No age graphs today. I spent the morning trying to approximate an adjustment for deaths since the second jab. However, today, the NHS has moved the age bands on from 31/3 to 31/8, so I now need to spend some more time considering the impact of that on my charts. 3/3

The run rate of 1.6m continues to be well short of those becoming eligible, so the backlog grows. After a brief dip below 2m, the required number will be around 2.1m/2.2m for the next month. 2/

Thu booster (& 3rd primary) update. 237k today, up an unimpressive 6% on a week ago. Total now 5.9m, out of 11.7m double jabbed six months ago. The "backlog" is now also 5.9m. Some of the backlog will have appts booked in, and sadly around 0.25m will have died. 1/

he Independent SAGE +++ ‘We are following the ​science’ is the message the British public have been hearing from government since COVID-19 mitigating measures began. It says it is following the advice of the Scientific Advisory Group for Emergencies (SAGE). But the activities of the committee have been kept secret and excluded from scrutiny by the public or wider scientific community. In response, on Monday May 4, the Independent SAGE convened as a group of preeminent experts from the UK and around the world. The aim of the Independent SAGE was and is to provide robust, independent advice to HM Government with the purpose of helping the UK navigate COVID-19 whilst minimising fatalities. The Independent SAGE is chaired by former HM Government Chief Scientific Advisor Sir David King and draws on a range of international and British experts.

indie_SAGE

After a summer of reports of breakthrough coronavirus infections, when it seemed that everyone knew someone who tested positive after vaccination, recently released federal data sheds light on how common these cases really were, how severe they became and who was most at risk.

Who Had Covid-19 Vaccine Breakthrough Cases?

LIVE NOW: Independent SAGE with experts discussing how we can build a better NHS and create a health, care and support system that is resilient to future shocks. Guests: @HelenKillaspy @AdelinaCoHe @drmarielouise @NeenaModi1 @RobertAunger & Dr Tony O’Sullivan

indie_SAGE 29.10.21

Lab escape theories cannot clearly account for a virus that has evolved for human-to-human transmissibility.

Why I Still Believe Covid-19 Could Not Have Originated in a Lab

Determining policies to end the SARS-CoV-2 pandemic will require an understanding of the efficacy and effectiveness (hereafter, efficacy) of vaccines. Beyond the efficacy against severe disease and symptomatic and asymptomatic infection, understanding vaccine efficacy against virus transmission, including efficacy against transmission of different viral variants, will help model epidemic trajectory and determine appropriate control measures. Recent studies have proposed using random virologic testing in individual randomized controlled trials to improve estimation of vaccine efficacy against infection. We propose to further use the viral load measures from these tests to estimate efficacy against transmission. This estimation requires a model of the relationship between viral load and transmissibility and assumptions about the vaccine effect on transmission and the progress of the epidemic. We describe these key assumptions, potential violations of them, and solutions that can be implemented to mitigate these violations. Assessing these assumptions and implementing this random sampling, with viral load measures, will enable better estimation of the crucial measure of vaccine efficacy against transmission.

Estimating Vaccine Efficacy Against Transmission via Effect on Viral Load

10.1097/EDE.0000000000001415

Vaccine Efficacy at a Point in Time

Vaccine trials are generally designed to assess efficacy on clinical disease. The vaccine effect on infection, while important both as a proxy for transmission and to describe a vaccine’s total effects, requires frequent longitudinal sampling to capture all infections. Such sampling may not always be feasible. A logistically easy approach is to collect a sample to test for infection at a regularly scheduled visit. Such point or cross-sectional sampling does not permit estimation of classic vaccine effiacy on infection, as long duration infections are sampled with higher probability. Building on work by Rinta-Kokko and others (2009) we evaluate proxies of the vaccine effect on transmission at a point in time; the vaccine efficacy on prevalent infection and on prevalent viral load, VEPI and VEPV L, respectively. Longer infections with higher viral loads should have more transmission potential and prevalent vaccine efficacy naturally captures this aspect. We apply a proportional hazards model for infection risk and show how these metrics can be estimated using longitudinal or cross-sectional sampling. We also introduce regression models for designs with multiple cross-sectional sampling. The methods are evaluated by simulation and a phase III vaccine trial with PCR cross-sectional sampling for subclinical infection is analyzed.

