Description: (research paper here)

Clear graphics from Italy, The decline of COVID-19 severity and lethality over two years of pandemic

www.medrxiv.org/content/10.1101/2022.07.01.2227713…

20 to 40-fold reductions during the period of dominance of Omicron compared to the initial acute phase.

Phase 1, Ancestral

Probability of hospitalization per infection of 5.4%

Probability of ICU admission of 0.65%

Probability of death of 2.2%

Phase 5, Omicron

Probability of hospitalization, 95.1% reduction in risk

Probability of ICU admission, 97.3% reduction in risk

Probability of death, 97.5% reduction in risk

Using epidemiological and genomic surveillance data

To estimate the number of daily infections in Italy in the first two years of pandemic.

Attack rate

Ascertainment of SARS-CoV-2 infections

Phase 1 (ancestral)

NPIs

Attack rate 2.8%

Phase 2 (ancestral)

Less stringent NPIs

Attack rate 11.4%

Phase 3 Alpha variant

Mid -February 2021 to early July 2021

Alpha infected about 10.1% of the Italian population

Phase 4, Delta

Second half of 2021

Progressive relaxation of NPIs

Attack rate 17.3%

Phase 5, Omicron

End of December 2021

Attack rate, 51.1% of the Italian population became infected with Omicron

Evolution of population susceptibility

Percentage of the population susceptible to SARS-CoV-2

End of first phase, 97.5%

February 20, 2022, 13%

By February 20th, 2022

a marked proportion of individuals unprotected against SARS-CoV-2 infection can be found among vaccinated subjects,

due to the waning of vaccine protection

Evolution of COVID-19 severity and lethality

Probability of hospitalisation

Probability of ICU admission

Probability of death

Evolution of population susceptibility

Natural, post infection immunity is now the main factor reducing population sensitivity

Vaccination protection is seen to be declining

Omicron natural infection had the largest protective effect

Repeat exposure to omicron (and sub variants) is likely to have the same effect going forward.

NPIs will reduce repeat exposures

NPIs will reduce exposure to other respiratory viruses such as RSV

Description:

This covid winter should be better than last

Dr. Anthony S. Fauci, President Biden’s chief medical adviser

www.nytimes.com/2022/11/22/us/politics/fauci-covid…

www.washingtonpost.com/health/2022/11/22/covid-biv…

Combination of infections and vaccinations,

enough community protection that we’re not going to see a repeat of what we saw last year at this time

Re bivalent effectiveness

It is clear now, despite an initial bit of confusion

United States

Nearly $5 billion to buy 171 million bivalent boosters

(Pfizer BioNTech, Moderna)

Hobson’s choice

Dr. Ashish K. Jha, White House’s Covid-19 response coordinator

Still heavily promoting vaccination

Nothing I have seen in the subvariants makes me believe that we can’t manage our way through it effectively, especially if people step up and get their vaccine

So far, 35 million people, (11% of over 5s) one bivalent shot

www.cdc.gov/mmwr/volumes/71/wr/mm7148e1.htm?s_cid=…

Effectiveness of Bivalent mRNA Vaccines in Preventing Symptomatic SARS-CoV-2 Infection — Increasing Community Access to Testing Program, United States, September–November 2022

This is the clinical trial, previous work had only been based on antibodies

Benefits are mentioned, adverse reactions are not

Any adverse reactions not reported

v-safe

www.cdc.gov/mmwr/volumes/71/wr/mm7144a3.htm?s_cid=…

Systemic symptoms

Fatigue (30.0%–53.1%)

Headache (19.7%–42.8%)

Myalgia (20.3%–41.3%)

Fever (10.2%–26.3%)

Reported inability to complete normal daily activities

10.6% among aged over 65 years

19.8% among aged 18–49 years

Bivalent boosters provided significant additional protection against symptomatic SARS-CoV-2 infection

Relative vaccine effectiveness (rVE) of a bivalent booster dose,

compared with that of more than 2 monovalent vaccine doses,

30% and 56% aged 18–49

with relative benefits increasing with time since receipt of the most recent monovalent vaccine dose.

