(Bloomberg) — Leading scientists cautioned that the level of immunity against the coronavirus among South Africa’s population due to earlier infections may be masking the severity of illness caused by the omicron variant.
Since the discovery of the variant in South Africa and Botswana was announced on Nov. 25, hospitalization rates in South Africa have risen, though at a much slower pace than in previous waves, even as cases are rising more rapidly. The number of deaths has also been lower.
A recent seroprevalence survey in Gauteng, the South African province where the omicron variant was first identified, showed that 72% of the population had a previous infection with the coronavirus, said Shabir Madhi, a vaccinologist at the University of the Witwatersrand. That compares with about 20% when the beta variant emerged a year ago, said Madhi, who led trials of both AstraZeneca Plc’s and Novavax Inc.’s shots in South Africa.
“The evolution of the omicron variant is coming at a very different stage of the pandemic,” Madhi said in an interview with the Global Health Crisis Coordination Center. “That is important to keep at the back of our minds when we see what is unfolding in South Africa and what we might see in other settings, which might have a very different epidemiology.”
Official statistics don’t reflect the extent of the pandemic’s impact on South Africa, with just 3.2 million positive tests and about 90,000 deaths. Excess deaths, a measure of mortality compared with a historical average, show that about 275,000 people may have died from the disease.
The disparity between official statistics and the likely extent of infections is more pronounced in South Africa, though not unique. The U.S. Centers for Disease Control estimates that over the course of the pandemic until September, there were 146.6 million infections and 921,000 deaths as a result of Covid-19. Official statistics show more than 50 million infections and 799,000 deaths.
Madhi’s hypothesis is backed up by other scientists.
“You have large pockets of population immunity,” Tulio de Oliveira, who runs two gene-sequencing institutes in South Africa, said in an interview with CBS News on Dec. 12. “We’re going to have to tease apart if the mild cases are due to young people getting infected or if the previous population immunity from infection and vaccination are responsible for decreasing the number of hospitalized individuals.”
About 6,000 people are in the hospital in South Africa with Covid-19, about a third of the number at the peak of the second and third waves of infection. Current daily cases are close to record levels.
“That could really be due to the fact that immunity in the country is high either from natural immunity, from past infection, or from vaccinations,” Barry Schoub, chairman of South Africa’s Ministerial Advisory Council on Vaccines, said in an interview with Sky News.
Of South Africa’s 60 million people, about 26% are fully vaccinated. That compares with 70% in the U.K.
While omicron has, in early studies, shown that it can evade antibodies produced by vaccinations or previous infections more easily than previous variants, Madhi says immunity may stem from protection by T-Cells, which kill infected cells.
“In South Africa, there is seemingly significant population protection against severe Covid due to underpinning T-cell immunity, despite omicron being antibody evasive,” he said by text message.
South Africa’s experience with omicron may once again raise the concept of so-called herd immunity, whereby enough of the population has been vaccinated or had a previous infection to blunt the impact of waves of infection. Still, the ability of the coronavirus to mutate and the different paths the pandemic has taken around the world may make that elusive.
“The data coming from South Africa are indeed very encouraging,” said Sam Fazeli, senior pharmaceutical industry analyst for Bloomberg Intelligence. “Let’s not forget that South Africa had a wave of infections with the beta variant, which was not seen elsewhere. This may make a difference to the response to omicron.”
©2021 Bloomberg L.P.
Canada’s Omicron wave may have peaked; hospitals still under strain
Canada is seeing early signs that a wave of infections caused by the Omicron variant of COVID-19 may have peaked, but hospitals are still under intense strain, chief public health officer Theresa Tam said on Friday.
Tam made her remarks days after the provinces of Ontario and Quebec – which together account for around 61% of Canada’s population of 38.5 million – said they were more optimistic about their ability to deal with coronavirus infections.
“There are early indications that infections may have peaked at the national level,” Tam said, noting daily case counts had dropped 28% compared to the previous week.
