Discussion thread VII - COVID-19: Endemic Stage

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Covid-19: “We are not at all on the end of the pandemic”

The Swiss epidemiologist and director of the Geneva Institute of Global Health, Antoine Flahault, analyzes for Capital the peak of the ninth wave of Covid-19, which France has just passed.

By Caroline Robin
Health journalist
Published on 21/12/2022 at 4:26 p.m. & Updated 22/12/2022 at 7:27 am

Can we really be happy to have reached the epidemic peak? Admittedly, the very first was life-saving and gave hope of emerging from particularly drastic confinement at the start of the Covid-19 pandemic. But things are different today. In particular because there are nine epidemic waves… including five, in 2022 alone . And that barrier gestures are no longer the norm within the population, despite the appeals to the French launched by the government in the midst of the triple epidemic of Covid, influenza and bronchiolitis. A report which, for the Swiss epidemiologist and director of the Geneva Institute of Global Health, Antoine Flahault, does not make it possible to predict the end of the Covid-19 pandemic. Maintenance.

Capital: That's it, France has crossed the peak of the ninth wave. But after so many epidemic waves, we know the song. Should we fear a rebound very quickly after Christmas?

Antoine Flahault : Indeed, we have seen an acceleration of the pandemic over the past year. In 2022, there were five waves in total, compared to only two in 2020 and 2021. Almost everyone was infected with Omicron. We are clearly not at all on the end of the pandemic, but rather on a very strong acceleration. We hardly see any respite, or even between two epidemic waves as in the summer of 2020. We no longer see mortality relapse. We are increasingly in a permanent high transmission plateau.

Capital: Is it the fault of a lesser application of barrier gestures? The government is content to recommend wearing a mask without making it compulsory...

Antoine Flahault : Yes, that completely explains the high level of contamination. We could live with it if the level of mortality was at the level of the flu . However, the mortality linked to Covid-19 is 4 to 5 times higher than for the flu. We are not taking all the measures that we could implement today to try to remedy this.

Capital: The Committee for monitoring and anticipating health risks (Covars) does not give a clear opinion on the wearing of a mask. Do you think it should be made compulsory?

Antoine Flahault: There are studies that show that in the United States, the obligation to wear a mask is much more effective than simply recommending it. In any case, in the West, the recommendation of the mask is not sufficient. Or, we could recommend the FFP2 mask to fragile people who are the only ones to wear the mask in transport and closed places. At least it would protect them better. It is a pity that the French health authorities are not very clear on this subject. As for the surgical mask, it is altruistic. He protects others above all else. So it is only effective if we all wear it. But to impose it, it would be necessary to define a numerical threshold, beyond which the mask is imposed in closed places.

Capital: From which indicator? The alert threshold for the incidence rate formerly set at 50 cases per 100,000 seems very far away...

Antoine Flahault: It's to be discussed with the scientists. We should perhaps not define the obligation to wear a mask on the basis of the level of contamination because this data depends on the number of tests carried out. We could possibly start from the level of hospitalizations or admissions to critical care. For example, from 1,500 people hospitalized for Covid, the mask is imposed.

In any case, a rule is missing which imposes the mask in an enclosed place where the CO2 sensor displays more than 600 ppm (part per million, editor's note) . If the rate is below 600 ppm indoors, the mask is less useful.

Capital: Precisely, what about air quality among health prevention measures? The pandemic has highlighted this problem, but we seem to be treading water.

Antoine Flahault:I like to take the example of water quality. Historically, the dangers of drinking water date back to the mid-19th century. John Snow discovered the reasons for the cholera epidemics in London, it was the fact of drinking the water of the Thames. The epidemic stopped after his demonstration. But it took 50 years for the public authorities to bring drinking water to homes. You don't realize it, but you flush toilets with water as pure as that of Evian. Thus, more risk of cholera. And I think we have the same problem with Covid-19. We breathe air polluted by viruses exhaled by others. And when we go to a closed place, we breathe an air whose quality we do not know. I think it will take some time between awareness and the moment when we proceed with the infrastructure works. Be that as it may, a more ambitious vision of buildings is needed.

https://www.capital.fr/economie-poli...ndemie-1455506

 

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France -

Translation Google

Covid-19. How the outbreak of the epidemic in China can also affect us

Covid-19 cases have soared in China since the lifting of the “zero Covid” policy. And this will not necessarily be without consequences for France.

West France
Lucas ROJOUAN.
Published on27/12/2022 at 5:28 p.m.

