Overview
Estimating the true mortality burden of COVID-19 for everycountry in the world is a difficult, but crucial, public health endeavor.Attributing deaths, direct or indirect, to COVID-19 is problematic. A moreattainable target is the excess deaths, the number of deaths in a particularperiod, relative to that expected during normal times, and we estimatethis for all countries on a monthly time scale for 2020 and 2021. The excessmortality requires two numbers, the total deaths and the expected deaths, butthe former is unavailable for many countries, and so modeling is required forthese countries, and the expected deaths are based on historic data and wedevelop a model for producing expected estimates for all countries.We allowfor uncertainty in the modeled expected numbers when calculating the excess.We describe the methods that were developed to produce World HealthOrganization (WHO) excess death estimates. To achieve both interpretabilityand transparency we developed a relatively simple overdispersed Poissoncount framework, within which the various data types can be modeled. Weuse data from countries with national monthly data to build a predictive log-linearregression model with time-varying coefficients for countries withoutdata. For a number of countries, subnational data only are available, and weconstruct a multinomial model for such data, based on the assumption thatthe fractions of deaths in specific sub-regions remain approximately constantover time. Our inferential approach is Bayesian, with the covariate predictivemodel being implemented in the fast and accurate INLA software. Thesubnational modeling was carried out using MCMC in Stan or in some nonstandarddata situations, using our own MCMC code. Based on our modeling,the 95% interval estimate for global excess mortality, over 20202021,is 13.316.6 million.
FDA Limits Use of COVID-19 Vaccine1
The US Food and Drug Administration (FDA) has restricted the use of the Janssen COVID-19 vaccine in most patient populations.
The Jansen vaccine is now authorized for use only in individuals aged 18 years or older who are unable to receive other authorized or approved COVID-19 vaccines due to access or clinical appropriateness, and individuals aged 18 years or older who want the Jansen vaccine and would otherwise not receive a COVID-19 vaccine.
This decision comes as a result of an analysis on the risk of thrombosis with thrombocytopenia syndrome (TTS), a rare but potentially fatal syndrome that results in blood clots and low levels of blood platelets. A total of 60 cases of TTS have been reported to the Vaccine Adverse Event Reporting System.
Seroprevalence of COVID-19 Infections2
More than half of the American public has been infected with COVID-19, according to the results of a recent national survey from the Centers for Disease Control and Prevention (CDC).
Researchers examined the seroprevalence of antibodies produced only during a COVID-19 infection to better understand the amount of asymptomatic, undiagnosed, or unreported COVID-19 infections within the United States from September 2021 to February 2022.
The results indicated the overall seroprevalence increased from 33.5% in December 2021 to 57.7% in February 2022. Additionally, approximately 75% of children and adolescents had evidence of previous COVID-19 infection as of February 2022, of which a third were newly infected from December 2021. Age groups with the lowest vaccination coverage had the highest increase of seroprevalence from September 2021 to February 2022.
Neurologic Symptoms Following COVID-193
Serious neurologic manifestations, such as stroke and seizure, occurred in 12.9% of individuals hospitalized with COVID-19.
Included in this prospective observational study were 16,225 individuals from 179 hospitals within 24 countries.
Of the total individuals included, 10.2% (n = 1656) had encephalopathy at admission. At admission or during the course of hospitalization, 2.0% (n = 331) developed stroke, 1.5% (n = 243) with seizure, and 0.5% with meningitis/encephalitis. These serious neurologic symptoms were associated with more severe disease, a higher likelihood of being admitted to the intensive care unit and to require critical care interventions.
Serious Complications in Unvaccinated Individuals4
Individuals with heart problems who are not vaccinated against COVID-19 are 9 times more likely to suffer adverse outcomes and events following COVID-19 infection.
Researchers examined the relationship between hypertension (HTN), diabetes mellitus (DM), ischemic heart disease (IHD), and myocardial injury on the risk of death, acute respiratory distress syndrome, invasive mechanical ventilation, admission to the intensive care unit, acute kidney injury, and severe disease. They conducted a meta-analysis of 110 studies, consisting of 48,809 individuals with COVID-19 between December 2019 and July 2020.
COVID-19 patients with myocardial injury are at substantially greater risk of death, severe disease and other adverse outcomes, researchers concluded. Weaker, yet significant associations are present in patients with HTN, DM, and IHD. Quantifying these associations is important for risk stratification, resource allocation and urgency in vaccinating these populations.
