Weekly Coronavirus Update: Tuesday, April 13, 2021
Happy Tuesday, everyone. This week’s research update includes information on blood clots and the AZ vaccine, the airborne spread of the virus vs surfaces, reinfection, new variants, post-Covid neurological and psychiatric diagnoses, severe Covid in children, a way to track the pandemic response of every government in the world, and of course a US/UK/world update.
1) Let’s start off by talking about something you’ve undoubtedly heard about: the AstraZeneca vaccine and rare blood clots. Two peer-reviewed research papers published in the New England Journal of Medicine studied the blood of 11 people and 5 people, respectively, who developed a condition called thrombotic thrombocytopenia, which causes both blood clots and abnormal bleeding, after their first dose of the vaccine. In the first study, nine of the 11 patients were women with a median age of 36. In the second study, four of the five patients were women with a median age of 40. Both studies found that the patients produced antibodies that activated their platelets, which play a major role in blood clotting. The lead researcher of the first study, Dr. Andreas Greinacher, told reporters that it was likely some people have rare, undiagnosed biological traits that lead to their bodies producing these misdirected antibodies after the vaccine. Unfortunately, he said there is currently no way to predict which people will develop these antibodies. Current data shows that the rare clots affect approximately one in 100,000 people who receive the vaccine. Severe headaches were identified as an early symptom of this rare issue. You can read the full text of first study here: https://www.nejm.org/doi/full/10.1056/NEJMoa2104840
And the second study here: https://www.nejm.org/doi/full/10.1056/NEJMoa2104882
And an insightful article about this from Science magazine here: https://www.sciencemag.org/news/2021/04/hard-choices-emerge-link-between-astrazeneca-vaccine-and-rare-clotting-disorder-becomes
2) At the beginning of the pandemic, most people thought Covid-19 was spread by touching contaminated surfaces. Over time, however, we’ve come to understand that airborne transmission is the primary way in which people contract Covid-19. Last week the US Centers for Disease Control and Prevention (CDC) published a science brief stating that the risk of contracting the virus through contaminated surfaces is low, and the chance of becoming infected from a surface is less than 1 in 10,000. The report concluded, “The principal mode by which people are infected with SARS-CoV-2 is through exposure to respiratory droplets carrying infectious virus. In most situations, cleaning surfaces using soap or detergent, and not disinfecting, is enough to reduce risk. Disinfection is recommended in indoor community settings where there has been a suspected or confirmed case of COVID-19 within the last 24 hours.” The CDC also recommends that people can reduce their risk of infection by wearing masks consistently and correctly. You can read the full report here: https://www.cdc.gov/coronavirus/2019-ncov/more/science-and-research/surface-transmission.html
3) A study of over 25,000 people, some who had previously been infected with Covid-19 and some who had not, examined whether antibodies from a previous Covid infection were associated with a decrease in reinfection, both symptomatic and asymptomatic. Results showed that those who previously had Covid had an 84% lower risk of infection than those who never had the virus. Of the 155 people who did become reinfected, the median number of days between the first infection and second infection was over 200 (nearly 7 months). The authors concluded, “This study shows that previous infection with SARS-CoV-2 induces effective immunity to future infections in most individuals.” This study was peer-reviewed and published in The Lancet. You can read the full text here: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00675-9/fulltext
4) Researchers in Angola identified a new Covid-19 variant from three airline passengers who flew from Tanzania to Angola in February 2021. The new variant, named A.VOI.V2 carries more mutations than any other strain previously identified. It has 34 mutations, 14 of which are in the virus’s spike protein (the part of the virus used to infect cells). The researchers stated that it is possible this variant could be resistant to existing immune responses due to its large number of mutations, and “this warrants urgent investigation as the source country has a largely undocumented epidemic and few public health measures in place to prevent spread within and out of the country.” The study has not yet undergone peer review (important disclaimer!) and the full text of the pre-print can be read here: https://www.medrxiv.org/content/10.1101/2021.03.30.21254323v1.full-text
5) Speaking of variants, a peer-reviewed study published yesterday in The Lancet Infectious Diseases found that the B.1.1.7 variant (UK variant), while more transmissible, is not actually associated with more severe disease or death in hospitalized Covid-19 patients. The researchers also found that the B.1.1.7 variant carried a higher viral load than other versions of the virus. The study used data from 341 hospitalized patients with the B.1.1.7 variant and 143 Covid patients without the B.1.1.7 variant. These findings differed from previous research that found the variant was deadlier. You can read the full study here: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(21)00170-5/fulltext
