The CODE Update – 8 July

Priscilla Robinson

View the latest spreadsheet here

Worldwide, there are still in the region of 300,000 people identified as having COVID EVERY DAY, and about 10,000 fatalities. So, it’s not going anywhere just yet.

First off, there has been something of a big upswing in Africa, especially South Africa, which does not seem to have reached the news.

Several countries, not just in Africa, are reporting around a 10% increase in cases (a huge 40% or so in Fiji; for example, about 20% in Zimbabwe, Liberia, and Vietnam, and nearly that in Rwanda and Afghanistan, another 10% in Cambodia) and in most of these countries the vaccination rates are low. In SEARO Mongolia has also seen a bit of a rise. However, case fatality rates have only risen a teeny bit in some places, and overall are stable, even starting to drop again. On the plus side, several countries have had double doughnut days (zero cases and zero fatalities for people not up with that particular aphorism) and many more have had a fatality-free week.

As the Olympics begin soon, here is a special mention for Japan. The overall rate in Japan sits at under 0.7%, amongst the lowest rates in the world. As a nation they seem to have had it well under control since the beginning, and seem to know how to deal with it. Nearly a quarter have had at least one vaccine dose, and about 12% are fully immunised, relying on Pfizer. So, whilst that is behind Europe and North America, is it better than most of SE Asia and the Pacific regions. It would be good though if all visiting teams were immunised though (with resource-poor countries having had access to the COVAX stock) instead of just criticising.

Reproductive (r) rates – remember them? The number of people who catch COVID from an infected person, the rate which we need to get to under 1.0? Well, the original version of COVID had a rate between 1.5 and 2.5, depending on various things, and the ‘lets-all-get-very-panicky’ Delta strain might have a rate as high as 5. Might have. Or might not. This is because the R-rate depends on many things, including the stuff we are all used to now, such as handwashing, mask-wearing, social distancing, and not forgetting vaccines. So, it is now much more complicated to know what the right number actually is. So please take comfort from the fact that seasonal ‘flu sits at around 1.2, but my favourite number is for measles, which is about 25 in an unvaccinated population.

This week at last some sensible commentary is happening around the new variant strain panic. The European Centre for Disease Prevention and Control has its finger on the variant pulse, so to speak, and a good paper is this one, with this place for updates. WHO is of course onto it  – it comes with a little video explaining how variants work; and then there is the reliable Public Health England Coronavirus site.

New strains are usually more transmissible (meaning they are somehow easier to pick up because they hang around in the air for longer etc), and they usually come with a lower fatality rate – and I cannot think of a disease where the new strain causes more deaths, except when it first emerges, but not overall. Someone called Kelly Victory has been leading a Twitter discussion on this (#FactsNotFear #DeltaVariant); it is also worth reading – and thinking about – read the responses too – and it is true that the 2012-14 Ebola newer strains had the same (very high at 95%) fatality rate, the point made is that if a strain is more transmissible then there might be more overall deaths. So, you can have a less ‘deadly’ strain (i.e., a lower case fatality rate), but with more attributable deaths overall. So the answer is ….. VACCINES!! (Again. Sorry!)

The table is copied from a Public Health England report, SARS-CoV-2 variants of concern and variants under investigation in England Technical briefing 17-25 June 2021, for people either interested in such things or who need insomnia assistance. Basically, it shows that the Delta variant has both a short- and longer-term LOWER fatality rate than other variants apart from Theta, which seems to have originated in the Philippines. No, it is NOT MORE DEADLY. Not that that should stop you getting vaccinated …

Table 2. Number of confirmed (sequencing) and probable (genotyping) cases by variant as of 21 June 2021

Variant Confirmed (sequencing) case number Probable (genotyping) case number* Total case number Case proportion* Deaths Case fatality Cases with 28 day follow up Deaths

among those with 28 day follow up

Case Fatality among those with 28 day follow up
Alpha 219,570 5,515 225,085 70.3% 4,262 1.9%

(1.8 – 2.0%)

219,948 4,259 1.9%

(1.9 – 2.0%)

Beta 892 54 946 0.3% 13 1.4%

(0.7 – 2.3%)

874 13 1.5%

(0.8 – 2.5%)

Delta 50,283 41,773 92,056 28.8% 117 0.1%

(0.1 – 0.2%)

11,250 32 0.3%

(0.2 – 0.4%)

Eta 442 0 442 0.1% 12 2.7%

(1.4 – 4.7%)

431 12 2.8%

(1.4 – 4.8%)

Gamma 180 45 225 0.1% 0 0.0%

(0.0 – 1.6%)

161 0 0.0%

(0.0 – 2.3%)

Kappa 439 0 439 0.1% 1 0.2%

(0.0 – 1.3%)

420 1 0.2%

(0.0 – 1.3%)

Theta 7 0 7 0.0% 0 0.0%

(0.0 – 41.0%)

5 0 0.0%

(0.0 – 52.2%)


Here is a useful discussion piece from a UK paediatrician on COVID vaccination for children, as this will be the next discussion to be had: Shall we vaccinate our children? We could start by asking them first

Lastly, cartoonist and creator Judy Horacek is acknowledged for this post in her monthly newsletter. It is here especially for the people in my family who work in the performing arts (that/s just about all of them).

Three cheers for this message at the State Theatre in Portland, USA, by administrative assistant Kevin Norsworthy, in charge of regularly updating the sign. The words came to him ‘on a whim’. It was shared on social media by famous musicians including Billy Bragg and Sinead O’Connor, and you can’t argue with them.”


About Dr Priscilla Robinson and The CODE Update

Dr Robinson is a public health epidemiologist with particular interests in international health and communicable diseases, and public health competencies. She has worked in health departments in England and Australia, has managed public health teaching programmes, and taught and researched many aspects of public health epidemiology and policy in many countries. She is an adjunct Associate Professor at LaTrobe University, and to stop herself being bored is an editor of PHAA’s journal ANZJPH, and holds board positions (almost all unpaid) on various NGOs, journals, and at her local hospital. Otherwise, 10 acres of untamed bushland on a hill in South Gippsland makes weight-bearing gym exercise and strength training a bit redundant.

The CODE Update is a regular feature on the Intouch blog to keep readers informed of COVID-19 developments around the world.

The CODE update originally began at the start of the SARS CoV-2 pandemic as a way of explaining it to Priscilla’s friends and family who happen to live all over the world, and who were being bombarded with information and misinformation in their own countries. The CODE Update provides links to practical materials and papers written for people who are not versed in the language of outbreaks and epidemic curves. It is sent out every week, and includes a short commentary to provide context to the numbers included in the spreadsheets.

Note: Whilst every attempt is made to transcribe all data faithfully, every now and again mistakes are made and not noticed until the next update. Also, on occasion numbers are revised after posting at the source databases.

We hope you will find these updates to be a helpful tool, and the links to current information useful.



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