Leigh Precopio
References:
Make no mistake, most of us are fed up with more than two years of battling the bug.
But the evidence is leading health professionals to believe that while the illness may not be as lethal as earlier strains, people who are older and immune compromised may be asked to go back to the tried and true preventions including wearing masks and distancing with a new wave expected this fall.
People are also advised to stay up to date with vaccinations.
Thats the best tool we have to prevent bad outcomes against COVID, and also wear a mask, no gatherings, and things like that if you are in that group of people, said Dr. Monika Murillo, LECOM Health.
A lot of things have changed with the bug in terms of its severity and the ways to fight it, but some things have stayed the same.
Some of the original suggestions including getting your vaccinations are still the best advice.
While the initial efforts was just trying to convince people to get vaccinated, now that many have the new frontier is booster shots, every four months for those at risk, both in terms of the initial shots and staying up to speed with boosters.
Get vaccinated with the series and if you have been vaccinated to check on your booster status. The booster is recommended if you have not received it in four months and youre older than 50 or if you have chronic medical conditions, said Dr. Chris Clark, MD, President of AHN Saint Vincent.
For news delivered right to you,subscribe to JET 24/FOX 66/YourErie.coms breaking, daily news & severe weather email lists
The ultimate goal may no longer be the elimination of COVID, but managing the illness the way an annual shot protects us from the flu.
The University of Georgia will end campus COVID-19 measures on May 16, according to a Monday Archnews email. UGA will begin treating COVID-19 the same as other infectious disease cases. The measures set to be discontinued include:
Weekly health and exposure updates on the COVID-19 website (a final update will publish on May 18)
Weekend call center staffing by Student Care and Outreach
Isolation and quarantine housing accommodations
Pop-up and surveillance testing
The reporting tool DawgCheck
The University System of Georgia, in compliance with a federal court judgment, no longer requires passengers to wear masks on campus transportation.
Faculty, employees, students and their qualifying dependents aged 16 and up will continue to receive free first, second and booster doses of the Pfizer vaccination from the University Health Center.
UGA plans to maintain a license for the DawgCheck notification system should it need to be redeployed and will continue to advise senior administrators as needed, the email said.
Onondaga County sees decline in new COVID-19 cases, hospitalizations over the weekend CNYcentral.com
Nearly three out of four Coloradans older than 5 are now fully immunized with two doses of the COVID-19 vaccine, according to the states vaccination dashboard. Thats higher than the national average, which is about 66 percent, according to the New York Times, and puts Colorado at 16th highest among the 50 states.
Colorado recently topped a total of 4 million people who had gotten at least two doses, according to the state health department. More than half of all residents got the first two shots, plus a booster.
Colorados progress on the vaccination front comes at another uncertain point in the pandemic. The latest wildly transmissible variant BA.2.12.1 has infected increasing numbers of people in the state and around the country. But many of the tools to limit spread have been dropped, and surveillance and reporting of coronavirus trends are less robust than earlier in the pandemic.
Those younger than 5 are still not eligible though approval could come soon. The Food and Drug Administration issued a timetable last month for a decision about authorizing a COVID-19 vaccine for the youngest children in the U.S. It said June 8 is the earliest date itll present data to outside advisers for a recommendation.
Getting vaccinated helps prevent severe illness, said Dr. Jon Samet, dean of the CU School of Public Health.
One thing that's clear is if you had the first two shots, get the third, he said. Theres some data from Israel that that fourth shot helps, at least for a while.
The latest COVID-19 data in Colorado is a decidedly mixed bag.
COVID-19 hospitalizations rose to 110 last week up 33 since mid-April. But that's 1,500 fewer than the highest level recorded in the omicron wave.
The positivity rate for COVID-19 test is staying above the key 5 percent threshold as public health officials closely watch. As of Thursday, the positive test rate was 6.3 percent, according to state data. It's been above 6 percent for the last week and doubled since mid-March. But it's five times lower than January's omicron wave peak.
Wastewater surveillance data showed a pronounced spike in virus detected in mid-April and another smaller rise at the end of last month.
So much of what happens next in this pandemic depends on the next variant or variants, which is why continuing to encourage Coloradans to get vaccinated and boosted is key, Samet added. If we had one (variant) with a high degree of immune escape, that is vaccine acquired protection is not great against the variant, that would be a problem.
