A new UK study has found that around 1 in 20 of children hospitalised with COVID-19 develop brain or nerve complications linked to the viral infection. The research, published in The Lancet Child and Adolescent Health and led by the University of Liverpool, identifies a wide spectrum of neurological complications in children and suggests they may be more common than in adults admitted with COVID-19.
“There’s no country that has attained herd immunity to SARS-CoV-2. And, certainly, there are countries with different levels of vaccination. I mean, some countries have over 60 percent of their population fully vaccinated. There are also countries that have had natural exposure to the infection at very high rates. But it hasn’t extinguished the pandemic. We’ve always seen surges even after that. And I think that reflects several factors.
One, I think natural immunity can wane over time. And I think the durability of that immunity does depend on the severity of original infection. When infections are mild and asymptomatic, we can have at least weighting of neutralizing antibodies and how that correlates with waning immunity. We don’t know yet, but we know that re-infection, or the getting infected again with the virus, either the same variant or another variant, are far more common than we originally thought. Although there is protection, even over longer duration of time, it’s not absolute.”
** One of just a handful of people on Earth who seems to understand the existential threat that Sars-CoV-2 poses
A report from the Alabama Department of Health’s online dashboard showed 1,883 hospitalized COVID patients, up by 432 over Sunday’s total. That’s an increase of 29.8% in just one day. The total is the highest since Feb. 1, which was during the downward trend of the winter surge in the virus, just as vaccines were first distributed. The pandemic record of 3,084 inpatients was set on Jan. 11. The new total is 11.3 times the low set on June 20 of 166 hospitalized COVID patients and 75% higher than one week ago.
Mike McCaul’s final report on the origins of the pandemic can be downloaded here.
A House Republican lawmaker’s investigation into the origins of COVID-19 is raising concerns that the pandemic outbreak stemmed from a genetically modified virus which leaked from the Wuhan Institute of Virology, the Chinese city where the disease was first detected in December 2019.
"Learn to live with the virus" either means nothing, or it means, "Learn to be quiet about the unnecessary deaths of your loved ones, friends, and compatriots."
Ain't gonna happen.
— Dominic Minghella (@DMinghella) August 1, 2021
This 👆 👆 👆
AY.3 is the main variant being sequenced weekly in Mississippi (>70% of all recent sequences), most falling within this sub-lineage of AY.3 that is distinguished by the mutations described below (>60% of all recent sequences). For example, of 91 Pangolin-typeable sequences generated on 13 July 2021 by Dr. Robinson’s team, from broad sampling across Mississippi, 68 are AY.3 and 13 are unclassified B.1.617.2. Of those 81 Delta sequences, 60 are this new sub-lineage (those sequences are not yet in GISAID and are thus not included in the counts above for the USA or MS). Thus, there is clear epidemiological relevance of this sub-lineage in a region of the USA.
One thing that we have been keeping on eye on recently is the possible successor variant to Delta B.1.617.2 in the UK. The Alpha B.1.1.7 variant had a shelf life of about 5 months before it was displaced by Delta. Will Delta have a similar shelf life?
Delta seems to have been on the wane in the UK over the couple of weeks, so is it already making way for a stronger, fitter variant? If it is, it won’t be long before that successor variant becomes apparent, and the removal of all Covid mitigations on UK “Freedom Day” has given it plenty of opportunity to spread quickly.
Below, Alpha had a shelf life of about 5 months in the UK. Delta already seems to be waning. What will take its place?
Below, Delta may have peaked worldwide, but there is no clear successor variant yet.
Below, It doesn’t look like the successor variant will be Delta AY.3 in the UK from this chart, but it’s too early to tell….
Below, Delta peaked in early May 2021 in India, but hasn’t immediately been followed by another stronger variant. The next variant could be waiting for a fall in the population’s antibody levels from the Delta wave which could take 3-6 months, creating an opportunity from August 2021 onwards. The shelf life for Delta in India, in a largely unvaccinated population, was just three months.
The problem for the UK government, though, is that by dropping all mitigations on 19th July 2021, they may have encouraged Delta to peak early and, as a consequence, left enough time for a second larger, and perhaps far worse, autumn or winter wave to form.
As we said in this post in on 16th July:
“According to the UK’s Chief Medical Officer, the idea is that a Covid-19 wave in the summer will prevent an even worse wave in the winter. Our prediction is that Johnson will simply get two waves for the price of one – the wave he is promoting now, by removing all mitigations, and an even worse winter wave caused by yet another new variant.”
A long and detailed Twitter thread by Vinod Scaria on the rise of the AY.3 Delta plus variant in the USA which seems to be outcompeting Delta B.1.672 in some states. Outbreak.info is showing that AY.3 genomes are found in 37% of recent sequences.