10.1101/2021.02.04.21251133

This report has been published to continue to share the detailed variant surveillance analyses which contribute to the variant risk assessments and designation of new VOCs and VUIs. The specialist technical briefings contain early data and analysis on emerging variants and findings have a high level of uncertainty. A separate report is published covering surveillance data on all other VOCs and VUIs. In summary: 1. There are 4 current variants of concern (VOCs) and 11 variants under investigation (VUIs) (Table 1). There are no new VOCs or VUIs in the UK classification since the last briefing. 2. Delta remains the predominant variant accounting for approximately 99.8% of sequenced cases in England as of 25 October 2021. 3. The Delta sublineage AY.4.2 (VUI-21OCT-01) accounts for a slowly increasing proportion of cases in the UK. It accounts for 8.5% of Delta cases in the most recent complete week of sequencing (4 October 2021 to 10 October 2021). In more recent weeks, sequencing data are incomplete, however AY.4.2 accounts for 10.3% of Delta cases in the week 11 October 2021 to 17 October 2021 and 11.3% in the week 18 October 2021 to 24 October 2021. 4. The growth rate and secondary attack rates have been refreshed with new data and the findings remain the same as last week. Estimated growth rates remain slightly higher for AY.4.2 than for Delta, and the household secondary attack rate is higher for AY.4.2 cases than for other Delta cases. 5. A preliminary rapid vaccine effectiveness analysis does not suggest a significant reduction in vaccine effectiveness for AY.4.2 compared to Delta. However, a further analysis more comprehensive analysis using the standard test negative case control study design is being undertaken. 6. The UKHSA variant definition for VUI-21OCT-01 currently has 95.2% sensitivity and 97.5% specificity for sequencing data outside of the UK (GISAID). 7. AY.4.2 live virus isolates have been obtained from residual biological materials and assays are in process. Pseudovirus work has been initiated. All risk assessments are published separately online, except for Gamma, which was published within Technical Briefing 7 and Alpha within Technical Briefing 9. As Delta is the dominant variant in the UK, epidemiological data in the weekly surveillance report is also relevant

SARS-CoV-2 variants of concern and variants under investigation in England

10.1038/s41467-021-26499-y

Rapid development of COVID-19 vaccines has helped mitigating SARS-CoV-2 spread, but more equitable allocation of vaccines is necessary to limit the global impact of the COVID-19 pandemic and the emergence of additional variants of concern. We have developed a COVID-19 vaccine candidate based on Newcastle disease virus (NDV) that can be manufactured at high yields in embryonated eggs. Here, we show that the NDV vector expressing an optimized spike antigen (NDV-HXP-S) is a versatile vaccine inducing protective antibody responses. NDV-HXP-S can be administered intramuscularly as inactivated vaccine or intranasally as live vaccine. We show that NDV-HXP-S GMP-produced in Vietnam, Thailand and Brazil is effective in the hamster model. Furthermore, we show that intramuscular vaccination with NDV-HXP-S reduces replication of tested variants of concerns in mice. The immunity conferred by NDV-HXP-S effectively counteracts SARS-CoV-2 infection in mice and hamsters.

A Newcastle disease virus expressing a stabilized spike protein of SARS-CoV-2 induces protective immune responses

When does the suffering become too great? Well, that's up to us. We all have our own limits of other people's suffering that we're willing to tolerate. But the people who would see it - doctors, nurses, care workers, patients, will all tell you that it is unacceptable now. 7/n

What happens now in the reasonable worst case scenario? This. More of this. That's all. It won't be like a disaster movie. We'll just see more people suffering more, and dying a little more often, in preventable ways. 6/n

So mistakes happen. More little mistakes, more big mistakes. Everything gets just a bit riskier with each new patient who arrives. Don't take my word for it, we have robust evidence. https://link.springer.com/article/10.1007/s00134-018-5148-2#change-history… 5/n

That means that you have to wait longer for everything, you get cared for by more exhausted, less experienced people with less support, tests and investigations are delayed, and you may be cared for in a part of the hospital that doesn't normally deal with your problem. 4/n

The main problem is Covid: more Covid means fewer nurses and doctors (they get it too), and more patients. We have too many patients, and not enough staff. 3/n

When a healthcare system fails, increasing numbers of people suffer and die needlessly. That's all. If you aren't a patient or staff, you don't see it. But this is happening, now, all over the UK. 2/n

I've been thinking about this and the responses. There are many complex problems in the NHS but I can give you some simple, important facts that I know to be true, from my own observations. 1/n

Vaccination reduces but does not eliminate the risk of covid-19 transmission within households, a study published in Lancet Infectious Diseases has found.1 It showed that one in four vaccinated household contacts of a covid-19 positive case became infected compared with 38% of unvaccinated contacts.

