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.
Hello readers,
View the latest spreadsheet here
When I started this blog I included about 20 countries (although there were fewer countries actually reporting cases at the time, so not really surprising), and I included mainly countries of interest. Somehow though, the list grew as people asked for countries to be added, or when they were reported as doing either well or poorly (mostly with the press asking why can’t we be like them? Or implying ha-ha, they don’t know what they are doing). At this end of the pandemic there are 76 countries on the list, but almost all of the 50 countries with the highest number of cases, and we are following about 90% of all cases. Australia, with fewer ports of entry than – say England has on its south coast, prided itself on keeping COVID out, but has certainly joined the ranks of the top 20 now, despite a small population – nothing to be proud of.
Anthony Fauci has announced his retirement, but rumour has it he is going to be working in improving and strengthening public health workforce matters. Hooray if that is true – we need him.
Epidemiology:
We are now closing in on 600 million cases worldwide, and 5 3/4 million deaths, but the fatality rate continues to steadily fall, and is now down to 1.09 and continues the same steady decline.
South East Asia has been the current hot spot, with nearly three million cases (an 11% increase on last week). However, in the Pacific the Marshall Islands have shot up this week, quadrupling cases and tripling fatalities, albeit from a low base, but still very difficult for them.
Vaccinations:
Apart from boosters picking up a bit this continues to be the same rather depressing story.
Papers:
Australia’s COVID-19 Vaccine Rollout – performance audit.
Even the bits of the report that say it was substandard manage to generally sanitise the roll-out. I still really do not understand why the government didn’t just expand a perfectly efficient existing system rather than invent a new and worse one.
And now for a scary paper about Long COVID:
N.B. I think this is pre-peer review.
Extract from the Methods section;
“In this analysis of 2-year retrospective cohort studies, we extracted data from the TriNetX electronic health records network, an international network of de-identified data from health-care records of approximately 89 million patients collected from hospital, primary care, and specialist providers (mostly from the USA, but also from Australia, the UK, Spain, Bulgaria, India, Malaysia, and Taiwan). A cohort of patients of any age with COVID-19 diagnosed between Jan 20, 2020, and April 13, 2022, was identified and propensity-score matched (1:1) to a contemporaneous cohort of patients with any other respiratory infection…”
Note: I think this is an clear and interesting design, with appropriate matching methods, for answering the authors’ basic question.
Extract from Results section
The recovery profiles differed in some important ways, and between children and adults.
“Risks of the common psychiatric disorders returned to baseline after 1–2 months (mood disorders at 43 days, anxiety disorders at 58 days) and subsequently reached an equal overall incidence to the matched comparison group (mood disorders at 457 days, anxiety disorders at 417 days). By contrast, risks of cognitive deficit (known as brain fog), dementia, psychotic disorders, and epilepsy or seizures were still increased at the end of the 2-year follow-up period. Post-COVID-19 risk trajectories differed in children compared with adults: in the 6 months after SARS-CoV-2 infection, children were not at an increased risk of mood (HR 1·02 [95% CI 0·94–1·10) or anxiety (1·00 [0·94–1·06]) disorders, but did have an increased risk of cognitive deficit, insomnia, intracranial haemorrhage, ischaemic stroke, nerve, nerve root, and plexus disorders, psychotic disorders, and epilepsy or seizures (HRs ranging from 1·20 [1·09–1·33] to 2·16 [1·46–3·19]). Unlike adults, cognitive deficit in children had a finite risk horizon (75 days) and a finite time to equal incidence (491 days)…” (Also: it was common for older adults in both groups with a “neurological or psychiatric diagnosis” … especially those “diagnosed with dementia or epilepsy or seizures” to die. Fatality rates for Omicron were lower but otherwise outcomes were similar to older strains).
Available here.
See you all next week,
Priscilla
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.