The CODE Update – 24 March

Priscilla Robinson

View the latest COVID data spreadsheet here

The main news of the week is that cases are up in all WHO regions. Fatalities are also up, but not by as much as cases. How much of SEARO’s rise is due to PNG’s sudden increase is not at all clear, but it does not account for all of the regional rise. There is a very big (but so far unreported) rise in the Philippines and Indonesia, and a smaller but obvious one in Malaysia.

In Africa the pattern remains as for the past few weeks, with most countries having about the same number of cases as for many weeks. Tanzania’s president died last week, cause unknown, but possibly from COVID. As a country, Tanzania has refused to acknowledge COVID as an illness and has not reported any cases for many months, which probably has some important implications for any population vaccination programme.

The Vaccination tracker sheet provides some quite mysterious information. One indicator I cannot find anywhere is the proportion of the populations who are fully vaccinated; however as the programmes have not been going very long, and as some countries are now recommending up to 12 weeks between doses, the total number of fully vaccinated people is going to be something like ‘all-the-people-in-the-non-placebo-arms-of-the-vaccine-trials-plus-just-a-few-more’ – i.e. we are way off having protected populations for a while yet, so the main message from that is to keep up those preventive measures. Anyway, they will stop you getting flu etc.

However, the island nation-states remain COVID-free, except for those still taking tourists from the US and Russia etc, where the imported problems are acute and vaccination rates mainly woeful. I honestly worry for those places.

Back to vaccines:

Larry Gostin, one of my hero public health lawyers, has written an informative article about the cost of vaccines to middle-income countries which is well worth reading.

And this article includes a list of side-effects from various COVID vaccines – unfortunately AstraZeneca is not one of them – but it does have a nice description of what happened to thousands of people included in vaccine trials.

For people who don’t read these papers often, a vaccine placebo is usually something like sterile water or a salt solution of some kind, and ‘controls’ are people who are in every respect like the people given the vaccine, and being allocated to get the actual vaccine or the placebo is a completely randomised process. The people running the trials do not know which people are given which substance, i.e. they are ‘blinded’ (vaccine or placebo) until the end of the trial, and they have no way of knowing.

Note: in very rare cases where there are reports of serious side effects there may be a halting of the trial and unblinding early, as a part of the safety monitoring in any of the Phases 1-3. This actually did happen with one of the COVID vaccines, but for the life of me I cannot remember which one, but it was decided the event was not linked to the vaccine for various reasons.

Lastly, as I mentioned last week, it is possible to have a vaccine on the same day as being infected with the same disease the vaccine should protect you from, but the coincidence does not mean the vaccine gave you the illness; and the Pakistani Prime Minister Imran Khan was kind enough to make that point for me, developing COVID a couple of days after having a COVID vaccine. So, thanks Imran, and wishing you a speedy recovery.

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.