Covid-19: One in four vaccinated people living in households with a covid-19 case become infected, study finds

10.1136/bmj.n2638

BackgroundCOVID-19 is a pandemic respiratory and vascular disease caused by SARS-CoV-2 virus. There is a growing number of sensory deficits associated with COVID-19 and molecular mechanisms underlying these deficits are incompletely understood.MethodsWe report a series of ten COVID-19 patients with audiovestibular symptoms such as hearing loss, vestibular dysfunction and tinnitus. To investigate the causal relationship between SARS-CoV-2 and audiovestibular dysfunction, we examine human inner ear tissue, human inner ear in vitro cellular models, and mouse inner ear tissue.ResultsWe demonstrate that adult human inner ear tissue co-expresses the angiotensin-converting enzyme 2 (ACE2) receptor for SARS-CoV-2 virus, and the transmembrane protease serine 2 (TMPRSS2) and FURIN cofactors required for virus entry. Furthermore, hair cells and Schwann cells in explanted human vestibular tissue can be infected by SARS-CoV-2, as demonstrated by confocal microscopy. We establish three human induced pluripotent stem cell (hiPSC)-derived in vitro models of the inner ear for infection: two-dimensional otic prosensory cells (OPCs) and Schwann cell precursors (SCPs), and three-dimensional inner ear organoids. Both OPCs and SCPs express ACE2, TMPRSS2, and FURIN, with lower ACE2 and FURIN expression in SCPs. OPCs are permissive to SARS-CoV-2 infection; lower infection rates exist in isogenic SCPs. The inner ear organoids show that hair cells express ACE2 and are targets for SARS-CoV-2.ConclusionsOur results provide mechanistic explanations of audiovestibular dysfunction in COVID-19 patients and introduce hiPSC-derived systems for studying infectious human otologic disease.

Direct SARS-CoV-2 infection of the human inner ear may underlie COVID-19-associated audiovestibular dysfunction

10.1038/s43856-021-00044-w

Story Highlights 36% of U.S. workers say their employer is requiring COVID-19 vaccine More employees continue to favor than oppose mandates Employees strongly opposed to mandates inclined to look for other jobs

COVID-19 Vaccine Now Required for 36% of U.S. Workers

TORONTO -- With Health Canada expected to soon begin considering COVID-19 vaccine eligibility for children aged five to 11 years, a new survey by the Angus Reid Institute says that more than half of Canadian parents plan to give their kids the jab as soon as they get the green light. However, in a sign of the divided opinions on vaccinations across the country, nearly one-quarter say they will not vaccinate their elementary school-aged children even if the vaccines are approved for the age group. The survey found that 51 per cent of parents plan to get their children vaccinated as soon as it is approved, while 18 per cent said they plan to eventually get their children vaccinated, but would wait a while first. Twenty-three per cent said they will not get their children vaccinated, and nine per cent said they weren’t sure.

Half of Canadian parents would vaccinate their 5-11 year old ASAP: survey

WASHINGTON — Among scientists, there’s little debate: People who get sick with Covid-19 develop at least some protection against being infected in the future. But exactly how much protection they have, and how long it lasts, are the subjects of the country’s latest Covid-19 controversy. For the past month, university employees, professional athletes, and conservative lawmakers across the country have argued they should be exempted from increasingly strict vaccine mandates because, scientifically speaking, they don’t need them: They’re already protected by their body’s own immune response.

Politics is derailing a crucial debate over the immunity you get from recovering from Covid-19

A video on Facebook, performed in the style of a rap battle and viewed more than 36,000 times, makes a number of misleading claims about Covid-19 and the vaccines.  In it, the self-proclaimed “truther” tells their “vaxxer” alter-ego that Covid-19 is as deadly as the flu, alludes to ivermectin as an effective treatment for the virus and describes side effects reported through the Yellow Card system.  These claims, alongside others made in the video, are identical to misinformation we have seen circulating throughout the pandemic and subsequent vaccination programme.  Here are the facts on six key points made during the video. 

Vaccine rap battle full of misinformation

Are workplace vaccine mandates prompting some employees to quit rather than get a shot? A hospital in Lowville, New York, for example, had to shut down its maternity ward when dozens of staffers left their jobs rather than get vaccinated. At least 125 employees at Indiana University Health resigned after refusing to take the vaccine. And several surveys have shown that as many as half of unvaccinated workers insist they would leave their jobs if forced to get the shot, which has raised alarms among some that more mandates could lead to an exodus of workers in many industries. New York, for example, is preparing for an exodus of health care workers – and may even call in the National Guard to help – as its vaccine mandate takes effect on Sept. 27, 2021.