China is facing an outbreak of Covid-19 cases on its territory, at the dawn of the year 2023. A direct consequence of the abandonment, on December 7, 2022, of its "zero Covid" policy , launched three years earlier.

Since the recent lifting of health restrictions, the increase in Covid-19 contamination has continued in China, where the population is poorly vaccinated. The country's main health authority also announced on Sunday that it would no longer publish daily figures for the epidemic. A way to break the thermometer? According to an estimate from the Institute of Health Metrics and Evaluation ( IHME ), published in mid-December, more than a million people could die from the virus in 2023 .

The very strong circulation of Covid-19 in China is therefore a “worrying” situation and “which must be closely monitored” , considers Yannick Simonin, lecturer at the University of Montpellier, specialist in emerging viruses. Especially since the circulation of the virus within a weakly immunized population can “generate a very large number of hospitalizations and deaths” . But this situation could also have repercussions in France: we explain why.

1. Fear of new variants

According to Yannick Simonin, a virus which circulates “very actively” in a weakly immunized population “can also contribute to the appearance of new variants” . This is particularly the case with the BF.7 strain of Covid-19 , a sub-variant of Omicron still not very present in France but very active in China.

The virologist is therefore waiting to “see how the Chinese authorities will manage to curb, or even reduce, this number of cases” . “It would seem that they want to rely on a greater vaccination of the population, it is perhaps a little late,” he notes.

Indeed, President Xi Jinping tried to temporize on Monday, calling for a “patriotic health campaign” to “build a bulwark” against the virus. A paradoxical situation when the power ended the restrictions without notice, against a backdrop of exasperation of the population and harmful economic consequences.

2. The risk of drug shortages

As tens of millions of daily cases are estimated in China, an ill workforce could curb the production of drug factories in China, even if infected residents are now allowed to work . This will increase the risk of drug shortages in France and in the rest of the world at the start of 2023.

Indeed, in France, nearly "80% of the active ingredients, the raw material for our medicines, are manufactured in China and India" , indicated on Twitter, Saturday, the president of the medical commission of the AP- HP, Rémi Salomon .
...
3. The consequences of a recovery in tourism

China has announced that on January 8, 2023, it will lift the mandatory quarantine at the entrance to its territory , one of the last major restrictions still in force. The reopening of China to the world and the resumption of tourist activity raise fears of a further increase in contamination at the start of the year.

Long cut off from the world, many Chinese flocked to the reservation centers following this announcement. Travel platform Qunar showed searches for international flights jumped sevenfold, with Thailand, Japan and South Korea topping the list, just 15 minutes after the news broke, The Guardian reported. .

Japan was the first country to react by announcing on Tuesday the return of Covid-19 tests to visitors from China. This is not yet the case in France.

https://www.ouest-france.fr/sante/vi...6-f8c7f0068918

 

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Covid-19 in China: "An epidemic of very large scale", deciphers virologist Bruno Lina

By The digital editorial staff of France Inter, Bruno Duvic
Published on Tuesday, December 27, 2022 at 4:40 p.m.
...
Bruno Lina, virologist at the Croix-Rousse hospital in Lyon and member of the committee for monitoring and anticipating health risks, discusses the situation in China, then in France, where the flu is added to the Covid.

FRANCE INTER: What do you know about the state of the coronavirus epidemic in China?

Bruno Lina: "It's an epidemic that has a very large scale, since it is believed that there is at least 10 to 15% of the population who is sick at the same time. For the moment, it is still difficult to have solid data. But we are talking about potentially several hundred million people infected at the same time, with attack rates - that is to say the number of people who are infected - which are extremely high. What we also know is that there are a number of variants descended from the Omicron variant circulating there, broadly the same as in Europe. And this is really the consequence of the introduction of viruses circulating in the world population inside China, because of the cessation of contact restrictions in the country.
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Do these dozens of variants and sub-variants circulating constitute, in a way, a reserve and that other more dangerous variants could emerge?

'That’s the real question, and the answer is very difficult to give. However, we can say that the epidemic in China occurs massively because of a lack of immune pressure. The virus spreads like wildfire because many people are susceptible to viral infection. What drives the evolution of viruses, and in particular the evolution of variants, is this immune pressure. So because it’s low right now in China, the risk is low as well. Although that doesn’t mean it’s zero. At the end of the day, the risk of variants emerging will be greater if there is ever an outbreak in a highly vaccinated or highly immunized area. But here in China, the virus has such a high transmission rate that everyone is bound to get infected. '
...

https://www.radiofrance.fr/francein...ante-decrypte-le-virologue-bruno-lina-7225769

 

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Tedros Adhanom Ghebreyesus
@DrTedros
As I said at our most recent press conference - in order to make a comprehensive risk assessment of the #COVID19 situation on the ground in #China, @WHO needs more detailed information.

