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Discussion thread VII - COVID-19: Endemic Stage

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  • Could a popular COVID-19 antiviral supercharge the pandemic?

    Merck & Co.’s molnupiravir appears to be speeding evolution of SARS-CoV-2

    1 FEB 20235:40 PMBYROBERT F. SERVICE

    A widely used COVID-19 drug may be driving the appearance of new SARS-CoV-2 variants, sparking concerns it could prolong and even reinvigorate the pandemic. The drug, molnupiravir, produced by Merck & Co., is designed to kill the virus by inducing mutations in the viral genome. A survey of viral genomes reported in a new preprint, however, suggests some people treated with the drug generate novel viruses that not only remain viable, but spread.

    “It’s very clear that viable mutant viruses can survive [molnupiravir treatment] and compete [with existing variants],” says virologist William Haseltine, chair of ACCESS Health International, who has repeatedly raised concerns about the drug. “I think we are courting disaster.” But a Merck spokesperson disputes that the drug has led to the emergence of widely circulating variants, and some researchers downplayed the significance of molnupiravir-caused mutations. “Right now, it’s much ado about nothing,” says Raymond Schinazi, a medicinal chemist at the Emory University School of Medicine, noting that with SARS-CoV-2 infecting millions of people worldwide, the virus is naturally mutating at a fast clip.
    ...
    From the start, however, Haseltine and others worried about the drug’s mechanism, which involves introducing so many mutations into the viral genome that it can no longer reproduce. One concern was that the drug might mutate not just the coronavirus, but the DNA of people receiving it—a side effect that has not been seen so far. Another was that mutated virus would survive and propagate—and perhaps turn out to be more transmissible or virulent than before. Before the U.S. Food and Drug Administration authorized the drug, a Merck spokesperson called the worry “an interesting hypothetical concern.”
    ...



    ---------------
    medRxiv

    Identification of a molnupiravir-associated mutational signature in SARS-CoV-2 sequencing databases

    Theo Sanderson, Ryan Hisner, I’ah Donovan-Banfield, Thomas Peacock, Christopher Ruis

    doi: https://doi.org/10.1101/2023.01.26.23284998

    This article is a preprint and has not been peer-reviewed [what does this mean?]. It reports new medical research that has yet to be evaluated and so should not be used to guide clinical practice.

    Abstract

    Molnupiravir, an antiviral medication that has been widely used against SARS-CoV-2, acts by inducing mutations in the virus genome during replication. Most random mutations are likely to be deleterious to the virus, and many will be lethal. Molnupiravir-induced elevated mutation rates have been shown to decrease viral load in animal models. However, it is possible that some patients treated with molnupiravir might not fully clear SARS-CoV-2 infections, with the potential for onward transmission of molnupiravir-mutated viruses. We set out to systematically investigate global sequencing databases for a signature of molnupiravir mutagenesis. We find that a specific class of long phylogenetic branches appear almost exclusively in sequences from 2022, after the introduction of molnupiravir treatment, and in countries and age-groups with widespread usage of the drug. We calculate a mutational spectrum from the AGILE placebo-controlled clinical trial of molnupiravir and show that its signature, with elevated G-to-A and C-to-T rates, largely corresponds to the mutational spectrum seen in these long branches. Our data suggest a signature of molnupiravir mutagenesis can be seen in global sequencing databases, in some cases with onwards transmission.
    ...