Half of unvaccinated workers say they’d rather quit than get a shot – but real-world data suggest few are following through

10.1038/s41586-021-04117-7

AbstractThe emergence of SARS-CoV-2 variants is jeopardizing the effectiveness of current vaccines and limiting the application of monoclonal antibody-based therapy for COVID-191,2. Here we analysed at single-cell level the memory B cells of five naive and five convalescent people vaccinated with the BNT162b2 mRNA vaccine to dissect the nature of the B cell and antibody response. Almost six-thousands cells were sorted, over three-thousand of them produced monoclonal antibodies against the spike protein and more than four hundred neutralized the original Wuhan SARS-CoV-2 virus. The B.1.351 (Beta) and B.1.1.248 (Gamma) variants showed to escape almost seventy per cent of these antibodies while a much smaller portion was impacted by the B.1.1.7 (Alpha) and B.1.617.2 (Delta) variants. The overall loss of neutralization was always significantly higher in the antibodies from naive people. In part this was due to the IGHV2-5;IGHJ4-1 germline, which was found only in convalescent people and generated potent and broadly neutralizing antibodies. Our data suggest that people that are seropositive following infection or primary vaccination will produce antibodies with increased potency and breadth and will be able to better control SARS-CoV-2 emerging variants.

Hybrid immunity improves B cells and antibodies against SARS-CoV-2 variants

SummaryBackgroundVaccine 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.MethodsIn 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.FindingsBetween 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.InterpretationOur 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.FundingPfizer.

10.1016/S0140-6736(21)02183-8

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

SummaryBackgroundThe effectiveness of heterologous prime-boost Coronavirus disease 2019 (Covid-19) vaccination is currently unknown.MethodsFrom individuals vaccinated with two doses against Covid-19 in Sweden until July 5, 2021 (N=3,445,061), we formed a study cohort including 94,569 individuals that had received heterologous ChAdOx1 nCoV-19 / BNT162b2 prime-boost vaccination, 16,402 individuals that received heterologous ChAdOx1 nCoV-19 / mRNA-1273 prime-boost vaccination, and 430,100 individuals that received homologous ChAdOx1 nCoV-19 / ChAdOx1 nCoV-19 prime-boost vaccination. In addition, 180,716 individuals were selected who were unvaccinated at the date of vaccination in the corresponding case. Unvaccinated individuals were censored at first dose of any vaccine. Baseline was the date of the second dose of any vaccine, with the same date in the corresponding unvaccinated individual. The outcome included incident symptomatic Covid-19 infection occurring >14 days after baseline.FindingsDuring a mean follow-up time of 76 (range 1-183) days, symptomatic Covid-19 infection was confirmed in 187 individuals with heterologous vaccine schedules (incidence rate: 2.0/100,000 person-days) and in 306 individuals from the unvaccinated control group (incidence rate: 7.1/100,000 person-days). The adjusted vaccine effectiveness was 67% (95% CI, 59-73, P<0.001) for heterologous ChAdOx1 nCoV-19 / BNT162b2 prime-boost vaccination, and 79% (95% CI, 62-88, P<0.001) for heterologous ChAdOx1 nCoV-19 / mRNA-1273 prime-boost vaccination. When combined and analysed together, the two heterologous vaccine schedules had an effectiveness of 68% (95% CI, 61-74, P<0.001) which was significantly greater (Pinteraction<0.001) than the 50% effectiveness for homologous ChAdOx1 nCoV-19 / ChAdOx1 nCoV-19 (95% CI, 41-58, P<0.001).InterpretationThe findings of this study suggest that the use of heterologous ChAdOx1 nCoV-19 and mRNA prime-boost vaccination is an effective alternative to increase population immunity against Covid-19, including against the Delta variant which dominated the confirmed cases during the study period. These findings could have important implications for vaccination strategies and logistics, and consequently in the battle against the Covid-19 pandemic.Research in context Evidence before this studyAfter the rare thromboembolic events coupled to the first dose of vector-based vaccines towards Covid-19, heterologous vaccine schedules have been proposed as an option. Pre-clinical and clinical studies have suggested that heterologous vaccine schedules using ChAdOx1 nCoV-19 as the first dose, and either the BNT162b2 or mRNA-1273 as the second dose, elicit a stronger immune response compared with a homologous ChAdOx1 nCoV-19 / ChAdOx1 nCoV-19 vaccine schedule. However, data on the potential effectiveness of heterologous vaccine schedules against symptomatic Covid-19 infection is lacking. Added value of this studyIn this study, heterologous Covid-19 vaccination using ChAdOx1 nCoV-19 as a first dose followed by either the BNT162b2 or mRNA-1273 as the second dose, was associated with 67% to 79% effectiveness against symptomatic Covid-19-infection. The effectiveness of the two heterologous schedules combined was significantly higher compared with the 50% effectiveness from homologous vaccination using ChAdOx1 nCoV-19 / ChAdOx1 nCoV-19. Implications of all the available evidenceThe use of heterologous vaccine schedules appears to be an effective alternative for increasing population immunity against Covid-19, including against the Delta variant which dominated the confirmed cases during the study period. These results could have important implications for vaccination strategies and consequently in the battle against the pandemic.