Quote Tweet
World Health Organization (WHO)@WHO
Dec 21
LIVE: Media briefing on global health issues with @DrTedros https://twitter.com/i/broadcasts/1yNxaNwgbZrKj
Show this thread

1:52 PM · Dec 29, 2022
...
In the absence of comprehensive information from #China, it is understandable that countries around the world are acting in ways that they believe may protect their populations. #COVID19
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We remain concerned about the evolving situation and we continue encouraging #China to track the #COVID19 virus and vaccinate the highest risk people. We continue to offer our support for clinical care and protecting its health system.

https://twitter.com/DrTedros/status/1608551642676486144

 

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Embassy of the People's Republic of China in the French Republic -

Home page > China and France

China's achievements in fighting COVID-19 cannot be discredited and altered
2023-01-02 00:30

Recently, China has adjusted and optimized its COVID-19 epidemic prevention and control policy. This is a good thing for the country and its people, as well as for the world. However, some French media have made a big fuss about it with an unmentionable purpose, seriously misleading the French public in its perception of China. These media ignore the most basic facts, but are quick to double standards, make up stories and pass off one aspect as the whole. The Chinese Embassy wishes to take this opportunity to highlight their nonsense.

Nonsense 1: The epidemic in China is out of control. Some French media spared no effort to portray the "humanitarian drama" in China: "the explosion of cases", "the rudimentary health system overwhelmed", "the Chinese fight against COVID-19 which was to be a blitzkrieg turns into a fiasco, and perhaps even a disaster”. One cannot help but ask: have they taken the time to go to China and do studies on the situation in different Chinese regions? Do they know the journey of the past three years of China's fight against COVID-19? It is by taking into account the facts: significant reduction in the rates of serious cases and mortality caused by Omicron, popularization of vaccination and accumulation of epidemic management experiences, as well as the practices of other countries, that China has decided to optimize its anti-COVID-19 policy in response to people's aspiration. It is moreover an adjustment carried out under more favorable conditions and at a much lower cost, after having passed the most difficult periods of the epidemic. The priority now shifts from “preventing contamination” to “protecting health and preventing serious cases”. This process is under control, and the situation is in line with forecasts. Cities like Beijing have already passed the peak. Other provinces and cities are also ready and closely monitoring the epidemic situation. Tiered care measures according to the severity of the cases have been put in place. The return to normal economic activity and daily life is in sight. Certainly, residents are rushing to stock up on medicines as a precaution. But there is no need to worry about it. China's production capacity of traditional Chinese medicines meets market demand, while its production capacity of antipyretics is the first in the world. Chinese authorities have also approved the import of anti-COVID drugs like those from Pfizer. Even if there are supply tensions for some drugs, they are temporary. ...

Nonsense 2: Chinese vaccines are ineffective. From the start of the epidemic, some French media have constantly denigrated Chinese vaccines. It seems that the recent adjustment of the epidemic management policy in China has given them a new opportunity to repeat the same tune. Some media have claimed, in defiance of the facts, that only 40% of Chinese people over 80 have been vaccinated and that the weak protection of Chinese vaccines has caused an "epidemic tsunami". The reality is quite the opposite. Chinese vaccines are quite effective and have prevented the deaths of millions of people. More than a dozen vaccines based on various technologies and inoculation methods are available in China, and more than 3.4 billion doses have been inoculated. Specifically, more than 92% of the Chinese population are vaccinated, of which more than 90% fully vaccinated, more than 85% of Chinese over the age of 60 and over 65% over the age of 80 are fully vaccinated. A study published by the University of Hong Kong shows that with a booster dose, inactivated vaccines are about as effective as messenger RNA vaccines in preventing severe forms caused by Omicron, both at 97%. The journal The Lancet Infectious Diseases also recognizes that inactivated vaccines have similar efficacy to messenger RNA vaccines. It should be noted that no vaccine in the world can prevent infection one hundred percent. This is a consensus of the scientific community. The CEO of Pfizer, having received four doses of his group's vaccine, has twice contracted COVID-19.