Closely tracking the delta+ lineages now across the world, one of the lineages AY.3 seems to be emerging in the United States of America. This tweetorial is to summarise the observations. I will be updating this thread as new evidence emerges.
— Vinod Scaria (@vinodscaria) July 24, 2021
Nextstrain makes AY.3 looks pretty widespread in the US already… pic.twitter.com/jO3hrKLRl3
— Ryan M. Ferris (@rferrisx) July 24, 2021
In a previous study we found a sublineage B.1.1.28+Q675H+Q677H with local transmission in Rocha, a Uruguayan department bordering Brazil. This clade probably arose by early November, 2020, and its introduction from other parts of Uruguay seemed like a reasonable hypothesis. To understand whether these sequences were part of a new emergent SARS-CoV-2 lineage broadly disseminated in Uruguay, herein we analyzed the genetic diversity of B.1.1.28 SARS-CoV-2 viruses circulating in different localities by the end of 2020 and first months of 2021.
The report that encouraged the CDC to change its facemask mandate this week
PAGE 6 – Blank
PAGE 14 – Blank
Scenario One: A variant that causes severe disease in a greater proportion of the population than has occurred to date. Scenario Two: A variant that evades current vaccines. Scenario Three: Emergence of a drug resistant variant after anti-viral strategies. Scenario Four: SARS-CoV-2 follows an evolutionary trajectory with decreased virulence.
Scenario One: A variant that causes severe disease in a greater proportion of the population than has occurred to date. For example, with similar morbidity/mortality to other zoonotic coronaviruses such as SARS-CoV (~10% case fatality) or MERS-CoV (~35% case fatality).
Likelihood of increased severity phenotype: Realistic possibility.
Scenario Two: A variant that evades current vaccines. This could be caused by: Antigenic ‘shift’: Natural recombination events that insert a different spike gene sequence (or partial sequence) from human CoVs MERS-CoV (highly unlikely due to the low frequency of MERS-CoV infections), or from currently circulating endemic human CoVs (more likely due to the prevalence of these viruses). This would recombine into the ‘body’ of SARS-CoV-2 that is capable of high replication in human cells. The consequence could be a virus that causes disease at a level similar to COVID-19 when it first emerged but against which our current battery of spike glycoprotein-based vaccines would not work.
Likelihood: Realistic possibility.
Scenario Three: Emergence of a drug resistant variant after anti-viral strategies. This could be caused by: Emergence of new variants following the administration of directly acting antiviral therapies. As we begin to use directly acting antiviral drugs it is highly likely a variant will be selected that had resistance to individual agents. For example, drugs that target the viral 3C protease, drugs that target the polymerase, monoclonal antibodies that target the spike glycoprotein. If the drugs are used as a mono therapy, then resistant variants have a high probability of emerging. This may render all drugs in that category unusable.
Likelihood: Likely – unless the drugs are used correctly.
Scenario Four: SARS-CoV-2 follows an evolutionary trajectory with decreased virulence. This could be caused by: Variants arising with increased transmissibility but decreased pathogenesis/virulence as the virus becomes fully adapted to the human host becoming an endemic infection. Coupled with the likelihood of eventual high populations immunity the infection produces less disease. In other words, this virus will become like other human CoV that causes common colds, but with much less severe disease predominantly in the old or clinically vulnerable.
Likelihood: Unlikely in the short term, realistic possibility in the long term.
At least 125,000 fully vaccinated Americans have tested positive for Covid and 1,400 of those have died, according to data collected by NBC News. The total number of breakthrough cases is likely higher than 125,683, since nine states, including Pennsylvania and Missouri, did not provide any information, while 11, like Florida, did not provide death and hospitalization totals. Four states gave death and hospitalization numbers, but not the full tally of cases.
Scientists researching the Provincetown, Cape Cod Covid outbreak reported that 79 percent of the breakthrough infections were symptomatic. Four of five people who were hospitalized were fully vaccinated.
The CDC study “raises the very worrisome possibility that high viral loads can occur in people who have Delta, and this is a fundamental as we have to approach the fall and winter,” said David O’Connor, a professor of pathology and laboratory medicine at the University of Wisconsin School of Medicine and Public Health.
What do the people who say “learn to live with the virus” actually mean?
They mean: fail to learn any of the lessons of the last 18 months, fail to mitigate against the spread of the virus and tolerate avoidable deaths and disease burden.
I’d rather we didn’t.
— Kit Yates (@Kit_Yates_Maths) July 30, 2021
Over to you Kirsty….