    Molnupiravir, an antiviral medication that has been widely used against SARS-CoV-2, acts by inducing mutations in the virus genome during replication. Most random mutations are likely to be deleterious to the virus, and many will be lethal. Molnupiravir-induced elevated mutation rates have been shown to decrease viral load in animal models. However, it is possible that some patients treated with molnupiravir might not fully clear SARS-CoV-2 infections, with the potential for onward transmission of molnupiravir-mutated viruses. We set out to systematically investigate global sequencing databases for a signature of molnupiravir mutagenesis. We find that a specific class of long phylogenetic branches appear almost exclusively in sequences from 2022, after the introduction of molnupiravir treatment, and in countries and age-groups with widespread usage of the drug. We calculate a mutational spectrum from the AGILE placebo-controlled clinical trial of molnupiravir and show that its signature, with elevated G-to-A and C-to-T rates, largely corresponds to the mutational spectrum seen in these long branches. Our data suggest a signature of molnupiravir mutagenesis can be seen in global sequencing databases, in some cases with onwards transmission. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement TS was supported by the Wellcome Trust (210918/Z/18/Z) and the Francis Crick Institute which receives its core funding from Cancer Research UK (FC001043), the UK Medical Research Council (FC001043), and the Wellcome Trust (FC001043). This research was funded in whole, or in part, by the Wellcome Trust [210918/Z/18/Z, FC001043]. For the purpose of Open Access, the authors have applied a CC-BY public copyright licence to any Author Accepted Manuscript resulting from this preprint. ID-B is supported by PhD funding from the National Institute for Health and Care Research (NIHR) Health Protection Research Unit (HPRU) in Emerging and Zoonotic Infections at University of Liverpool in partnership with Public Health England (PHE) (now UKHSA), in collaboration with Liverpool School of Tropical Medicine and the University of Oxford (award 200907). The views expressed are those of the authors and not necessarily those of the Department of Health and Social Care or NIHR. Neither the funders or trial sponsor were involved in the study design, data collection, analysis, interpretation, nor the preparation of the manuscript. TP was funded by the G2P-UK National Virology Consortium funded by the MRC (MR/W005611/1). CR was supported by a Fondation Botnar Research Award (Programme grant 6063) and UK Cystic Fibrosis Trust (Innovation Hub Award 001). ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: No new data were generated for this study. Source global sequencing data were available from GISAID ([epicov.org][1]) and the INSDC via GenBank: <https://www.ncbi.nlm.nih.gov/genbank/>. AGILE2 genomic data was published in <https://www.nature.com/articles/s41467-022-34839-9> and deposited at <https://www.ncbi.nlm.nih.gov/bioproject/PRJNA854613> from which we analysed it. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes No new primary data was generated for this study. We used data from international sequencing databases (GISAID and INSDC), and from the AGILE clinical trial, where genomic data were obtained from BioProject PRJNA854613 at the SRA. Our GitHub repository is available at <https://github.com/theosanderson/molnupiravir>. <https://github.com/theosanderson/molnupiravir> [1]: https://epicov.org
    "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
    -Nelson Mandela

    Comment


    • longshots
      longshots commented
      Editing a comment
      DANG!!! Who needs a lab for Gain of Function?!?!? We'll just use humans as our lab!

    • JJackson
      JJackson commented
      Editing a comment
      Molnupiravir is not particularly effective, compared to Paxlovid or Remdesivir, but still has a place. If you are interested in its action and the possible problems raised, https://www.microbe.tv/twiv/twiv-888/ should answer any questions. I view the risks as very small, but no drug is without risks.
      Remdesivir is also a nucleoside analogue, although mechanistically its action is different. It causes a blockage in the polymerase rather than just inducing a mismatched replication product. Its action is explained here https://www.microbe.tv/twiv/twiv-819/

  • Why should anyone take the COVID-19 pandemic seriously when only one person wore an N95 mask to last night's crowded indoor venue for the state of the union address?

    A complete lack of leadership on this issue. There are many lawmakers who are in COVID-19 high risk categories.


    Comment


    • gsgs
      gsgs commented
      Editing a comment
      and how could anyone take masks seriously when they can't produce evidence
      that they work ?
      Remember CDC's change towards masks in mid 2020, because of that Missouri barber
      Now see the latest Cochrane review, the Jefferson interview.

  • WHO Director-General's opening remarks at the media briefing – 15 February 2023

    15 February 2023

    ===

    Following the large increase in reported COVID-19-related deaths last month, especially from China, hospitalizations and deaths have declined.

    Last week, around 10,000 deaths were reported to WHO, which is similar to the number of weekly deaths reported prior to last month’s increase.

    I’ve said it before and I’ll say it again: 10 thousand deaths a week is 10 thousand too many, for a disease that can be prevented and treated.

    We also know that the data reported to WHO are an underestimate, due to reduced testing and delays in reporting.

    Subvariants of Omicron remain dominant globally, and remain a cause of concern, given their increased transmissibility and the fact that all subvariants can kill.

    We have the tools to save lives and end COVID-19 as a global health emergency this year. We must continue to use them all, and use them well.

    ===

    "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
    -Nelson Mandela

    Comment


    • Thread
      See new Tweets
      Conversation

      Marc Johnson
      @SolidEvidence
      ·
      Feb 25
      We found a new cryptic lineage this week.

      This time it's from Dallas (I think). The same sequence was in two different samples from January.
      Marc Johnson
      @SolidEvidence
      ·
      Feb 25
      The lineage is a B.1 derivative (pre-Alpha).

      The RBD is R346T/A372T/N388S/K417T/N460K/E484A/S494P/Q498H/H519N

      This is a pretty 'classic' cryptic RBD.
      Marc Johnson
      @SolidEvidence
      ·
      Feb 25
      It also has some of the other hallmark cryptic mutations outside of the RBD: 828 and some Orf3 mutations (a few people will know what I'm talking about).
      Marc Johnson
      @SolidEvidence
      To put this in layman's terms:

      A person in Dallas has been infected with COVID for about 2 years.