Nonsense 3: The Chinese were under imprisonment for three years. It is a falsification of notions and a gratuitous slander. The "dynamic zero COVID" policy in China is not one of containment. For most of the past three years, thanks to this policy of containing the virus at the country's doorstep, Chinese people have been able to live freely, travel, shop, eat out and go to the movies. During the holidays, the tourist sites were full of people. During the Spring Festival holiday from February 11 to 17, 2021, 160 million movie theater admissions were recorded with a box office of 7.822 billion yuan, or about $1.3 billion. Yes, China was leading the global box office in 2020 and 2021! At this same time,

Ineptitude 4: The “dynamic zero COVID” policy is a failure. For most of the past three years, China has enforced the “dynamic zero COVID” policy. The Chinese mainland has recorded just under 400,000 cases and around 5,235 deaths. For comparison, the United States recorded more than 100 million cases and 1.06 million deaths during the same period. According to official estimates, France would have registered 38 million cases and around 160,000 deaths. As China ended its “dynamic zero COVID” policy at the beginning of last December to adopt the policy of reopening like Europe and the United States, the number of cases rose sharply, “possibly go up to several million a day", to hear some. At the end of the day,

Nonsense 5: China's COVID-19 data is wrong.Some French media blithely and slyly accuse China of "covering up the data", claiming that "the obvious discrepancy between the statistics and the reality of the epidemic situation could have become too blatant", even sensationally predicting "the death of approximately one million citizens in the next few months”. Following the adjustment of the approach to combating COVID-19, China no longer conducts PCR testing on a general scale. It is thus impossible to obtain precise figures of cases of contamination. This is normal in all countries, including France. The US government announced in October 2022 that it would no longer release official data on COVID-19. And France currently only publishes reported cases, a good part of the cases being unreported. 

As for the criteria for death attributed to COVID-19, there are two in the world: death directly caused by respiratory failure due to COVID-19 and death from all causes within 28 days of infection, otherwise says “deaths due to COVID-19” and “deaths with COVID-19”. Since 2020, China reports deaths according to the first criterion. Let's imagine: a person dies in a road accident and it turns out that SARS-CoV-2 is detected in his body. Is it a traffic accident death or a death due to COVID-19? At present, China mainly uses questionnaires to monitor the epidemic situation. While it is true that in times of epidemics and especially rapid transmission, it is difficult to calculate mortality exactly,

After the adjustment of sanitary measures, a period of adaptation is inevitable. This is no stranger to France, since it was also hit by an "epidemic tsunami" in the first quarter of 2022 after choosing to lift all health restrictions against the Omicron variant. For a large country like China, which has 1.4 billion inhabitants, the ordeal is even tougher. But we are confident and able to overcome this epidemic wave with minimal cost and return economic activity and daily life to normal. In recent days, in Beijing, Shanghai, Guangzhou and other Chinese metropolises, we have already seen heavy traffic flows on the roads and the swarm of crowds in shops and subways: the daily dynamism is back. Major international institutions predict that the world economy could fall into recession in 2023, while the Chinese economy could take off. We are confident that China's economic take-off will boost the growth of the global economy and help it avoid recession.

The French government has just announced that it will impose restrictions on the entry of travelers arriving from China. We believe that this measure is unnecessary and discriminatory. The European Center for Disease Prevention and Control (ECDC) has publicly stated that the introduction of mandatory COVID-19 testing within the EU for travelers arriving from China is "unwarranted". The ECDC also noted in a statement that EU countries have relatively high immunization and vaccination levels and that variants circulating in China are already circulating in the EU. Moreover, he points out, the potential infections that can be imported are “rather low” compared to the number of infections already circulating on a daily basis. As for the fear of the appearance of new dangerous variants in China, the French virologist Bruno Lina said that it "is a fantasy". He noted that "reported to the whole of the French population, which today registers daily 440 infections per 100,000 inhabitants, a few dozen Chinese arriving per day, it is marginal". And about the screening of travelers, the question seems to him “more political than scientific”.

http://fr.china-embassy.gov.cn/fra/z...2_10999685.htm

 

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Translation Google

Covid-19 in China: doctors must triage patients

Posted on 04/01/2023 10:44

J. Debraux, A. Miguet, M. Marini, France Televisions China - franceinfo
France Televisions
franceinfo evening
Edition of Tuesday, January 3, 2023

An independent British organization estimates that 11,000 Covid-19 patients die every day in China.

On stretchers, lie lifeless bodies at the hospital in Beijing (China), Tuesday, January 3. The images were shot by Spanish television in the afternoon. According to estimates by a British company, 11,000 Covid-19 patients die every day in China. The epidemic seems out of control. In a facility in Chongqing, the number of hospitalizations has increased fivefold in recent days.

The peak of contamination reached?