10.1016/j.lanepe.2021.100249

Effectiveness of heterologous ChAdOx1 nCoV-19 and mRNA prime-boost vaccination against symptomatic Covid-19 infection in Sweden: A nationwide cohort study

Importance  Recent data suggest a relatively low incidence of COVID-19 among children. The possible role that children attending primary school may play in the transmission of SARS-CoV-2 remains poorly understood.Objective  To gain a better understanding of the possible role of children in the transmission of SARS-CoV-2.Design, Setting, and Participants  This prospective cohort study was conducted from September 21 to December 31, 2020, in a primary school in Liège, Belgium, among a volunteer sample of 181 children, parents, and school employees.Exposures  Participants were tested for SARS-CoV-2 infection once a week for 15 weeks through throat washing, performed with 5 mL of saline and collected in a sterile tube after approximately 30 seconds of gargling. Quantitative reverse transcription–polymerase chain reaction was performed to detect SARS-CoV-2 infection.Main Outcomes and Measures  In case of test positivity, participants were asked to complete a questionnaire aimed at determining the timing of symptom onset and symptom duration. SARS-CoV-2 genetic sequencing was also performed. Confirmed cases were linked based on available information on known contacts and viral sequences.Results  A total of 181 individuals participated in this study, including 63 children (34 girls [54.0%]; mean [SD] age, 8.6 [1.9] years [range, 5-13 years]) and 118 adults (75 women [63.6%]; mean [SD] age, 42.5 [5.7] years [range, 30-59 years]). Forty-five individuals (24.9%) tested positive: 13 children (20.6%; 95% CI, 10.6%-30.6%) and 32 adults (27.1%; 95% CI, 19.1%-35.7%) (P = .34). Children were more often asymptomatic compared with adults (6 [46.2%; 95% CI, 19.1%-73.3%] vs 4 of 31 [12.9%; 95% CI, 1.3%-24.5%]; P = .04). The median duration of symptoms was shorter in children than in adults (0.00 days [IQR, 0.00-1.00 days] vs 15.00 days [IQR, 7.00-22.00 days]). A reconstruction of the outbreak revealed that most transmission events occurred between teachers and between children within the school. Of the observed household transmission events, most seemed to have originated from a child or teacher who acquired the infection at school.Conclusions and Relevance  Despite the implementation of several mitigation measures, the incidence of COVID-19 among children attending primary school in this study was comparable to that observed among teachers and parents. Transmission tree reconstruction suggests that most transmission events originated from within the school. Additional measures should be considered to reduce the transmission of SARS-CoV-2 at school, including intensified testing.

10.1001/jamanetworkopen.2021.28757

Transmission of SARS-CoV-2 After COVID-19 Screening and Mitigation Measures for Primary School Children Attending School in Liège, Belgium

Novavax is just the latest vaccine maker to run into core production problems after promising to serve as a major vaccine contributor to the developing world.

‘They rushed the process’: Vaccine maker’s woes hamper global inoculation campaign

Year-to-year change in age-adjusted death rate in the US from 1960-2020:

(CNN)She was a frequent guest on The Oprah Winfrey Show -- an Ivy League-educated OB-GYN who often spoke about women's health and holistic medicine. She was a media darling, and in 2013 made Reader's Digest's annual list of 100 most trusted people in America. If you go to Dr. Christiane Northrup's Facebook page, her posts dispensing advice on health and aging to her 558,000 followers seem consistent with that persona of several years ago.But Northrup also uses her Facebook page to direct followers to Telegram, where another side of her is apparent. Here, on this platform with lax moderation, lies a miasma of misinformation and conspiracy theories.