Other public health experts worry Colorado and the U.S. may be flying blind. Many governments dropped non-pharmaceutical interventions like masking and contact tracing, while not beefing up surveillance enough to give warning of a potential coming surge, said May Chu, an epidemiologist and clinical professor, also at the Colorado School of Public Health.
I think the trend away from contact tracing, from not promoting vaccination and boosters and the promotion of at home-testing, whose results are not seen by public health, because most are not reported to health departments, all point to an uneasy second half of the year, Chu said.
We are far from being endemic, the point where the pandemic has become predictable, Chu said. New variants are rising and most of the world is blind to that.
Two omicron subvariants, which have emerged since the start of the year account for nearly all of Colorados cases, after first delta, then the original omicron variant swamped the state. In the most recent data posted to the state dashboard, the BA.2 subvariant makes up 74 percent and BA.2.12.1 comprises 14 percent. But thats as of the week of April 10, so that data hasnt been updated in nearly a month, according to the states dashboard.
Billions in funding for further COVID-19 prevention and protection is stalled in Congress. Colorado Gov. Jared Polis in March urged Congress to approve more money to secure enough booster vaccine doses for all Americans and invest in variant-specific vaccines or a pan-COVID vaccine.
It would protect against a range of variants should the science and data demonstrate the need, he said.
Though vaccination has grown steadily in Colorado since vaccines first started to become available late in 2020, the pandemics first year, there's wide variability across the state and across populations.
One group has lagged consistently behind when it comes to COVID-19 vaccines: Hispanics. Just 40 percent of that population has been vaccinated with at least one dose, according to the states dashboard. State models suggest the actual number may be higher, 48 percent.
Either way its measured, that trails all other groups for which the state has recorded information including white Coloradans (78 percent), as well as Black or African-American (66 percent), Asian, Native Hawaiian or Pacific Islander (69 percent), American Indian or Alaska Native (73 percent) residents.
I am still seeing first and second vaccines. We are leaving my community behind, said Julissa Soto, an independent health equity consultant who works with the state. Soto said she and others have helped vaccinate some 15,000 Latinos since last fall, but would like the numbers to be much higher. Everyone is talking about the fourth booster and my community still struggles to get their first and second dose.
Gaps persist as well, comparing the states urban, suburban and rural counties.
More than 80 percent of those residents 5 and up have gotten two doses in Denver, several metro counties, and some mountain counties.
The figure is better than 70 percent for other large Front Range counties: Jefferson, Douglas, Arapahoe, Adams and Larimer counties.
For El Paso County it's 67 percent, Pueblo County is at 61 percent and Mesa County, on the western slope, is at 54 percent.
Fewer than 50 percent of residents are vaccinated in many sparsely populated rural Colorado counties. In Kiowa, Rio Blanco, Cheyenne, Washington and Dolores counties the rate is below 40 percent.
The spotty coverage leaves under-vaccinated areas especially vulnerable to future outbreaks.
Even where vaccination rates are higher, vaccine effectiveness wanes over time and almost half of all Coloradans have yet to get a booster dose, on top of the first two shots.
Chu also worries about another virus taking off in the coming months: the flu. She said Colorado has essentially not had to battle much influenza for two flu seasons now, because COVID-19 precautions also limited the spread of the flu. But that could rise sharply this year, she said.
Chu said work is underway to develop a global platform to monitor exposure to COVID-19 and other diseases of public health concern, but this has many moving pieces. We cannot let our guard up just yet.
A recent article published in Science Translational Medicinedemonstrated that mucosally delivered adenovirus type 5 (Ad5)-based coronavirus disease 2019 (COVID-19) vaccination minimized COVID-19 transmission and severity.
The currently approved intramuscular (IM) severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccinations for clinical use can protect vaccinees from COVID-19-related hospitalization, symptomatic illness, and mortality. They do not, however, totally protect against SARS-CoV-2 infection.
Besides, messenger ribonucleic acid (mRNA) vaccinated individuals with COVID-19 linked with the SARS-CoV-2 Delta (B.1.617.2) as well as Omicron (B.1.1.529) variants could shed infectious virus and viral RNA, possibly spreading SARS-CoV-2 to others. Hence, transmission-blocking techniques are required to restrict the spread of SARS-CoV-2 while also protecting against COVID-19.