In Chengdu, doctors must now triage patients. " We divide patients into several categories: those who are unable to breathe and whose heart does not beat are obviously the most urgent ," said Tang Shiyun, a doctor at Chengdu Hospital. The peak of contaminations could have been reached. Some specialists speak of nearly two million people infected every day in the country.

Video (in French) :
https://www.francetvinfo.fr/sante/m...ecins-doivent-trier-les-patients_5579970.html

 

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Covid-19: “We cannot stop the Chinese and American variants”, especially without a global response to the epidemic

MUTATION France has implemented controls for travelers from China, but has not reinstated the obligation to wear a mask on public transport

Xavier Regnier
Twitter
Published on 04/01/23 at 12:49 — Updated on 01/04/23 at 1:57 p.m.
...
They expire faster than fast fashion. The variants of Covid-19 multiply and follow one another at a speed that is very difficult to follow, to the point that, for the past year, almost all versions of the virus have still been called Omicron . However, France was swept away by waves BA.1, BA.2, BA.5 this summer and is now contaminated by BQ.1.1. In addition, faced with the explosion of cases in China, and faced with the lack of transparency on official figures, France now imposes a compulsory test on all travelers from the Middle Empire, which has its own strains.

But other forms of the virus also circulate in Western countries. And, for a few days, the “American” variant seems to have become a new strong competitor. What is the risk of seeing new variants arrive in France? Can we avoid their circulation and their possible recombinations? 20 Minutes takes stock.

Where is the epidemic in France currently?

There has been a majority strain since December, BQ.1.1, which descends directly from Omicron's BA.5 strain. Nearly 23,000 cases have been confirmed over the past seven days, in a country that no longer tests itself much. “We are facing a triple epidemic”, with the flu and bronchiolitis, reminds general practitioner Michaël Rochoy for 20 Minutes . Besides sick people who don't go to the doctor, it can be difficult, based on symptoms alone, to tell the difference between these viruses. In addition, "we remain around 150 deaths per day , and there are not many diseases which cause 40,000 deaths per year", warns the doctor.

What are the risks if new variants arrive in France?

Since the start of the Covid-19 epidemic, the variants have replaced each other rather than added to each other. Exit, for example, the Delta variant , which accounted for 99% of cases at the end of 2021, which rules out the idea of ​​a parallel epidemic. "The virus mutates randomly, and sometimes this gives it an advantage over other variants to be transmitted more easily or to escape vaccination", explains Michaël Rochoy, also a researcher in epidemiology and member of the collective "Du Côté de Science ".

“ China did not use the same vaccines as us”, he recalls, and the variant which developed there to resist the vaccine “would probably not be effective here”, according to him. On the other hand, "the selective advantage is more probable in the American variant", confronted with the same vaccines as those used in France and which is already a recombinant , that is to say a crossing of two variants to keep the best ones strengths. But that does not mean that the American XBB.1.5 will integrate the good reproduction capacity of the French BQ1.1 to supplant it. “We cannot predict what will become of a variant”, tempers the doctor, while imagining the extreme case of a “totally asymptomatic variant, but fatal, after several days”. ...

Can we fight against these new variants?

“We cannot stop a variant,” says Michaël Rochoy. Despite a very limited number of cases, the “American” variant is indeed already present in France. And the doctor wonders about the relevance of border controls: "it is not by taking the temperature of travelers that we will avoid anything", especially if people have been contaminated on the plane and do not develop symptoms until later. Moreover, "why act on the planes that come from China and not the others"?

“We are a house burning everywhere, and we are worried that a person could bring a flame from the outside”, image the doctor. He pleads for a strengthening of health measures in general. "Wearing a mask reduces the replication rate by 20%" and also helps fight the flu, he argues. “It should be compulsory” , at least in transport and closed places, “if we want to curb transmission and reduce the impact on hospitals”, asks the general practitioner.

https://www.20minutes.fr/sante/4017...s-americains-surtout-reponse-globale-epidemie

 

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WHO Director-General's opening remarks at the media briefing – 4 January 2023

4 January 2023
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We are really concerned about the current COVID-19 epidemiological picture, with both intense transmission in several parts of the world and a recombinant sub-variant spreading quickly.

In recent weeks, there has been increasing reports of hospitalization and health system pressure, particularly in temperate regions of the northern hemisphere where respiratory diseases including flu are also circulating.

In the last week, WHO held a high-level meeting with counterparts in China to discuss the surge in cases and hospitalisations, and subsequently WHO’s Technical Advisory Group on SARS-CoV-2 Virus Evolution and the COVID-19 clinical management expert network groups both met with Chinese experts.