      The virus has mutated a lot in those 2 years.

      The patient is shedding so much virus that it was the dominant SARS-CoV-2 sequence from wastewater in a sewershed with 900k people.

      10:26 AM · Feb 25, 2023
      ·
      132.4K
      Views
      354
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      Liz Highleyman
      @LizHighleyman
      ·
      Feb 25
      Replying to
      @SolidEvidence
      Have you identified the individual or just seeing the viral signature in wastewater? If so, I wonder how they're going to try to treat him or her?
      Marc Johnson
      @SolidEvidence
      ·
      Feb 26
      Replying to
      @LizHighleyman
      Only seeing the signal.
      Stéphane Deny
      @StephaneDeny
      ·
      Feb 25
      Replying to
      @SolidEvidence
      could it be a case of long-covid?
      Marc Johnson
      @SolidEvidence
      ·
      Feb 25
      Replying to
      @StephaneDeny
      Long-COVID is defined based on symptoms. I believe that at least some long-COVID patients have chronic infections, but there have been surprisingly few studies that I know of that address this. This is clearly a chronic infection, but I don't know if they have symptoms.
      Show replies


      Steph
      @ObservingAngel
      ·
      Feb 25
      Replying to
      @SolidEvidence
      Weird poo question but when I see my local wastewater samples, I find it remarkable how elevated it consistently is. Know much may be unreported cases but also really wonder how much is lingering COVID infections. Delta crops up months after its wave. Any thoughts on this?
      Marc Johnson
      @SolidEvidence
      ·
      Feb 25
      Replying to
      @ObservingAngel
      We don't see a lot of lineages from long term infections (we can tell because it's an old sequence). When we do see it we often see A LOT of it. If you see Delta now, it is almost certainly a long term infection. When is the last time you saw Delta?

      ...
      Alice
      @otterstamp
      ·
      Feb 25
      Replying to
      @SolidEvidence
      Until I read this tweet, I did not even know that chronic infection was possible. I'm a layman but I consider myself well informed and cautious with covid. How common is chronic infection with viruses?
      Marc Johnson
      @SolidEvidence
      ·
      Feb 25
      Replying to
      @otterstamp
      We don't really know. I only find out about them when they start shedding so much that we can detect the sequence from wastewater (we've found about 40 that way).

      ...
      https://twitter.com/SolidEvidence/st...18117905809409


      --------------------------------------------------

      Viruses Hiding Out in Patients Hold Long Covid Answers

      Scientists track mutants from one manhole cover to the next; others scan patients’ bodies for signs of hidden infections.


      ByJason Gale
      March 1, 2023 at 7:00 AM CST

      Tracking microbes through a malodorous network of sewer lines led virologist Marc Johnson to the source of unusual coronavirus mutants.

      After months of sampling effluent, the University of Missouri School of Medicine microbiologist found exactly where the mutants originated: from a regular user of restrooms at a specific Wisconsin business. Although unable to identify that individual, Johnson could still see from genetic data that viral particles were being freshly made and expelled for more than a year — many times longer than a typical two-week Covid infection.
      ...
      “You can find lots of chronic infections — people that are probably infected for over a year — where the virus hasn’t changed at all,” he said. “And I don’t understand why in some patients it just goes crazy.”
      ...
      "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
      -Nelson Mandela

      Comment


      • I agree with this observation. Most people have decided the COVID-19 threat is over. I know very few people who wear N95 masks indoor.

        COVID-19 is still circulating and killing people. And that is a fact.



        Anthony J Leonardi, PhD, MS

        @fitterhappierAJ
        When I see @ashishkjha's following list I can resolve the two streams of propaganda in the USA:
        For republicans: Herd immunity was attained 4/2020 and natural immunity suffices
        For democrats: The pandemic is over thanks to vaccination and Covid is an endemic cold


        Some rough numbers at:

        CDC’s home for COVID-19 data. Visualizations, graphs, and data in one easy-to-use website.

        Comment


        • Canada -

          High steady state of COVID-19 case levels are a concern, according to CoVaRR-Net experts



          April 13, 2023| News releases and statements

          OTTAWA, Ontario, April 13, 2023 Despite a general perception that the COVID-19 pandemic is over, CoVaRR-Net experts have found that COVID-19 case levels and related hospital occupancies in Canada have remained steady at a high level over the past eight months – facts with serious implications for Canadians, our healthcare system, and our economy.