Prior studies indicated that because the mucosal layer of the upper respiratory tract (URT) is the first location of SARS-CoV-2 replication and infection, therapies that produce strong mucosal immunitymighthave the utmost influence on attenuating the SARS-CoV-2 transmission. The authors of the present investigation previously developed an orally administered Ad5-vectored SARS-CoV-2 vaccine option that expresses the viral spike (S) protein (r-Ad-S). Available reports showed that this shelf-stable, replication-defective oral r-Ad-S COVID-19 vaccine candidate induced both mucosal and systemic immunity.
In the present study, the researchers employed unidirectional airflow chambers and a hamster infection model to investigate the possible influence of oral SARS-CoV-2 r-Ad-S vaccination on COVID-19 transmission to naive people.
The researchers used IM SARS-CoV-2 S protein, oral phosphate-buffered saline (PBS), and intranasal (IN) r-Ad-S as protein, mock, and mucosal stimulation controls, respectively, when they vaccinated index hamsters using oral r-Ad-S. Further, they inoculated a high SARS-CoV-2 titer intranasally in vaccinated hamsters to replicate a post-vaccination COVID-19. One day following the viral challenge, index hamsters were put in a compartment with vaccine-nave hamsters that facilitated airborne movement, yet no fomite or direct contact transmission.
The authors reported the virological and clinical responses of both the nave (SARS-CoV-2 exposed) and vaccinated (SARS-CoV-2-infected) hamsters. Besides, they presented mucosal antibody details from subjects from a phase I clinical study (NCT04563702) utilizing the same platform expressing the SARS-CoV-2 S and nucleocapsid proteins (NPs).
According to the study results, oral r-Ad-S vaccination decreased COVID-19 and SARS-CoV-2 transmission in a hamster model. Moreover, the scientists stated that it could elicit CoVcross-reactive, S protein-specific immunoglobulin A (IgA) in thehuman mouth and nose.
The team reported potent anti-SARS-CoV-2 S protein IgG responses after IN and oral r-Ad-S vaccination, as earlier shown in another oral r-Ad-S hamster trial. Furthermore, enhanced IgA was detected in the bronchoalveolar lavage (BAL) fluid and serum of mucosally vaccinated animals. During an eight-hour airborne exposure period, mucosally vaccinated animals with COVID-19 exhibited decreased airborne SARS-CoV-2 transmission to nave animals. This was determined by lower nasal swab SARS-CoV-2 RNA titers in nave animals one and three days following transmission exposure to IN/oral r-Ad-S-immunized hamsters versus control exposed animals.
The authors hypothesized that mucosal antibodies in the URT could boost SARS-CoV-2 clearance in vaccinated animals, thus decreasing the infectiousness capacity of transmitted aerosols. Supporting this theory, anti-S protein IgA levels in the BAL fluid of IN and oral r-Ad-S vaccinated animals were higher than in mock- or IM protein-vaccinated animals. These findings indicated that SARS-CoV-2 transmission from vaccinated to non-vaccinated animals might be reduced by mucosal vaccination.
Additionally, the team showed serum IgG from all immunized hamsters bound to S protein of both the SARS-CoV-2 Delta and Beta variants of concern (VOCs). This indicated that mucosal immunization might result in cross-protective antibodies against novel SARS-CoV-2 VOCs.
The researchers presented data showing that immunization with the VXA-COV2-1 oral tablet S and NP vaccine resulted in substantial anti-S protein IgA in saliva and nasal swabs in a subgroup of people, which bonded to the S proteins of various CoVs. This included the four endemic human CoVs (HKU1, NL63, 229E, and OC43) and several pathogenic CoVs (SARS-CoV-1 and Middle East respiratory syndrome CoV (MERS-CoV)). Compared to systemic IgG antibodies, mucosal immunization against SARS-CoV-2 might generate IgA antibodies at the mucosal surface with enhancedcross-reactivity to CoVs.
The study findings showed that hamsters given an IN or oral r-Ad-S COVID-19 vaccinedeveloped cross-reactive and robust antibody responses. Followingthe SARS-CoV-2 challenge, IN or oral-vaccinated hamsters exhibited a lower infectious virus and viral RNA in the lungs/nose. They also demonstrated less lung pathology than mock-vaccinated hamsters.
Nave hamsters subjected to mucosally vaccinated hamsters with SARS-CoV-2 infection in a unidirectional airflow chamber had fewer clinical symptoms and reduced viral RNA in nasal swabs relative to control animals. These inferences implied that viral transmission via the mucosal route was decreased.