“However, daily hospital and intensive care unit numbers are still rising steeply, and many hospitals across Canada are under intense strain,” she said in a news briefing.
Over the past week, an average of more than 10,000 people with COVID-19 were being treated in hospitals every day, surpassing peak daily numbers for all previous waves, she said.
Although politicians at all levels have repeatedly urged Canadians to get inoculated against the virus, Tam said 6.5 million people in the country were still not fully vaccinated.
(Reporting by David Ljunggren in Ottawa and Ismail Shakil in BengaluruEditing by Paul Simao)
BC Centre for Disease Control apologizes for isolation guidance flip flops – Globalnews.ca
The BC Centre of Disease Control is apologizing after making multiple changes to COVID-19 isolation guidelines over the past few days.
On Tuesday, the BC CDC posted guidance reducing the isolation requirement for all COVID-19 test positive cases to five days no matter the vaccination status.
Then, less than 24 hours later, it updated the guidance to require unvaccinated adults to isolate for ten days following a COVID-positive test.
But at the same time the guidelines changed for any one 17 years old and younger. That demographic only needs to isolate for five days, no matter vaccine status, following a positive test.
BC CDC adjusts isolation requirements for close contacts
In all of these cases, the isolation time will be longer if there are still COVID symptoms.
The BC CDC also waived all isolation requirements for close contacts.
None of this information was included in a press release or public briefing.
“We apologize for the web posting and changes that occurred yesterday,” a statement from the BC CDC said.
“We understand the significant interest in these testing and isolation guidelines, which is why we updated the website immediately with clarifications made yesterday. We recognize this approach led to confusion.”
BC CDC adjusts isolation requirements for close contacts
The BC CDC said it acknowledges the frustration people are feeling about the pandemic and the need people have for clear communication on changes impacting their lives.
“We will strive to ensure there is a better change management process for future changes,” the statement reads.
“These changes are a step toward enabling British Columbians to self-manage their illness and will help guide their actions to limit the spread of illness in our communities.”
On the issue of the new guidelines, the CDC said public health guidance always strives to strike a balance between preventing infection and limiting the harms caused by preventing people from participation in societal activities like working, going to school and socializing.
Public health officials have stated frequently the highly-transmissible Omicron variant has changed the COVID situation in the province.
BC CDC adjusts isolation requirements for close contacts
The province has struggled with providing access to COVID testing and the contact tracing has entirely broken down amid the arrival of the Omicron variant.
“The guidance and how we manage the situation is changing rapidly and we always intend to provide the public with the most up-to-date information as quickly as possible,” the CDC said in the statement.
“We expect further changes to the guidance in the weeks to come and commit to keeping British Columbians informed.”
Here is a summary of the key changes from the CDC:
- If you have mild symptoms and do not need a COVID-19 test, stay home until you feel well enough to return to your regular activities.
- If you test positive for COVID-19 and you are under 18 or a fully vaccinated adult you must self-isolate at home for five days AND until your symptoms improve and you no longer have a fever. In this case avoid non-essential visits to high-risk settings for an additional five days.
- If you test positive for COVID-19 and you are 18 years of age or older and not fully vaccinated you must self-isolate at home for 10 days AND until your symptoms improve and you no longer have a fever.
- Close contacts do not need to self-isolate, regardless of vaccination status, but should self-monitor.
© 2022 Global News, a division of Corus Entertainment Inc.
Take 2 steps and call me in the morning: Exercise as a prescription for depression – CBC.ca
Judy Mulloy’s voice breaks and her eyes well up with tears as she describes how a simple walk in the park and chair yoga has helped her through the pandemic.
“Oh, it’s a happy cry, I assure you,” she said. “My life has changed around. It’s no longer a thing of sadness.”
Mulloy, 56, first turned to physical activity years ago to manage her depression. She says staying active in her hometown of Nelson, B.C., hasn’t eliminated her need for a daily antidepressant.
“But the thing that can boost my mood is to go for a walk. Go for a swim. Do some exercise,” she said.