Staying up to date with COVID-19 vaccination, including getting a bivalent booster dose when eligible, is critical to maximizing protection against COVID-19

350,000 tests at almost 10,000 retail pharmacies between Sept. 14 and Nov. 11

Relative risk given

Absolute risk not given

What about protection from severe disease?

Paul Offit, director of the vaccine education center, professor of pediatrics, Children’s Hospital of Philadelphia

The only reasonable goal is to prevent serious illness,

We are still waiting for one shred of evidence that this bivalent vaccine or any bivalent is better than what we had

Virus continues to evolve

This should be a cautionary tale for what happens when you try to chase these variants

Celine Gounder, infectious-disease specialist, Kaiser Family Foundation

It doesn’t show the bivalents are better than the original boosters

(but still advocated the bivalent shot)

Pei-Yong Shi, virologist, University of Texas Medical Branch

difficult to measure how well the updated boosters were working because so many people now had some immunity from earlier infections,

including people who were never vaccinated or boosted.

John P. Moore, virologist, Weill Cornell Medicine

Are the boosters working better than the original shots?

Personally, I doubt there would have been much, if any, difference, but we may never know

Dr. Roby Bhattacharyya, infectious disease physician, Massachusetts General Hospital

This winter should be better than last

we’re a more immune population

China

www.reuters.com/world/china/chinas-daily-covid-cas…

www.telegraph.co.uk/world-news/2022/11/24/iphone-f…

Record high COVID-19 infections

Rigid zero-COVID policy

Cities nationwide imposing localised lockdowns

Mass testing, masks

No furlough scheme

Description:

58% of covid US deaths now in the vaccinated

Kaiser Family Foundation vice president Cynthia Cox

www.cdc.gov/vaccines/covid-19/effectiveness-resear…

covid.cdc.gov/covid-data-tracker/#rates-by-vaccine…

www.cdc.gov/coronavirus/2019-ncov/vaccines/effecti…

data.cdc.gov/Public-Health-Surveillance/Rates-of-C…

www.washingtonpost.com/politics/2022/11/23/vaccina…

58% of coronavirus deaths in August were people who were vaccinated or boosted

(people who had completed at least their primary series of vaccines)

Therefore 42% coronavirus deaths in August were people who were unvaccinated

First time there were more deaths covid deaths in the vaccinated versus the unvaccinated

covid.cdc.gov/covid-data-tracker/#vaccinations_vac…

In September 2021
Vaccinated people, 23% of coronavirus fatalities

In January and February 2022

Vaccinated people, 42% of coronavirus fatalities

We can no longer say this is a pandemic of the unvaccinated

(who conducted the analysis on behalf of the Post)

www.cdc.gov/mmwr/volumes/71/wr/mm7144a3.htm?s_cid=…

Safety Monitoring of Bivalent COVID-19 mRNA Vaccine Booster Doses Among Persons Aged ?12 Years — United States, August 31–October 23, 2022

On August 31, 2022

FDA authorized bivalent, Pfizer-BioNTech and Moderna

mRNA encoding the spike protein from original strain of SARS-CoV-2,

and from Omicron BA.4 and BA.5

Advisory Committee on Immunization Practices (ACIP) recommended,

all persons ?12 years receive an age-appropriate bivalent mRNA booster dose

v-safe

a voluntary smartphone-based U.S. safety surveillance system,

established by CDC to monitor adverse events after COVID-19 vaccination

As of 3rd October, 10 million users

icandecide.org/press-release/breaking-news-ican-ob…

Vaccine Adverse Event Reporting System (VAERS)

Total data, August 31–October 23, 2022

14.4 million received a bivalent Pfizer-BioNTech

8.2 million adults (?18 years) a bivalent Moderna booster dose

v-safe, among the 211,959 registrants (aged ?12 years)

August 31–October 23, 2022

Reported in the week after vaccination

Injection site reactions, 60.8%

Systemic reactions, 54.8%

Fewer than 1% of v-safe registrants reported receiving medical care

Vaccine Adverse Event Reporting System (VAERS)

5,542 reports of adverse events after bivalent booster vaccination (?12 years)

95.5% of reports were nonserious

4.5% were serious events

Health care providers and patients can be reassured that adverse events reported after a bivalent booster dose are consistent with those reported after monovalent doses.