They take an oath to do no harm, but these doctors are spreading misinformation about the Covid vaccine

9780521184816

Description Contents Resources Courses About the Authors How do we make sense of complex evidence? What are the cognitive principles that allow detectives to solve crimes, and lay people to puzzle out everyday problems? To address these questions, David Lagnado presents a novel perspective on human reasoning. At heart, we are causal thinkers driven to explain the myriad ways in which people behave and interact. We build mental models of the world, enabling us to infer patterns of cause and effect, linking words to deeds, actions to effects, and crimes to evidence. But building models is not enough; we need to evaluate these models against evidence, and we often struggle with this task. We have a knack for explaining, but less skill at evaluating. Fortunately, we can improve our reasoning by reflecting on inferential practices and using formal tools. This book presents a system of rational inference that helps us evaluate our models and make sounder judgments. Introduces the notion of causal thinking and the key role it plays in how people reason about evidence Highlights the pitfalls and dangers when people evaluate complex evidence or deal with uncertainty and unreliable sources Introduces a formal framework for causal modelling to improve reasoning about complex cases

Explaining the EvidenceHow the Mind Investigates the World

WFH really is only for a very privileged few now. Not sure how that can stay a “thing” as an NPI. Too many harms being done by a fractured society where people are thriving by getting other people to bring them stuff/ make them things/ look after their family members for them

Despite government narrative of a return to normality, schools in areas with high Covid rates lack support

A new mutated form of coronavirus that some are calling "Delta Plus" may spread more easily than regular Delta, UK experts now say. The UK Health Security Agency (UKHSA) has moved it up into the "variant under investigation" category, to reflect this possible risk. There is no evidence yet that it causes worse illness. And scientists are confident that existing vaccines should still work well to protect people. Although regular Delta still accounts for most Covid infections in the UK, cases of "Delta Plus" or AY.4.2 have been increasing. Latest official data suggests 6% of Covid cases are of this type.Experts say it is unlikely to take off in a big way or escape current vaccines. But officials say there is some early evidence that it may have an increased growth rate in the UK compared to Delta. "This sub-lineage has become increasingly common in the UK in recent months, and there is some early evidence that it may have an increased growth rate in the UK compared to Delta," the UKHSA said.

Delta 'Plus' Covid variant may be more transmissible

EXECUTIVE SUMMARY The prophylactic Pfizer-BioNTech COVID-19 Vaccine (BNT162b2) has been available in the US for prevention of Coronavirus Disease 2019 (COVID-19) as a two-dose primary series in individuals ≥16 years of age since December 2020 under an Emergency Use Authorization (EUA 27034; 11 December 2020). An amendment to the EUA was submitted to the FDA on 09 April 2021 and was authorized on 10 May 2021 to support emergency use as a two-dose primary series in individuals ≥12 years of age. Emergency Use Authorization of a single booster dose in at risk individuals1 ≥18 of age was granted on 22 September 2021. A Biologics License Application (BLA) was approved on 23 August 2021 in the United States (US) for BNT162b2 30 μg administration as a two-dose primary series to individuals ≥16 years of age. Approximately 1.4 billion doses of BNT162b2 have been distributed globally as of 31 August 2021.

Vaccines and Related Biological Products Advisory Committee October 26, 2021 Meeting Document

Workplace Covid-19 vaccination mandates have largely survived a first wave of legal challenges even as the number of lawsuits over them has soared with their expanded use.

Vaccine Mandates Withstand Challenges as Suits Surge Across U.S.

