Coronavirus report 62

 

Violent mandate protest, Los Angeles

Pandemicia coronavirus report #62

Global report

Delta outbreaks in Low-Covid countries

Substantial epidemics now rage in countries that were able to suppress coronavirus outbreaks in 2020 and early 2021 - as the Delta variant takes control. As we have previously underlined, it is very hard to stop the Delta variant except at the earliest stages. Around 47 countries have rising numbers of cases, and 33 have twice as many new cases as last week.

The epidemic in Thailand peaked on 13 August at over 20,000 cases a day. The disease spread rapidly among slum families, crowded markets and construction worker camps. As cases rolled upwards, hundreds of frontline medical workers previously injected with Sinovac were infected. Thailand began to distribute locally made Astrazeneca vaccine from March, but were hampered by supply shortages. Some wealthy Thais were reportedly spending over $8000 to go abroad on 'jab tours'. 

Vietnam had no deaths for the first six months of the pandemic, keeping the disease at bay with strict border closures and uncompromising lockdowns. Now it has over 10,000 deaths, mostly in the last three weeks. Cases continue to rise, running at about 11,500 cases and 400 deaths per day. In heavily infected areas, people cannot leave their homes even for food.

Cases are still rising in Malaysia and the Philippines, though Indonesia and Bangla Desh passed their peaks about three weeks ago. 

Japan has by far its largest outbreak so far, and it has declared a state of emergency in 13 prefectures. Daily cases are 5000 in Tokyo and stabilising at 25,000 nationwide. About 2000 people in Tokyo cannot find a hospital or 'treatment hotel'. Deaths are running at about 40 a day (a very low result compared with the February and May waves). 

Sri Lanka has a rapidly rising record outbreak of about 8000 cases a day, accompanied by 180 deaths a day. Like some other places, they are increasingly using cardboard coffins for the deceased. 

The countries of central America are having a substantial breakout following waves in July 2020 and January 2021.

The Balkans are beginning a third major wave. Montenegro and Kosovo in the Balkans have almost the highest case rates per million population in the world, along with Georgia in the Caucasus. 

Nigeria and African neighbours have a moderate third wave, with about a thousand cases a day. Reported deaths remain very low, despite the absence of vaccination.. 

On a positive note, Taiwan managed to suppress an Alpha outbreak which began in May, and also a very small Delta outbreak of five cases.

Living with Covid

While most of the world has in fact been 'living with Covid', this phrase has recently become code for the 'Singapore strategy' of vaccinating a percentage of the population and then letting Covid-19 rip. This is not proving particularly successful, particularly with the Delta variant. Cases are reaching all time highs, children are infected, and while deaths have fallen substantially below what would have been pre-vaccination levels, they are still far beyond anything that might have been acceptable before Covid.

Israel was the first country to be 60% vaccinated, and then removed movement restrictions and mask mandates. Like USA and the UK it now has near-record cases, and is being held up as an example of what not-to-do. Daily deaths are about a third of what they were in the January wave - but 4800 recovered cases have been re-infected (mostly young people). About 60% of hospitalised cases were vaccinated, mostly older people. Booster jabs are to be introduced and indoor masks and social distancing has been mandated.

While cases in the United Kingdom are at three-quarters of the January peak, Covid deaths have fallen by a factor of about 12, thanks to vaccination. Nevertheless, there are nearly 700 deaths a week, which compares very poorly with Australia's grand total of 999 deaths. Restrictions have been removed, and massive rock festivals are under way.

Despite summer warm weather, the USA is presenting its second major wave, with new cases over a million a week. Several US states have among the highest infection rates in the world. In Texas there are nearly 14,000 hospitalisations, compared with 1500 at the end of June. Many children are infected and paediatric ICUs are full. New records for hospitalizations have also been reached in five counties in northern California. Hospitals in Oklahoma, where vaccination is 'low' at 43% and 80% of patients are unvaccinated, are buckling under the strain. "We have seen too many body bags". 