          “Unfortunately, COVID-19 has hovered at a steady level since the early fall of 2022, rather than declining, even though immunity in the Canadian population is high,” says Dr. Sally Otto, Co-Lead of CoVaRR-Net’s CAMEO (Computational Analysis, Modelling and Evolutionary Outcomes) Pillar and Killam Professor and Tier 1 Canada Research Chair at the University of British Columbia.

          “A relatively high level of COVID-19 in the population matters because it impacts rates of hospitalizations, long COVID development, and absenteeism in workplaces – collectively impacting both healthcare and the economy,” adds Dr. Fiona Brinkman, Deputy, CoVaRR-Net’s CAMEO Pillar and Distinguished Professor in Bioinformatics and Genomics at Simon Fraser University. “The waves have changed from big peaks and low troughs to smaller waves (or wavelets) centering around an overall higher COVID level. With the spread of recent immune-evasive variants, COVID case levels are consistently higher than we would want, and some people are getting re-infected three or four times a year.”

          Spring uptick in COVID-19 cases predicted

          “XBB.1.5 is the major strain that is driving cases now, and I expect a minor uptick in cases this Spring that should last for about a month,” says Dr. Otto. “Like glacial melt raising sea levels, the higher transmissibility of XBB.1.5 and waning immunity are raising the sea level of COVID-19 cases. We continue to see new variants emerge, so we don’t yet know what variant will dominate this summer, but we don’t predict a big downswing in the summer either.”

          More boosters would curb case levels

          “The current vaccination rate in Canada is less than one million shots a month. If Canadians doubled the rate at which they are getting vaccinated, the level of COVID-19 cases would decline by about 40%,” states Dr. Otto. “When more people get vaccinated, this helps to offset waning immunity. If Canadians were to stop getting boosters, our projections show cases would rise by about 40%.”

          Improving ventilation in crowded indoor settings would also reduce cases substantially. “Our modelling shows that if half of crowded environments improved ventilation – halving the risk of transmission in those places — cases in Canada would also drop by 40%,” adds Dr. Otto.

          CoVaRR-Net’s CAMEO team – composed of more than 15 academic researchers and members of the Public Health Agency of Canada with diverse subject expertise – uses computer modelling and simulations to evaluate the genetic evolution of SARS-CoV-2 variants and monitor how quickly they spread in the Canadian population.


          OTTAWA, Ontario, April 13, 2023 - Despite a general perception that the COVID-19 pandemic is over, CoVaRR-Net experts have found that COVID-19 case levels and related hospital occupancies in Canada have remained steady at a high level over the past eight months - facts with serious implications for Canadians, our healthcare system, and our economy. “Unfortunately,
          "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
          -Nelson Mandela

          Comment


          • Translation Google

            The alarming effects of the Covid-19 epidemic on life-saving vaccines

            According to a UNICEF report, 67 million children were at least partially deprived of vaccines between 2019 and 2021, due to the health crisis.

            By QM with AFP


            Published on 04/20/2023 at 05:00

            An alarming global health finding. Between 2019 and 2021, 67 million children were completely or partially deprived of life-saving vaccines due to the disruptions linked to the Covid-19 epidemic . A figure that takes the world back more than ten years in terms of childhood vaccination, the UN is alarmed .

            In three years, due to strains on health systems or pandemic-related lockdowns , "more than a decade of advances in routine childhood immunizations have been undermined", and "recovering the right path will be a challenge”, underlines the report of Unicef ​​published Wednesday April 19, which is worried about risks of epidemics of measles or polio.

            According to the UN agency, this vaccination coverage is down in 112 countries. And between 2019 and 2021, the childhood vaccination rate worldwide fell by 5 percentage points, to 81%, a level not seen since 2008: 67 million children missed out on vaccines, particularly in Africa and South Asia , and 48 million of them received no dose of any kind.

            Over 4 million lives saved each year

            A situation all the more worrying as this decline occurred at the end of a decade when “the growth of childhood vaccination was stagnating”, after the massive increase in the 1980s, underlines the UN agency. “Vaccines have played a really important role in allowing children to live long and healthy lives”, so “any decline in vaccination rates is worrying”, Brian Keeley, editor in chief, told Agence France-Presse. report leader.

            Childhood immunization saves 4.4 million lives each year, says UNICEF, a number that could rise to 5.8 million if the world managed to halve the number of deprived children by 2030. of essential vaccines and to achieve 90% coverage for key life-saving vaccines.

            Before the introduction of the vaccine in 1963, measles killed some 2.6 million people a year, mostly children. A figure dropped to 128,000 in 2021 for this disease which today is of particular concern to the UN. In three years, the vaccination rate against measles – so contagious that it requires 95% vaccinations in a community to achieve herd immunity – has dropped from 86% to 81%, according to the report. And the number of measles cases doubled in 2022 compared to 2021.

