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 LaTrobe University, and an editor for the Australian and New Zealand Journal of Public Health.
Dear CODErs
Hello again everyone. Here is this week’s shipping forecast …
View the latest spreadsheet here
Epidemiology
This week is the sixth in a row that the number of new cases and fatalities has again fallen, although Africa in general seems to be having a notification catch-up (not in all countries – several are reporting few-to-no cases of deaths). The one exception is North America where the same reductions are not evident.
Note as always, the differences between Johns Hopkins and WHO data continue to be very unstable, changing a great deal from day to day. The gap between WHO and Johns Hopkins global case numbers is currently widening to about two and a half million, although the gap in fatalities has shrunk to just over 1,000. Oddly, JH reports more cases and WHO more fatalities. The cumulative attack rate (proportion of the population who have had of COVID) remains low at 6.57% for JH, and 6.53% (WHO) of whom, according to JH 2.1% and WHO 2.2%, have died. The fatality rate continues to fall, but slowly. However, several European countries have had reported overall case rates of over 40% (including France, Netherlands, Austria, Switzerland, Denmark (53.5%), Iceland (54.4%), and Liechtenstein), and many more close to or over 25%, mainly the USA and the rest of Europe (Germany, UK, Italy, Spain, Belgium, Czechia, Portugal, Greece, Sweden, Monaco; and also Korea, Mongolia and the Maldives). So a European holiday should come with masks and hand gel …
Evidence is slowly emerging about second COVID infections in people who have had it once, including people who have been vaccinated. Whilst generally less severe the second time around, advice would be ‘don’t bank on it’ because it might not be. Vaccination clearly is good though for reducing the likelihood of ending up in an ICU, with severe disease. Prior infection might, or might not, help. Of note, whilst data on second infections are not collected routinely in the UK (or anywhere really) one estimate is that anything up to about 10% are now second infections with newer strains, basically showing that the lessons about what protects people were not learned the first time around. I will try to find some scientific evidence about this soon.
Another point to note is that the three WHO regions with their own spreadsheets included in these papers have very low attack rates (6% for Africa, and less than 3% for SE Asia and the Western Pacific. Some of this is just because these are mainly quite remote from the rest of the world and so far they have been protected. But their immunisation rates, whilst good in places, are generally not enough to protect from severe disease.
Papers
[Research Review COVID-19 Issue 2, 2022] is a useful summary of recent COVID-related research. [It] includes article abstracts plus a short decode (which is still quite technical!). Basically current research shows that vaccines are both safe and work, and people who have had COVID still need boosters. Boosters plus recovery from COVID infection (now called hybrid immunity) still need to have boosters, and boosters are really helpful in preventing (especially severe) disease. And some information about newer treatments in the northern hemisphere.
Plus following on from last week’s paper about COVID in deer, this week it is in hamsters. Dutch hamsters imported to Hong Kong, not Omicron variant.
Other infections
I gather that Adenovirus infections in children are having a field-day in Australia, which is a problem in that the initial symptoms are so similar to early COVID. Influenza is also getting started.
Anecdotal evidence suggests that some of the common symptoms of the first COVID variants do not seem to be so common in infection with the newer strains (especially loss of taste and smell) although I have not seen any research which re-evaluates symptoms with newer strains. This makes identification of early cases more complicated, so keep up the good RATs/PCRs if you are symptomatic in any way.
We definitely are lacking up-to-date local epidemiology, including information about risk-factors and transmission in vaccinated people – some of us are not convinced that a five-day testing for close contacts is sufficient to pick up all incubating cases, because we know of several day seven (from exposure) RAT conversions. Some early epidemiology seems not to be as accurate and useful as it was for current strains, which is important for emerging strains which might be different again. This is a plea for some more up to date analysis on which to base response activities.
Vaccination
Yes, you can have your COVID booster at the same time as your annual flu vaccination, as long as your health care provider actually has both in stock …
That’s it for this week. See you next time. Keep well,
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.