In July, 2021, another wave of COVID-19 began in the USA as the highly infectious delta (B.1.617.2) SARS-CoV-2 variant drove outbreaks predominantly affecting states with relatively low vaccination coverage. Some US states have shown the feasibility of rapidly achieving high vaccination coverage. Specifically, an average of 74·0% of adults had been fully vaccinated in Vermont, Connecticut, Massachusetts, Maine, and Rhode Island by July 31. By contrast, two states facing substantial delta-driven surges, Florida and Texas, had fully vaccinated only 59·5% and 55·8% of their adult residents, respectively.1The New York TimesSee how vaccinations are going in your county and state.https://www.nytimes.com/interactive/2020/us/covid-19-vaccine-doses.htmlDate: Dec 17, 2020Date accessed: August 5, 2021Google Scholar Here, we estimate the deaths, hospital admissions, and infections that could have been averted if Florida and Texas had matched the average vaccination pace of the top-performing states and vaccinated 74·0% of their adult populations by the end of July.We adapted our agent-based model of SARS-CoV-2 transmission2Moghadas SM Sah P Fitzpatrick MC et al.COVID-19 deaths and hospitalizations averted by rapid vaccination rollout in the United States.medRxiv. 2021; (published online July 8.) (preprint).https://doi.org/10.1101/2021.07.07.21260156Google Scholar,  3Shoukat A Vilches TN Moghadas SM et al.Lives saved and hospitalizations averted by COVID-19 vaccination in New York City.medRxiv. 2021; (published online July 18.) (preprint).https://doi.org/10.1101/2021.07.14.21260481Google Scholar to the demography, contact patterns, and age-stratified vaccination trajectories of Florida and Texas. We further accounted for the emergence and spread of the alpha (B.1.1.7), gamma (P.1), iota (B.1.526), and delta variants, in addition to the original strain.2Moghadas SM Sah P Fitzpatrick MC et al.COVID-19 deaths and hospitalizations averted by rapid vaccination rollout in the United States.medRxiv. 2021; (published online July 8.) (preprint).https://doi.org/10.1101/2021.07.07.21260156Google Scholar,  3Shoukat A Vilches TN Moghadas SM et al.Lives saved and hospitalizations averted by COVID-19 vaccination in New York City.medRxiv. 2021; (published online July 18.) (preprint).https://doi.org/10.1101/2021.07.14.21260481Google Scholar Vaccine efficacies against infection and symptomatic and severe disease for different vaccine types, each variant, and by vaccine dosage were parameterised from clinical studies (appendix pp 4–5). The model was calibrated to the reported incidence in each state between Oct 1, 2020, and Aug 31, 2021 (appendix p 6). Using the calibrated model, we evaluated the impact of enhanced vaccination rollout by scaling the daily vaccine doses distributed to achieve 74·0% coverage of fully vaccinated adults by July 31, 2021, and continued with the associated daily rates of vaccine rollout. We then simulated the epidemiological trajectories of outbreaks in Florida and Texas and compared them with the observed cases, hospital admissions, and deaths in these two states from Dec 12, 2020, to Aug 31, 2021.We found that enhanced vaccination would have markedly blunted the increase in cases, hospital admissions, and deaths in Florida and Texas (figure; appendix p 6). From the start of vaccination on Dec 12, 2020, until Aug 31, 2021, Florida had reported 2 221 520 COVID-19 cases and Texas had reported 2 142 833. Achieving 74·0% vaccination coverage by July 31 and continuing with the associated daily rate would have averted 664 007 additional cases (95% credible interval [CrI] 419 219–848 020) in Florida and 647 906 additional cases (507 298–789 885) in Texas (appendix p 7). By Aug 31, the enhanced vaccination in Florida would have reduced hospital admissions by 61 327 (95% CrI 49 723–73 501) and deaths by 16235 (13 243–19 473). The reduction in hospital admissions in Texas during the same period would have been 37 587 (95% CrI 31 575–44 659) and the reduction in deaths would have been 6353 (5227–7501). Collectively, these two states could have averted more than 95 000 hospital admissions and 22 000 deaths had they reached the vaccination coverage achieved by the top five states and continued at the same pace until Aug 31, 2021.FigureModel projections of daily deaths in (A) Florida and (B) TexasShow full captionBlack lines show mean estimates, with uncertainty bounds of simulations shown in grey shaded areas. Red dots are reported data. Blue lines and shaded areas show the model projections for mean estimates and uncertainty bounds under the counterfactual scenario of enhanced vaccination with 74·0% coverage of adults by July 31, 2021. The purple lines and shaded areas show the model projections for mean estimates and uncertainty bounds under the scenario of a 50% increase in daily vaccination rate starting from Sept 1, 2021. All uncertainty bounds are 95% credible intervals.View Large Image Figure ViewerDownload Hi-res image Download (PPT)We further projected the epidemiological impact of a 50% increase in the daily vaccination rate in Florida and Texas compared with the status quo from Sept 1, 2021 (figure; appendix p 6). Our projections suggest that between then and Oct 31, 2021, such acceleration of vaccination would prevent more than 26 000 cases and 1200 deaths in the two states.Hospitals and intensive care units in several US states are currently overwhelmed by a surge in symptomatic COVID-19 illness almost entirely among unvaccinated individuals. The combination of relatively lower vaccination rates in southern and central US states, especially among younger people, is even more concerning as schools return to in-person classes and non-pharmacological measures such as mask wearing and physical distancing are relaxed. As the pandemic continues, efforts to increase vaccination will be crucial to preventing future SARS-CoV-2 variants that can fuel additional waves of severe illness, hospital admissions, and deaths.This work was supported by The Commonwealth Fund, of which ECS is an employee. All other authors declare no competing interests. SMM also acknowledges support by the Canadian Institutes of Health Research (OV4 – 170643, COVID-19 Rapid Research) and the Natural Sciences and Engineering Research Council of Canada, Emerging Infectious Disease Modelling, MfPH grant. The computational codes for reproducibility are available at https://github.com/thomasvilches/multiple_strains/tree/TXnFL.