That tonic began to dry up when the first COVID-19 lockdown hit in 2020 and gyms and recreation centres were shuttered. Mulloy responded to a social media post looking for volunteers for a study that replaced facilities and classes with a commercially available app.
“I’ve not looked back. It’s been amazing,” she said.
Anxiety, depression increased in pandemic
The study was conceived by Eli Puterman, an assistant professor at the School of Kinesiology at the University of British Columbia in Vancouver.
Puterman says he was moved by surveys such as the poll done for Mental Health Research Canada in early 2020, which suggested anxiety levels had quadrupled and depression levels doubled during the pandemic.
“People were suffering. So, we wanted to see whether we can support people,” Puterman said.
His research team recruited over 300 people, gave them a free subscription to an exercise app and divided them into four randomized groups that either did yoga, high-intensity interval training, a combination of the two, or were relegated to a wait list.
Each week, participants completed a standard questionnaire that’s used in the diagnosis and treatment of depression. Using a scale of zero to three, people reported how often they experienced symptoms such as sleeplessness or feeling lonely.
The results were reported in the British Journal of Sports Medicine last fall.
“Everyone dropped in their depression levels,” Puterman said.
While none of the participants were screened to determine whether they had been diagnosed as clinically depressed, of those who were active in the study, the ones who reported the most severe symptoms at the start showed the biggest improvement, Puterman said.
“I am surprised by how drastic of an effect it was,” he said.
Past studies show similar results
Puterman’s results are only the latest to link physical activity and mood. “There’s been enough studies,” said Vancouver psychiatrist Dr. Ron Remick.
Remick thinks physical activity can be as effective as some more common treatments for depression, such as psychotherapy or antidepressants. But while it’s true that research going back decades demonstrates the ability of exercise to measurably reduce symptoms of depression and stave off relapse, on its own, it may not be enough to treat severe depression, a complex disease that can have multiple causes.
Remick’s advocacy for movement as medicine comes from his own experience. Seven years ago, as medical director of the Mood Disorders Association of British Columbia he pioneered a weekly program of low-impact movement for his patients called Jump Step.
It involved outdoor walks, floor exercises and cardio routines combined with a group medical visit.
When the pandemic struck, the program went virtual. Participants were given the only equipment they’d need: a yoga mat and an exercise band. Jump Step now runs for eight weeks, four times a year. Its results have drawn attention from the B.C. government, which was interested in potentially implementing it provincewide.
“Much like our earlier research, it has continued to show that a significant number of people who do a program like this have significant improvement in their depressive symptoms,” Remick said.
‘A break from all of that chatter’
Michael Sarvari leads the weekly classes. Sarvari draws on his own experience as someone who wrestled with severe depression for most of his life until one day, he says, he crawled out of bed and convinced himself to do a pushup. The next day he tried two, and so on.
“When you’re depressed, your mind is so busy with negative thoughts and chatter,” Sarvari said.
“When you kind of take yourself out of your mind and into your body doing physical things, you get a break from all of that chatter. It kind of creates that calm within yourself.”
Sarvari says it’s hard to overstate the benefits of basic, regular physical activity
“I could be homeless because I wasn’t able to support myself. I wasn’t able to work,” he said. “I would be in a very dark place and possibly not alive because I was suicidal for many years.”
Researchers are hoping to ease that kind of personal suffering while acknowledging there’s a payoff for the wider public if they’re successful. A decade ago, the World Economic Forum and the Harvard School of Public Health forecast the global cost of mental health conditions by 2030 to be over $7 trillion a year.
“Changes occur slowly in medicine even when the evidence is there for a long long time,” said Remick.
Unlike a pill, prescribing exercise has to be tailored to a patient’s abilities by doctors who know how to motivate people.
Puterman says while there is ample evidence to support his broader findings, some research gaps remain. Most of the participants in his study were white and maintained their jobs during the pandemic. He plans to focus a future study on more diverse and vulnerable communities.
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