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Monday, November 28th, 2022, 11:59 am

The Decline of COVID-19 Severity and Lethality Over Two Years of Pandemic (Center for Health Emergencies, Bruno Kessler Foundation, Trento, Italy)

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

Sunday, November 27th, 2022, 6:12 am

No Clinical Trials

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

Saturday, November 26th, 2022, 1:27 pm

Statistics About COVID-19 Vaccines in the United States

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

Friday, November 25th, 2022, 2:00 am

Origins of COVID-19

Description

I feel let down and apologise if I have misled anyone

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30418-9/fulltext

We are public health scientists who have closely followed the emergence of 2019 novel coronavirus disease (COVID-19)

and are deeply concerned about its impact on global health and wellbeing.

We stand together to strongly condemn conspiracy theories suggesting that COVID-19 does not have a natural origin.

https://www.nature.com/articles/S41591-020-0820-9

Our analyses clearly show that SARS-CoV-2 is not a laboratory construct or a purposefully manipulated virus.

Conclusion

Obtaining related viral sequences from animal sources would be the most definitive way of revealing viral origins.

(Fully formed or evolutionary intermediate)

UK experts helped shut down Covid lab leak theory

- weeks after being told it might be true

Sir Patrick Vallance among scientists behind paper that stifled debate into the origins of the virus

https://www.telegraph.co.uk/news/2022/11/23/uk-experts-helped-shut-covid-lab-leak-theory-weeks-told-might/

https://www.youtube.com/watch?v=lpZz9rCz3Co

Top scientists including Sir Patrick Vallance,

Were warned that virus could have evolved in lab animals

Collaborated in above paper

Debate therefore stifled

To date

Proximal origins paper

Accessed more than 5.7 million times and cited in 2,627 subsequent papers.

Emails from early 2020

FoI request, James Tobias, freelance journalist

Authors held lengthy discussions with experts, Sir Patrick and Sir Jeremy Farrar, head of the Wellcome Trust

Warned WIV had been carrying out research on bat-coronaviruses,

at worrying levels of biosecurity.

Research to alter Sars-like bat coronaviruses had been taking place for many years in Wuhan

(not mentioned in paper)

Sir Jeremy Farrar, (Wellcome)

Wuhan was like the “Wild West”.

Prof Kristian Andersen, Scripps Research Institute La Jolla, California (lead author)

had earlier told colleagues that features of the virus looked as if they’d been engineered in a lab.

(No mention of this was made in the paper)

Dr Jeremy Farrar, (Wellcome)

It is important that we understand how all pathogens emerge so that we can prevent future pandemics

as the efforts to gather evidence continue, it is important to stay open-minded

Serial passaging

Would cause the virus to contain o-glycans

The second notable feature of SARS-CoV-2 is a polybasic cleavage site (RRAR) at the junction of S1 and S2

Prof Ron Fouchier, Dutch virologist

(from another e mail chain)

It is good that this possibility was discussed in detail with a team of experts.

However, further debate about such accusations would unnecessarily distract top researchers from active duties,

and do unnecessary harm to science in general and science in China in particular

February 8th e mail Prof Edward Holmes

(one of the authors)

Ever since this outbreak started there have been suggestions that the virus escaped from the Wuhan lab,

if only because of the coincidence of where the outbreak occurred and the location of the lab.

I do a lot of work in China and I can tell you a lot of people there believe this and believe they are being lied to

Prof Kristian Andersen, February 8th

(Lead author)

Passage of Sars-live coronaviruses have been going on for several years and more specifically in Wuhan under BSL-2 conditions

BSL-2 laboratories are used to study moderate-risk infectious agents or toxins such as salmonella.

Serious diseases should be handled in BSL-3 or 4 labs.

Wuhan Institute of Virology (WIV)

Importing bat coronaviruses from areas of China which hold the closest viruses to Covid-19

Had also applied for funding to manipulate viruses by inserting a furin cleavage site (FCS)

The email chain

Involved Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases (NIAID),

an organisation which was funding research at the Wuhan lab.

Senate report on viral origins

the emergence of SARS-CoV-2 that resulted in the COVID-19 pandemic was most likely the result of a research-related incident

https://www.help.senate.gov/imo/media/doc/report_an_analysis_of_the_origins_of_covid-19_102722.pdf

https://asiatimes.com/2022/10/new-evidence-firmly-revives-wuhan-lab-origin-theory/

https://www.researchgate.net/publication/364599030_Endonuclease_fingerprint_indicates_a_synthetic_origin_of_SARS-CoV-2

Dec. 20, 2019 to Jan. 18, 2020

Searches for flu-like symptoms

Differs from Previous Natural Zoonotic Spill overs

Severe Acute Respiratory Syndrome (SARS)

Middle East Respiratory Syndrome (MERS)

Lack of intermediate bats to humans

Influenza

H7N9 (2019) multiple independent introductions across multiple locations

Geographically disparate, independent spill overs of H7N9

Wednesday, November 23rd, 2022, 3:57 am

Excess Deaths Very High in England and Wales This Year

The new data from ONS:

The new data from ONS

Let’s look at what happened before the pandemic:

2014-2019-deaths-by-week

Compared to this year (so far):

2022-deaths-by-week

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)

Wednesday, November 23rd, 2022, 1:01 am

Since the Pandemic Began Over 30,000 Excess Deaths Involving Heart Disease in the UK, 3,600 to 60,000 Excess Cancer Deaths So Far

Australia, Key statistics

https://www.abs.gov.au/statistics/health/causes-death/provisional-mortality-statistics/latest-release

In 2022, there were 111,008 deaths that occurred by 31 July,

and were registered by 30 September, which is 16,375

(17.3%) more than the historical average.