In addition, the authors reported that in one phase I clinical study, the same platform expressing the SARS-CoV-2 S and NP evoked mucosal cross-reactive SARS-CoV-2-selective IgA responses. Overall, the present study demonstrated that mucosal vaccination was a promising method for reducing the airborne transmission of SARS-CoV-2 and COVID-19.
New research suggests that adults with severe obesity generate a s significantly weaker immune response to COVID-19 vaccination compared to those with normal weight.
Pfizer/BioNTech linked to a more robust antibody response than CoronaVac in people with severe obesity.
New research suggests that adults (aged 18 or older) with severe obesity generate a significantly weaker immune response to COVID-19 vaccination compared to those with normal weight. The study was conducted by Professor Volkan Demirhan Yumuk from Istanbul University in Turkey and colleagues and was presented at this years European Congress on Obesity (ECO) in Maastricht, Netherlands (May 4-7).
The study also found that people with severe obesity (BMI of more than 40kg/m2) vaccinated with Pfizer/BioNTech BNT162b2 mRNA vaccine generated significantly more antibodies than those vaccinated with CoronaVac (inactivated SARSCoV2) vaccine, suggesting that the Pfizer/BioNTech vaccine might be a better choice for this vulnerable population.
Obesity is a disease complicating the course of COVID-19, and the SARS-CoV-2 vaccine antibody response in adults with obesity may be compromised. Vaccines against influenza, hepatitis B, and rabies, have shown reduced responses in people with obesity.
To find out more, researchers investigated antibody responses following Pfizer/BioNTech and CoronaVac vaccination in 124 adults (average age 42-63 years) with severe obesity who visited the Obesity Center at Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty Hospitals, between August and November 2021. They also recruited a control group of 166 normal weight adults (BMI less than 25kg/m2, average age 39-47 years) who were visiting the Cerrahpasa Hospitals Vaccination Unit.
Researchers measured antibody levels in blood samples taken from patients and normal weight controls who had received two doses of either the Pfizer/BioNTech or CoronaVac vaccine and had their second dose four weeks earlier. The participants were classified by infection history as either previously having COVID-19 or not (confirmed by their antibody profile).
Overall, 130 participants received two doses of Pfizer/BioNTech and 160 participants two doses of CoronaVac, of whom 70 had previous SARS-CoV-2 infection (see tables in notes to editors).
In those without previous SARS-CoV-2 infection and vaccinated with Pfizer/BioNTech, patients with severe obesity had antibody levels more than three times lower than normal weight controls (average 5,823 vs 19,371 AU/ml).
Similarly, in participants with no prior SARS-CoV-2 infection and vaccinated with CoronaVac, patients with severe obesity had antibody levels 27 times lower than normal weight controls (average 178 vs 4,894 AU/ml).
However, in those with previous SARS-CoV-2 infection, antibody levels in patients with severe obesity and vaccinated with Pfizer/BioNTech or CoronaVac were not significantly different from normal weight controls (average 39,043 vs 14,115 AU/ml and 3,221 vs 7,060 AU/ml, respectively).
Interestingly, the analyses found that in patients with severe obesity, with and without prior SARS-CoV-2 infection, antibody levels in those vaccinated with Pfizer/BioNTech were significantly higher than those vaccinated with CoronaVac.
These results provide new information on the antibody response to SARS-CoV-2 vaccines in people with severe obesity and reinforce the importance of prioritizing and increasing vaccine uptake in this vulnerable group, says Professor Yumuk. Our study confirms that immune memory induced by prior infection alters the way in which people respond to vaccination and indicates that two doses of Pfizer/BioNTech vaccine may generate significantly more antibodies than CoronaVac in people with severe obesity, regardless of infection history. However, further research is needed to determine whether these higher antibody levels provide greater protection against COVID-19.
Why do I have to complete a CAPTCHA?
Completing the CAPTCHA proves you are a human and gives you temporary access to the web property.
If you are on a personal connection, like at home, you can run an anti-virus scan on your device to make sure it is not infected with malware.
If you are at an office or shared network, you can ask the network administrator to run a scan across the network looking for misconfigured or infected devices.
Another way to prevent getting this page in the future is to use Privacy Pass. You may need to download version 2.0 now from the Firefox Add-ons Store.
