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The CODE COVID-19 International Update, 2 June 2022

The CODE COVID-19 International Update, 2 June 2022
Dr Priscilla Robinson

The Code COVID19 International Update is a weekly snapshot of the COVID-19 pandemic, assessing efforts by nations around the world to test, track and fight the virus. It’s compiled by Dr Priscilla Robinson, an Adjunct Associate Professor of Public Health at La Trobe University, and an editor for the Australian and New Zealand Journal of Public Health.

 

Hi Folks

View the latest spreadsheet here

Winter has arrived here in South Gippsland with a bit of a vengeance, causing more crowding indoors and therefore more transmission opportunities and problems…

Epidemiology:

Worldwide there are still around half a million cases and 10,000 deaths reported every day by both WHO and Johns Hopkins.

In general fatalities have slowed down almost everywhere, and the global fatality rate is now 1.19, so continuing to fall slowly but surely. A number of countries have reported no cases or fatalities this week, but that might just be a reporting issue. Africa has reduced its overall total fatalities by about 1,500, mainly apparently a recalibration from Zambia. Presumably these people were not mostly called Lazarus but more likely previous reporting error (such as double counting), and this accounts for the minus number in this week’s snapshot table. On the subject of fatalities, the most vulnerable people are sadly the earliest fatal casualties in any epidemic, so although Omicron seems to be less fatal that its predecessors especially Alpha, Beta, and Delta, it is possible that the most vulnerable people are no longer with us to test any such theory, which in any case could never be put through a gold standard clinical trial to test out.

Australia reported over a quarter of a million cases last week, which seems to be the third largest weekly count in the world, only behind the USA with over 400,000 and China with over 500,000 – BUT their populations are many times the size of ours, so we are having the highest attack rate per head of population by quite a lot. That is definitely not a race we needed to win. Australia has now risen to #16 on the ‘league table’ of total reported numbers of cases, and of more importance, is reporting more deaths than most countries (around 50 daily; many countries are not reporting that many in a week (and some WHO whole regions do not report that many). And remember, we started very late because our isolation and closed borders prevented much happening for the first 10 months of the pandemic.

Vaccinations:

I have no idea why the vaccination tracker behaves as it does. This week Johns Hopkins total vaccination reduced by about 50 million doses … and WHO, where vaccination data lag JH by a week, has also reduced the doses given but still reports more than JH.

I have added a couple of columns to the vaccination tracker because I am interested/ashamed on behalf of us all about the lack of action on the COVAX programme front. Maybe the new Australian government will get around to doing something about its COVAX promises, and whilst there are a few other countries which have promised and not delivered that is not an excuse for Australia to be such a laggard. We have had 18 months now – what is the hold-up?

Papers:

Bartsch SM et al. Maintaining face mask use before and after achieving different Covid-19 vaccination coverage levels: a modelling study. Lancet Public Health 2022; 7: e356-65 (Abstract): this paper shows that multi-factor public health interventions continue to be necessary and cost-effective. Personally I am a lot more interested in the effectiveness than cost-effectiveness, but that could be just me.

Izikson R et al. Safety and immunogenicity of a high-dose quadrivalent influenza vaccine administered concomitantly with a third dose of the mRNA-1273 SARS-CoV-2 vaccine in adults aged ≥65 years: a phase 2, randomised, open-label study. Reference: Lancet Respir Med 2022; 10: 392-402 (Abstract): Shows how we need high levels of vaccination for both COVID and Flu heading into winter.

A number of papers this week show how previous infection (especially with Delta) does not prevent against a second infection (with Omicron) although it does seem to be less risky when all other factors are taken into account. But better to be vaccinated than try recovering from disease.

Also, my observation in working in this area over the past few months (important note – observation but not the same as research evidence), suggests that whilst people quite often have no or few symptoms early in infection, as time progresses things get a lot worse. Almost nobody seems to have symptom-free COVID, most are still quite knocked about a week on, and as these papers show, past infection is not a prevention for a second dose, so there is no such thing as ‘getting it over and done with’.

Influenza in Australia

Now that the flu season in underway, of note reports are not collected in the same way as COVID 19. Not all influenza is confirmed with RATs and laboratory tests, although RATs for flu are now available and it would be hugely useful if these two diseases were treated the same way. Interesting that the focus is not on flu and there seems to be a lot of ‘lalalala nothing to see here anymore’ about COVID. However, this Department of Health influenza report of two weeks ago noted this (so we do know about hospitalisations and serious cases):

  • In the year to date, of the 38,743 notifications of laboratory-confirmed influenza, three influenza-associated deaths have been notified to the NNDSS.
  • Since commencement of seasonal surveillance in April 2022, there have been 368 hospital admissions due to influenza reported across sentinel hospitals sites, of which 7.6% were admitted directly to ICU.

Since the beginning of January, Australia has had around 6.5 million cases, with about 6,000 deaths (about three quarters of the almost 8.5 thousand so far). Just saying.

On a different public health note, here are a couple of useful articles about epidemiological evidence for the need for gun control in the USA:

Scientific American editors write, “The science is abundantly clear. More guns do not stop crime. Guns kill more children each year than auto accidents. More children die by gunfire in a year than on-duty police officers and active military members. Guns are a public health crisis, just like COVID, and in this, we are failing our children, over and over again.”

H. Holder Thorp, Science editor-in-chief, writes, “Scientists should not sit on the sidelines and watch others fight this out… If children do not feel safe, they cannot learn. And a country that cannot learn cannot thrive. A nation of children threatened by gun violence does not have a future.”

 

About Dr Priscilla Robinson and The CODE COVID-19 International 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, VIC, makes weight-bearing gym exercise and strength training a bit redundant.

The CODE Update is a regular Intouch feature 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 Priscilla’s way of explaining to her friends and family around the world what was happening, and counter their experiences of information overload and misinformation. The update provides links to practical materials and papers written for people who are not versed in the language of outbreaks and epidemic curves. Published weekly, it includes a short commentary to provide context to the numbers included in the spreadsheets.

Note: While 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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