            A decline in confidence in vaccination in many countries

            The fall in the vaccination rate, similar for polio, diphtheria or whooping cough, is also occurring in a broader context of the "survival crisis" of children, notes UNICEF, highlighting an overlapping of crises (malnutrition, impacts climate change, poverty, etc.). "It is increasingly difficult for health systems and governments to meet the need for vaccinations ," said Brian Keeley.

            To improve vaccination coverage, however, it is necessary to "strengthen primary health care and provide front-line staff, mostly women, with the resources and support they need", insists UNICEF. Without forgetting the 67 million children deprived of vaccines during the Covid who will leave the age group targeted by vaccinations, pleads Brian Keeley, calling for them for a “determined catch-up program”.

            At the same time, while the debates around Covid have put antivaccines back in the spotlight, the report is concerned about a drop in confidence in vaccination in 52 out of 55 countries studied. "These data are a worrying warning signal," warned UNICEF boss Catherine Russell in a statement.

            “Encouraging” data for 2022

            “ Trust in routine immunization must not be a casualty of the pandemic as well, or large numbers of children will soon die of measles, diphtheria or other diseases. avoidable”. In half of these 55 countries, “notoriously changing” vaccine confidence remains above 80%, however, tempers UNICEF.

            And despite this distrust, "there is reason to be optimistic that services are resuming in a number of countries," said Brian Keeley, referring to "encouraging" preliminary data for vaccinations in 2022.

            But “even if we manage to get back to where we were before the pandemic, hopefully in a few years”, progress will still have to be made to vaccinate those who were deprived of their injections already before the Covid, he insists.

            https://www.lepoint.fr/sante/les-eff...7086_40.php#11

            ------------------------------------------------------------

            Press release

            New data indicates declining confidence in childhood vaccines of up to 44 percentage points in some countries during the COVID-19 pandemic

            New UNICEF report shows 67 million children missed out on one or more vaccinations over three years due to service disruption caused by strained health systems and diversion of scarce resources, conflict and fragility, and decreased confidence.

            20 April 2023

            ...

            https://www.unicef.org/press-release...3_immunization
            "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
            -Nelson Mandela

            Comment


            • Originally posted by sharon sanders View Post
              More remarkable comments from the Florida Surgeon General:


              Joseph A. Ladapo, MD, PhD
              @FLSurgeonGen
              25th State Health Officer & Surgeon General of the great state of Florida. Father of three. Runner. Advocate for healthy living.
              FloridaHealth.GovJoined October 2021
              1 Following
              117.1K Followers


              Joseph A. Ladapo, MD, PhD’s Tweets


              Joseph A. Ladapo, MD, PhD

              @FLSurgeonGen
              ·
              1h
              Parents, don’t hold your breath… CDC & FDA abandoned their posts. Keep sticking with your intuition and keep those COVID jabs away from your kids.
              151
              2,026
              6,790
              Joseph A. Ladapo, MD, PhD

              @FLSurgeonGen
              ·
              1h
              https://nejm.org/doi/full/10.1056/NEJMoa2209367… Curious why this isn’t getting more attention… According to Moderna themselves: “serious adverse events” affected 1 in 200 toddlers. But they still concluded the mRNA vaccine was “safe in children.”

              nejm.org
              Evaluation of mRNA-1273 Vaccine in Children 6 Months to 5 Years of Age | NEJM
              Original Article from The New England Journal of Medicine — Evaluation of mRNA-1273 Vaccine in Children 6 Months to 5 Years of Age
              53
              766
              1,407
              More interesting tweets from the Surgeon General of Florida:


              Joseph A. Ladapo, MD, PhD
              @FLSurgeonGen
              ·
              19h
              PhD-trained physician revises report based on his scientific expertise = “scandalous altering of results” Fauci enthusiasts are terrified and will do anything to divert attention from the risks of mRNA COVID-19 vaccines— especially cardiac deaths. Truth will prevail.


              Joseph A. Ladapo, MD, PhD
              @FLSurgeonGen
              ·
              Apr 21
              A new study in
              @NatureComms
              found a 70% increased risk of cardiac death in 12 29-year-old males after mRNA COVID-19 vaccination. Florida saw a similar risk for young men. Health officials who don't look won't find anything. Review by Dr.
              @TracyBethHoeg
              . https://bit.ly/3oxcAvr

              Comment


              • tetano
                tetano commented
                Editing a comment
                Whilst COVID-19 vaccination has been linked to an increased risk of myocarditis and other cardiac events in young people, we found no evidence of substantially increased mortality risk, either due to cardiac events or overall, from mRNA vaccines, which suggest that cases of myocarditis or myopericarditis due to mRNA COVID-19 vaccines are unlikely to be fatal. We do, however, find evidence of an increased risk of cardiac death after a first dose of a non mRNA vaccine among females. It should also be noted that non mRNA vaccines are no longer used in the UK vaccination programme28. This provides reassurance that mRNA vaccines pose minimal risk of increased mortality in the first twelve weeks post-vaccination in young individuals.