We continue to ask China for more rapid, regular, reliable data on hospitalizations and deaths, as well as more comprehensive, real-time viral sequencing.

WHO is concerned about the risk to life in China and has reiterated the importance of vaccination, including booster doses, to protect against hospitalization, severe disease, and death.

This is especially important for older people, those with underlying medical conditions, and others who are at higher risk of severe outcomes.

With circulation in China so high and comprehensive data not forthcoming – as I said last week it is understandable that some countries are taking steps they believe will protect their own citizens.

This data is useful to WHO and the world and we encourage all countries to share it.

Data remains essential for WHO to carry out regular, rapid and robust risk assessments of the current situation and adjust our advice and guidance accordingly.

Outside of China, one of the Omicron sub variants originally detected in October 2022 is XBB.1.5, a recombinant of two BA.2 sub-lineages.

It is on the increase in the US and Europe and has now been identified in more than 25 countries.

WHO is following closely and assessing the risk of this subvariant and will report accordingly.

COVID-19 will no doubt still be a major topic of discussion, but I believe and hope that with the right efforts this will be the year the public health emergency officially ends....

https://www.who.int/news-room/speec...emarks-at-the-media-briefing---4-january-2023

 

[gsgs]

it is strangely difficult to find NCHS's mortality data.
with keyword search . 2021 is due.
They rearranged the pages. ?!
Instead I find, that they threaten with 5year prison and $250000.
I didn't see that before.
Of course, as a German I don't want to use the data to identify single US persons,
but who knows, if they would conclude that I did,
you could find some person from my
published data and statistics and charts and someone uses it
to do that ?!
They should show, how much prison and fees they collected last year.


https://www.cdc.gov/nchs/nvss/new_nvss.htm
https://www.nber.org/research/data/m...use-death-data
https://www.cdc.gov/nchs/data_access...ality_Multiple
https://www.cdc.gov/nchs/data_access/restrictions.htm



nber must have recently updated their webpage, last moth the nchs-links didn't work.

And now I see, that 2021 is available ! 164MB, zipped

(no geographical data since 2004 , bur multiple cause, age etc,)

 

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10 January 2023
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Statement by Dr Hans Henri P. Kluge, WHO Regional Director for Europe
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From the information available to WHO, the SARS-CoV-2 virus variants circulating in China are those that have already been seen in Europe and elsewhere.

We share the current view of the European Centre for Disease Prevention and Control (ECDC) that the ongoing surge in China is not anticipated to significantly impact the COVID-19 epidemiological situation in the WHO European Region at this time.
...

https://flutrackers.com/forum/forum...covid-19-challenge-who-europe-10-january-2023

 

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WHO Director-General's opening remarks at the media briefing – 11 January 2023

11 January 2023

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It’s now three years since the first sequence of SARS-CoV-2 was shared with the world.

That sequence enabled the development of the first tests, and ultimately, vaccines.

Throughout the pandemic, testing and sequencing helped us to track the spread and development of new variants.

But since the peak of the Omicron wave, the number of sequences being shared has dropped by more than 90%, and the number of countries sharing sequences has fallen by a third.

It’s understandable that countries cannot maintain the same levels of testing and sequencing they had during the Omicron peak.

At the same time, the world cannot close its eyes and hope this virus will go away. It won’t.

Sequencing remains vital to detect and track the emergence and spread of new variants, such as XBB.1.5.

We urge all countries now experiencing intense transmission to increase sequencing, and to share those sequences.

Investment in testing at-risk people to ensure they receive adequate care and in tracking the virus remains vital.

There is no doubt that globally we are in a vastly better position than we were a year ago.

Since February last year, the number of deaths reported to WHO each week has dropped by almost 90%.

But since mid-September, the number of weekly reported deaths has been stuck between 10 and 14 thousand deaths per week.

The world cannot accept this number of deaths when we have the tools to prevent them.

Last week, almost 11 500 deaths were reported to WHO – about 40% from the Americas, 30% from Europe and 30% from the Western Pacific region.

However, this number is almost certainly an underestimate given the under-reporting of COVID-related deaths in China.

Most of those dying are at-risk groups, including older people.

During the last six months of last year, people aged 65 or over accounted for almost 90% of all reported deaths.

But once again, the data we receive from countries is inadequate to give us a clear picture of who is dying, and why.

Only 53 out of 194 countries provide data on deaths that are disaggregated by age and sex.

As we enter the fourth year of this pandemic, we ask all countries to provide this data. The more data we have, the clearer a picture we have.

We continue to call on all countries to focus on fully vaccinating the most at-risk groups, especially older people.