Relative risk

Absolute risk not given

Health impacts after COVID-19 vaccination are less frequent and less severe than those associated with COVID-19 illness (2).

Relative risk

Absolute risk not given

This is their Reference 2

Block JP, Boehmer TK, Forrest CB, et al. Cardiac complications after SARS-CoV-2 infection and mRNA COVID-19 vaccination—PCORnet, United States, January 2021–January 2022. MMWR Morb Mortal Wkly Rep 2022;71:517–23. doi.org/10.15585/mmwr.mm7114e1 PMID:35389977

myocarditis; myocarditis or pericarditis; and myocarditis, pericarditis, or MIS,

within 7-day or 21-day risk windows after the index date

Comparisons between after vaccine and after infection

Relative risk

Absolute risk not given

Review of v-safe Data

During August 31–October 23, 2022

211,959 v-safe registrants had a bivalent booster

1,464 (0.7%) were aged 12–17 years

68,592 (32.4%) were aged 18–49 years

59,209 (27.9%) were aged 50–64 years

82.694 (39.0%) were aged ?65 years

Fourth dose

96,241; 45.4%

Fifth dose

106,423; 50.2%

In the week after receipt of the bivalent booster dose

Local injection site reactions

49.7% among aged ?65

72.9% among aged 18–49

Systemic reactions

43.5% among aged ?65

67.9% among aged 18–49

Systemic symptoms

Fatigue (30.0%–53.1%)

Headache (19.7%–42.8%)

Myalgia (20.3%–41.3%)

Fever (10.2%–26.3%)

Reported inability to complete normal daily activities

10.6% among aged ?65 years

19.8% among aged 18–49 years

Receipt of medical care

Reported by 0.8% of registrants

The new data from ONS:

Let’s look at what happened before the pandemic:

Compared to this year (so far):

We’re at almost 12,000 deaths per week. It was below 10,000 just a few years ago.

Data file: deaths by week (week 45) (ODF)

Description:

Association between vitamin D supplementation and COVID-19 infection and mortality

https://www.nature.com/articles/s41598-022-24053-4

(12th November 2022)

Johns Hopkins
University of Michigan
National Bureau of Economic Research
Department of Medicine, University of Chicago
Department of Veterans Health Affairs
Department of Medicine, University of Chicago, Chicago

Vitamin D deficiency, associated with reduced immune function,

can lead to viral infection

Vitamin D deficiency, associated, increases the risk of COVID-19

But is it a treatment / prognosis improver?

Population of US veterans, we show that Vitamin D2 and D3 fills

Associated with reductions in COVID-19 infection

After applying all restrictions

220,265 supplemented with vitamin D3

34,710 supplemented with vitamin D2

407,860 untreated patients.

Study design

Retrospective cohort

Supplemented (before and during the pandemic),

versus untreated controls

One to one matches

D2, D3, or calcifediol

Veterans Administration Corporate Data Warehouse (CDW) electronic health records.

Vitamin D levels typically respond to treatment following two months of exposure

D3 cohort

COVID-19 rates for the treated = 2.66%

COVID-19 rates for the untreated = 3.30%

D3 20%, reduction

D2 28% reduction

Mortality within 30-days of COVID-19 infection

Infection ending in mortality within 30 days

D3 group

Treated group death rate after infection = 0.23%

Untreated group death rate after infection = 0.35%

Vitamin D3 33% mortality lower (HR, 67%)

P? less than ?0.001

Vitamin D2 25% lower (HR, 75%) (but not significant)

Veterans receiving higher dosages of Vitamin D obtained greater benefits from supplementation than veterans receiving lower dosages.

Vitamin D blood levels between 0 and 19 ng/ml,

exhibited the largest decrease in COVID-19 infection and mortality following supplementation

(0–19 ng/ml, 20–39 ng/ml, and 40?+?ng/ml)

Dosage options, 20 IU, 40 IU, 100 IU, 125 IU, 200 IU, 250 IU, 400 IU, 500 IU, 800 IU, 1000 IU, 2000 IU, 5000 IU, 8000 IU, and 50,000 IU

Black veterans received greater associated COVID-19 risk reductions, with supplementation than White veterans

As a safe, widely available, and affordable treatment, Vitamin D may help to reduce the severity of the COVID-19 pandemic.