6) Using the electronic health records of over 236,000 Covid-19 patients (mostly from the US), researchers found that 33.6% of people who had Covid suffered from a neurological or psychiatric diagnosis in the six months following their infection. The number was even higher for those who had been admitted to an intensive treatment unit at 46.4%. The researchers compared these findings to those of patients who had the flu or a respiratory tract infection during the same time, and neurological and psychiatric diagnoses were more common in those with Covid-19. The most common diagnoses in Covid-19 patients were mood, anxiety, or psychotic disorder (23.98%), substance use disorder (6.58%), insomnia (5.42%), nerve, nerve root, or plexus disorders (2.85%), and ischaemic stroke (2.10%). The authors of this peer-reviewed paper, published in The Lancet Psychiatry, concluded that services and resources need to be put in place to deal with the anticipated needs of many Covid survivors. You can read the full study here: https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(21)00084-5/fulltext
7) Researchers studied the medical data of nearly 21,000 pediatric Covid-19 cases from 869 medical facilities in the US to better understand the characteristics and disease severity of children and adolescents with Covid-19 (patients aged 2–18). Of the pediatric patients studied, 11.7% were hospitalized. Of those, 31.1% were severe cases. The male sex and the existence of chronic conditions were independently associated with developing severe Covid-19. Non-Hispanic Black and Hispanic or Latino children were found to be overrepresented in pediatric patients, but no significant associations were found between severe disease and race/ethnicity. The researchers concluded that “understanding factors associated with severe COVID-19 disease among children could help inform prevention and control strategies.” The study was peer-reviewed and published in the journal JAMA Network Open. You can read the full text here: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2778347
8) Have you ever wondered how every country compares in their response to the Covid-19 pandemic? Last January researchers from the University of Oxford developed the Oxford COVID-19 Government Response Tracker, which is the largest repository of global data relating to pandemic policies. Using data from 20 different response indicators based on containment and closure policies, economic policies, and health system policies, the tracker determines the stringency of each country’s response. The data spans from January 22, 2020 to present. Currently Mauritius ranks first in terms of its stringency, with a score of 96.30 on a scale of 0 to 100. The UK’s stringency score is currently 75.93 and the US is currently at 58.80. The least stringent nations are currently Afghanistan, Nicaragua, and Tanzania at 8.33 each. The data also shows that of all nations, the UK has spent the longest time at a very high level of stringency (175 days at the maximum level). You can read more about the tracker and the team’s research updates at the following site: https://www.bsg.ox.ac.uk/research/research-projects/covid-19-government-response-tracker
9) Now for your world update. In the US daily new cases have increased 6% over the past two weeks. Yesterday there were 72,286 new cases. Hospitalizations have risen 10% over the same time period and deaths have fallen 27%. Cases are higher and staying high in 26 states, Washington, D.C., and Puerto Rico (Indiana, you’re in that category). Cases are lower but going up in four states. With new cases in Michigan surging (average of 7,284 cases per day over the past week) due to the highly infectious B.1.1.7 variant, the CDC Director Rochelle Walensky urged the state’s governor, Gretchen Whitmer, to “shut things down” because the state’s vaccination efforts cannot keep up with the case numbers. In terms of US vaccinations, 22% of the nation is fully vaccinated and 36% have had at least one dose.
— The UK began to come out of its strict nearly four-month lockdown yesterday, with pubs and restaurants allowed to serve customers outdoors and shops, salons, and gyms allowed to reopen. The UK has seen a 48% decrease in cases over the past two weeks and there were 3,568 new cases yesterday. Deaths have also fallen by 46%. In terms of vaccinations, 48.2% of the population has received at least one dose and 11.5% are fully vaccinated. Today the Moderna vaccine will begin being used in the UK for the first time.
— Elsewhere, the Covid death toll in Europe passed 1 million yesterday. India, the second-worst infected country behind the US, approved use of Russia’s Sputnik V vaccine and has signed a deal to receive over 750 million doses of it. Globally, Covid-19 cases have risen every week for the past seven weeks (9% increase in the past week) and the World Health Organization said the trajectory of the pandemic is now “growing exponentially”. It is thought that more transmissible new variants are responsible for this global surge.
US numbers: https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html?action=click&module=Top%20Stories&pgtype=Homepage
Michigan info: https://www.cnbc.com/2021/04/12/covid-shutdown-cdc-chief-says-vaccinating-alone-wont-stop-michigan-covid-surge.html
UK numbers: https://www.theguardian.com/world/2021/apr/12/covid-uk-coronavirus-cases-deaths-and-vaccinations-today
Europe & India updates: https://www.theguardian.com/world/live/2021/apr/13/coronavirus-live-news-europe-death-toll-passes-one-million-india-approves-russias-sputnik-v-vaccine?page=with:block-607527148f088c820d86514e#block-607527148f088c820d86514e
Global info: https://www.cnbc.com/2021/04/12/who-says-covid-pandemic-is-growing-exponentially-at-more-than-4point4-million-new-cases-a-week.html
That’s all for this week. Please keep staying safe, everyone. Practice social distancing, wear a mask, and get your vaccine when you’re eligible!