Australasia

Daily cases have crossed the 1000 mark and are right on target for our 1340 end-of-month estimate. Much of rural NSW and some parts of rural Victoria and now heavily infected. As an example, the midwestern NSW town Dubbo had no cases apart from sewage residue in Report #61, 8 August - and now it has over 350. In Shepparton Vic, where Australia's only PPE manufacturing plant, , 

The Delta outbreak from New South Wales has passed to New Zealand, the first country to fully suppress Covid-19 after a marathon lockdown. New Zealand has had only one Covid death in almost a year. The two countries had opened borders in a "Trans-Tasman bubble" which New Zealand was rather slow to close in July. Another 70 cases today takes their outbreak to 347 cases. This is probably too many to stop, and could be very damaging as the country is only 27% vaccinated. 

Australia's only PPE plant in Shepparton has been forced to sack 100 staff when the government turned to a "cheaper product". Now, an outbrake of about 70 cases has sent about 15 of teh population or about 20,000 people into isolation - including 500 health care staff. 

Part 2 of the story of Australia's third wave will contain an account of the continuing growth of Covid along a very steady trajectory in NSW and Victoria, the spread to rural areas and the forced change in policy away from zero-Covid to high-vax. 

Other virus issues

Delta differs from other variants in that the whole family mostly becomes infected. While coronavirus is typically brought into the house by sociable older teens and young workers, a Canadian study has shown that small children may then spread it to other household members. 

Response

Vaccine

The world has thrown its hopes on rapid vaccine deployment, and over 5 billion doses have been distributed. Unfortunately, immunity has fallen off six months after the vaccine was administered. As well, the Delta variant does not respond as readily to vaccines. Both President Biden in the USA and the Israeli government are talking of booster programs, to start from September.

In the USA, mandating of vaccination or masks by employers has become ubiquitous since the full approval of the mRNA vaccines. These continue to fuel protests, a few of which have turned violent.

In Australia, vaccination rates have accelerated, with over half the adult population having had a single 'jab', vaccination is being offered to progressively lower age groups, many vaccination centres have been opened, and a number of measures have been introduced to convince the population to be vaccinated. In NSW alone, the numbers being vaccinated have moved up from about 20,000 a day to 150,000 a day, with 80% of over 70s fully vaccinated. 

In early August, the National Vaccination Task Force anticipated the worst and created a dedicated national vaccination unit to create pop up vaccination hubs at sports stadiums in highly infected areas. It will give 2000-3000 extra vaccinations daily over a two-week period, when called to intervene. 

Breakthrough cases

Breakthrough cases of vaccinated people have become quite widespread, but symptoms are usually mild - typically headache, runny nose, sneezing, sore throat and loss of smell — not fever, persistent cough or shortness of breath, as is common in unvaccinated people. Symptomatic breakthrough infections are running at 35,000 a week in the USA. 

In the original clinical trials, almost no-one who was vaccinated later caught the virus. Widely varying results are now being obtained as to the effectiveness of vaccines against the Delta variant. A general consensus has been that the unvaccinated are 3 times more likely to catch Covid-19 and 30 times more likely to die (66% effectiveness to catch, 97% effectiveness for fatality). However - these moderate claims are also being challenged.

Israel has 78% of over-12s vaccinated, but has one of the highest infection rates. It is saying the flagship Pfizer vaccine is only 40% effective as cases mount. Deaths are only 0.1%, but with cases at 24,000 a day The country has re-introduced indoor masks and quarantine for incoming.

A CDC study in Los Angeles to April gave good results for vaccination. Fully vaccinated people were 29 times less likely to be hospitalised with Delta variant and five times less likely to be infected than unvaccinated people. 

More recent results from states where Covid is much more active have been giving less impressive results. Now, from 12 to 18 per cent of hospitalised cases are breakthrough.

A large cohort study in Minnesota showed a very substantial fall in mRNA vaccine effectiveness between January and June, as the Delta variant took hold.

Results from Chile till April showed the widely supplied Sinovac vaccine had an efficacy rate of 65.9% against basic Covid-19, was 87.5% effective at preventing hospitalisation and 86.3% effective at preventing death. This was not against the Delta variant. 

Other

The US Supreme Court struck down an attempt to renew the national eviction moratorium. 

The annual Sturgis motor rally in North Carolina, which draws half a million vehicles, has been connected with 100 cases of Covid.

Motorcycle enthusiasts at Sturgis rally

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