More background

Vitamin D insufficiency and deficiency affect approximately half of the US population,

with increased rates in people with darker skin,

reduced sun exposure,

people living in higher latitudes in the winter,

nursing home residents,

and healthcare workers

Populations with low levels of Vitamin D have also experienced higher rates of COVID-19

New mechanism

Vitamin D is needed to allow T helper cells to control and reduce Interferon gamma (IFN-?) production

Conclusions

These associated reductions in risk are substantial and justify more significant exploration and confirmation using RCTs.

This is particularly important given the high rates of vitamin D deficiency in the US population and COVID-19.

Extrapolate, D3 supplementation to the entire US population in 2020

4 million fewer COVID-19 cases (19,860,000 actual cases)

116,000 deaths avoided (351,999 actual deaths)

Given our findings,

the absence of severe side effects,

the widespread availability of vitamin D3 at low cost,

vitamin D3 presents a unique opportunity to reduce the spread and severity of the COVID-19 pandemic.

K2, MK-7

Supplement, probably 100 micrograms per day

Nato, 1,000 micrograms per 100 g

Cheese, typically 50 micrograms per 100 g

Safe and effective

UK, GP incentives to vaccinate

Home, £30

Standard reimbursement to Primary Care Networks (which then gets passed to GPs) £15

New contract, £12.58 each

Lawrence

I have heard that Dr. John Campbell is in the pocket of Big Overhead Projector Lobby.

Rumour is that he has accepted tens of dollars of under the table expenses.

Anyone else notice that he always seems to have an endless supply of A4 paper and fountain pens?

Minutes ago ONS released these new numbers, which I’ve been eager to see for days (also refreshed the page once in several minutes), having examined closely some troubling trends since the summer. Here’s the update:

We’ve made a local copy as OpenDocument Format (ODF).

For comparison’s sake, here are the latest numbers:

Week 44 deaths in 2019:

11795 (this year) – 9777 (pre-COVID 5-year average) = 2018 or 20.64%.

As per these pre-pandemic numbers, the causes of death across the UK look like this:

This should be self-explanatory. The data is here as ODF.

2022′s breakdown by causes is framed rather differently, which makes comparison difficult (maybe intentionally).

The corresponding Web page does not specify totals per cause. The hypothesis here is that there’s a correlation between the increases in heart attacks or other cardiac events. Some are fatal.

An earlier report said that “leading cause of death in England in June 2022 was dementia and Alzheimer’s disease (10.8% of all deaths); in Wales, the leading cause was ischaemic heart diseases (10.7% of all deaths).”

So there’s somewhere around 11%. This is for June:

To quote some more:

In the first six months (January to June) of 2022, the leading cause of death in England was dementia and Alzheimer’s disease (107.7 deaths per 100,000 people). In Wales, the year-to-date leading cause of death was ischaemic heart diseases (116.8 deaths per 100,000 people).

In England, the year-to-date COVID-19 mortality rate decreased to the fifth leading cause of death (46.7 deaths per 100,000 people) from the third in May 2022. This was statistically significantly lower than the top two leading causes of death (dementia and Alzheimer’s disease, and ischaemic heart diseases), and significantly lower than four of the other seven leading causes.

In Wales, deaths due to ischaemic heart diseases, and dementia and Alzheimer’s disease were also the top two leading causes of deaths. They were statistically significantly higher than any other cause of death. Deaths due to COVID-19 decreased to the sixth leading cause of death in the year-to-date (46.9 deaths per 100,000 people), from fourth in May 2022. This was significantly higher than all leading causes ranked lower.

So about 1.17 in 1,000 people died with “leading cause of death [being] ischaemic heart diseases” in the first 6 months.

The tendency to release in such inconsistent presentation forms (or presenting different kinds of data) makes one wonder if the motivation is to hide something. Why should it be so hard to figure out how many people died annually from heart failure before and during the pandemic?