              • tetano
                tetano commented
                Editing a comment
                On the basis of safety and immunogenicity results in part 1 of the trial, the 25-μg dose was evaluated in part 2. In part 2, 3040 children 2 to 5 years of age and 1762 children 6 to 23 months of age were randomly assigned to receive two 25-μg injections of mRNA-1273; 1008 children 2 to 5 years of age and 593 children 6 to 23 months of age were randomly assigned to receive placebo. The median duration of follow-up after the second injection was 71 days in the 2-to-5-year-old cohort and 68 days in the 6-to-23-month-old cohort. Adverse events were mainly low-grade and transient, and no new safety concerns were identified.

            • WHO Director-General's opening remarks at the media briefing – 26 April 2023

              26 April 2023
              ...
              We’re very encouraged by the sustained decline in reported deaths from COVID-19, which have dropped 95% since the beginning of this year.

              However, some countries are seeing increases, and over the past four weeks, 14,000 people lost their lives to this disease.

              An estimated one in 10 infections results in post-COVID-19 condition, suggesting that hundreds of millions of people will need longer-term care.

              And, as the emergence of the new XBB.1.16 variant illustrates, the virus is still changing, and is still capable of causing new waves of disease and death.

              We remain hopeful that sometime this year, we will be able to declare an end to COVID-19 as a public health emergency of international concern.

              But this virus is here to stay, and all countries will need to learn to manage it alongside other infectious diseases.
              ...

              "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
              -Nelson Mandela

              Comment



              • New COVID-19 strain Arcturus may cause pink eye, LA Department of Public Health warns

                By Jack Hobbs
                April 30, 2023 12:24pm Updated

                Observational data recorded by the LACDPH suggests those who have been infected with the rapidly spreading Omicron strain XBB.1.16 — better known as Arcturus — have shown symptoms of conjunctivitis.

                According to a statement issued by the LACDPH, “it is too early to know with certainty if XBB.1.16 is truly associated with higher rates of conjunctivitis, amid an already active allergy season in Southern California.”

                “Residents should be aware that itchy, watery or red eyes may be a sign of a COVID-19 infection and these symptoms should not be simply dismissed as a result of pollen or seasonal allergies,” continues the statement. “Especially if someone more vulnerable to severe illness could be exposed.”

                ...

                Observational data recorded by the LACDPH suggests those who have been infected with the rapidly spreading Omicron strain XBB.1.16 have shown symptoms of conjunctivitis.


                -------------------------------------

                For Immediate Release:

                April 27, 2023

                With New COVID-19 Strain Confirmed in Los Angeles County, Residents Advised to

                Be Aware of Symptoms, Take Precautions
                Bivalent Vaccine Formulated to Protect Against Omicron Strains


                With the first cases of the newest Omicron strain confirmed in Los Angeles County, residents are being asked to be aware of possible new COVID-19 symptoms, which include conjunctivitis, more commonly known as “pink eye,” and take the same sensible COVID precautions to help avoid infection from the new and likely more communicable XBB.1.16 strain, also known as “Arcturus.”

                The Los Angeles County Department of Public Health (Public Health) has confirmed three reported cases of the new strain. However, the U.S. Centers for Disease Control and Prevention (CDC) predicts that XBB.1.16 currently accounts for 8% of COVID-19 cases in California and 10% nationally.

                Local reporting is delayed due to the time it takes for samples to be sequenced after reported to Public Health. The CDC has advanced models that predict the levels at which each strain is currently circulating.

                Observational data suggests that people infected with XBB.1.16 may be more likely to experience conjunctivitis as a symptom of their COVID infection, along with more traditional COVID symptoms, such as fever, cough and shortness of breath. Conjunctivitis can be painful and itchy, highly contagious and, if left untreated, can cause damage to the cornea. Historically, conjunctivitis was reported in 1-3% of COVID-19 cases.

                Given limited data, it is too early to know with certainty if XBB.1.16 is truly associated with higher rates of conjunctivitis, amid an already active allergy season in Southern California. However, residents should be aware that itchy, watery or red eyes may be a sign of a COVID-19 infection and these symptoms should not be simply dismissed as a result of pollen or seasonal allergies, especially if someone more vulnerable to severe illness could be exposed. At-home COVID-19 testing is an important tool to use to rule out possible COVID-19. And because untreated conjunctivitis can cause eye damage, those who suspect conjunctivitis should speak with their health care provider.