And we continue to call on all people to take appropriate precautions when necessary to protect yourself and others.

You may not die with this disease, but you could give it to someone else who does.

===
https://www.who.int/news-room/speec...marks-at-the-media-briefing---11-january-2023

 

[sharon sanders]

During the Spring Festival holiday, you must be careful when encountering the recovery period of the new crown infection!


January 23, 2023 19:53




During the recovery period of the new coronavirus infection, although the nucleic acid and antigen test results have turned negative, but the body has not yet returned to the pre-disease level, it will take 1 to 2 weeks or even longer to completely relieve the "yang health" What should I pay attention to? How to do a good job in health management during the recovery period?
Precautions for daily life

​

Good habits should be maintained: after "Yangkang", try to minimize going to crowded places, continue to adhere to good habits such as wearing masks, washing hands frequently, maintaining social distance, and opening windows for ventilation, while paying attention to coughing etiquette.

Healthy life without staying up late: ensure adequate nutrition, regular work and rest, and good sleep. In terms of diet, pay attention to eating more high-protein and nutritious foods. It is recommended to quit smoking and limit alcohol after "Yangkang".

Relax without anxiety: Actively carry out psychological adjustment, communicate more with others, encourage each other, support each other psychologically, and divert attention. Do not adopt negative coping methods such as denial, avoidance and retreat, excessive dependence on others, accusations and complaints, transfer of emotions, tantrums, impulsiveness, etc., especially do not try to relieve tension through smoking and drinking.

Moderate exercise and not strenuous exercise: Do not exercise vigorously in the early stage of recovery, but start with low-intensity activities, such as walking, Baduanjin, and simple daily housework. If there is no obvious discomfort, the activity intensity can be gradually increased within a few weeks until the normal activity state before the illness is restored. If chest pain, palpitations, dizziness and other uncomfortable symptoms occur during exercise, you should stop immediately and seek medical treatment if necessary.

Vaccination intervals: If confirmed to be infected with the new coronavirus, the time of infection and the time of vaccination against the new coronavirus should be separated by more than 6 months.

Precautions for returning to work: At the beginning of returning to work, you can start with lighter work and gradually return to the normal workload and working status. Avoid stress, overtime, staying up late and other behaviors, and you can take a lunch break of 30-60 minutes. Due to individual differences in physique, age, and illness, the recovery time will also vary. Therefore, the recovery work should be done step by step, and the intensity should be based on not feeling tired.

Key population considerations

Elderly people: After the elderly with underlying diseases are infected with the new coronavirus, the underlying diseases will aggravate. For example, the elderly with hypertension may have unstable blood pressure after infection, the elderly with diabetes may have unstable blood sugar after infection, the elderly with cerebrovascular disease may have a risk of cerebral infarction or hemorrhage after infection, and the elderly with chronic obstructive pulmonary disease may have cough and dyspnea after infection aggravated etc. After the nucleic acid or antigen test of the elderly turns negative, the aggravated underlying disease may not be stable. Close monitoring of blood pressure, blood sugar, finger blood oxygen saturation, etc. is required. If the condition is unstable for a long time, please go to the hospital in time to adjust Basic disease treatment plan.
Pregnant women: At present, it is believed that the possibility of vertical transmission of the new coronavirus to the fetus causing intrauterine infection is extremely small, and generally it will not cause deformities. Pregnant women should have regular pregnancy checkups, and pregnant women in the second and third trimesters should monitor fetal movement by themselves. If you have abnormal fetal movement, abdominal pain, abdominal discomfort, vaginal bleeding and other symptoms, you should go to the hospital immediately.

Children and adolescents: Ensure adequate sleep. Go to bed and get up on time, sleep at least 12 hours a day for babies under 1 year old, 11 hours for children under 3 years old, 10 hours for children aged 3-6, at least 9 hours a day for elementary school students, and at least 8 hours for middle school students.

When the child persists in high fever for more than 3 days, shortness of breath, listlessness, persistent chest tightness and chest pain, or the condition worsens, seek medical treatment in time.


zhttps://finance.sina.com.cn/jjxw/2023-01-23/doc-imycerri1482844.shtml

 

[Emily]

I'll try to see what is going on here.

 

[Emily]

I looked at the restriction page and they are just talking about 'intentional' use of the date to identify people, if that is even possible. If you have concerns about what you find, you can message Sharon, but I don't think CDC means to worry researchers about the type of analysis you do. You have never tried to identify anyone.

 

[Pathfinder]

WHO Director-General's opening remarks at the media briefing – 24 January 2023

24 January 2023
...
Since the beginning of December, the number of weekly reported deaths from COVID-19 has been increasing.

