it will help very significantly, but I still think we are likely to be under quite a lot of pressure in a very short time.”

https://www.theguardian.com/world/2021/dec/09/daily-omicron-cases-in-uk-could-exceed-60000-by-christmas-sage-adviser-says

Edited December 9, 2021 by vememah

[Roger Sanchez]

Južna Afrika:

Glenda Gray, president of the South African Medical Research Council, said there were far more unvaccinated people among current hospital admissions.

On the Pfizer vaccine, she said: “We are seeing this vaccine is maintaining effectiveness. It may be slightly reduced, but we are seeing effectiveness being maintained for hospital admissions and that is very encouraging.”

[barrcode]

Za jbnih 7 dana 90%

[vememah]

Da, tako nekako, sa 1,3 na jučerašnjih 13,3% udela skočio je za 7 dana.

 

 

Edited December 10, 2021 by vememah

[vememah]

 

Quote

Meaghan Kall, 1h, 20 tweets, 7 min read

NEW: Omicron Variant report from UKHSA
Technical Briefing 31 - Omicron Variant (VOC-21NOV-01) assets.publishing.service.gov.uk/government/upl…
Updated Omicron Risk Assessment assets.publishing.service.gov.uk/government/upl…

Firstly, the context of England epi:

Omicron case are rising rapidly.

Latest official count is 696, though the true number of infections is likely to be much higher, as we know Omicron is now ciruclating in many areas.

Omicron cases are rising faster than earlier variants

A vanishingly small number of Omicron cases are in people who recently travelled abroad (any country) or had a known contact with a traveller.

Evidence of 2 things:
1) ongoing community transmission
2) we have effectively interrupted infections entering the country

Right, onto the data...

1. VACCINE EFFECTIVENESS (symptomatic infection)
*caveat: early estimates*

Real-world surveillance data shows a significant reduction in VE for Omicron vs Delta

* 2x AZ, VE is ZERO
* 2x Pfizer, VE is ~30%

BUT! Boosters increase VE to 70-75% (Pfizer, in the 1st month)

Interpret VE data with caution due to low numbers & some residual uncontrolled biases.

It is too early to measure protection against severe disease, but with earlier variants protection against hospitalisation & death has been largely preserved. All hoping this holds true 🤞 

The VE drop off is much greater than we saw with Delta, and suggests a level of immune evasion that could result in a surge in 'breakthrough' infections.

Good news is that boosters appear to mitigate much of that loss in VE, taking VE back to pre-booster levels

2. REINFECTIONS

Likewise, with an immune evading virus you expect to see an increase in re-infections. And we do.

7% (25/361) Omicron cases were re-infections, vs
0.4% (336/85,460) Delta

After adjustment, this equals a 3- to 8-fold increased risk of re-infection with Omicron

3. LABORATORY NEUTRALISATION STUDIES

Capping off the mounting evidence for Omicron's immune evasion, 2 UK & 3 international live virus studies were reviewed (UK papers coming!)

Omicron gives 20- to 40-fold reduction in nAbs compared to the viruses used to develop vaccines

Both UK studies show more than 20-fold reduction in neutralising antibodies for Omicron vs Delta

2-dose AZ showed the greatest reduction: in most cases no detectable neutralising activity🙄

BUT! Boosters significantly improved nAbs, regardless of the vaccine in first course 

Taken together, this paints a very consistent picture for Omicron being immune evading.

This is reassuring scientifically, but also pretty depressing.

Let's move on to transmissibility studies.

🚨WARNING: also fairly depressing 

4. HOUSEHOLD TRANSMISSION
(caveat: early data)

Analysis of transmission in residential households (121 Omicron, 72,882 Delta)

19% of Omicron cases resulted in household outbreaks vs 8.5% of Delta cases

Adjusted odds of household transmission for Omicron:
3.2 (95%CI 2.0-5.0)

For comparison the adjusted odds was 1.7 when this analysis was done for Delta vs Alpha. pubmed.ncbi.nlm.nih.gov/34729548/

This preliminary analysis will be repeated with more cases next week.

We cannot determine how much increased transmission is immune evasion vs infectiousness 

Household transmission of COVID-19 cases associated with SARS-CoV-2 delta variant (B.1.617.2): national case-control study - PubMedWe found evidence of increased household transmission of SARS-CoV-2 Delta variant, potentially explaining its success at displacing Alpha variant as the dominant strain in England. With the Delta vari…https://pubmed.ncbi.nlm.nih.gov/34729548/

5. SECONDARY ATTACK RATES (SAR)

Analysis using NHS T&T contact tracing data

Household SAR 2-fold higher for Omicron (21.6%) vs Delta (10.7%)

The risk of a close contact becoming a secondary case (adjusted odds ratio 2.1 (95% CI: 1.5-2.8)

Again, small numbers of Omicron limit the analysis and lead to wide confidence intervals so this analysis must be repeated.