In July there were 17,936 deaths,

2,503 (16.2%) above the historical average.

There were 300 (22.5%) fewer deaths due to COVID-19 in August than July.

https://www.bhf.org.uk/what-we-do/news-from-the-bhf/news-archive/2022/november/extreme-heart-care-disruption-linked-to-excess-deaths-involving-heart-disease

Since the pandemic began

Over 30,000 excess deaths involving heart disease

(average over 230 additional deaths a week)

Heart disease is among the most prominent diseases involved in the high numbers of excess deaths since the start of the pandemic.

While Covid-19 infection was likely a significant factor

Covid infections no longer a driving force

https://www.cancer.gov/news-events/press-releases/2021/covid-19-pandemic-disparities-excess-deaths

Meredith S. Shiels, Infections and Immunoepidemiology, NCI Division of Cancer Epidemiology and Genetics

Focusing on COVID-19 deaths alone without examining total excess deaths

—that is, deaths due to non-COVID-19 causes as well as to COVID-19
—may underestimate the true impact of the pandemic

https://www.cdc.gov/cancer/dcpc/research/update-on-cancer-deaths/index.htm

https://www.cancerresearchuk.org

https://news.cancerresearchuk.org/2020/07/21/why-its-difficult-to-estimate-the-number-of-extra-cancer-deaths-caused-by-service-disruption-during-covid-19/

July, 2022

3,600 to 60,000 excess cancer deaths so far

https://www.cancerresearchuk.org/about-cancer/cancer-symptoms

Excess mortality in England and English regions: December 2022 update

https://www.telegraph.co.uk/news/2022/11/20/true-impact-covid-cancer-patients-revealed-excess-deaths-soar

https://www.gov.uk/government/organisations/office-for-health-improvement-and-disparities

https://app.powerbi.com/view?r=eyJrIjoiYmUwNmFhMjYtNGZhYS00NDk2LWFlMTAtOTg0OGNhNmFiNGM0IiwidCI6ImVlNGUxNDk5LTRhMzUtNGIyZS1hZDQ3LTVmM2NmOWRlODY2NiIsImMiOjh9

25 to 49 years

Based on 2015 to 2019 data

Sunday, November 20th, 2022, 7:42 pm

Individualised Health Care

Description:

Download free high-res PDFs of the posters, download free copies of my two text books. Any donations using this link help the work of campbell teaching.

https://drjohncampbell.co.uk/

I taught bespoke health care as a fundamental principle for decades.

Does natural and hybrid immunity obviate the need for frequent vaccine boosters against SARS-CoV-2 in the endemic phase?

https://pubmed.ncbi.nlm.nih.gov/36366946/

https://onlinelibrary.wiley.com/doi/10.1111/eci.13906

Stefan Pilz John PA Ioannidis

The coronavirus disease 2019 (COVID-19) pandemic has entered its endemic phase

We observe significantly declining infection fatality rates due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Now

It is crucial but challenging to define current and future vaccine policy,

in a population with a high immunity against SARS-CoV-2,

conferred by previous infections and/or vaccinations.

Vaccine policy must consider the magnitude of the risks conferred by new infection(s),

with current and evolving SARS-CoV-2 variants,

how these risks vary in different groups of individuals,

how to balance these risks against the apparently small, but existent, risks of harms of vaccination,
and the cost-benefit of different options.

More evidence from randomized controlled trials,

and continuously accumulating national health data is required,

to inform shared decision-making with people who consider vaccination options.

Vaccine policy makers should cautiously weight what vaccination schedules are needed,

and refrain from urging frequent vaccine boosters unless supported by sufficient evidence.

The key issue

Whether and how to consider natural immunity after SARS-CoV-2 infections, and hybrid immunity

It is very likely that the large majority of the global population has been infected with SARS-CoV-2,

at least once by late 2022

(Excluding China)

People who have never been infected have probably become a rarity.

It is well established that previous SARS- CoV-2 infections induce a significant and long-lasting protection against reinfections,

and even more so against severe COVID-19.3-6

Lets check the evidence

https://pubmed.ncbi.nlm.nih.gov/35904405/

Risk of reinfection and disease after SARS-CoV-2 primary infection: Meta-analysis

91 studies, n = 15,034,624

Infections n = 158,478 reinfections

During the first 3 months of Omicron wave,

the reinfection rates reached 3.31%.

Overall rates of severe/lethal COVID-19 were very low,

(2-7 per 10,000),

and were not affected by strain predominance.

Conclusions

A strong natural immunity follows the primary infection and may last for more than one year,

suggesting that the risk and health care needs of recovered subjects might be limited.

Although the reinfection rates considerably increased during the Omicron wave,

the risk of a secondary severe or lethal disease remained very low.

The risk-benefit profile of multiple vaccine doses for this subset of population needs to be carefully evaluated.

Back to Pilz, PA loannidis paper

Compared to vaccination by two doses,

natural immunity was associated with a significantly higher protection against SARS-CoV-2 infections before the emergence of Omicron,

when identical times have elapsed since the last immune conferring event.

Denmark

Little viral spread until late 2021,

and then massive infections with Omicron,

ensued in a population that had been widely vaccinated.

Omicron infection fatality rate (IFR) until mid-March 2022,

6.2 per 100,000 infections,

among apparently healthy people 17-72 years

Compared to previous infection waves in Denmark, there was a very significant decline in IFR
Omicron wave
In populations with substantial prior exposure to SARS-CoV-2,
re-infections, less than a quarter of the hospitalization risk,
and one-tenth the mortality
Vojvodina, Serbia
1% of re-infections required hospitalization
Case fatality for re-infections was 0.15%
Accounting for non- ascertained infections,
this suggests that IFR for re-infections,
may be less than 0.05%, (even in people who have not been vaccinated)

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