The CODE Update – 4 March

Priscilla Robinson

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We have had some quite panicked publicity in Australia over the last three days about a global rise in case numbers, and about the use of AstraZeneca vaccines in over 65s, so I will provide some information about these issues.

Firstly, this week’s snapshot does show a rise in cases this week over the last (1.05, i.e. a 5% rise compared with last week), so that much is true. However, the snapshot also shows that the rise is in Europe and the Eastern Mediterranean, with a teeny blip in SE Asia – so a warning, but not necessarily a trend. Fatalities are generally down with the rather worrying rise in SE Asia.

There are however certainly some spots of increased notifications in the countries on this list. For newcomers to the list, there are reasons for sudden blips, including a revision of case (and fatality) numbers because of internal reviews (these numbers can be revised both upwards and downwards). There are also some rates which don’t really make sense, for example when neighbour countries with porous borders have very different rates. For example, Belgium and Holland/The Netherlands have similar population infection rates, but the fatality rate is double in Belgium (2.86 compared with 1.43). There is not a separate South America spreadsheet, but it is worth looking at the countries included here for some examples. For example, why would Mexico have a fatality rate four times that of Argentina when they have similar case numbers, but because of population size Argentina’s population rate is three times higher so is apparently more of a problem, but Mexico has a fatality rate of 8.9 compared with Argentina’s 2.47? Is Mexico just not finding / diagnosing most of the actual cases or is something else going on? Now look at Israel and the Occupied Palestinian Territories … again, Israel has a higher attack rate, but Palestine has a higher fatality rate … South Africa (case rate 2,552/100,000, fatality rate 3.31) compared with next door neighbour Namibia (case rate 1,539/100,000, fatality rate 1.09). All of this of course has implications for communicable disease control units and for health (i.e., sick care) service provision. A few small countries have reported large increases, which will have stretched their resources, even though the actual numbers involved are small compared with larger countries with more resources.

Now to vaccines:

Clearly, many of the countries with very small or zero case numbers are tourist destinations. It would be excellent if these places were given sufficient vaccines to protect their people who have had no exposure to COVID and will be immunologically naïve. Visitors will possibly be carrying COVID with them, unless all visitors are vaccinated and the vaccines prove to prevent carriage and therefore transmission. Just saying.

It is worth noting that regarding the warnings about AstraZeneca and its use in over 65-year-olds, the clinical trials did not include many older people, so there has not been much information about how well it does in older people. There is now a lot of information from surveillance information about how well it does, and clearly, as with the Pfizer vaccine, it is excellent at stopping hospitalisations in all ages (therefore if people happen to get COVID it is less severe). It is also worth noting that several million doses have now been given of these vaccines and they clearly do not cause severe problems or we would know about them by now – although I am certainly not trying to say that there are not possible side effects, as with any vaccines.

Also to note, that there are seven days in a week, many hundred thousand doses administered on any given day, and thousands of new COVID infections daily – so sometimes these events coincide, just like with ‘flu and ‘flu vaccines. It can happen – a pity but also a reality. It is not a reason to not have the vaccine – either COVID or ‘flu.

That’s it for this week. Until next week, keep well.


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 new 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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