                ...
                "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
                -Nelson Mandela

                Comment


                • Please see:

                  Statement on the fifteenth meeting of the International Health Regulations (2005) Emergency Committee regarding the coronavirus disease (COVID-19) pandemic (WHO, May 5, 2023)

                  ---------------------------------------------------------------------------------

                  FluTrackers.com
                  @FluTrackers
                  ·
                  1m
                  While the emergency status of #COVID19 is over,

                  The disease is not over.

                  Please see our scientific library for data: https://flutrackers.com/forum/forum/welcome-to-the-scientific-library…

                  Take care of you.

                  Comment


                  • WHO Director-General's opening remarks at the media briefing – 5 May 2023

                    5 May 2023

                    Good morning, good afternoon and good evening.


                    One thousand two hundred and twenty one days ago, WHO learned of a cluster of cases of pneumonia of unknown cause in Wuhan, China.


                    On the 30th January 2020, on the advice of an Emergency Committee convened under the International Health Regulations, I declared a public health emergency of international concern over the global outbreak of COVID-19 – the highest level of alarm under international law.


                    At that time, outside China there were fewer than 100 reported cases, and no reported deaths.


                    In the three years since then, COVID-19 has turned our world upside down.

                    Almost 7 million deaths have been reported to WHO, but we know the toll is several times higher – at least 20 million.

                    Health systems have been severely disrupted, with millions of people missing out on essential health services, including lifesaving vaccinations for children.


                    But COVID-19 has been so much more than a health crisis.


                    It has caused severe economic upheaval, erasing trillions from GDP, disrupting travel and trade, shuttering businesses, and plunging millions into poverty.


                    It has caused severe social upheaval, with borders closed, movement restricted, schools shut and millions of people experiencing loneliness, isolation, anxiety and depression.


                    COVID-19 has exposed and exacerbated political fault lines, within and between nations. It has eroded trust between people, governments and institutions, fuelled by a torrent of mis- and disinformation.


                    And it has laid bare the searing inequalities of our world, with the poorest and most vulnerable communities the hardest hit, and the last to receive access to vaccines and other tools.


                    For more than a year, the pandemic has been on a downward trend, with population immunity increasing from vaccination and infection, mortality decreasing and the pressure on health systems easing.


                    This trend has allowed most countries to return to life as we knew it before COVID-19.


                    For the past year, the Emergency Committee – and WHO – have been analysing the data carefully and considering when the time would be right to lower the level of alarm.


                    Yesterday, the Emergency Committee met for the 15th time and recommended to me that I declare an end to the public health emergency of international concern. I have accepted that advice.


                    It is therefore with great hope that I declare COVID-19 over as a global health emergency.


                    However, that does not mean COVID-19 is over as a global health threat.


                    Last week, COVID-19 claimed a life every three minutes – and that’s just the deaths we know about.


                    As we speak, thousands of people around the world are fighting for their lives in intensive care units.

                    And millions more continue to live with the debilitating effects of post-COVID-19 condition.


                    This virus is here to stay. It is still killing, and it’s still changing. The risk remains of new variants emerging that cause new surges in cases and deaths.


                    The worst thing any country could do now is to use this news as a reason to let down its guard, to dismantle the systems it has built, or to send the message to its people that COVID-19 is nothing to worry about.


                    What this news means is that it is time for countries to transition from emergency mode to managing COVID-19 alongside other infectious diseases.

                    I emphasise that this is not a snap decision. It is a decision that has been considered carefully for some time, planned for, and made on the basis of a careful analysis of the data.

                    If need be, I will not hesitate to convene another Emergency Committee should COVID-19 once again put our world in peril.


                    While this Emergency Committee will now cease its work, it has sent a clear message that countries must not cease theirs.

                    On the Committee’s advice, I have decided to use a provision in the International Health Regulations that has never been used before, to establish a Review Committee to develop long-term, standing recommendations for countries on how to manage COVID-19 on an ongoing basis.


                    In addition, WHO this week published the fourth edition of the Global Strategic Preparedness and Response Plan for COVID-19, which outlines critical actions for countries in five core areas: collaborative surveillance, community protection, safe and scalable care, access to countermeasures, and emergency coordination.


                    ===


                    For more than three years, the experts on the Emergency Committee have devoted their time, their experience and their expertise, not just to advise me on whether COVID-19 continues to represent a global health emergency, but to also advise on recommendations for countries.


                    I would like to express my deep gratitude to all the members of the Emergency Committee for their thoughtful consideration and wise advice.