However, these 2 analyses use different datasets and methods to estimate household transmission so is compelling to get such similar results. 

6. GROWTH ESTIMATES

Taken together, it is no surprise that we are seeing exponential growth in Omicron cases (using SGTF as proxy)

3 day doubling time (0.35/day)
Rt= 3.7 (3.3-4.2)

So let's recap.

Omicron has a large growth advantage over Delta.

At least part (if not all) is due to it's ability to evade our existing immunity acquired through either vaccination or previous infection.

Left unchecked, this will result in exponential growth of infections.

 

But will in result in more hospitalisations and deaths?

Well good news so far is there are no hospitalisations or deaths associated with Omicron.

This is encouraging news, probably largely due to vaccines and high levels of immunity.

But also, its very early days.

There are very few cases in high risk groups, including the elderly

And so Omicron would have to be very much milder than Delta, in order to avoid an increase in hospitalisations and deaths.

Remember, a small percentage of a big number is still a bigger number than we would like to see... 

 

https://threadreaderapp.com/thread/1469350830864322560.html

Edited December 10, 2021 by vememah

[barrcode]

South Africa has recorded fewer severe cases in the Omicron wave of coronavirus infections sweeping the country’s economic hub compared to earlier in the pandemic, according to the latest data, although the health minister said it remained early days for assessing the variant’s severity.

Just under a third of Covid patients in hospital in Tshwane, the centre of the country’s Omicron outbreak, needed specialist care or spent time in an intensive care unit in the past 25 days, compared with two-thirds in two previous waves this year, South Africa’s National Institute for Communicable Diseases said on Friday.

Four per cent of patients died, compared with a fifth in the other waves of infection, according to the data.

“It must be noted that severity data has several limitations at the early phase of a wave, where the numbers are small”, and because many Covid-19 patients were only found with the virus after being admitted for something else, health minister Joe Phaahla said in a briefing on Friday.

“It’s early days, but there are promising signs that largely patients, even those who are in hospital, are mild and many of them are accidental”

Dr Harsha Somaroo, president of the Public Health Association of South Africa, said the emerging hospital data from the country was “reassuring”.

“The early findings suggest that [Omicron] might be milder,” said Somaroo. “In Gauteng, there is a higher level of existing immunity because we had a very intense third wave. That, coupled with immunity from vaccination, could account for some of that positive picture.”

But Somaroo stressed that “we can’t be complacent” despite reports from hospital wards indicating that length of stays are shorter, ICU admissions are less common and fewer patients are on supplementary oxygen.

“Those who have had a prior infection or vaccination are not likely to have severe disease,” said Dr Fareed Abdullah, director of Aids and TB research at the South African Medical Research Council.

[Aleksija]

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Edited December 10, 2021 by Aleksija

[vememah]

Gauteng 10.12. vs 8.12.
Hospitalizacije 2512 vs 1990 (rast od 26% - odgovara vremenu dupliranja od oko 6 dana)
Na kiseoniku 331 vs 280 (rast od 18% - odgovara vremenu dupliranja od oko 8 dana)
Na respiratoru 69 vs 58 (rast od 19% - odgovara vremenu dupliranja od oko 8 dana)

 

Broj umrlih za dva dana: 54, tj. dnevni prosek 27
Broj umrlih za 10 dana pre toga: 124, tj. dnevni prosek 12,4
I smrtnost očigledno raste.

 

Izvor:
https://www.nicd.ac.za/diseases-a-z-index/disease-index-covid-19/surveillance-reports/daily-hospital-surveillance-datcov-report/

 

Slike u spoileru:

Spoiler

 

 

[vememah]

Raspodela ovih 54 umrlih u zadnja dva dana po starosnim grupama:

 

0-9: 2
10-19: 1
20-29: 1
30-39: 6
40-49: 8
50-59: 7
60-69: 7
70-79: 8
80+: 14

Edited December 10, 2021 by vememah

[vememah]

Dobra vest je da je u Gautengu danas prijavljeno za 20% manje novozaraženih nego prošlog petka, što bi moglo da znači da će se talas izduvati pre nego što postane kritično u bolnicama. Nažalost, drugde i dalje raste pa je ukupan broj slučajeva u državi veći nego prošlog petka.