In total, in the past eight weeks, more than 170 thousand people have died of COVID-19.

That’s just reported deaths; the actual number of deaths is much higher.

Almost exactly three years on from declaring a Public Health Emergency of International Concern, our highest level of alert, this week the Emergency Committee on COVID-19 will meet to discuss whether the current situation still constitutes a global emergency.

While I will not pre-empt the advice of the Emergency Committee, I remain very concerned by the situation in many countries and the rising number of deaths.

While we are clearly in better shape than three years ago when this pandemic first hit, the global collective response is once again under strain.

Too few people – especially older people and health workers – are adequately vaccinated.

Too many people are behind on their boosters.

For too many people, antivirals remain expensive and out of reach.

And too many people don’t receive the right care.

Fragile health systems are struggling to cope with the burden of COVID-19, on top of caring for patients with other diseases including flu and RSV.

Surveillance and genetic sequencing have declined dramatically, making it more difficult to track known variants and detect new ones.

And there is a torrent of pseudo-science and misinformation circulating, which is undermining trust in safe and effective tools for COVID-19.

My message is clear – do not underestimate this virus, it has and will continue to surprise us and it will continue to kill, unless we do more to get health tools to people that need them and to comprehensively tackle misinformation.

===

https://www.who.int/news-room/speec...marks-at-the-media-briefing---24-january-2023

 

[sharon sanders]

Judy Melinek M.D.

@drjudymelinek
·
Jan 27
From a forensic pathologist doing autopsies: Long COVID is real. SARS-
CoV-2 causes organ damage. Brain damage. Heart damage. We can’t just
rely on vaccines to lower hospitalization & death. We need to decrease
transmission.

 

[Pathfinder]

WHO Director-General's remarks at the 152nd session of the Executive Board

30 January 2023

...

Three years ago today, I declared a public health emergency of international concern over the global spread of COVID-19 – the highest level of alarm under the International Health Regulations, and for the moment, the only level of alarm.

As you know, on Friday the Emergency Committee met to consider whether that remains the case. The committee has advised me that in its view, COVID-19 remains a global health emergency, and I agree.

As we enter the fourth year of the pandemic, there is no doubt we are in a far better situation now than we were a year ago, when the Omicron wave was at its peak.

But since the beginning of December, weekly reported deaths have been rising.

In the past eight weeks, more than 170,000 people have lost their lives to COVID-19.

And that’s just the reported deaths; we know the actual number is much higher.

We can’t control the virus, but we can do more to address the vulnerabilities in populations and health systems.

That means vaccinating 100% of the most at-risk groups;

It means increasing access to testing and early antiviral use;

It means taking context-specific measures when there is a surge in cases;

It means maintaining and expanding laboratory networks;

And it means fighting misinformation.

We remain hopeful that in the coming year, the world will transition to a new phase in which we reduce hospitalizations and deaths to the lowest possible level, and health systems are able to manage COVID-19 in an integrated and sustainable way.

Vaccination will remain an essential part of our approach.

We are now working to determine the most effective mechanism for advising Member States and manufacturers on vaccine composition and vaccination frequency.

===
https://www.who.int/news-room/speec...s-at-the-152nd-session-of-the-executive-board

 

[gsgs]

new metaculus tournament to forecast epidemics :
(the linked webpages don't work correctly in my browser = old firefox version)

=============================================
The inaugural Keep Virginia Safe Tournament was a first-of-its-kind partnership between a public
health agency and a community forecasting platform. With 15,000 forecasts generated,
it helped shape vaccination, testing, and contact tracing programs in Virginia.

Now, Keep Virginia Safe II builds on the success of our partnership with the Virginia Department of
Health and the University of Virginia's Biocomplexity Institute, providing a $20,000 prize pool for forecasts on:

• COVID-19, influenza, and other respiratory diseases
• Global disease risks like mpox, avian influenza, and COVID-19 variants
• The impact of hurricanes and other disasters on operations
• New technologies and policies that could affect Virginia's health landscape

Forecasts will help public health officials anticipate likely scenarios and will serve
as valuable inputs for computational modeling efforts. Get started.
=================================================

 

[Pathfinder]

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.”
...

https://www.science.org/content/article/could-popular-covid-19-antiviral-supercharge-pandemic

---------------
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.
...

https://www.medrxiv.org/content/10.1101/2023.01.26.23284998v2

 

[longshots]

DANG!!! Who needs a lab for Gain of Function?!?!? We'll just use humans as our lab!