                    I thank especially Professor Didier Houssin for his leadership as Chair over the past three years. He has led the committee with a calm demeanour and a steady hand through turbulent times.

                    I also wish to thank the incredible people who I have the privilege to call my colleagues.


                    For more than three years, the people of WHO have laboured day and night, under intense pressure and intense scrutiny.

                    They have brought together partners and experts from around the world to generate evidenced, study and translate it into guidance and actions the world.


                    In countries around the world, WHO has worked closely with governments to translate that guidance into policies and actions to save lives.

                    My colleagues have worked tirelessly to get vaccines and other supplies to more people faster.


                    And they have countered mis- and disinformation with accurate and reliable information.

                    I do not have the words to express my gratitude to everyone around the world, who like me, is proud to be WHO.

                    ===

                    At one level, this is a moment for celebration.

                    We have arrived at this moment thanks to the incredible skill and selfless dedication of health and care workers;

                    The innovation of vaccine researchers and developers;


                    The tough decisions governments have had to make in the face of changing evidence;

                    And the sacrifices that all of us have made as individuals, families, and communities to keep ourselves and each other safe.

                    At another level, this a moment for reflection.


                    COVID-19 has left – and continues to leave – deep scars on our world.

                    Those scars must serve as a permanent reminder of the potential for new viruses to emerge, with devastating consequences.

                    As a global community, the suffering we have endured, the painful lessons we have learned, the investments we have made and the capacities we have built must not go to waste.


                    We owe it to those we have lost to leverage those investments; to build on those capacities; to learn those lessons, and to transform that suffering into meaningful and lasting change.


                    One of the greatest tragedies of COVID-19 is that it didn’t have to be this way.


                    We have the tools and the technologies to prepare for pandemics better, to detect them earlier, to respond to them faster, and to mitigate their impact.

                    But globally, a lack of coordination, a lack of equity and a lack of solidarity meant that those tools were not used as effectively as they could have been. Lives were lost that should not have been.


                    We must promise ourselves and our children and grandchildren that we will never make those mistakes again.

                    That’s what the pandemic accord and the amendments to the International Health Regulations that countries are now negotiating are about – a commitment to future generations that we will not go back to the old cycle of panic and neglect that left our world vulnerable, but move forward with a shared commitment to meet shared threats with a shared response.

                    In 1948, the nations of the world came together in the aftermath of the bloodiest war in history to commit to working together for a healthier world, recognising that diseases have no regard for the lines humans draw on maps.


                    They forged an agreement – a treaty: the Constitution of the World Health Organization.

                    Three-quarters of a century later, nations are once again coming together to forge an agreement to ensure we never repeat the same mistakes again.

                    If we don’t make these changes, then who will?

                    This is the right generation to make those changes.


                    And if we don’t make them now, then when?

                    Like countries, communities and public health institutions around the world, WHO has learned an enormous amount from this pandemic.


                    COVID has changed our world, and it has changed us.

                    That’s the way it should be. If we all go back to how things were before COVID-19, we will have failed to learn our lessons, and we will have failed future generations.

                    This experience must change us all for the better. It must make us more determined to fulfil the vision that nations had when they founded WHO in 1948: the highest possible standard of health for all people.​

                    "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
                    -Nelson Mandela

                    Comment


                    • There are a lot of entities doing statistical analysis of the pandemic now, including excess deaths. I would like to make the comment that all COVID-19 numbers are off and especially unreliable are the countries with marginal public health systems. Most poorer countries can barely keep up with the demands for health care and they perform a lot less disease monitoring (human and animal) in general.

                      Comment



                      • From the Florida Surgeon General:


                        Joseph A. Ladapo, MD, PhD
                        @FLSurgeonGen
                        ·
                        4h
                        - Florida analysis shows an 84% increased risk of cardiac death after mRNA COVID vaccines in young men. - An English analysis shows a 70% increased risk in a similar age group. - Two young boys in Connecticut died days after COVID vax with autopsies showing acute myocarditis.


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                        Joseph A. Ladapo, MD, PhD
                        @FLSurgeonGen
                        ·
                        4h
                        Instead of acknowledging these facts and analyzing their own data, critics perseverate on why I decided not to use an untested method first published during the pandemic — which happens to yield a result they find palatable.
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                        Joseph A. Ladapo, MD, PhD
                        @FLSurgeonGen
                        ·
                        4h
                        Aren’t the lives of those who suffered or died after COVID vaccination, just like those who died from COVID, worthy of compassion and scientific curiosity? Grateful to serve as Surgeon General of Florida and lay out a compassionate, human-centered vision of public health.
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                        Comment


                        • Please see:

                          International Covid Summit III - European Parliament, Brussels - videos - May 2023

                          Comment

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