Implications of suboptimal COVID-19 vaccination coverage in Florida and Texas

10.1016/S1473-3099(21)00620-4

The Covid-19 vaccines are not like those Monday morning surprise dishes at your local restaurant. They aren’t like some of those less regulated dietary supplements that may secretly contain Viagra or steroids either. No, Covid-19 vaccines should not have unexpected ingredients. To make sure people know what they are getting, the U.S. Food and Drug Administration (FDA) has posted an ingredient list for the Pfizer/BioNTech Covid-19 vaccine on its website. So, has the Centers for Disease Control and Prevention (CDC).

Graphene Oxide In Pfizer Covid-19 Vaccines? Here Are The Latest Unsupported Claims

What was claimed Vaccines contain graphene oxide. Our verdict False. The Covid-19 vaccines do not contain graphene oxide.

Covid-19 vaccines still don’t contain graphene oxide

10.1001/jamanetworkopen.2021.28568

Importance  Short-term and long-term persistent postacute sequelae of COVID-19 (PASC) have not been systematically evaluated. The incidence and evolution of PASC are dependent on time from infection, organ systems and tissue affected, vaccination status, variant of the virus, and geographic region.Objective  To estimate organ system–specific frequency and evolution of PASC.Evidence Review  PubMed (MEDLINE), Scopus, the World Health Organization Global Literature on Coronavirus Disease, and CoronaCentral databases were searched from December 2019 through March 2021. A total of 2100 studies were identified from databases and through cited references. Studies providing data on PASC in children and adults were included. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines for abstracting data were followed and performed independently by 2 reviewers. Quality was assessed using the Newcastle-Ottawa Scale for cohort studies. The main outcome was frequency of PASC diagnosed by (1) laboratory investigation, (2) radiologic pathology, and (3) clinical signs and symptoms. PASC were classified by organ system, ie, neurologic; cardiovascular; respiratory; digestive; dermatologic; and ear, nose, and throat as well as mental health, constitutional symptoms, and functional mobility.Findings  From a total of 2100 studies identified, 57 studies with 250 351 survivors of COVID-19 met inclusion criteria. The mean (SD) age of survivors was 54.4 (8.9) years, 140 196 (56%) were male, and 197 777 (79%) were hospitalized during acute COVID-19. High-income countries contributed 45 studies (79%). The median (IQR) proportion of COVID-19 survivors experiencing at least 1 PASC was 54.0% (45.0%-69.0%; 13 studies) at 1 month (short-term), 55.0% (34.8%-65.5%; 38 studies) at 2 to 5 months (intermediate-term), and 54.0% (31.0%-67.0%; 9 studies) at 6 or more months (long-term). Most prevalent pulmonary sequelae, neurologic disorders, mental health disorders, functional mobility impairments, and general and constitutional symptoms were chest imaging abnormality (median [IQR], 62.2% [45.8%-76.5%]), difficulty concentrating (median [IQR], 23.8% [20.4%-25.9%]), generalized anxiety disorder (median [IQR], 29.6% [14.0%-44.0%]), general functional impairments (median [IQR], 44.0% [23.4%-62.6%]), and fatigue or muscle weakness (median [IQR], 37.5% [25.4%-54.5%]), respectively. Other frequently reported symptoms included cardiac, dermatologic, digestive, and ear, nose, and throat disorders.Conclusions and Relevance  In this systematic review, more than half of COVID-19 survivors experienced PASC 6 months after recovery. The most common PASC involved functional mobility impairments, pulmonary abnormalities, and mental health disorders. These long-term PASC effects occur on a scale that could overwhelm existing health care capacity, particularly in low- and middle-income countries.

Short-term and Long-term Rates of Postacute Sequelae of SARS-CoV-2 Infection: A Systematic Review

A new report in MMWR this week provides a stark reminder. COVID vaccines save lives – especially for teens with obesity and other medical conditions. The study analyzed 464 patients 12 to 18 years old. Of those, 179 were hospitalized with COVID-19 and 285 were case controls. Nearly three quarters (72 percent) of these patients had at least one underlying health condition, including obesity. But vaccination with two doses of the Pfizer-BioNTech vaccine proved to be 93% effective for preventing hospitalization with COVID-19. Furthermore, it was 100 percent effective in preventing ICU admission and death. None of the ICU admissions or deaths occurred in vaccinated teens.

For Teens with Obesity, COVID Vaccines Save Lives

Thankfully, we have not seen any evidence of antibody-dependent enhancement of infection or disease by any COVID vaccines to date. Vaccine are not making infections worse, and are very effective in preventing disease.

Revelations about World Doctors Alliance pages raise questions about platform’s efforts to control misinformation

Group that spread false Covid claims doubled Facebook interactions in six months