 

 

 

https://twitter.com/nicd_sa/status/1469400938964307969
https://twitter.com/nicd_sa/status/1466814557154906116

Edited December 10, 2021 by vememah

[vememah]

Južnoafrikanci su juče ujutru držali KZŠ, evo sažetka i snimka:

 

Quote

 

Mia Malan, 21h, 18 tweets, 12 min read

Update on #Omicron in SA via @Dr_Groome from @nicd_sa (presented @ Fri's @heatlhza press briefing):

[Thread]

1. The 7 day moving average of new #COVID19 cases = increased 40-fold between 16 Nov (332) + 8 Dec (13,237)
2. This increase is much steeper than in any previous wave

2. @Dr_Groome:
1. The increase in new #COVID19 cases = mostly driven by Gauteng, where the #Omicron outbreak started
2. Left graph = absolute nr of cases, right graph = incidence (new cases), accounted for population size = starting to see increases in other provinces too

3. What do new #COVID19 cases look like by age?
1. Early on in the #Omicron wave we saw more cases in younger age groups
2. Currently, the incidence is highest in the 20-39 year and 40-59 year group, followed by the 60+ year group

4. @Dr_Groome:
There has been a dramatic increase in the test positivity rate (the % of tests that come out positive) - this increase is steeper than in any previous wave:
- Between 14 + 28 Nov the + rate increased from 2.5% to 24.9%
- Yesterday (Thu), the + rate was: 29.8%

5. @Dr_Groome:
1. This is how positivity test rates are distributed across SA (red = over 30%)
2. See how the red is concentrated in the north of SA in Gauteng, but is now filtering to the rest of the country

6. @Dr_Groome:
1. This is a table of test positivity rates for provinces
2. Gauteng's (35%) + rate is the highest (where the #Omicron outbreak in SA started), followed by Northwest, MP and Limpopo (all 3 = neighboring provinces of GP)

7. Which SA provinces have officially entered a 4th wave?
@Dr_Groome:
1. Gauteng
2. Northwest
3. Mpumalanga

8. What's happening with reproductive (R) numbers? (This is how many other people 1 infected person will infect):
1. Nationally our R nr = 2.55 (this is the highest R nr SA has seen since the start of #COVID19)
2. In Gauteng (where SA's #Omicron outbreak started) the R nr = 3.06

9. What's happening with hospitalisations?
1. The right graph shows the increase in hospitalisations in both the private and public sector
2. The left graph shows a drop off, but that is due to a delay in the reporting of cases, not an actual drop in cases

10. The left graph compares the nr of new cases (orange) with hospital admissions (grey) for all waves:

The diffs with the 4th (#Omicron) wave = admissions start later (a while after a steep increase in cases; admissions in previous waves = along with an increase in cases).

11. Early indications of #Omicron hospitalisations, based on SA data:
1. We're starting to see a disconnect between cases and hospitalisations
2. Right graph = there is a much lower % of patients getting admitted (blue) - but could be because it's still early in the wave

12. What's happening with #COVID19 deaths?
1. We haven't seen any significant increase nationally
2. We're starting to see small increases in Gauteng (where SA's #Omicron outbreak started)

13. This table shows increases in #COVID19 hospital admissions/deaths in provinces:
1. Gauteng: Increase from an average of 32.57 (for 2 weeks) to 181.07 (the average of the following 2 weeks) = 455% increase
2. Deaths in Gauteng = 68% increase

14. AGE breakdown 4 GAUTENG admissions (last 3 weeks):
1. We started off with a larger % of admissions in younger (20/below) groups, but that is now changing
2. We're now seeing the % of younger admissions decreasing + the % of admissions in older groups (slightly) increasing

15. GAUTENG admission data broken down into smaller age bands:
1. 0-5 years = a high % of admissions initially, but this has decreased from 14% of admissions to 7% of admissions over the last 3 weeks
2. 60+ admissions have increased from about 13% to just over 16%

16. @Dr_Groome:
1. This graph shows that the #COVID19 admissions we're seeing are mostly among the age groups with low vaccination rates
2. This is in line with evidence that vaccines protect people from falling severely ill with COVID (so they don't need hospitalisation)

17. What is defined as severe illness?
= People with acute respiratory distress syndrome, those needing oxygen or are admitted to ICU

Note: The data presented = early stage data, which means many beds = still available + docs are more likely to admit patients with mild disease

18. Summary:
1. The nr of new #COVID19 cases are on a sharp increase and so is the test positivity rate
2. % of younger admissions = changing (becoming a smaller % of total admissions)
3. No signals of more severe disease
4. Most hospital admissions = unvaccinated people

 

 

https://threadreaderapp.com/thread/1469268349679030274.html